The Amish Midwife

by Mindy Starns Clark

  “Mom?” Ella called up the stairs.

  There wasn’t an answer.

  “She’s probably out in her office,” I said.

  “I’ll check.” Ella stepped out the door as Zed sat down at the computer. I stopped in front of the stove, warming my hands.

  Ella returned a few moments later. “She’s out there making phone calls. She wants to see you,” she said to me.

  When I got there, Marta was sitting at her desk with only a small reading lamp on. She wore her cape and didn’t have the heat on in the room. There were shadows under her eyes, and she wore her black bonnet. She looked like a woman who was ready to flee.

  “Sit down,” she said, motioning to the chair by the door and then returning to the paper in front of her. She made a mark and then looked up again. “The grand jury convened today.” Her voice was monotone. “I’m to be arraigned Wednesday.”

  I wasn’t surprised. “What are the charges?”

  “Negligent homicide.” She squinted as she talked. “The autopsy came back Friday and was presented to the jury. There were no signs of a heart defect. No indication of cardiac arrest. So they assume it was my negligence because I didn’t call 911 sooner, based on Lydia’s blood pressure.”

  “Are they surmising it was preeclampsia-induced shock?” It was the third leading cause of death in late-term and postpartum women.

  “I’m guessing that’s it.”

  “What do you think?” I shot Marta a quick look. Her face was expressionless.

  “She didn’t have any of the other signs. No swelling. The baby was full term. No abdominal pain.”

  “What about fatigue?”

  Marta inhaled and then exhaled slowly. “Most women who are nine months pregnant suffer from fatigue.” She had a point. Still, preeclampsia sounded plausible to me.

  “The autopsy should have shown if it was preeclampsia, though. Elevated liver enzymes. Low platelets.”

  “Those results were inconclusive,” Marta said. “A little high for the liver enzymes. Borderline for the platelets.”

  “How high was her blood pressure?”

  “It spiked at 160/110. That’s when I told her she needed to go to the hospital.”

  “Not that it’s any of my business, but do you have some savings set aside? Some way to cover the bills until this whole mess is taken care of and you can practice again?”

  “Not really,” she said vaguely.

  “How about your bail? Any idea how much that will be?”

  She tilted her head. “Excuse me?”

  “Your bail. How high will it be?” I didn’t even ask whether or not she’d be able to pay me the small amount we’d agreed on that she owed me. I already knew the answer to that. Thankfully I had some money set aside.

  She spread her palms flat on the desktop. “I don’t know,” she answered. “My lawyer didn’t say.”

  I couldn’t imagine her bail would be all that high. She wasn’t exactly a flight risk, even though she looked like it right now. “When is my replacement arriving?”

  She tapped her finger on the list. “I’ve called close to thirty different midwives from Pennsylvania and nearby states. I’m expecting a return call—maybe a couple—tomorrow. Then I’ll know.”

  I was sure she was stalling. I would bet good money that she didn’t have a couple of prospects, or even one, ready to call. What would happen to the mothers who were expecting her care? And what would happen to Ella and Zed? Would they be eating oatmeal for dinner? What if Marta couldn’t post bail and ended up in jail? Surely someone from their church would come through and help. It wasn’t my responsibility.

  But they were my cousins…

  Birth cousins. Not legal cousins, I reminded myself. I had no obligation. Except that I liked them more and more every day.

  “I’m sorry for all of this, Marta, but I was planning on leaving in the morning,” I said.

  “So be it,” she answered.

  I backed out of her office and crossed the sodden lawn. The wind and rain were blowing through the stand of evergreens. I stepped into the side yard. Zed had left the ax in the chopping block. I remembered doing that when I was about his age and then the lecture from Dad, reminding me that we needed to take good care of what we had, that it was a way of honoring God. I yanked the ax from the wood and slipped it under the tarp over the woodpile.

