Arms Wide Open

by Patricia Harman

  “You’ll still help me have him in our new home, won’t you?”

  “Yeah . . . I guess . . . but are we supposed to be happy?”

  Rachel, on the other end of the bench, hasn’t said a word. The red-haired woman lets out a heavy sigh, stands, and strolls toward the Growing Tree as if nothing’s happened, as if she’s not concerned, not involved. Since we started building her little chateau, maybe she doesn’t care anymore. Maybe she’s already given up on the commune. The Growing Tree’s bright green door slams behind her.

  “Well, I hope you’ll enjoy your life.” What I want to say is, Mara, don’t leave me! You’re my sister. We’ve been friends all these years.

  A farmer in coveralls limps by, dragging a small blond boy in a wagon. I throw my knapsack of beans, wheat berries, and cornmeal over my shoulder and follow Rachel. Each step away feels like something is ripping.

  CHAPTER 11

  Fool

  The whole way down Route 119, past Speed, Gandeeville, and Snake Hollow, I’m thinking about a baby that died at a homebirth in Hardy County, on summer solstice, the longest day of the year.

  What am I doing in this new Ford station wagon being whipped back and forth as we race through the night? What am I doing even going to deliveries when our community is falling apart?

  The driver, a clean-shaven stranger, the minister of the Spencer Seventh-Day Adventist Church, handles his late-model vehicle like a racecar, and sitting in back, with the winding road and the new-car smell, I’m about to puke.

  Yesterday, Fern called and told me that word on the West Virginia homebirth hotline is that the fetal death happened during labor. The baby got stuck. When the head came out, the midwife tried everything, squatting, hands and knees, pressure on the pubic bone. She even tried to turn the baby with the screw maneuver that I’ve read about in Williams Obstetrics, but nothing worked.

  You’d think I’d have more concern about the devastated family and the poor birth attendant; that my heart would go out to them. Instead, my eyes got steely and I asked Fern for the obstetrical details: “Were there risks for shoulder dystocia?” “Any sign of gestational diabetes?” “Had the mother ever delivered a large infant before?” What I’m really asking is, “Were there any predictive factors? Is there a way to prevent such a terrible outcome?”

  All I could learn was that Jade, the primary birth attendant, called the squad to take the mom to the hospital with the little baby’s blue head still sticking out, but it was too late. Of course it was too late . . .

  This is the first bad outcome in the state’s loosely knit network of homebirth midwives and it will be investigated by the state coroner’s office for sure. Jade is sick with grief and fear. Homebirths, by midwives, are legal in West Virginia as long as we don’t charge money, but birth at home isn’t sanctioned, either, and there’s no doubt there will be some kind of repercussions. We are all scared.

  Now, here I am hurling down this snake of a road on my way to some stranger’s house to do another home delivery. What am I thinking? Am I prepared for this kind of responsibility? Do I imagine Jade has a monopoly on tragedy?

  We pass the sign to Bear Fork and, a few hairpin turns later, Wolf Run. Tom puts his arm around me. He knows how nauseated I get on a curvy road, and he knows about the baby’s death. He also knows how fragile and forlorn I’ve felt since Mara’s announcement that she and Benny are leaving the ridge. His hand on my shoulder says everything. He and I are solid. We are in this together. The commune may come and go but we are for always.

  Another horseshoe twist and I urgently wind down the window and watch as my pinto bean supper covers the side of the pastor’s shiny burgundy auto. “Sorry,” I mumble, wiping my mouth with the back of my hand. The pastor, worried about getting me to the birth on time, doesn’t even pull over. Ten minutes later, we screech into the drive of a pleasant brick ranch house. The front door flies open and light streams out on the porch.

  “Oh, Patsy,” Mr. Blundell, a pale, balding forty-year-old, erupts through the opening with a ragged sigh. “Praise Jesus, you got here! She’s having a pretty hard time.” I glance around the living room. Kids’ colorful plastic toys are everywhere, but I don’t hear any children’s voices. They must be spending the night with grandparents.

  Ordinarily I insist on a home visit before attending a birth, but because I injured my back, delivered two other babies, and started work for Community Action, there wasn’t time. Now I see the results of my hastiness. I’m walking into the home of a family I barely know, have met only once. I have more enthusiasm than sense. Fool. Fool.

