The Reluctant Midwife

by Patricia Harman

  “Patty-cake. Patty-cake. Baker’s man.” I try to entertain him, taking his sticky little hands in mine and making them clap. “Make me a cake as fast as you can.” The vet ambles back across the lawn.

  “Afraid she’s going to have to leave. Lately, one of us is always going. It’s hard. That’s why we haven’t been over to see you. It’s always something.”

  A few minutes later, Patience returns with her birth bag in hand. “I wish I didn’t have to go. We were having such a nice time. Daniel and I don’t have much of a social life.”

  “None,” cuts in Daniel.

  “Want to come with me?” Patience brightens. “It’s Mrs. Mitchell. You know her. The one I told you about, the woman expecting twins. I could sure use a baby nurse.”

  I go on alarm. This is exactly what I don’t want to do. I’d rather face Willa’s geese.

  “I don’t think so, maybe another time. The doc and I were driving around all day toting groceries. I’d better get him home.”

  “Blum can stay here,” Daniel offers, supporting his wife. “I have some work in the barn, mucking out stalls. He can help.”

  “But Dr. Blum has his good clothes on,” I argue, still trying to get out of it.

  “I have a pair of coveralls and old rubber boots.” That’s Hester again.

  “Please! It will be fun. I’ll split my fee,” Patience pleads. “Well, I’ll split whatever I get. Sometimes it’s cash. Sometimes it’s food. Sometimes it’s nothing. I could even split nothing!” She thinks this is funny.

  I haul myself up. “You know how I enjoy childbirth. . . .”

  Patience can tell I’m wavering. “Please! It would help to have company.”

  Daniel doesn’t wait for my answer. He balances his toddler on his shoulders and leads Blum away.

  Five minutes later we are rolling along Bucks Run in the midwife’s dusty Olds. The oaks, maple, and hickory are covered in leaves now, a beautiful blur of summer green, but my stomach is tight, and I wonder why I agreed to this. Was it just to be nice to Patience? We owe her a lot. Was it out of some kind of sense of duty as a nurse? Was it the lure of sharing Patience’s fee? I hate to think it was only the latter. I’m getting to be a money-grubber. Poverty will do that to you. Once you’ve been broke, you’re always looking for a dime.

  I’m about to ask Patience about Danny’s birth, what the experience had been like for her, when she makes a sharp turn to the left, bumps across a creek through a foot of water, and pulls up in front of a dingy white two-story farmhouse with what looks like a chicken coop attached to the side.

  A man waves wildly from the front steps, then runs back inside as a woman screams. Patience is already in motion.

  Double Trouble

  “Becky!” Patience calls.

  “Right behind you.” I enter the upstairs bedroom as a disheveled, unshaven father in coveralls backs out. He looks down, wipes tears from his eyes with a red bandanna, and runs down the hall.

  “Asepto suction,” commands Patience.

  I know what she’s asking for and find it wrapped in white cloth at the bottom of her birth satchel, a glass syringe with a red rubber bulb that’s used to suck out the newborn’s nose and mouth. As I hand it over, I get a look at the baby and my stomach drops. It’s a tiny limp male, around five pounds, covered in meconium, baby poop.

  Now I understand Patience’s urgency. If the newborn aspirates the brown stuff that’s been floating around in his mother’s womb, he can get pneumonia and die. If she can manage to get it out of his airway before he breathes, his chances are better. Gently she places the pointed glass tube in his mouth and then his tiny nose, sucking out only clear fluid, no meconium.

  “Thank you, Lord,” the midwife mutters. “Here, get him going.” She hands me the wet infant and pulls out her fetoscope to listen for the second twin’s heartbeat.

  “Okay, little one. Let’s hear you cry. Open up those lungs.” I give him a few pats on the butt and he wails.

  “Is he okay? Is he all right?” sobs Lucy Mitchell. Her face is red and sweating, her golden eyes wet with tears. “I tried to wait for you, but he was coming and I couldn’t stop.”

  Patience listens to the second twin’s heartbeat as she consults the pocket watch hanging on a ribbon around her neck. “One hundred and fifty-two beats per minute, just fine.”

