A Breath of Snow and Ashes - Diana Gabaldon [212]
Anger swelled suddenly under my breastbone, a huge, solid thing, pushing hard enough to burst it.
Was she bleeding at all? No. No pain, bar tenderness from the bruises. No cramping. No contractions. Her blood pressure seemed normal, so far as I could tell.
A cord accident was still possible—likely, even. But it could be a partially detached placenta, bleeding into the uterus. A ruptured uterus? Or something rarer—a dead twin, an abnormal growth . . . The only thing I knew for sure was that the child needed to be delivered into the air-breathing world, and as soon as possible.
“Where’s Fergus?” I said, still speaking calmly.
“I dinna ken,” she said, matching my tone of absolute calm. “He’s no been home since the day before yesterday. Dinna put that in your mouth, a chuisle.” She lifted a hand toward Félicité, who was gnawing a candle stub, but couldn’t reach her.
“Hasn’t he? Well, we’ll find him.” I removed the candle stub; Félicité made no protest, aware that something was going on, but not knowing what. In search of reassurance, she seized her mother’s leg and began determinedly trying to climb up into Marsali’s nonexistent lap.
“No, bébé,” Germain said, and clasped his sister round the waist, dragging her backward. “You come with me, a piuthar. Want milkie?” he added, coaxing. “We’ll go to the springhoose, aye?”
“Want Mama!” Félicité windmilled arms and legs, trying to escape, but Germain hoisted her fat little body into his arms.
“You wee lassies come with me,” he said firmly, and trundled awkwardly out the door, Félicité grunting and squirming in his grasp, Joanie scampering at his heels—pausing at the door to look back at Marsali, her big brown eyes wide and scared.
“Go on then, a muirninn,” Marsali called, smiling. “Take them to see Mrs. Bug. It will be all right.
“He’s a sweet lad, Germain,” Marsali murmured, folding her hands across her belly as the smile faded.
“Very sweet,” I agreed. “Marsali—”
“I know,” she said simply. “Might this one live, d’ye think?” She passed a hand gently over her belly, looking down.
I wasn’t at all sure, but the child was alive for the moment. I hesitated, turning over possibilities in my mind. Anything I did would entail hideous risk—to her, the child, or both.
Why had I not come sooner? I berated myself for taking Jamie’s and then Fergus’s word that she was all right, but there was no time for self-reproach—and it might not have mattered, either.
“Can you walk?” I asked. “We’ll need to go to the Big House.”
“Aye, of course.” She rose carefully, holding to my arm. She looked around the cabin, as though memorizing all its homely details, then gave me a sharp, clear glance. “We’ll talk on the way.”
THERE WERE OPTIONS, most of them horrifying to contemplate. If there was danger of a placental abruption, I could do an emergency cesarean and possibly save the child—but Marsali would die. To deliver the child slowly, via induction of labor, was to risk the child, but was much safer for Marsali. Of course—and I kept this thought to myself—induction of labor raised the risk of hemorrhage. If that happened . . .
I could perhaps stop the bleeding and save Marsali—but would be unable to help the infant, who would likely also be in distress. There was the ether . . . a tempting thought, but I reluctantly put it aside. It was ether—but I’d not used it, had no clear idea of its concentration or effectiveness, nor did I have anything like an anesthetist’s training that would allow me to calculate its effects in such a dicey situation as dangerous childbirth. For a minor operation, I could go slowly, judge the patient’s respiration, and simply back off if things seemed to be going wrong. If I were in the middle of a cesarean section and things went pear-shaped, there was no way out.
Marsali seemed preternaturally calm, as though she were listening to what was going on inside