  “Mr. Blundell, this is my husband, Tom.” Blundell nods and shakes hands with Tom, glad to have another man around. The perspiring pastor beats a hasty retreat out the front door, saying he’ll pray for us, and Jay Blundell immediately leads the way down the carpeted hall.

  FAITH

  At the door to the dark master bedroom, I see Bonnie crouched in an unmade bed. This doesn’t look good. She reaches out, opening and closing her hand in a silent plea for me to come closer, then groans and grabs my fingers until the bones crunch. I notice a wet towel on the floor, soiled with brown amniotic fluid as thick and dark as beef gravy. “When did your water break?” I ask when the contraction lets up.

  “Three days ago.”

  “Three days! Has it been that color all along?” The woman stares at the linen.

  “I didn’t notice . . . No. I don’t think so. It was clear this morning. I called my OB in Charleston when I started leaking . . . that was Wednesday. He knows I was planning a homebirth and told me if I didn’t have a fever, it was all right to stay home.”

  I am both impressed and appalled: impressed because it’s rare in West Virginia to find a physician who’s supportive of a woman giving birth at home; and appalled because after twenty-four hours with ruptured membranes the risk of infection goes up. It’s been three days! Bonnie should have contacted me. I would have come to her. I might have recommended castor oil or intermittent nipple stimulation to get things moving. I would certainly have asked her what color her amniotic fluid was.

  “Oh no, here’s another one!” The woman grabs my hand again.

  When she’s done, I sit down on the bed. “Bonnie, I need to check you. The color of your water isn’t normal. That brown is meconium, baby poop. It could mean danger for the infant. If there’s time we need to get to the hospital.”

  “The hospital. No! Our baby is OK. God will protect . . .” She breaks off her sentence and rolls on her hands and knees. “My back! My back!” I press on her sacrum with the flat of my hand.

  “Hey, Bonnie, you look like you feel a lot better. Is it time?” It’s nervous Jay Blundell, standing with Tom at the bedroom door, holding a pack of sterilized bedding in his outstretched arms. Bonnie shoots him a look, as if her pain is his fault. Tom takes in the chaotic scene and turns on the bedside light.

  “We’re going to find out right now how close she is,” I tell the father as I pull on sterile gloves. “But I’m concerned about something.” I catch Tom’s eye, wanting him to know how serious this is but not wanting to freak out the family.

  As the woman lies back and spreads her legs, I continue. “Bonnie’s been leaking for three days, and at some time the amniotic fluid turned brown. This means the baby has pooped in its water. It’s called meconium and is potentially dangerous. If the infant aspirates the poop as he’s born, he can experience respiratory distress.” I would like to add and babies sometimes die of this, but bite down on my lower lip when I find that Bonnie’s cervix is already almost fully dilated, just a rim left.

  “This is Bonnie’s third baby,” I explain to the couple. “She’s going to deliver in the next thirty minutes. I thought we might try to get to the hospital, but there’s no time.”

  That’s probably why my hospital transfer rate is so low. My patient
s all progress too fast or call me too late. Then there are the bad country roads and the long distances to the hospitals to consider . . .

  How did I get into this? You break one rule: always make a home visit. You break another few rules: take time to get to know the family and be sure they understand what you expect of them. It’s a slippery slope, and you wind up risking an infant’s life by delivering at home with thick meconium-stained fluid.

  I worry my jaw back and forth while I check fetal heart tones. Tom, silent, understanding what’s at stake, lays out the birth equipment. There’s the usual olive oil, gauze, two sterilized hemostats, a blue suction bulb, a pair of scissors, and a cord clamp that looks like a girl’s plastic hair barrette, and, lastly, though I’ve never even opened the package before, a sterile DeLee suction trap.

  “The baby’s heartbeat sounds great and he or she will be here in a few minutes, but when he comes out,” I warn the couple, “I won’t try to make him cry right away. I purposely won’t stimulate him.” I hold up the DeLee catheter. “With this plastic tube, we’ll try to suck the meconium out of the baby’s mouth before he has a chance to breathe. The filter will catch the brown mucus.” I hand the clear plastic apparatus to Tom, who looks it over. He’s a musical-instrument repairman, a carpenter, a mechanic, and a father; the suction trap doesn’t faze him.