  “One hundred and fifty-two,” I repeat out loud, to remember the rate, then reach over and take the mother’s pulse. “One hundred and ten.” That’s fast, but then she just delivered a baby unattended, which would be enough to accelerate anyone’s heartbeat.

  “Can you help get the baby nursing, Becky? It will bring on the next set of contractions. Sometimes there’s a delay after the first twin, as the womb reorganizes itself. I need to do a vaginal exam to feel what’s coming. I think it’s a head, but I’m not sure.”

  Lucy doesn’t need any help from me; she takes her nipple, gently strokes it against the newborn’s cheek, and the baby opens his mouth, just the way nature intended.

  “What will you need next, Patience? Scissors? Sterilized string to tie off the cord? Anything else?”

  “That should be it. Oh, some more sterilized pads and Mrs. Potts’s bleeding tonic. You know about that?”

  I find a small brown bottle and hold it up to the light.

  “It’s a tincture of motherwort, pennyroyal, and blue cohosh to make the womb contract after the afterbirth is delivered,” Patience explains. “I keep it ready at every delivery, but don’t often use it. Twins are a special case though. The womb has been so stretched with two babies, it might need help contracting down afterward, but you probably know all this.” She turns and takes off the rubber gloves, carefully arranging them on one of the sterile pads.

  “Did you feel the presenting part?” I whisper, not wanting to alarm Mrs. Mitchell if the presentation isn’t head down. Even Dr. Blum knew that frightening the mother could stop her contractions.

  “No. It’s too high,” Patience whispers back and then in a louder voice. “We will just have to wait. . . . Clarence,” she calls. “You can come back now. Everything’s okay! Come see your new baby boy. You can bring the children.”

  My eyebrows shoot up. The children! Lucy is still half naked. Quickly I pull a blanket over the woman’s bare legs. Certainly this never happened when Dr. Blum did a delivery!

  Clarence Mitchell, having recovered himself, enters softly. He’s a fair-haired fellow with a sunburned face, a few whiskers, and a band of white on his neck where his shirt collar usually covers his skin.

  “Wife, you done good! Right healthy,” he says about the baby and surprises me when he sits down next to her on the side of the bed. The couple’s little boy and girl climb up too and Patience seems unfazed.

  “Only the first baby is out. The labor will start up again soon,” Patience explains as she plunks down on the other side and pulls the baby blanket down a bit so the children can see. “Look at that little sucker,” she says. “He knows exactly what to do, just like a calf or a foal.”

  “Can we touch him?” asks the girl, who must be about six. She strokes the baby gently on the back with one finger. Timidly, I find a corner on the very full bed and sit down with them.

  “Mmmmmmm,” groans Lucy with a contraction, but there’s a smile on her face. “Mmmmmm.” It doesn’t look like pain, almost pleasure.

  “The labor is starting again. Let me listen to the next baby’s heartbeat and then it will be time to walk,” Patience says.

  “We’ll move out of your way, then,” the father announces, leaping up.

  Snow Globe

  “Mmmm,” the mother moans again and takes the midwife’s arm. They walk and then stop, walk and then stop. While contracting, Lucy stands staring into space, rotating her hips. There is peace and a timeless feeling, as if nothing else matters.

  Finally, I work my way across the room and in a hushed voice ask Patience, “Shouldn’t we get her back in bed?”

  “It’s oka
y,” Patience tells me. “It’s not time yet. Lucy’s voice hasn’t dropped. When her voice changes the baby will come. I’ll check her in ten minutes,” she adds, consulting her gold timepiece.

  “Mmmmmmmm.”

  “Can you lie down for a bit, Lucy?” Patience finally asks exactly at ten minutes. “I’d like to check your progress and listen to the baby again.”

  The second Lucy is on her back I observe something odd.

  “Look, it’s the water bag,” Patience explains. “It reminds me of a floppy snow globe. See the bits of white in the amniotic fluid? That’s vernix, a creamy substance that protects the newborn’s skin while it’s floating around in there. By the time the baby is full term it’s mostly worn off.”

  I’ve never seen an intact amniotic sack before. Dr. Blum and the other physicians I’ve worked with always broke the membrane early in labor. With the very next contraction the sac pops and water squirts all over the bed.

