Kate Hardy - Their Pregnancy Gift

Actually, Alex wasn’t happy about it. At all. But he didn’t have much choice.

Maybe he should’ve taken a longer break. But six months was surely long enough to get your head round the fact that you weren’t who you thought you were, and everything you’d always believed wasn’t true. He needed to stop sulking about it and just get on with things. And he’d really missed his job. At least he knew who he was at work. Alexander Morgan, obstetric consultant.

He shook himself. Now wasn’t the time to start brooding. Or to wonder whether his shortness of temper and foul mood was an early sign of the incurable neurodegenerative disease that the man he now had to think of as his father was suffering from. He had notes to write up, a sandwich to eat, and a clinic to sort out.

* * *

‘OK, Mrs Hamilton—may I call you Judy?’ Dani asked.

The other woman nodded, looking wretched.

‘According to our notes, you’re sixteen weeks pregnant at the moment, and your midwife asked if I could fit you into my clinic today.’

Judy dragged in a breath. ‘Thank you so much for seeing me, Dr Owens.’

‘Call me Dani. And it’s no problem. So tell me how things are going,’ Dani said.

‘It’s awful,’ Judy said. ‘I’ve never felt so ill in my entire life. I can’t keep anything down, even water. I’ve tried everything—sniffing lemons, drinking ginger tea and eating a dry biscuit before I get up in the morning. I’m not doing any cooking, and when I do try to eat it’s things that don’t smell and are high in carbs and not fatty, but I still can’t keep anything down.’

Judy was doing all the right things to help with morning sickness, Dani knew; but what she was suffering from sounded rather more serious than everyday morning sickness.

‘Nothing works, and all I seem to do is throw up all day.’ Judy grimaced. ‘My boss sent me home from work today, saying I had to take a few days off, and there was blood in the vomit last time I threw up. That’s why I called my midwife, because I was so worried.’

‘I’m glad you did. Did the blood look like little streaks?’ Dani asked.

Judy nodded.

‘OK. I know it looks scary but it’s actually quite normal in pregnancy,’ Dani reassured her. ‘When you’ve been sick a lot, the lining of your oesophagus gets irritated and it’s more likely to get a tiny little tear in it, which is why you saw blood. But we really need to get to the bottom of why you’re being sick all the time. Are you OK for me to take a blood sample from you?’

Judy looked slightly nervous. ‘I hate needles, but yes.’

Dani took a sample of blood to check Judy’s electrolytes, renal function and liver function.

‘And can I ask you to get on the scales for me?’ She checked the display. ‘You’ve lost four kilograms since your last check-up.’

‘Is that bad?’

‘It’s completely what I expected, with what you’ve told me about being so sick,’ Dani said, and handed Judy a sample bottle. ‘Can you do me a midstream urine sample, please?’

While Judy was in the toilet, Dani sent the blood tests off. When Judy came back, the urine sample was quite dark, indicating that Judy was dehydrated, and a dipstick test showed signs of ketones, where the body broke down fat instead of glucose for energy.

‘Is it all OK?’ Judy asked.

‘All your symptoms added together are giving me a better picture,’ Dani said. She checked Judy’s notes. ‘When you had your twelve-week scan, the radiographer confirmed there was only one baby.’ And, to Dani’s relief, there was also no indication of a molar pregnancy.

‘And then I was sick on the bed,’ Judy said miserably. ‘Everyone I know says morning sickness goes by twelve weeks, but that was a month ago for me. I feel worse every day, instead of better.’

‘Morning sickness can last for up to twenty weeks,’ Dani said, ‘but in your case I agree with your midwife. I think you have hyperemesis gravidarum—which is a very severe form of morning sickness.’

‘Did I do something wrong to get it?’ Judy asked.

‘No. We don’t actually know what causes it, though it does seem to run in families. Do you know if your mum had it, or do you have a sister who had it?’

Judy shook her head. ‘Mum never said, and I’m an only child.’

‘The most likely cause is hormonal activity, which I know doesn’t help you much,’ Dani said.

‘I feel rotten, but I can live with that as long as the baby’s all right.’ Judy bit her lip. ‘Though I can’t eat anything, so I’m scared the baby’s not getting proper nutrition.’

‘Try not to worry,’ Dani said, and squeezed her hand. ‘It’s very possible that the baby will be smaller than average because of your situation, but we’ll keep a close eye on you. I hope it reassures you to know that being sick isn’t going to hurt your baby—though obviously it’s very miserable for you.’

‘I can’t believe how bad all kinds of things smell, even tins. I can’t stand being on the Tube because of the smell of people’s armpits—and it must be so much worse in summer.’ Judy shuddered at the thought, and retched again.

Dani handed her a tissue. ‘I’m going to admit you to the ward and put you on a drip so we can get some fluids into you,’ she said. ‘We can also give you some medicine that will help to stop the sickness.’

Judy frowned. ‘But won’t that harm my baby?’

‘No. We’ll give you some tablets that are safe for the baby,’ Dani reassured her. ‘You’ll be able to take them at home as well.’

Judy closed her eyes for a moment. ‘I’m so tired. I don’t think I can cope with this for much longer.’

‘Hyperemesis can last for a long time, and I have to tell you that in some cases it doesn’t actually get better until the baby arrives,’ Dani warned.

‘So I might be sick like this for the rest of my pregnancy?’

‘Hopefully not. Let’s see how you’re feeling after a day or so in here,’ Dani said. ‘Once you’re no longer dehydrated, you’ve had some proper rest and maybe managed to keep something down, you’ll feel a bit better.’

‘So I have to stay in?’

Dani nodded. ‘For a day or two, so we can keep an eye on you. And, because we want you on bed rest, we’ll get you to wear compression stockings and give you some heparin injections, to make sure you don’t develop any blood clots. I’ll have a word with your consultant at the end of my clinic, and he might come and have a chat with you. But in the meantime I’ll get one of the midwives to help settle you onto the ward. Is there someone we can call for you?’

‘My husband,’ Judy said.

Dani checked his mobile number with Judy. ‘I’ll call him while you’re getting settled on the ward, and maybe he can bring you some things from home.’

‘Thank you.’ Judy’s eyes filled with tears. ‘I feel so stupid, making such a fuss.’

‘You’re not making a fuss,’ Dani said. ‘You have a medical condition that’s making you feel awful, and my job’s to help you feel better. You did exactly the right thing, calling your midwife—and your midwife did the right thing, telling you to come here.’ She opened the door of the consulting room and went over to the first midwife she could see. ‘Jas, I’ve got a mum with hyperemesis and I want her admitted to the ward and put on a drip. Would you be able to settle her in for me, please?’

‘Sure,’ Jas said with a smile.

‘Thanks.’

Back in the consulting room, Dani introduced Jas to Judy. ‘Judy, this is Jasminder Lund, one of our midwives. Jas, this is Judy Hamilton. Judy, Jas is going to look after you, and I’ll pop in and see you after my clinic.’

‘Thank you so much,’ Judy said, and let Jas lead her out to the ward.