  I can’t tell how Bonnie and Jay are taking all this, or if they’re even listening. Contractions are coming one after the other and Jay prays into his wife’s ear. “The Lord is my shepherd, I shall not want . . .”

  “Oh, heavenly Jesus, I got to push!” That’s Bonnie.

  “Warm compresses.” Tom holds out the bowl.

  “He maketh me to lie down in green pastures . . .” That’s Jay.

  “It’s coming! Oh God, it’s coming!” Bonnie again.

  Furious activity.

  “Lay down now, Bonnie! Here on your side. Jay, hold her leg. Blow! Blow! Ready with the DeLee?” The head’s hanging out of the vagina. Everything stops. Dead silence.

  Tom calmly leans over and suctions the baby’s mouth with the vinyl tube, as if he’s done this before. I flash for a second on what it must have been like for Jade, the midwife, when her patient’s baby got stuck, then I take the fragile skull between my two hands and gently push down. First shoulder out. Up now. Second shoulder out. Carefully, I lay the chalky newborn on the sheets. It looks dead, but it’s only not here yet and we want it that way. As promised, we make no effort to stimulate until my husband suctions again and then looks up with a wide smile.

  “No meconium in the mouth or throat.”

  “All right, little one. Time to breathe!” Dawn is just creeping under the curtains. I blow on the infant’s belly. The breath of life I call it. The baby gasps when the cool air hits her abdomen and she lets out a wail.

  “My baby. My Faith!” That’s Bonnie.

  “Praise Jesus!” That’s Jay.

  The tiny girl opens her eyes.

  Reckoning

  The smell of new-cut hay through the Volvo’s open windows reminds me that summer is more than half over as I wind along Johnson Creek after my fourth visit with Etta Utt.

  White clapboard homes with pots of red geraniums and neatly mowed yards line the side of the blacktop road, but I am not really seeing them. My churning mind turns to Mara.

  On the farm, we go on with our work. We tend the garden, mulch our young apple orchard, and cut winter wood, but never talk about our friends’ decision to move into Spencer. What’s there to say? Benny and Mara are leaving. Once community surrounded me like a warm quilt. Now the quilt is mostly holes.

  When I turn off the pavement onto Snake Run, everything changes. The gravel road is rough and rutted. I’ve just landed in the third world. Worn mobile homes on cement blocks sit in overgrazed fields. In every yard there’s a pig or two, an outhouse, a tilting barn, and the inevitable body of a broken-down vehicle being saved for parts. I stare hard at the ramshackle dwellings, not believing people live there.

  I, who have chosen voluntary poverty . . . I, who have elected to live without running water, plumbing, or electricity, I, who only recently had a phone installed, am shocked to see families existing without the basic conveniences of the twentieth century. These are homes right out of the Great Depression.

  I recall the Walker Evans photographs taken for the Farm Security Administration in the 1930s, the gaunt, sad-faced women standing on falling-down porches. Nothing has changed. That’s what I’m thinking when, in a tight curve just past the cemetery, a mammoth water truck rumbles around the bend in the narrow road.

  There are ditches and trees on either side, nowhere to pull over . . . I slam my eyes shut, stomp on the brake, flash on Mica and Orion’s faces, and brace for the inevitable. There’s the crash of metal. Glass flies everywhere. The front end of the Volvo crumples like a wad of paper but the safety belt holds as my neck jerks forward and back.

  After that, silence . . .

  It’s the insistent chirp-chirp of a tiny wren that alerts me I’m not dead. With my eyes squeezed shut, I find myself still sitting in the Volvo’s comfortable upholstered seat with my hands braced on the steering wheel. I check my limbs, clinch my fists, and wiggle my toes. I have feeling . . . without searing pain. That seems good. Then I notice the sound of the motor still running and blink my eyes open. The air reeks of gasoline, and through the shattered windshield I see black smoke.

  Fumbling frantically with the safety restraint, I manage to crawl out, stagger into a ditch, and collapse on the grass.

  “You OK, honey?” A white-haired woman with gray rhinestone bifocals bends over me. She wears a black dress, old black grandma shoes, and dark hose. The rail-thin driver of the water truck hobbles toward us. It’s hard to tell if he’s been injured, or has walked like this for years.