  “Whoops!” says Patience, not a bit fazed. A tiny pink girl follows with the next push.

  “You okay, Becky? You’re as white as a sheet.”

  “Yes,” I lie. I’ve watched amputations, assisted in surgery, scraped dead tissue out of infected wounds, but this baby came so fast I didn’t have time to prepare myself.

  “You sure?”

  “Yes,” I lie again and sit down before I faint.

  “That was wonderful!” The mother laughs.

  Patience gives Lucy some of Mrs. Potts’s herbal medicine, just in case, and she tells me not to bathe the second baby; the white vernix is healthy for her skin. Then Mr. Mitchell and the children creep back into the room and we all sit on the bed again and watch as Lucy feeds both babies from both breasts.

  I have never given birth. Never wanted to. It horrified me to watch women scream and cry through labor until someone could put them under anesthesia, but this is different, and now that it’s over, I see that all that we did in the hospital and the clinic and even at Dr. Blum’s homebirths was more to comfort ourselves than to really help the mother.

  “Isn’t she wonderful?” Mr. Mitchell exclaims, taking his wife’s hand and pressing it to his cheek. Six-year-old Clara crawls into my lap.

  June 17, 1934

  Birth of twins, a male, Cecil Mitchell, (5 pounds, 8 ounces) and a female, Callie Mitchell (5 pounds) to Lucy and Clarence Mitchell of Bucks Run.

  The first twin was already out when we got there. Lucy and Clarence birthed him alone, but he was covered with meconium and the midwife had to suck out the baby’s mouth and nose. Luckily the baby hadn’t aspirated.

  The second baby had a separate sack. That was a good thing, because there was no meconium in her water and everything went as smooth as silk. Just as a precaution, Patience gave Lucy a spoonful of Mrs. Potts’s hemorrhage medicine and she only bled about 400 ccs. There were no perineal tears, but the babies were small.

  Clarence said he was sorry he couldn’t afford more and gave us five dollars. Patience laughed and said that was a good deal because we only delivered one baby.

  13

  An Idea

  All week, Dr. Blum and I have worked planting our kitchen garden. We now have a nice little plot thirty by fifty feet. Nothing like the Hesters’ or Maddocks’ but for beginners it will do. Mrs. Maddock sent over some tiny tomato plants she had started in cans from seeds she’d saved last fall. Some will be red, some will be yellow, some with be almost purple.

  Carefully, I transplanted them, digging the holes, patting the soil around their roots and watering each one. Dr. Blum helped, after I showed him how to carry the bucket back and forth from the spring.

  The Reverend Miller, with his wife, Mildred, a bundle of energy and concern, stopped by with a sack of seed potatoes that they’d saved last fall, and Patience shared some of her bean and squash seeds.

  Finished with the watering, we sit on the porch and stare out at our plot, or I stare at the plot, and my companion stares at the air in front of him.

  “Dr. Blum. It’s Sunday and we need a day of rest!” I break the silence. “I’ve been thinking we could go to church, but with your strange ways, people would stare, so let’s go on a picnic to the Hope River instead. What do you think?” Blum acts like he can’t hear, but I know he can. He got the water from the spring when I asked him to, didn’t he?

  It doesn’t take long to get ready. I pack two pieces of corn bread in a small willow basket, along with a canning jar of water, and a pint of applesauce I made with the Bittmans’ half-rotten apples, then I take Isaac’s hand like a child and lead him down Wild Rose Road.

  At the Maddocks’ place, there’s no truck in front. They’ve probably gone into town to attend services or maybe they belong to the closer church at Hazel Patch. It’s a colored church, but Reverend Miller is so kind, whites would probably be welcome.

  As we walk, I reflect on the changes in Dr. Blum’s health. Some of his actions have purpose now, though in the case of his stroll down Main Street, when he ended up at the soup line, it’s hard to tell. Most important, when I show him how to do something he can copy me.

  One thing is for sure: He has altered physically. When he was a physician he was tall, thin, and bookish. Now he actually has muscles and so do I. Carrying water, hoeing and digging, walking the land, sawing wood. We are both stronger.

