The Amish Midwife

by Mindy Starns Clark

  “Sounds familiar,” I said. It had to be Giselle. Avoidance was a family trait. Feeling weak, I slid down onto a chair.

  “I emailed him back and asked him what last name the woman goes by. I also asked him if he would ask her for her email address.” He glanced down at the screen and then back up again, squinting a little. “Maybe I can chat with her directly.”

  I wanted to hug him but settled for patting his back.

  When I crawled into my alcove bed, I prayed that somehow, someway Ada would be willing to get tested. Then I prayed again for Caroline. Just as I was drifting off to sleep, my phone rang. It was James.

  I answered with a sleepy hello, and he asked how Caroline was. I gave him an update. He said he’d been praying. He said he was sorry he called so late. He just wanted to tell me “sweet dreams.” I was too tired to ask him about classes or the orchard or anything else. After we said our farewells, I realized I felt a peace I hadn’t for years, as if someone were tucking me into bed. Was it Mama I was feeling in my sleepy state? Or Dad? Maybe it was James. And then I realized it was none of them. After Mama died, when I used to talk to God nonstop, it was almost as if I could feel Him tuck me in at night—not physically but spiritually, right before I drifted off.

  “I’ve missed You,” I whispered, as I slipped into sleep.

  The next morning Ada sent me a text at five thirty saying to pick her up at the end of the lane at nine twenty. I left the house with a few hairs from the locks tucked inside an envelope in my purse.

  After I discreetly handed Chuck the envelope, he swabbed Ada and me and then we both hurried up to the pediatric ICU. So far that morning, Sophie and James had both texted me to ask how Caroline was, and Mrs. Glick and Mr. Miller had each left a voice mail message on my phone, asking the same. I needed an answer so I could get back to all of them.

  Ada waited outside while I checked in with the nurse and then slipped through the door. I gasped at first—the isolette was empty. But then I spotted Esther in a rocking chair off to the side of the big room, holding Caroline in her arms, the tiny infant still hooked up to an IV and oxygen and bundled in a blanket.

  “How is she?” I knelt down in front of Esther. She wore the same pair of sweatpants and pink T-shirt from the day before.

  “Doing better,” she answered. “She had a couple of rough moments during the night, though.”

  “You must be exhausted,” I said, patting her hand.

  She nodded and then went back to staring at her baby.

  “You should go home and rest.”

  She didn’t answer me.

  When I went back out into the hall, Sean was talking to Ada. They looked like quite the pair, he in his lab coat and dress slacks, she wearing a burgundy dress, white apron, and cap. They seemed to be chatting up a storm, and Ada must have explained what I’d been doing.

  “I didn’t realize you knew the baby who came in yesterday,” he said.

  “I delivered her,” I answered, surprised he would have heard about Caroline. I knew my voice sounded defensive, but I could imagine the talk going around the hospital about the home-birth baby. “And it’s viral pneumonia caused by a respiratory infection,” I said, needing him to know that the source of her illness was a common cold, not a bacterial infection from birth.

  He held up both hands and grinned, his blue eyes dancing. “Whoa. No one’s said otherwise.”

  I relaxed, a little.

  His voice dropped and he leaned closer, as if he were going to tell us an important secret. “I was thinking about the praise meeting going on in the lobby last night. All sorts of people praying and singing, ‘The Lord giveth and the Lord taketh away, blessed be the name of the Lord’ and stuff like that. It was a little weird. I felt like I was back home.”

  A nervous smiled crossed my lips and I glanced at Ada. She had a blank expression on her face.

  “No harm intended,” Sean said quickly to Ada.

  “I don’t think the Amish have prayer meetings like that,” I said.

  Ada agreed and Sean shrugged, grinning again.

  “Anyway,” I said, desperate to change the subject, “Ada and I both got swabbed.”

  “So I heard,” Sean said. “Chuck will get right on it. You’ll know in a couple of days.” He turned to Ada, charming as ever. “It’s so nice to meet you,” he said. “I hope I’ll see you again soon.” He started down the hall but then pivoted around.

