Given where the pain was and the description, Theo knew exactly what the problem was. But rather than muscling in, he waited for Madison, who smiled at Mrs Ellis and squeezed her hand. ‘The baby’s in absolutely no danger. What you’ve got is something called symphysis pubis dysfunction—SPD for short. It sounds a lot scarier than it is, and an awful lot of women get it. At eighteen weeks, you’re practically halfway through pregnancy, and that’s the most common time to start noticing the pain.’
She sat down next to the bed, drew a notebook and pen from her pocket, and sketched a swift diagram to show their patient. Theo liked the way she was managing this: focusing on the patient’s worries, making it easy for her to understand. That kind of empathy would make her a brilliant consultant, as Iris had said. And on a personal level…
No. No involvements. He’d made his decision years ago: he wasn’t going to settle down, get married and have children. Sure, he dated—he was only human—but he always made sure his dates knew he wasn’t able to offer anything long term. If that meant people thought he was a shallow playboy, then fine—he could live with that. As far as he was concerned, other people didn’t have to know the real reason behind his decision. He wasn’t prepared to put the woman he loved through childbirth, knowing first-hand what could happen when everything went wrong. And no way was he going to go through what his father had gone through.
He forced himself to concentrate on what Madison was saying, just in case she decided to throw a question or two his way.
‘Basically your pelvis is in two parts and it’s held together by a joint called the symphysis pubis, which is strengthened by lots of ligaments. When you’re pregnant, your body produces a hormone called relaxin, which softens your ligaments to make it easier for you at birth—but that also means your pelvis can move during pregnancy, and the movements are what cause the pain.’
‘Can you make it stop?’ Mrs Ellis asked.
‘I’m going to give you a support belt, which will help, and you can take paracetamol to help with the pain—that’s perfectly safe for the baby. I’m also going to refer you to a physiotherapist, who can teach you some exercises for your tummy and pelvic floor that won’t hurt the baby but will help ease the pain. I can’t promise you’ll get an appointment with the physio today,’ Madison warned, ‘but if I can do it, I will.’
‘Thank you.’ Mrs Ellis wiped away the tears that had started to spill over. ‘I was so scared I was going to lose the baby.’
‘It’s always the first thing that goes through your mind,’ Madison sympathised, ‘but you’re going to be absolutely fine. Even better news is that there are a few things you can do to help make the pain go away.’
This was his cue, he thought. ‘Why don’t I tell Mrs Ellis while you talk to the physios?’ Theo suggested.
Her eyes narrowed for a moment, as if she thought he was trying to take over; but then she nodded, clearly realising that this was going to save them some time. ‘Is that all right with you, Mrs Ellis?’
‘That’s fine. I don’t mind talking to student doctors.’
She thought he was a student? Well, it was an easy mistake to make. Madison had been planning to bring her fourth-year students with her, and no doubt the emergency department had cleared it with Mrs Ellis first. Theo just about managed to suppress his grin, though as Madison left the cubicle he could see amusement all over her face. Well, he could live with it. Telling Mrs Ellis that actually he was Madison’s boss wasn’t going to achieve anything other than make her feel awkward and embarrassed—and his patient’s comfort was much more important than his dignity.
He talked her through the things she could do to help herself, and was just discussing the birth plan with her when Madison swished the curtain aside, carrying a support belt. ‘I’m sorry, Mrs Ellis. The physiotherapy department is completely booked up today—but I’ve persuaded them to squeeze you in first thing in the morning, just before their list starts. For now, I’m going to show you how to put this belt on and that’s going to take some of the strain for you.’
‘Thank you so much,’ Mrs Ellis said, looking relieved that she wasn’t going to have to suffer pain for much longer.
‘My pleasure.’ Madison smiled at her. ‘Do you have any questions, or has Mr Petrakis already answered them?’
‘Mr Petrakis said I should put it in my birth plan to make sure I get the most supportive birth position, and it might affect my pain relief. Will I have to have a Caesarean?’