I felt sick. In my entire career, I’d had to give this kind of news only a couple of times. Once when I’d delivered a child with a hemangioma birthmark covering the entire left side of its face. The other time was when I’d delivered a little girl with only two full fingers on her left hand. “I guess we’re going to the hospital, then,” I said after more than a minute of silence. “If the baby has a cleft palate, there could be a host of other problems. We’ll need a pediatrician present.” I braced myself and took a step toward the door.
“Wait,” Neva said. She took a deep breath, as if weighing up her thoughts. “I know a pediatrician. I might be able to convince him to come here.”
I paused, afraid to hope. “Really?”
“Maybe. At least that way Gillian wouldn’t have to have a hospital birth on top of hearing this news.”
“But … do you think your pediatrician would come to a home birth?” I asked.
“Not sure,” Neva said. “Give me two minutes.”
She tugged her phone out of her pocket and jogged down the stairs. I waited where I was. I wouldn’t go in until I knew for sure; I didn’t want to get Gillian’s hopes up for a home birth if this pediatrician didn’t come through. But I was also delaying the inevitable. Was it the right thing, giving Gillian the option to proceed with a home birth? Even with a pediatrician present, we didn’t have the resources of a hospital. If the baby required a blood transfusion or operation, we would lose precious time transferring it to the hospital. On the other hand, keeping Gillian in an environment that she was comfortable with benefited everyone. I was still going back and forth when Neva appeared in front of me.
“The pediatrician is on his way. Let’s go chat with Gillian.”
Neva pushed past me into the room. If she had any doubts, I couldn’t see them. And if Neva, Miss By-the-Book, was comfortable, I didn’t have any reason to worry.
Gillian and David sat up straight as we entered, and I took a seat at the end of the bed. I placed a hand on Gill’s thigh. “Neva and I have discussed what we felt, and we are not convinced that your baby is breech after all. We need to confirm, but we think what we were feeling is—” I took a breath. “—a cleft palate.”
Gillian looked blank, then turned to her husband.
“A cleft palate is when the baby’s top lip is missing or deformed,” David said, not to Gillian but to himself. His own lip thinned as he spoke, perhaps in solidarity with his child.
“No!” Gillian’s face became alarmed. I wanted to assure her that a cleft palate was no big deal. That her baby would still be beautiful, and most likely, the deformity would be minor. But I owed her more than that.
“David’s right,” I said. “The baby may have a minor or significant deformity to the lip and palate, usually a hole between the top lip and nasal area. Now that we know what we’re looking for, we’ll check for the rest of the face to confirm, but we both think that is what we are dealing with.” I paused as another contraction took hold. Gillian worked through it and her husband helped her. When it was over, I continued. “A pediatrician is on his way. He will examine the baby once it is born. And that might be the end of it—”
“But it might not?”
“There’s no evidence of any other problems at this stage,” I said. “But we don’t know anything for sure until the baby is born. Once we confirm that the baby is not, in fact, breech, we can still try to deliver here, if you’d like.”
“Yes,” Gillian said. “I want to have the baby here. More than anything.”
I smiled at Neva, sending her a silent thank-you.
“Okay,” I said to Gillian. “Now, why don’t you lie down again?”
*
An astonishingly good-looking young man arrived an hour later. Even mid-contraction, Gillian was silenced at the sight of him. Thanks to the unforgiving rain outside, his hair was stuck to his head and his clothes were sodden. When he pushed his hair back off his face, I actually gasped. Out loud. With his strong jaw and pronounced forehead, he had a look of Elvis Presley but more chiseled, more defined. I silently cursed my daughter. It would have been nice to have some warning.
“Sorry I took so long,” he said, peeling off his soaked jacket and hanging it over the back of the chair. “I could hardly see with all the rain. The thin part of Beavertail Road was terrifying, the waves were actually crashing onto the road—I’m surprised it wasn’t closed.”
“Thank God it wasn’t,” Neva said. “That road is the only way in and out of this part of the island. If it closes…” Neva trailed away, obviously not wanting to frighten Gillian, but we all heard the subtext. If it closes, we’re stuck here. No one comes in, no one leaves. “But the rain seems to have eased off now, so we should be fine.”
He looked at me. “You must be Grace. It’s nice to finally meet you.”
He grinned, revealing almost-perfect-but-not-so-perfect-that-they-looked-fake white teeth. I raised my eyebrows at Neva. Finally? How long had he been around?
“I’m Patrick,” he said. I waited for the rest. Patrick Whoseummywhatsit, doctor of this and that, and God of all things medical. That was how all doctors introduced themselves in my experience, particularly when they were addressing midwives, who—according to them—were a bunch of uneducated cowboys. But not Patrick. He didn’t even give me his last name. And before I could ask him for it, he was already wandering over toward my clients.
“Hi, there, Gillian, David,” he said, pulling up a chair and sitting. “I’m Patrick. I’m a pediatrician. Neva’s filled me in on what’s going on. I’m sure you are worried, but try to leave all the worrying to me and concentrate on delivering this baby. Cleft lips and palates can be corrected with surgery. And you’ve had proper prenatal care, so I say we remain optimistic. In fact, let’s get excited. We’re about to meet one of the most important people in your life.”
I glanced at Neva and she shrugged. Yes he’s special, her expression said. Indeed, he was rather special. In a couple of sentences, he had managed to turn the somber mood in the room around. It was very un-doctorlike. I liked him immediately.
“Okay, I’m going to sit back now and let the pros do their thing,” he said. “Neva is one of the best midwives in town, and if Grace is her mother, then you’re in fantastic hands.”
Patrick rose even further in my opinion. A doctor who wasn’t taking over? Who called us—the midwives—pros? Where did Neva find him? And more important, how could I make sure she kept him?
“Right, let’s get you moving,” Neva said. “I’d like to see this baby come before sunup!” She brushed past Patrick, giving him a nudge with her elbow. He smiled at her, and I saw something in his eyes. He liked her. Hope fizzed inside me, but I tried to push it down. Dared I even hope that this gorgeous man was the father of my grandchild?
Neva moved Gillian onto a birthing stool, where she spent the next three hours. Labor progressed steadily, and as the sun peeked through the blinds, she began to bear down.
“Try not to push,” I told her as she began to crown. I squatted by her feet. “Just pant. Slowly, slowly. Good girl. I want the head to come out slowly.”
“Here it comes,” Neva said, moving in close with a towel.
As the baby’s face came out, Neva cooed. Patrick had moved in closer and was studying the baby’s face. The baby had a cleft lip and palate, no doubt about it. But Patrick smiled encouragingly at the parents. I had an overwhelming urge to hug him. What a wonderful doctor. What a wonderful man.
“The head’s out,” Neva said.
I hooked my fingers under the baby’s shoulder to bring it under and around the pubic bone. Then we waited for the next contraction. The atmosphere was exuberant, exactly as it should be for a first-time home birth.
“Here we go,” I said as Gillian began to moan again. Neva moved Gillian’s husband down next to me so he could watch his child being born. “I want one more big push.”
“Come on, Gill,” Neva urged.
With the next push, I caught their baby girl. She was big, maybe nine pounds or more. She cried immediately.
“A girl!” we all cried.