  “Hey, have you heard anything on your house?”

  “Nothing yet.” Darci hadn’t called me and, frankly, I was too anxious to call her.

  “That’s too bad.” He grinned. “I accepted the offer on mine.”

  I gave him a smile and big thumbs-up, and then he turned back around and continued to walk away.

  TWENTY-SEVEN

  He seems really nice,” Ada said as I drove down Queen Street, heading out of town.

  I agreed, though I was still a little taken aback by his comments about the people praying for Caroline. But the truth was, until recently I might have said the same.

  “Did he give you this bag?” she asked, holding up my purse. “It’s a Coach, right?”

  I was dumbfounded. “Really? You know what a Coach is?”

  “Ya,” she answered. “You’d be surprised at what Amish women know about.” She put it down on the console between us. “It’s nice,” she said. “The purse. So is Sean.” Her voice held a hint of teasing. “Are you two courting?”

  I smiled. The word was so old fashioned. So innocent. “No. And we’re not dating, either. I guess you could say we’re just friends.” Of course I was lying. I was contemplating moving to Baltimore, for goodness’ sake.

  “How about you?” I asked. “Is anyone courting you?”

  Ada blushed. “No,” she answered. “And I’m not dating anyone, either.” She gave me a sly smile and then burst out laughing. I had to laugh with her as I thought of Will Gundy stopping by to visit her while her parents were gone. Maybe we were both lying. Then again, his wife had only been dead three months. Perhaps his interest in Ada was strictly neighborly.

  Once the laughter stopped, she asked me about Marta and the case against her. After I told her everything I knew, Ada said she wondered if Lydia’s death had anything to do with her poor health.

  “Pardon?” No one had said anything about Lydia being in poor health.

  “Ya,” Ada said. “She used to have spells. She was an eighth grader, and I had just started at school. I was sickly myself, so I noticed that sort of thing.”

  “What was the matter with her?”

  “I don’t know exactly, but she would get tired and have to sit, although she never drew attention to herself. Then, when she was older and out of school, there was a period of time where she didn’t get out much at all, not even to church. The rumor was she was very ill.”

  As I came to a stop at the light in Willow Street, Ada gazed out the window at the strip mall. “I wondered if having the twins was too much for her, even though she had them in the hospital. And then she got pregnant again so soon.”

  No one had said anything about Lydia going to the hospital to have the twins. Surely she hadn’t had a C-section. If she had, Marta would have insisted she have the next baby in the hospital too, although there were midwives who did deliver a vaginal birth at home after a C-section.

  “What does Marta say?” Ada asked.

  “Not much. Just that she didn’t do anything wrong.”

  Ada sighed. “That’s what Will says too.”

  The light turned green and I accelerated. “Do you see him much?” I blushed as soon as I spoke. After all, the man’s wife had died only a few months before.

  “You saw him that one day, ya?” Now it was Ada’s turn to blush.

  I nodded.

  “He was driving by and thought he would stop by to visit Daed. He didn’t know my parents were gone.”

  I turned off the main highway onto the country road that led to Klara’s farm.

 
“He just talked about his girls. How they’re doing.” Her gaze drifted out the window. “He said next time he’ll bring them by. I’d like that,” she said, her voice soft. “I’d like that a lot.”

  Given Ella’s interest in Ezra, it looked as though both my cousins—or whatever Ada was—were falling for a Gundy brother.

  I thought through that family tree again. Alice gave birth to Nancy, who married Benjamin and gave birth to four kids: Will, Hannah, John, and Ezra.

  Will married Lydia, who gave birth to three kids: Christy, Mel, and Mat.

  Hannah married Jonas, gave birth to Rachael, and was expecting another baby soon.

  John married Sally, who was currently expecting their first child.

  Ezra. Well, and then there was Ezra—wild, charming, motorcycle-riding Ezra. I didn’t know whether to smile or cry. Would Ella someday be around the big dining room table feasting and laughing with the Gundys too, alongside him? Or maybe Ada, alongside Will?