  “You OK, honey?” the lady asks again and places one wrinkled hand on my arm.

  “Yeah, I’m fine.” I am not really fine and our blue Volvo, uninsured, is totaled.

  “Shit, I’m sorry,” the other driver curses. “There was no way I could get over or brake in time.”

  “My old man is calling the sheriff. Do we need an ambulance too?” the lady interrupts.

  “No, I’m going to be all right . . . really. My shoulder hurts but nothing’s bleeding, nothing’s broke. How about you?” I turn back to the middle-aged fellow who wears jeans, a two-day-old beard, and a Southern States Farm Co-op cap low over his eyes.

  He shrugs and pushes his hat back, but skips my question. “God, I’m sorry as hell. These roads is too narrow. You’re sure you’re all right?” He kneels next to me.

  I try to stand up to show them I’m fine, but my legs buckle, so I sit back down. “Could someone call my husband? He’s home with the kids.”

  “Hobart!” the lady shouts to her mate, who’s watching the scene from the sloping porch of the faded green trailer across the road. “Get over here with a pencil and paper. This girl wants you to call someone.”

  Thirty minutes later, I’m sitting in Mr. and Mrs. Wheeler’s trailer on their brown plaid sofa with a flowered plate of cookies on my lap and a cup of strong tea in a mug at my side. The living room smells like Lysol and there isn’t a dust bunny anywhere. From outside the worn mobile home, I hadn’t imagined such a tranquil interior.

  The silenced TV across the room shows pictures of the first test-tube baby, Louise Brown. I’m transfixed. She looks entirely normal, a cute kid. Then I catch sight of myself in a silver framed mirror over the television and am startled to see a woman I hardly recognize, pale, with disheveled short hair sticking up at all angles. I smooth it down.

  “So you’re the midwife,” Mrs. Wheeler confirms. “We’d heard about you at the Seventh Day Adventist Church.” I’m just about to ask what they heard, bad or good, when Tom appears at the screen door.


  “It wasn’t the little lady’s fault,” Hobart Wheeler says in my defense when my husband sits down. “I was here on the porch. Saw the whole thing. Been an accident on that turn every year as long as I can remember. We told the state highway department least three times, but they don’t listen. County highway superintendent says they’ll come by and check. I wouldn’t hold my breath. They won’t come ’til someone gets killed.” Tom and I catch each other’s eyes again. We don’t need words to understand . . . that someone could have been me.

  An hour later, we sit in the jeep in the dark at the end of Steel Hollow. The full moon is just rising over the hills. Whip-poor-will. Whip-poor-will, a night bird sings. When I finally begin to cry, I’m not sure if I weep because our first good car, the Volvo, is totaled, because Mara and Benny are leaving the commune, or because the world is so beautiful and I’m not dead.

  “I’m so sorry about the car,” I tell Tom. “I’m so sorry.” Before us the valley is a huge bowl of light. He holds me in his arms and I cry, deep gulping sobs; then he presses our foreheads together.

  CHAPTER 12

  Falling Star

  “Did you see that? A falling star! It went clear across the sky to Steele Hollow.” Tom and I lie alone in the middle of the horseshoe ridge, under a moonless sky, with a silk banner of tiny lights above us. Orion and Mica are already in bed and Rachel is babysitting. I shake my head no, meaning I missed the meteor, and stare off where Tom points.

  Seen a shooting star tonight . . . He sings a few bars of an old Dylan song, then turns on his side and pushes my bangs back from my eyes. “I know you’re sad about the community. There’s not much left.”

  Rachel’s little clapboard house was finished right on schedule, August 20. Though the twelve-by-twelve two-story dwelling is not yet insulated, the windows are tight and she has a door, a blue one we trash-picked from the Roane County dump.

  In her ritual move to her new place, we followed Snow White like the Seven Dwarfs, marching up through the woods, carrying books and bedding, boxes of papers, and the used dishes she scored at a Methodist Church yard sale. As we trooped inside her new house, I flicked my gaze up to her roof, where Tom almost lost his life falling two stories onto the lumber pile, and thanked the Great Spirit for saving him.