walked with her. When the contractions hit, Bianca braced herself on Tess’s body. Twenty minutes ticked by . . . thirty. . . . The contractions were closer together, each one lasting longer.
Bianca wanted Ian, who held her as Tess had. Bianca leaned against him. “You know I love you.”
“I know,” he said.
Bianca was tiring and finally wanted to lie down. Tess made her as comfortable as she could, but hard labor had taken over. Bianca would reach out for her husband, crush his hand, and then abruptly let him go. As her contractions peaked, her low, guttural groans grew louder. North repositioned himself at the head of the bed, out of sight of the action. Tess slipped a clean towel under Bianca’s hips.
Bianca threw back her head and screamed as her next contraction crested. “Take care of my baby!” Her fingernails gripped the sheets. “If something happens . . . promise me, Tess. . . . He doesn’t care! Promise me you’ll take care of my baby.”
Tess stroked her leg. “You’re strong and healthy. You’ll be taking care of your own baby.”
The contraction had eased, but Bianca’s eyes were frantic. She grabbed for Tess’s hand with supernatural strength. Tess winced. “I want you!” Bianca cried. “Promise me!” Tess glanced up at Ian, who stood tight-lipped and grim. Bianca’s fingers dug into Tess’s hand. “If something happens to me, promise you’ll take care of my baby.”
“Oh, honey . . . I—I can’t promise that. I—”
Another contraction. Another scream ripped from her throat. “You have to.”
“Promise her!” North exclaimed. “For God’s sake, promise her!”
The very top of a tiny head appeared, wrinkled like a prune from the pressure. “The baby’s crowning,” Tess said soothingly. “You’re doing great. Turn on your side now. Here. Let me help you.” Lying this way would get more oxygen to the baby and might reduce tearing.
She ordered North to brace Bianca’s top leg. From his reaction, she might have been asking him to hold a cobra, but he did as she said. “That’s good. Perfect.” North looked everywhere except at the place where his offspring would emerge.
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