  Later, as I settled into bed, I heard Marta knock on Ella’s bedroom door and go in. I tried to stay awake to hear any words they might exchange, but I fell asleep to the sound of the rain against the alcove window. It wasn’t until the morning when Ella came out of the bathroom, her eyes puffy and red, that I realized how upset she was about the news of her mother’s arraignment. Her whole world had just shifted.

  I slipped from the bed and pulled out the carved box. I wrapped it in my baby quilt and then slid it back in the cloth bag. Next, I packed my bag. I would stop by Klara’s house and demand to see Mammi. Then I would head to the hospital to see if Sean was free for a farewell lunch. If not, I hoped he would come to Philly to see me sometime soon.

  I’d had enough of Lancaster County.

  SIXTEEN

  Ella and Zed had already left for school by the time I finished my shower. I’d wanted to tell them goodbye, but maybe it was better this way. I’d never been very good at farewells. I lugged my suitcase down the stairs and through the living room, ignoring Marta, who sat at the dining room table with her phone to her ear and the same list from the day before in front of her. Next I gathered my computer and the bag with the box and quilt, my coat and my tote bag, and deposited them in my car. All that was left was to tell Marta goodbye.

  I stood in the living room, warming my hands by the woodstove while she spoke on the phone. I purposefully tuned her out. Maybe she was still trying to recruit another midwife to help her. Maybe she’d found one, after all, and was working out the details. Maybe she hadn’t found one and was trying to cancel her appointments for the day—which would be quite a feat, considering that most Amish seemed to check their message machines in the barn only once every few days. Oh, well. It wasn’t my problem.

  “Lexie?”

  I stepped into the archway between the two rooms.

  “I wanted to say goodbye.” The ribbons on her head covering hung loose and the rings under her eyes were more pronounced than the day before. She wore the same mauve print dress she’d had on for the last few days, but now it was wrinkled and limp. “Thank you for your help,” she said, extending her hand. I took it and she squeezed mine, and then she quickly let go. “Blessings to you and your work in Philadelphia. I’m afraid I’ll have to mail a check to you rather than pay you now. Though it might be a few weeks.”

  “Of course. Take your time.”

  On impulse, I gave her a hug, one she stiffly endured, though she didn’t hug me back. A minute later I was hurrying down the front steps, but something made me stop. I turned around. Through the window I could see Marta sitting back down at the table and then burying her head in her arms. In a moment her shoulders began to convulse. I took another step down the stairs and stopped again. Slowly, I turned and forced myself back into the house.

  She was sobbing.

  “Marta,” I said.

  The sobbing stopped. “I thought you’d gone.”

  “I heard you—”

  “I’m fine.” Her voice was muffled. “Please go.”

  “Is there something I can do? Before I leave?”

  “No.”

  I stepped back out the door and a few minutes later, after texting Sean about lunch, I was on my way. It was a perfect late March morning: clear, cool, and crisp, yet promising to bloom warm and bright. On the highway I slowed behind a buggy and then navigated a hairpin turn, coming upon a cemetery in the corner of a field with every tombstone exactly alike in both size and shape.

  I passed the buggy and realized I was avoiding thinking about the task at hand. Thanks to the information Ella found in the family Bible, I
knew where my grandmother was. The woman I had imagined all these years wasn’t whom I’d thought, but at least I had located her. And I had another cousin to meet and an aunt and an uncle. I passed the turn off to the Kemp and Gundy farm and came up behind another buggy. Maybe it was Nancy or Hannah or Alice. Maybe it was Ezra or Will. I sighed. If only my birth family were like that. I went around the buggy on the next straight stretch, giving the driver a wave and watching him nod in return. It was an old man, hunched over, his long gray beard hanging down against his chest, the collar of his jacket turned up on his neck. He held the reins loosely and seemed to be enjoying the ride.

  My heart began to race again as I neared the lane down to Klara’s. I turned and then stopped at the entrance to the lane, peering down the dirt road and then scanning the fields. I saw no one and began to ease my foot off the brake. There was nothing to do but get it over with.

