Radclyffe - Crossroads

Just as she’d passed through the gate in the white picket fence and started up the walk to the pale yellow gingerbread Victorian she had been lucky to rent, her cell chimed. She paused to check the readout, mentally preparing to rearrange her day if she had a delivery. At least a dozen patients were due in the next month, and with babies—well, they kept their own schedules.

Her heart sank. It wasn’t the switchboard. It was her boss.

“Hi, Barb,” Annie said.

“Are you on your way to GWWC?”

“Not yet—I just took Callie to school.”

“Oh good.” Barb Williams sounded brisk and efficient, as always. She had to be that and a whole lot more to oversee seventy-five midwifes in Pennsylvania alone, and another three hundred in the Northeast.

Annie waited, pretty sure she knew what the call was about. Her stomach tightened.

“The board met on a conference link this morning. They voted six to one in favor of the resolution.”

Annie sat down on her front steps. A fat sparrow plucked at the grass in the small square of front yard inside the meandering fence, searching for worms. At not yet nine the sun cut through the leaves of the huge maple by the corner of the house with enough heat to warm her skin. Summer weather and it wasn’t quite June. She loved spring, but nothing lasted forever. She drew a breath and chose her words carefully. Barb would have been one of the yes votes.

“I’m still not sure I see the reason for this. We already have well-established protocols for urgent situations requiring hospital care. Why formalize anything further? The more we ally ourselves with medical practitioners, the more likely we are to be subjected to outside regulation.”

“I know you’re not sold on this, but our insurance premiums will go down if we’re handling high-risk pregnancies in association with an obstetrician. That alone was incentive enough to sway the board.”

“If we become hospital based, we lose our main purpose for existing,” Annie said, hearing the heat in her voice but helpless to stop it. Their whole specialty was geared toward providing women with a safe alternative to hospital birth—why weaken their mission by allying with hospital-based practitioners?

“They’re not the enemy,” Barb said as if reading her thoughts. “From a professional point of view, this will allow us to take care of even more women outside the hospital setting.”

Annie closed her eyes. None of her colleagues knew her history—only that Callie’s father wasn’t in her life and Annie wasn’t interested in dating anyone. They didn’t know about the nightmare of Callie’s delivery or the agony of recovering, when the psychic pain of knowing she’d never have the opportunity to share the birth of another child with someone she loved was even worse than the physical. Her choice had been taken from her in a flurry of technology and medical imperative. All perfectly justifiable, but in her heart, she would never be sure of the necessity. And she’d never forgive herself for believing so many lies. Jeff had only been the beginning.

“Annie, you there? Damn cell pho—”

“I’m here. Sorry. Bad battery.”

“We need a regional director of the new program to work with the hospital on training schedules, supervisory details, triage protocols, that sort of thing.”

“Chris Ames was an OR nurse before he got his CNM, he could—”

“Chris is terrific, no question. But we want a Philadelphia U graduate, since that’s where the program will be based.”

Annie’s chest hurt. Barb’s jovial, already-been-decided tone confirmed her fears.

“We want you for this, Annie. You’ll meet with your OB counterpart at ten o’clock this morning at PMC.”

Chapter Three

Hollis pulled off her surgical cap and snapped the paper tie on her mask, balled them up, and tossed them toward the trash can across the small anteroom adjoining the delivery room. She’d gotten a few hours’ sleep the night before, but her eyes felt gritty and her shoulders ached. She washed her hands and splashed her face with cold water. With luck she’d be able to put some time in on her bike before the end of the day—twenty miles cycling along the Schuylkill ought to work out the kinks.

“I thought you were off today,” Ned Williams said, stopping in the hall that ran the length of Labor and Delivery.

“I am—was.” Hollis pulled a few paper towels from the dispenser and mopped the water off her neck. Ned was a few years her senior in the department, a good-looking redhead with playful blue eyes, a smile that put patients immediately at ease, and an ex-wife and four kids. She gestured to the delivery room behind her. “One of my patients is a week early. I got the call just as the staff meeting finished. I’m waiting on her now.”

Three other rooms like the one where her patient was being monitored were reserved for women in labor. A fifth room was reserved for scheduled C-sections during the week and for emergency surgeries, day or night. Hollis spent a lot of time in that room. High-risk pregnancies usually went well, but when they went bad they went bad fast, and she often had to operate emergently to save the baby and mother.

“Anything problematic? I don’t mind giving an assist,” Ned said, a hopeful note in his voice.

Ned was double-boarded in adolescent medicine and did a lot of teen pregnancies along with routine OB, and he regularly referred his surgical cases to Hollis. He frequently hung around when he was off call, and Hollis often wondered if the excitement of the hospital was more satisfying for him than his personal life. Her father had loved his job, but he was home at five p.m. every day for supper unless he had a fire call-out. Then no one cared how late he was as long as he came home. Hollis dismissed the unfair comparison—her family wasn’t like most families she knew. She and her five brothers never fought, her mother and father were affectionate and still in love after thirty-nine years, and there was an unspoken rule that no matter how bad things got, together they could handle anything. That’s how it had been until one Tuesday in September when the Towers came down and Rob never came home. Everything changed after that. The world had changed, her world had fractured, and she’d vowed she’d never be that vulnerable again.

Ned was waiting, a faint smile on his face. He was just being friendly. He couldn’t know she didn’t want friends.

“Hopefully this will go smoothly,” she said. “She’s thirty-eight and had preeclampsia with her last delivery, but she’s been on bed rest for the past six weeks and her pressure’s looking good. She’s already fully effaced and moving right along.”

“Good enough.” He started to turn away, then paused. “What do you think about this whole thing with the midwifes? One of the OB practices I did a rotation with when I was a resident worked with midwifes. It was great, actually. I don’t know why, but for some reason, mothers seemed more comfortable with them, especially around all the prenatal stuff.”

“I think there’s plenty of room for other caregivers to get involved with prenatal and aftercare,” Hollis said. “But delivering high-risk mothers in an outpatient setting? Seems like a recipe for disaster to me.”

“Well, I guess you’ll get the chance to find out. Glad Dave volunteered you and not me.” He grinned. “Kind of feel sorry for the poor midwife, though.”

“Thanks,” Hollis said dryly. “I’ll try not to bite.”

“You off the weekend?” Ned asked.

“Yes,” Hollis said, although she’d told Bonnie McCann, who had the call on Monday, she’d back her up if she got busy. She wasn’t doing anything and Bonnie had three kids and a birthday party scheduled.