‘Wait.’ Something wasn’t quite right, though Ava wasn’t sure exactly what it was. She hadn’t had a chance to feel Jessamine’s uterus and she knew the young mum hadn’t had a lot of obstetric care. This baby seemed too small for the size of his mother’s belly. While she thought about it, she allowed a minute for the extra blood from the placenta to flow into the baby. Anaemia could be a problem for some outback and especially Indigenous babies if the mother was anaemic, and the extra blood could mean a much healthier start to life. After a moment’s pause, she clamped and cut the cord to allow Zac to lift the baby away and around to the front of the mother.

But Jessamine was busy again. Another gush of water, not blood, flowed from her, and another tiny buttock slid into view.

‘Second baby,’ Ava breathed.

‘Exciting times,’ Zac murmured.

‘I did wonder,’ Ava said, glancing quickly at Jessamine. ‘Jill, can you put a cannula in for Jessamine? I want Zac free for the babies. Then give that injection, IV. With twins, our PPH risk just went up.’

The second baby was also a frank breech, and again two little buttocks presented and another little scrotum. Ava couldn’t help a tiny laugh as once more the procedure was accomplished easily. This baby’s trunk delivered quickly and Ava allowed the infant to rotate slightly to the left as the natural curves of the mother’s pelvis facilitated delivery of first one shoulder and arm and then pivoted the other way so that the other arm came free. Then there was a plop as the baby’s head eased out and he fell forward into Ava’s hands. Another baby who knew what to do.

Ava waited again for an extra minute before she clamped and cut this cord, too. There was a small gush of bright blood and the cord lengthened suddenly as the placenta began to come.

‘Needle now,’ said Zac. Ava had no doubt he’d be thinking about the last post-partum haemorrhage they’d had in Alice Springs.

Ava nodded. ‘Jessamine, I’m worried that you’ll bleed. So we have a needle here to give you. Is that okay?’

Jessamine eyed the needle in Jill’s hand with trepidation. ‘Better be quick before I change my mind.’

Ava marvelled at Jessamine’s fear of the needle when she’d just pushed out twin boys. She said soothingly, ‘Needles make people nervous, but Jill’s really good at it.’ At Jessamine’s nod, Ava said to the nurse with a smile, ‘Now would be good, Jill.’

Jill tightened the tourniquet and inserted the cannula. Denise helped her strap it, and then Jill slowly inserted the uterotonic injection, then assembled an IV line. The look on Zac’s face was priceless – it was so full of amazement.