The Girl Before(34)

Yesterday he gave me my first orgasm before he’d even taken off his clothes. That’s something he likes, I’ve noticed. To stay fully dressed while he peels my clothes off, everything but the necklace, and reduce me to a quivering wreck with fingers and tongue. As if it’s not enough for him to retain control: I have to lose it too. Only then does he feel comfortable letting go himself.



That feels like an interesting insight about him and I’m still mulling it over as I come downstairs. There’s a small pile of damp mail on the doorstep. I’ve asked Edward why there’s no letter box here—it seems a strange oversight in what is, generally, such a well-thought-out house—and he told me that when One Folgate Street was built, his partner David Thiel was predicting that email would have replaced physical letters altogether within a decade.

I glance through them. They’re mostly political circulars to do with the upcoming local elections. I doubt I’ll even register to vote. Debates about the local library and the frequency of garbage collections have little relevance to my life at One Folgate Street. A couple of the letters are addressed to Ms. Emma Matthews. They’re clearly junk, but I put them aside anyway to send on to Camilla, the agent.

The last letter is addressed to me. The outside looks so bland that at first I assume it’s just more junk mail. Then I see the logo of the Hospital Trust and my heart skips a beat.

Dear Ms. Cavendish,

Postmortem results: Isabel Margaret Cavendish (deceased).

I agreed to a postmortem because it seemed right to try to get some answers. Dr. Gifford told me when I went for my follow-up appointment that it hadn’t revealed anything, but I’d be sent a note of the findings anyway. That was a month ago. The letter must have been stuck in the system since then.

I sit down, my head swimming, and go through it twice, trying to understand the medical jargon. It starts with a brief history of my pregnancy. There’s a reference to the time, a week before they realized something was wrong, when I’d had back pain and taken myself to the maternity unit for a checkup. They’d done some tests, listened to the baby’s heartbeat, then sent me home to have a hot bath. I’d felt Isabel kicking quite actively after that so I’d been reassured. The letter makes it clear that correct procedures were followed on that occasion, including a symphysis–fundal height assessment in accordance with NICE guidelines. Then there’s a description of my subsequent visit, when they discovered Isabel’s heart had stopped. And finally, the postmortem itself. Lots of figures that mean nothing to me—platelet counts and other blood work, followed by the comment:



Liver: normal.

At the thought of some pathologist patiently removing her tiny little liver, my throat constricts. But there’s more.

Kidneys: normal.

Lungs: normal.

Heart: normal.

I skip down to the summary.

While an exact diagnosis is not possible at this stage, signs of placental thrombosis may point to a partial placenta abruptio, leading to death by asphyxiation.

Placenta abruptio. It sounds like a Harry Potter spell, not something that could kill my baby. Dr. Gifford’s name at the bottom of the page swims glassily as the tears spring to my eyes and I start crying again, great gulping snotty sobs I can’t control. It’s all too much to take in and anyway I don’t understand most of the words. Tessa, the woman I share a desk with at the office, has a background in midwifery. I decide to take the letter to work so she can talk me through it.

—

Tessa reads the letter carefully, giving me the occasional concerned look. She knows, of course, that I had a stillbirth: Many of the women who volunteer at Still Hope have a similar personal reason for doing so.

“Do you know what it all means?” she says at last. I shake my head.

“Well, placenta abruptio is a ruptured placenta. Effectively, they’re saying the fetus stopped getting nutrients and oxygen before you went in.”

“Nice of them to use English,” I say.

“Yes. Well, there may be a reason for that.”

Something about her voice makes me look at her.

“When you went in with back pain,” she says slowly, “what happened, exactly?”

“Well.” I think back. “They clearly thought I was being over-anxious—first-time mother and all that. But they were very nice about it. I don’t actually remember being given all those tests they talk about—”



“A symphysis–fundal height assessment is just medical-speak for measuring the bump with a tape measure,” she interrupts. “And while it’s true that it’s a NICE guideline to do one at every prenatal visit, it’s certainly not going to reveal a failing placenta. Did they do a cardiotocograph?”

“The heart monitor thing? Yes, the nurse did that.”

“Who did she show the trace to?”

I try to remember. “I think she phoned Dr. Gifford and read the results to him. Or at any rate, told him they were normal.”

“Any other scans? Regular ultrasound? Doppler?” Tessa’s voice has taken on a grim tone.

I shake my head. “They told me to go home, have a hot bath and try not to worry. And I felt Isabel kicking later so I realized they were right.”

“Who’s they?”

“Well—the nurse, I suppose.”