  Just as I began to accelerate, my cell phone rang. I pulled it from the pocket of my jacket. It was Marta. I answered it cautiously.

  “I wouldn’t be calling if I had another choice,” she said. “Believe me.”

  I stopped the car again, in the middle of the lane. Believe her? She was unbelievable. That’s all there was to it.

  “But Peggy is in labor and her contractions are two minutes apart.”

  I thought of her trip to the big box store. Maybe it had been too much.

  “She lives close to where you are at—or where I think you are.”

  “I don’t have any equipment with me.”

  “I’ll meet you there with the bag.” She gave me the address and I jotted it down, hoping the GPS would be able to find it.

  “Thank you,” she said.

  I stared down the lane again. I could chance taking the time to try to meet my grandmother or I could go take care of Peggy. Contractions two minutes apart for a woman who’d already birthed nine babies probably meant she was breezing through the transition phase and was close to delivering. I didn’t actually know because I’d never delivered a mother with anywhere close to that many births. Right now my obligation was to Peggy, no doubt about it.

  I backed out of the narrow lane, keyed the address into my GPS, and turned right onto the highway, leaving the house behind. My heart rate slowed, even though I was hurrying to a birth. I passed the weeping willow trees where Zed and I had waited together just five days before. It seemed like a month ago already. A mile later I turned into a farmyard right on the highway.

  A girl older than Ella stood at the back door. “Hurry!” she called out. I raced toward the house. “She’s in her room.”

  A younger girl stood at the kitchen sink, washing dishes.

  I dropped my jacket on a chair. “Is your daed here?”

  “No,” the older girl said as I followed her down the hall. “He works construction. He’s on a job.”

  Peggy was wearing a dress, with no apron, that hung loose around her and she knelt beside her bed, her hands clasped as if she were praying. “I think it’s time,” she said.

  I asked the older girl where the bathroom was, and she pointed across the hall. I told Peggy I would be right back after I scrubbed. I pushed my sleeves to my elbows and began washing my fingers, hands, and forearms. If Marta didn’t arrive soon, I wouldn’t even have latex gloves.

  By the time I was scrubbed and back in the room, Peggy was on the bed. A minute later, the baby came out with one push and I caught him easily. Baby number 257. He howled right away, a good sign considering I didn’t have a bulb to clear his airway. I ran my finger through his mouth, and it came out clean.

  I cut the cord with a pair of sewing scissors, sterilized by the oldest girl under my instruction, cleaned up, and had Peggy in a fresh white nightgown and the little boy nursing in no time. The older sisters came in and out of the room, bringing food to their mother and blankets for the baby. I didn’t have scales to weigh the little one, but I guessed he was close to seven pounds. The four-year-old, also a boy, wasn’t much interested in the baby, but he came in to say hello and then returned to the yard to play with his toy trucks.

  It was nearly an hour later that Marta arrived with the medical bag. I was surprised to find Ella with her. They waited as I finished up. When I weighed the baby, I wasn’t surprised to see that I had been right; he was seven pounds three ounces. After recording the details in Peggy’s chart, I filled out the certificate of live birth and then added a worksheet detailing how to apply for the Pennsylvania birth certificate—not that Peggy would need it. Having been through this nine times before, she’d already had plenty of experience.

  When I was finished, Marta pulled me aside and handed me another chart. It was Esther’s.

  “She’s in labor,” Marta said. “That’s why I took Ella out of school—to go with you to help with Simon.”

  I nodded.

  “Will you go?”

  “Of course,” I answered. Did Marta think me heartless?

  I gave Peggy’s daughters instructions to walk with their mother when she got up to go to the bathroom, to make sure they gave her plenty to eat and drink, and to call my cell phone if anything seemed amiss with their mother or the baby. The girls nodded as if they didn’t need my instructions, even though it had been four years since there had been a birth in the family. I took a final look at the baby boy, etching him into my memory, thinking “Peggy’s baby.” She said she wouldn’t name him until her husband arrived. Her oldest daughter had tried to call the cell phone of one of the men he worked with, but the call had gone into voice mail, so her husband didn’t even know that he was now the father of a tenth child.

