Dance Away with Me(16)

The cord was wrapped around the baby’s neck. Tess eased it over the baby’s head without difficulty.

With the next contraction, a tiny shoulder emerged. She gently lifted it and waited, murmuring words of encouragement.

The other shoulder appeared, and with the following contraction, the baby slipped into her hands.

Tess took a long breath of relief. “You have a girl.” Tess kept the baby’s head down to drain the fluids then settled her on Bianca’s bare chest. The baby was so utterly defenseless. A sea creature suddenly washed to shore.

“A girl,” Bianca said weakly. “Look, Ian . . . a girl.”

“I see.” His voice was hoarse.

Breathe, baby girl. Tess gently rubbed the small body with a towel. She stroked along the slopes of her minuscule nose to get rid of any more fluid trapped there. I know those fragile little lungs don’t want to work yet, but they’re going to have to.

Bianca’s voice sounded as if it were coming from the next room. “She’s not crying. Isn’t she supposed to cry?”

“Give her time. It’s a big adjustment. The placenta’s still attached, so she’s getting oxygen.”

The seconds ticked by. And then the tiny baby drew one shallow breath. . . . Another . . . A tiny birdlike wail . . .

Tess smiled. “That’s the way, sweetheart.”

Bianca made cooing sounds as she stroked the infant’s back. Tess delivered the placenta. The cord stopped throbbing, no longer a lifeline. She tied it off. Cut it.

And then everything went to hell.

“I’m cold. I’m so cold.”

Tess’s head shot up. Bianca’s complexion was developing a blue tinge. Tess’s own skin began to prickle.

“Take off your shirt,” she ordered Ian.

He stared at her dumbly.

“Take off your shirt!” she exclaimed, picking up the baby. “Hold her against your skin. Keep her warm!” She thrust the baby into his arms.

Bianca gagged and then vomited.

A gush of blood between her legs . . .

She was having a stroke.

“What’s wrong?” North cried. “What’s happening to her? Why is she choking?”

Tess struggled to comprehend what was happening. She’d never seen anything like this. But she knew what it was.

Amniotic fluid embolism.

With frightening clarity, the words from that long-ago lecture rushed through her head as if she’d heard them yesterday.

One of the rarest complications of pregnancy . . . Cells have managed to enter the mother’s bloodstream and trigger an allergic reaction. . . . Amniotic fluid, fetal skin, even a fragment of an infant’s fingernail . . . Bronchial tubes constrict. . . . Airways shut down. . . .

The last part she remembered exactly. It often results in the death of the mother.

This was a condition so rare, so calamitous, that most midwives retired from long careers without ever having witnessed it. A condition with an 80 percent mortality rate . . .

Tess grabbed a towel and stuffed it against the rush of blood. Her mind raced as she struggled to come up with something—anything—she could do to stop the inevitable. She was dizzy, nauseated.

“What’s wrong with her?”

The sweet, cloying scent of blood filled her nostrils. She pulled herself together enough to speak. “Anaphylactic shock. She’s having an allergic reaction to the baby’s cells.” A fatal allergic reaction. “It’s rare . . . random.” As if that were some comfort.

Bianca screamed in pain, blotting out whatever else she was saying. Even as Tess applied pressure to the blood gushing from her body, Bianca’s blood pressure was dropping. Soon she wouldn’t be able to breathe. She needed arterial catheters, a breathing tube, a ventilator. And even with all the intervention of modern medicine, women still died from this.

Without that surgical intervention . . . Tess fought against her panic.

“I don’t understand!” he cried. “Why aren’t you doing anything?”

Because there was nothing she could do. Your wife is dying, and I’m powerless to save her. She couldn’t say it aloud. Couldn’t tell him that, in the space of minutes, Bianca’s life was being snuffed out by a condition so rare, so catastrophic, that it was nearly incomprehensible.

She was helpless. As helpless as she’d been when Trav was dying. Her heart was pounding so hard she felt it in her throat. All her experience, all her years of training, counted for nothing.

Bianca had begun making horrible choking sounds. Her throat was closing. Tess had to make an impossible decision. She could do a tracheotomy without anesthesia, using whatever tools were in the house. The most brutal, barbaric tracheotomy imaginable. The pain would be excruciating. And for what purpose? It wouldn’t save her, only make her death more agonizing.

“She can’t breathe! Do something!”

She gazed up at Ian North. Saw his fear and his bewilderment as the baby lay forgotten against his chest. One moment his wife was cooing over their new daughter, and the next moment his wife was dying. Tess shook her head, wordlessly telling him what she couldn’t speak out loud.

His mouth twisted. His snarl, so primal it was barely human, cut through her. “You can’t let this happen!”

Tess turned away, hating her impotence, hating herself. As Bianca gasped for air, Tess stroked her hair, fought her tears, trying to calm, to comfort.