  Near the corner of Wild Rose and Salt Lick Road, I notice for the first time the square rock foundation of the small cottage that Maddock said vagrants burned down. The remains of the barn are nowhere to be seen.

  This is our turning-off point and we cut across the road onto a well-worn grassy path toward the sound of the water. Here and there in the brush are the remnants of cold campfires, rusted tin cans, cleared areas where makeshift tents have been erected and then pulled down.

  Patience tells me that the homeless like this spot because they can get water and they can fish. Also, no one seems to own this stretch along the river, so no farmer will come with a shotgun to run them off.

  Closer to the water, in the wetlands, it’s another wilder world, where purple iris and yellow buttercups bloom. Red maples, wild cherry trees, and tall oaks press into the sky. I let out my breath, breathe in and blow out again, remembering my youth, when hiking and climbing and canoeing with David used to bring me joy.

  At the edge of the rushing water, we sit on the rocks and eat our corn bread with applesauce and drink our water. Dr. Blum stretches out on a flat slab of stone, his muscled arms under his head, looking up at the clouds.

  I turn away and to distract myself from his handsome body, watch the schools of tiny trout darting through the water. For an hour I watch them, and then an idea comes to me. Here’s a source of protein I hadn’t thought about! If the hoboes can fish, why can’t we? And why didn’t I think of it before?

  Excited, I yank Isaac up. “Come on, old buddy, let’s go home and search the house and the barn. Maybe there’s something we can use for a pole or a net, something we can use to get fish.”

  I’m on a mission now, pulling the doctor along as we hurry through the willows and low brush up to the road. This time as we approach the corner of Salt Lick and Wild Rose, I see two vagrants searching through the rubble of the burned-out cottage, looking for metal that they can salvage and sell.

  “Hey, lady. Hey, mister,” one of them yells. “Can you spare a dime? Or can you give a couple of working Joes, down on their luck, a bite of food?”

  “Sorry,” I say. “We are poor ourselves and have nothing to share.” I turn over our empty basket to make my point. The truth is, I’m scared of them. The taller man with the full beard and the torn denim shirt stands up straighter.

  “Well, bless you then, sister, you and your man. Don’t give up hope. That’s about all we have in these dark times.” He turns and heads for the river.

  As soon as they are out of sight I walk slower, ashamed of myself for being afraid. It’s true we have little, but still we have more than they have. I just didn’t want them to follow us
home.

  When we get back to the farm to search for a fishing pole, I discover a wealth of other tools I’d overlooked. Hanging on one of the walls in the barn, I find a scythe that could be sharpened and used to cut grass, a hammer, some nails in a tin can, another bucket, a rake . . . but no fishing pole.

  Disappointed, I return to the house and find Dr. Blum sitting on the front steps with both a net and a pole. Not only that, there’s a hook and a line!

  “Isaac, you amaze me. Where did you find it?”

  “Under,” he says pointing toward the porch, and I think he’s as surprised as I am to hear his own voice.

  “You can talk, Isaac. You can talk if you want to,” I tell him. “It’s okay. I get lonely sometimes.” But the curtain is already down and the lights are turned off.

  Purple Iris, Pale Lilac

  “Miss Becky! Miss Becky!” The girl named Sally calls from across the swinging bridge. We are on a first-name basis now, and this is my third trip to the Hucknell house. “Can I help you?” she asks.

  “Sure.” I hand her my box when I get to the end of the swinging bridge. (I’ve got the knack of crossing the metal-and-wood contraption now, just roll with the rhythm like a sailor on the sea.)

  “What did you bring us?” The little girls swarm around like a flock of sparrows.

  “Whatever your mama ordered,” I respond. “I don’t look in the boxes. Mr. Bittman, the grocer, packs them.”

  “How are you, Willa?” I greet the children’s mother on the porch as I wipe my sweating face and arms with a handkerchief.

  “About half.”

  I let that pass. In the mountains “about half” means you aren’t swell, but you don’t want to talk about it.

  As usual, despite the heat wave, Blum takes his place on the porch with the four little girls. Sally has taken to reading to him from Louisa May Alcott’s Little Women and he sits there like one of the family.

  “Got a pot of coffee brewing?” I ask as I open the screen door.