  As I walked to my car, I checked my phone. Sean was available for lunch, but I texted him back to say I was involved with an unexpected delivery and would have to touch base with him later.

  By the time Ella and I followed Marta out of the driveway, it was eleven fifteen. “There was a full moon last night, right?” I was joking. I’d recently read a study that debunked the lunar effect theory as an old wives’ tale.

  “Mom always says women are more likely to deliver during full moons.”

  “People have thought for years that it was the pull of gravity because our bodies are eighty percent water,” I said. “But the full moon theory has been proved wrong.”

  Ella scowled and said whatever the reason for it, it was true.

  I changed the subject. “Peggy’s daughters sure seemed to know what they were doing.”

  Ella gave me a funny look. “It’s not like they haven’t done all of this before.”

  “It’s been a few years.”

  “You expect too little out of people,” Ella said. We rode in silence for a moment and then she spoke, a little hesitantly. “Peggy already had her oldest daughter when she got married.”

  “Really?” I wasn’t sure if I was encouraging Ella to gossip, but she definitely had my attention.

  “Yeah. Peggy got pregnant by her boyfriend. She thought they were going to get married. But then he didn’t want to join the church and she did. So she had her baby and joined the church. Later she got married to someone else and started having all those other kids.”

  My instincts had been right. Not all Amish would give up a baby for adoption. My situation could have been handled differently…

  Oops. Here I was again. Back to speculating.

  We passed back by the willow trees and then the lane to Klara’s house. As we neared the road to the Kemp and Gundy place, I noticed Ella’s nose was against the window. A roar filled the car. I slowed. Sure enough, coming up the road was Ezra on his motorcycle, his red hair sticking out from under his black helmet. Ella smiled. He must have spotted her because he pulled out behind us and followed closely. I slowed, allowing more distance between us and Marta, who was still ahead. On the straight stretch Ezra passed, waving and smiling. A truck came over the crest of the hill opposite him, and he darted back into his lane just in front of us. A half mile later he pulled over to the side of the road, and we passed
by as he waved again.

  I accelerated. “How long have you known Ezra?”

  “Since we were kids. Mom would visit his grandma.” She paused. “They used to all be friends.”

  “Aren’t they still?”

  “Sort of. I guess. Not like they used to be.”

  “They seemed friendly enough last week when we were there for Hannah’s appointment.”

  Ella nodded. “We just don’t see them much anymore, but I used to play with Ezra when we were little. He’s two years older.”

  Marta turned off toward her cottage, and Ella and I continued on to Lancaster. I asked if her mother pulled her out of school very often to help with a birth, and she said no. Esther had asked if she could come to take care of Simon though, because she didn’t have any family to help.

  When we arrived at Esther’s, she called out that the door was unlocked. We entered and found her stooping at her desk, her hands on her keyboard. David was in the kitchen, and Simon was sitting on the floor of the living room, wailing. When he saw Ella he stopped for a minute, gulped a breath of air, and then started again.

  “He’s been this way all day,” Esther said, straightening up. She nodded toward her computer screen. “I have a paper I need to finish editing. It’s due tomorrow.”

  I wondered if we’d come too early; if Marta had overreacted out of her devotion to Esther and her family. The woman didn’t look as though she was in labor, let alone ready to give birth.

  David strolled into the living room, stepping over the screaming Simon. He shook my hand and said, “So you will end up delivering our baby after all.” He smiled widely.

  “It looks that way,” I said, glancing at Esther. “How far apart are the contractions?” Marta had said three minutes.

  Esther held up a hand. Was she having one now? A minute later she said, “I quit keeping track.” She turned back toward her computer. “I just have a few more minutes on this, and then I can send it off.”