  Again, I felt a twinge of jealousy.

  Marta showed up at the cottage that afternoon, explaining that a woman from her church had dropped her off. I was alarmed, afraid Caroline had taken a turn for the worse, but Marta assured me that the church had rallied and another woman was staying the night and caring for Simon the next morning. She said Caroline was getting better, and they hoped she would be discharged the next afternoon.

  My relief must have been obvious because she patted my shoulder. It was the most affectionate she’d been with me.

  That evening as Marta and I did the dishes, I brought up the subject of Lydia and her general health.

  “She was fine,” Marta said. “Her blood pressure ran a little high but not dangerously so.”

  “She had plenty of energy?” I asked as I dried a plate.

  “I wouldn’t say plenty, but she had enough to do what she needed to do.”

  I asked if she’d had a C-section with the twins.

  “No.”

  I bit my lower lip as I dried another plate and then said, quickly, “Do you still have her chart or was it taken by the DA?”

  “The DA’s office made a copy and took that. I still have the original.”

  “Mind if I take a look at it?”

  Marta turned her head toward me. “Why ever so?”

  “I’m curious, that’s all.”

  She shook her head. “There’s nothing in her chart. My lawyer hired an expert to go over it, and it offers no more information to the case.”

  I put the plate in the cupboard, bumping it against the stack. She hadn’t told me yes, but she hadn’t told me no, either.

  Marta pulled the plug to the sink. “I’m tired.” She yawned, covering her mouth with her forearm. “Poor Simon was up half the night crying for Esther. David and I took turns with him, but we weren’t who he wanted.”

  I didn’t dare go out to the office while Marta was still up. It would be too obvious. Then I remembered that I had appointments in the morning. I decided I could wait to look at Lydia’s chart then.

  Sometime during the night I had a text from James asking how Caroline was again. I saw it in the morning and texted him back. Better. Thx for praying.

  My first appointment was at nine, but I was in the office by eight thirty and pulling the Gundy, Lydia file from the cabinet. In midwifery a mother’s chart, besides keeping all the information on hand for the midwife, is the legal document of care. It safeguards both the caregiver and the mother. From what I’d seen, Marta’s records were clear, concise, and accurate.

  I worked my way backward through Lydia’s chart, starting with the death of the baby. 4:32 a.m. stillborn baby boy delivered by C-section at Lancaster General…4:10 a.m. mother DOA at Lancaster General…mother on life support, taken by ambulance to Lancaster General…EMTs arrive at patient’s home…CPR administered for 15 minutes…patient stops breathing, eyes roll back…3:05 a.m. called 911 against patient’s wishes…baby’s heart tones at 95…patient instructed that transfer to hospital is necessary; patient declines…patient’s blood pressure 160/110…Marta should have called 911 once Lydia’s blood pressure spiked, but it might have only been another minute, just long enough to check the fetal tones, which were dangerously low. At that point, in a hospital, the mother would have been whisked down the hall for a C-section.

  I kept reading. 2:45 a.m. urge to push… 10 cm dilated… Labor had started at ten thirty p.m. the day before, January 29. At the appointment the week before, Lydia’s blood pressure had been 120/90, not too bad for a woman nine months pregnant. The cervix was thinned and dilated to two. The baby’s head was in a good position. There were no indications, at that point, that Lydia’s and the baby’s lives were in danger. I kept flipping back through the chart. At one appointment Lydia’s blood pressure was 140/110, and Marta had instructed her to see her doctor. At another her pulse was elevated, 120.

  I flipped to the birth of the twins. They had been delivered by a doctor at the hospital and not by Marta, but the chart from the birth had been copied from hospital records and included here anyway. According to the notes, Lydia’s blood pressure was fine through the ten-hour labor and also through the delivery. It seemed like a best-case scenario situation for the birth of twins.

  Christy’s birth was nine years before the twins’, and there was no explanation for the gap. No record of miscarriages, stillbirths, or lost babies. Labor had been longer, fifteen hours, but not bad. There was no indication of high blood pressure, although Lydia’s pulse had run high at a few appointments. Gravid 2 was marked at the top, which meant Christy was her second pregnancy.

