‘Push now, Jaquinda. Please push.’

Jaquinda let out a hoarse, incoherent yell as instinct overran fear and she bore down.

The baby crowned and Emily supported its head with her hand. Twenty months ago she had just started at this hospital and she had held Jaquinda’s baby’s head in her gloved hand and had felt the sick, impotent sensation when she saw that underneath the slick of hair, the baby’s scalp was blue.

The best people hadn’t been able to help Jaquinda then. Emily hadn’t been able to help her.

‘You’re doing marvellously, Jaquinda. I think the baby’s head is going to be delivered in the next contraction. You’re so brave. So very brave. Miguel is going to be proud of you, and so is this little person.’

‘I can’t do this,’ Jaquinda sobbed.

‘Yes, you can. You can do it. It’s the most natural thing in the world, and in a few minutes you’re going to hold your baby in your arms.’

The baby was blue, its limbs floppy. As if made of rubber. The most unnatural sight in the world. Jaquinda panting, and Emily silent, the nurses silent; and over everything, quieter than them all, the baby’s silence.

‘Why isn’t my baby crying?’ Jaquinda had asked.

The contraction came. Jaquinda yelled and pushed and the baby’s head was a hot slippery weight in Emily’s hand.

‘It’s going to be all right,’ Emily said. ‘It’s all going to be all right.’

‘Please,’ said Jaquinda. ‘Please, God, please. Please. Please.’

Emily guided the shoulders, and the rest of the baby followed quickly on the same push. A girl, small and pink and perfect.

She didn’t cry.

For a fraction of a second, Emily forgot her training and knowledge. She thought of Jaquinda’s blue baby, the baby Emily had not been able to save, and the tears that Jaquinda had shed in her office, her belly still distended from the dead child she had birthed. The grief in her husband’s face that had made it grey.

‘Why isn’t my baby crying?’ asked Jaquinda, and it was twenty months ago, the same thing, except this baby was fine, she was pink and she was fine, there was no reason for her not to—

The baby sucked in a breath and screamed.

‘It’s a beautiful girl,’ Emily said, and she quickly clamped and cut the cord, and put Jaquinda’s daughter safely into her arms.

She managed to wait until she had locked herself into the staff restroom before she burst into tears. She sat on the toilet, eyes closed, and saw that vision behind her eyelids: Jaquinda and her healthy baby, her daughter, the baby she wanted more than anything in the world. The happiness on her face had been so intense it looked almost like pain.

And then Miguel had come in and held his daughter who had been cleaned and wrapped in a blanket. He put his finger in her tiny fist and the tiny fingers curled around it and he looked over at his wife with the most perfect awe.

Emily had thought that she wouldn’t have tried again, if she had suffered the losses that Jaquinda had. But she would have. If she could, she would have. Just to live that moment.

If she could . . .

She cried a messy cry, mouth open, not wiping the tears, doubled up in pain, but she didn’t cry loudly. Hospitals were places for crying, but not by the doctors.

When she was done, she washed her face and held a wet paper towel over her eyes to reduce the swelling and redness. She left the restroom and went to change out of scrubs and to put on some make-up.

Robbie was waiting for her in the car outside: a 1956 Plymouth, which he kept going with some sort of wizardry, along with hope and, occasionally, string. He leaned over and opened the door for her.

‘What’s wrong?’ he asked instantly.

‘Nothing’s wrong.’ She leaned over and kissed him on the cheek. ‘Everything’s right. I delivered a wonderful healthy baby just now. To Jaquinda.’

The words caught in her throat. Robbie nodded, and touched her hand. ‘Do you want to tell me about it?’

‘Not particularly. Not right now. Maybe later.’

He nodded and started up the car. It had an old-fashioned purr. She turned on the radio, which was tuned to Robbie’s favourite blues station, and leaned back in her seat, closing her eyes and focusing herself. There was no air conditioning in the car, so they had to ride with all the windows open. The air wasn’t much cooler than when they stayed still.

This could be their solution. It could be the answer to the empty room in their house, to the yearning she felt every day at her job, every time she walked along their favourite beach on Biscayne Key, watching tiny chubby hands fashioning sand castles. She laid her hand on Robbie’s thigh as he drove, feeling the strength of him.

Their appointment was in a new, very ugly brick building. Somehow the interior managed to look both dingy and austere. They walked up the stairs and waited on plastic chairs outside the office door, holding hands. The round industrial-looking clock on the wall at the end of the corridor ticked loudly. Robbie’s hand was slightly damp. Emily wanted to say something, to offer some word of reassurance or hope, the kind of thing she’d been saying to Jaquinda not much more than an hour ago. But she couldn’t. This was . . . this was a risk.

But it was a risk they were going to have to take. For that empty room. For those tiny chubby hands. For the hole in Robbie’s life: not to fill it, but to help him cope with it. For the hole in her own life.

The door opened. ‘Mr and Mrs Brandon?’ said a woman with a perm and large glasses, a brown pinafore dress and beige flowered blouse. She was pregnant: mid-second trimester, Emily judged. Emily stood. Robbie was already smiling, that charming, friendly, confident smile. He shook the woman’s hand, and then she shook Emily’s. Her fingers were cold. ‘I’m Donna Hernandez.’

‘Great to meet you,’ he said as they entered her office. Emily took in spider plants, plastic chairs, wood-effect desk, two neatly placed manila folders and three blue Bic ballpoints. There was a poster of a Keane painting pinned to the corkboard on the wall: two huge-eyed children, a boy and a girl, one holding a stick with which he had just traced a heart in the sand. It was not exactly what Emily would have chosen.

‘So, Mr and Mrs Brandon,’ said the woman, taking a seat behind her desk and picking up one of the Bics, ‘this is your first meeting, to establish some details and for you to ask some questions.’

‘Dr Brandon,’ said Robbie, with his easy smile. He took Emily’s hand again.

‘Oh, I’m sorry, you’re a doctor?’

‘I’m the doctor,’ Emily told her. ‘I’m an OB-GYN. An obstetrician. I work at Jackson Memorial.’

‘Oh. I’m having my baby there. I’m with Dr Perez.’

‘Good choice. Dr Perez is excellent and we’ll look after you well there. Maybe I’ll see you. What are you – about twenty-six weeks?’

‘That’s right.’ Mrs Hernandez put her hand on her swollen stomach in the universal gesture of expectant mothers. ‘I’ve started to get terrible heartburn.’

‘That’s only going to continue, I’m afraid. The baby’s pushing all your organs out of the way as it grows. Try small meals, more often, and an over-the-counter antacid. Some people find that peppermint tea helps. But really it’s a case of mechanics, and trying not to eat too much at once.’

‘Thank you,’ she said.