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Braxton Hicks?’ Oliver asked.

      ‘I have a bad feeling about this,’ Mike said. ‘She doesn’t have any signs of bleeding but, given the fall and the length of her pregnancy, I think it might be a concealed abruption. That’s why I called you guys rather than doing a manual exam myself.’

      ‘Good call,’ Oliver said. If it was an abruption, a manual exam would make things much worse. ‘Have you managed to contact her partner or a friend to be with her?’

      ‘We tried her partner, but he’s in a meeting, so we’ve left a message for him either to call us or to come straight in,’ Mike said. ‘I’ll introduce you to Courtney.’

      Once Mike had introduced Oliver and Ella and headed off to treat his next patient, Oliver said, ‘Mrs Saunders—may I call you Courtney?’ At her nod, he continued, ‘I’d like to examine you, if I may.’

      Courtney gave her consent, and Oliver examined her gently. ‘Tell me if there’s any pain or tenderness,’ he said.

      ‘I’m fine. I can put up with being a bit sore and the Braxton Hicks. But I’m scared about the baby,’ she said.

      Ella took her hand to reassure her. ‘That’s why we’re here. Oliver’s the Assistant Head of Obstetrics, so he’s really good at his job.’

      ‘Assistant Head of Obstetrics?’ Courtney looked panicky. ‘Does that mean it’s really serious?’

      ‘It simply means,’ Oliver said gently, ‘that all my other obstetricians are in Theatre or in clinics right now and I happened to be the doctor who was free. It’s nothing sinister, I promise. But what I’m going to do first is reassure you by checking the baby, OK? Once I’ve listened to the heartbeat, Ella’s going to put some wires on you so we can monitor how the baby’s doing and keep an eye on—do you know if it’s a boy or a girl?’

      Courtney shook her head. ‘We didn’t want to know. But Alex—he’s my oldest—he tells everyone he’s going to have a little sister.’

      ‘Baby Saunders, then,’ Oliver said with a smile. ‘And we’ll also measure how your contractions are doing.’ He took the Pinard stethoscope and listened to the baby’s heartbeat, then smiled at Courtney. ‘That’s a nice strong heartbeat, so that’s good news.’ It was a little slow for his liking, but he wasn’t going to worry Courtney about that just now. Not until he’d checked the ultrasound. ‘Before Ella puts the wires on, I’d also like to give you an ultrasound scan—it’s just like the ones you’ve had before, when you came in at twenty weeks.’

      And the scan showed him the one thing he’d hoped it wouldn’t. He glanced across at Ella who mouthed, ‘Abruption?’ At his tiny nod, she mouthed, ‘Line in and cross-match?’

      He was glad she was so quick to pick things up—and he was even more glad that she was professional enough not to let the difficulties between them affect their patient.

      He turned the screen so that Courtney could see it. ‘When you fell, Courtney, it caused part of the placenta to start to come away from the wall of your womb—this dark area here shows bleeding behind the womb, which is why you’re not seeing any spotting,’ he said. ‘It’s what we call a placental abruption.’

      Courtney turned pale. ‘Can you stitch it back or something?’

      ‘Unfortunately we can’t reattach the placenta,’ he said. ‘If a mum has a small tear in the placenta and the baby’s doing OK, we can send her home to wait it out, or we can admit her to Teddy’s and see how things go—but this is quite a big tear. It means that right now your baby isn’t getting enough oxygen and nutrients from the placenta, and the baby’s heartbeat is getting slower.’

      ‘Is my baby going to die?’ Courtney asked, her eyes wide with panic.

      ‘We’re going to do our best to keep your baby safe,’ Ella said.

      ‘And the safest thing for me to do is to deliver the baby now through an emergency Caesarean section,’ Oliver finished.

      ‘But it’s too early for me to have the baby!’ Courtney said. ‘I’m only thirty-four weeks—there’s another six weeks to go yet.’

      ‘The baby’s going to be small,’ Oliver said, ‘but I promise you at thirty-four weeks Baby Saunders will manage just fine. I’m going to give you steroids to help mature the baby’s lungs.’

      ‘Like bodybuilders use?’ Courtney asked.

      ‘No, they’re corticosteroids, like the ones the body produces naturally or people with asthma take to help with their airways,’ Ella explained. ‘Babies born before thirty-seven weeks sometimes have trouble breathing because their lungs aren’t developed fully. The steroids help the lungs develop so the baby doesn’t have breathing problems.’

      Oliver didn’t chip in; he was enjoying watching Ella in action. She was so good with patients, explaining things simply in terms they could understand.

      She’d be a good mum, too, he thought wistfully. But would she give him the chance to be a good dad?

      He shook himself. Now wasn’t the time. Their patient had to come first. But he’d try to find a good time for him and Ella to talk. They really, really needed to talk about the baby—and about them.

      ‘What happens is we give you an injection,’ Ella continued, ‘and the steroids go through your bloodstream and through the placenta into the baby’s body and lungs. And as well as being able to breathe better, the baby can suck better and take in more milk.’

      ‘So the baby won’t have side-effects?’ Courtney asked.

      ‘No, and neither will you,’ Ella reassured her.

      ‘But Ryan isn’t here yet. He can’t miss our baby being born,’ Courtney said, a tear running down her cheek.

      ‘I’ll try him again,’ Ella said, and squeezed her hand. ‘I’m just going to put a butterfly in the back of your hand so we can give you any drugs we need, and then I’ll call him myself—Mike said he was in a meeting so they left a message, but I’ll make sure I actually speak to him.’ She smiled at Courtney. ‘I know this is really scary, but you’re in the best place.’

      Once Ella had put the line in, cross-matched Courtney’s blood and set up continuous foetal monitoring for the baby’s heartbeat and Courtney’s contractions, she went off to call Courtney’s partner.

      ‘I can’t believe this is happening. I wish I’d stopped work last week instead of trying to keep going a bit longer,’ Courtney said.

      ‘Hey, it could’ve happened anyway,’ Oliver said. ‘You might have slipped on your front doorstep, or when you were taking Alex out to the park.’ He sat next to her and held her hand. ‘There is something else I need to talk to you about, Courtney. With an abruption like this, it’s possible that you might lose a lot of blood—we can’t tell from the scan how much blood you’ve already lost. That’s why Ella cross-matched you, so we can make sure we can sort that out and give you more blood if you need it. But if I can’t stop the bleeding once I’ve delivered the baby, I might have to give you a hysterectomy.’

      Courtney looked dismayed. ‘You mean—like someone who’s near the menopause?’

      ‘Sort of,’ Oliver said. ‘I know you’re very young and you might want to have more children, so I’m hoping it’ll all be straightforward. But I do need to prepare you for the worst-case scenario too—because if that happens then a hysterectomy might be the only way I can save your life.’

      ‘So this abruption thing could kill me as well as the baby?’

      ‘That’s the very worst-case scenario,’ Oliver stressed. ‘In most cases it’s fine. But I do need you to sign a consent form just in case the very worst happens.’

      ‘I…’ Courtney shook her head, looking dazed. ‘It’s a lot to

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