The Midwife of Hope River

by Patricia Harman

  There’s the secondhand davenport Mrs. Feder gave us for helping with the birth of her daughter-in-law’s twins. I’ve covered it with a blue-and-white quilt that I made myself in the flying goose pattern. There’s a pine table I pulled out of the cellar and sanded till it looks almost new. There are shelves of worn chestnut barn boards for books and a potbellied stove in the corner. (The cookstove and the heater stove, an oak rocker, two iron bedsteads with feather mattresses, and the bicycle were all that we found when we moved here.)

  Other than that, there’s just the ornate black-and-gold mantel clock that Mrs. Kelly brought on the train from Pittsburgh and the piano, a used dark upright I bought for thirty dollars when the Mt. Zion Church purchased its organ. That was back when I could get work now and then and still had some cash. Now the jobs have dried up, and, let’s face it, there’s not much money in delivering babies.

  Whether a birth is long or short, I’m always done in when I get home. I step out of my shoes, flop down on the sofa, and glance at the painting on the whitewashed pine wall above me.

  My baby’s father painted that oil portrait when I was sixteen. Lawrence was a student at the Art Institute of Chicago then. In the picture, a girl stands on a pier overlooking Lake Michigan with a strand of long loose auburn hair across her face. Her head is thrown back and she’s laughing. That girl was me, Elizabeth Snyder. I adopted my alias, Patience Murphy, when we left on the run from Pittsburgh, and the name fits now, has a nice ring. Patience Murphy. Patience the midwife . . .

  Lawrence, my first husband—I call him my husband, though he died before we could marry—was a scene designer when I was a chorus girl at the Majestic Theatre. I had lied to get the job, told everyone I was eighteen, and got chosen out of a queue of girls because of my voice. The House of Mercy Orphanage was probably glad to be rid of me. One less mouth to feed.

  I throw some wood on the coals in the heater stove, fill the teakettle with water from the bucket, and pull the rocker up to the fire. Light fills the room through the two tall front windows.

  Why didn’t my baby live? Katherine’s lived.

  I think I know the answer, have read about it in DeLee’s heavy text. My afterbirth, or placenta, as Dr. DeLee refers to it, separated too early, an obstetrical emergency, and they didn’t do cesarean operations routinely then, certainly not on an orphan like me. I experienced two deaths in two weeks: Lawrence’s in the train wreck and then the baby’s. I still don’t know how I made it, didn’t crumble into dust. Somehow I went on, as we all have to go on; stuffed my grief in my pocket like a chunk of black coal and stumbled forward. I carry it still, but over the years the lump has grown smaller, harder, like a diamond.

  The girl from so long ago stares out across the inland sea. Birth and death, so intertwined. Love, birth, death, my trilogy.

  There’s a distant moo from the barn. My animals! I had stayed for breakfast at the MacIntoshes’ . . . sausages, biscuits, and home-canned peaches with maple syrup, a real celebration breakfast, Big Mary called it. We three ate in the kitchen, Bitsy, Mary, and I, after we helped Katherine clean up and dress in a dark blue silk robe so that she and Mr. MacIntosh could enjoy breakfast together.

  Now it’s past noon, the chickens haven’t been fed, and poor Moonlight’s udders must be bursting! The cat, Buster, is okay because I leave a bowl of milk on the stoop and he can find field mice and chipmunks. My beagles can hunt, but the critters confined to the barn this time of year are helpless. I grab a clean metal bucket from the pantry, step into the high black rubber boots I keep on the enclosed back porch, and curse myself for my forgetfulness.

  When I pull open the double barn doors, the animals’ cries assault me. The chickens are squawking, and poor Moonlight moans in pain. I throw the fowl their grain and toss hay into the cow’s stall, then sit down on my three-legged stool and beg her forgiveness.

  “I’m so sorry, girl,” I apologize. “I was at the MacIntosh house in town all night. I still can’t believe it! I was sure their baby was dead. I listened so long for a heartbeat . . . I even had Dr. Blum check. Katherine told me that for over two days there’d been no movement.

  “Now I feel foolish, and by tomorrow every woman in Union County will know I’m inept. Even though Dr. Blum was there to confirm the stillbirth, I’m the one they’ll blame.”

  As I rhythmically express the milk from the tense udders, I look around this warm space, the sunlight coming through the cracks high above me, the rough golden walls and the hand-hewn oak beams. There’s the smell of hay and sweet manure. Moonlight looks around, sympathy in her brown eyes. She accepts me just as I am, energetic or tired, inept or confident, in love with life or walled off in pain.

  3

  Summons

  On the way back to the house, with my bucket of milk and six eggs in my pockets, I laugh as the wind sweeps the red and yellow leaves off the maples and oaks and scatters them across the blue sky. There was a time, after Mrs. Kelly died, that I didn’t notice such things, just kept my head down, plodding along, careful not to step in the puddles of my own tears.