  Her second pregnancy?

  I thought about that and finally decided that maybe she’d had a miscarriage before. Because Amish women often didn’t seek medical attention until well into their second trimester, a lot of miscarriages were likely missed. It could be that Lydia had had an unconfirmed one. I flipped to the next page.

  Primigravida was marked, indicating her first pregnancy. Continuing backward through the file, I read Marta’s notes about that birth, a healthy baby boy, though no date was listed. In fact, I realized, none of the entries related to this first birth had dates next to them. Odd. It wasn’t like Marta to be so sloppy. At least, from what I could tell, the birth and pregnancy were uneventful. Turning the pages, I finally came to the very first entry in the file, when Lydia was five months pregnant with her first child.

  Smoothing the pages back into place, a wave of grief washed over me. Will had lost his wife and not one but two sons. I closed the chart as my first patient of the day opened the door. But instead of the person I was expecting, I saw Hannah, Will’s sister.

  I quickly turned Lydia’s chart over on the desk, hiding her name.

  “Do you have a minute?” she asked.

  I glanced at the clock. I had five. I nodded.

  “Will was headed to the feed store, so I hitched a ride. I’ve been having nightmares. I know it’s because of Lydia, but I keep dreaming this baby dies. And that Rachael dies. And that Jonas dies.” I hadn’t met her husband yet. “I’m hardly sleeping, and I wake exhausted from my dreams.” It wasn’t unusual for women to think they were dreaming excessively. In reality they were waking excessively and remembering their dreams. Although I was sure the content of a pregnant woman’s dreams did tend to be bizarre, likely due to fluctuations in hormones.

  I talked with her about exercise and showed her a few breathing techniques. Then I gave her a bottle of valerian tincture and told her to mix it with water or juice. “And talk about how you’re feeling with someone.”

  She tilted her head as she took the bottle and looked confused.

  “Or write it down. But you can’t keep it bottled up inside, Hannah. This has been a huge loss for all of you.”

  “She had a premonition.” She sighed and shook her head. “I’m not saying I’ve had a premonition. I’m just saying I’m having nightmares.” She stepped toward the door. “But Lydia was afraid something bad was going to happen.”r />
  I’d heard of that before, but usually there was nothing to it. “Hannah.” I wasn’t sure how to phrase my question. “Did Lydia have any miscarriages or stillbirths?”

  She shook her head.

  “Did she lose any other babies?”

  “No.” She appeared absolutely sincere. “Why?”

  “Oh, I’ve just been trying to figure out what happened that night.” I smiled and stepped toward the door after her. “I’ll see you Monday.” She’d just started her ninth month and so would have appointments on a weekly basis from now on.

  “See you then. And thank you,” she replied.

  Before closing the door behind her, I looked out, noticed Will waiting in the buggy, and gave him a wave. He waved back, a smile on his face, completely unaware that I had been in here snooping through his late wife’s medical records. Heat burning my cheeks, I hurried back into the office to refile Lydia’s chart.

  I did pray for Hannah, and I also prayed I’d have a chance to talk with Will in person, alone, when I was at the Gundy and Kemp farm. Three days later I headed over there, surprised to find that just driving down the lane made my heart race. I knew Will had bought this farm from Burke Bauer, the man who Mammi claimed was my biological father. If that was true, then that meant this had once been my father’s home, my family’s land. Trying to wrap my head around that, I made my way past the greenhouses and parked beside the smaller residence. As I climbed out and grabbed my bag from the trunk, the back door to the big house opened and Will stepped onto the porch.

  “Hello,” I called out.

  He shaded his eyes against the morning sun and then smiled once he recognized me.

  “Hannah has an appointment,” I said.

  “Ya. She’s over here.” He started down the stairs. “She’s having a difficult time, thinking about Lydia and all.”

  I nodded.

  “Oh, that’s right. You already know. I took her by your place Friday.” He pulled his straw hat over his red hair. “Seems everyone is having a hard time.”