  It happened our second spring here, a sudden massive heart attack, Dr. Blum called it. One afternoon, coming in from the garden, I found my dear Sophie slumped on the sofa. On some dark nights, she’s sitting there still.

  I ate little, lost weight, stopped washing my long hair. There was no more singing as I worked or dancing in the field on a sunny day. I’d come to a similar black place not long before, after Ruben died at Blair Mountain, but experiencing loss is not something you get used to. The more death one experiences, the more painful it is. For almost a year, I hovered on the edge of my own dark grave; then one afternoon I raised my head, sniffed the air, and recognized the changing light. It was spring again.

  “Grief takes about a year,” Mrs. Kelly once told a young mother who had lost her son. “You have to get through each holiday, each new season. You will cry at Christmas and New Year’s and Mother’s Day and Thanksgiving. You will suffer with the first daffodil, the first falling red leaves, the first snow . . . Each occasion, each new season will rip your heart out; then, when there’s nothing left, you’ll get better.” She was right, and she knew from experience.

  Sophie, like me, had suffered great loss: her sister from typhoid fever when she was little, her mother from stomach cancer, and, worst of all, her young husband and daughter in that big flood in Pennsylvania, the one in 1911 where a thousand people died when the pulp mill dam broke and flooded the whole town. My teacher, protector, and friend had lost everything, home and family, all in one day, and had been found, more dead than alive, a mile down the river, hanging on to a tree limb. For a while, she told me, she wished she had died. I know the feeling.

  In the kitchen, I wash my hands again, wipe my glasses, then tenderly clean the brown eggs and gently place them in a woven basket. I strain the milk though cheesecloth and pour it in a clean gallon jar. Through the small window over the sink, the green hills tumble toward the valley where the Hope River twists, fuller now than in summer.

  I am just getting ready to pour boiling water from the top of the woodstove into the washtub to rinse out some necessaries when I spy a small figure moving up the hill, a solitary fellow who leans forward on his burro as if in a hurry. He’s leading a second animal. At the first mailbox, the Johnsons’, a half mile away, he stops and looks at the name, then stops again at the second, the Maddocks’, and moves on up the mountain. I have a sinking feeling he is coming for me.

  Carefully, I haul the jar of milk out to my springhouse, where cold water collects in a rock basin and stays cool all summer, and when I come back, I see a tall black man tying his two animals to a tree. He’s wearing a gray fedora and a gray canvas jacket that’s torn at the sleeve, maybe a miner looking for help. The companies used to have their own physicians, but most of them are gone now, the best of them anyway. Sanitation and health conditions are so poor in the mining camps that Dr. Blum refuses to go into them.

  The man
tips his dusty felt hat. “I’m Thomas Proudfoot, Mary Proudfoot’s son. Izzie Cabrini, one of the miners at King Coal, asked me to fetch you. His woman’s in trouble.” I know what the word “trouble” means.

  “How long’s she been paining?”

  “A day, maybe two.”

  These cases worry me. I don’t know the Cabrinis and have never been to the King Hollow Coal Camp. I don’t know if the missus is too early or too late or what the situation is.

  “Has she had babies before? Won’t the coal camp foreman drive her to the hospital in Torrington?”

  Thomas shakes his head no.

  “Doesn’t King Coal have a doctor?”

  Thomas looks me right in the eye and shakes his head no again. I see by his look that he’s an intelligent man who believes this is wrong but knows enough to keep his mouth shut.

  Coal Camp

  It’s three miles on rocky dirt roads to King Coal, and we move right along, although burros are not much for hurrying. Three vehicles overtake us, and we have to get down into the ditch while they pass: a Pontiac roadster, a Ford Model T, and a John Deere tractor, moving just a little faster than we are.

  I think of the Frontier Midwives in Hyden, Kentucky. I’ve been told the nurses ride horses into the hollows and over the mountains to attend the laboring mothers. Maybe I should get a horse! I brighten at the thought, but at once my hope dims. Money would be the problem. I don’t have more than a few dollars, and Mr. MacIntosh didn’t offer me anything except a ride home. Maybe they’re still in shock that their dead baby lives.

  I cringe again, thinking of my mistake and how it will look to the community. Maybe people will just chalk it up as a miracle! The baby was dead, but it came back to life! Maybe they’ll say that I performed the miracle. Not likely.

  At last we arrive at the mining village. The King Coal camp is a ramshackle community set up along King Lick. Though the camp has been here only five years, the water in the creek is already brown and the rocks have turned yellow from the mine’s acid runoff.

  Coal camps that are unionized have a one-room schoolhouse, basic cabins for the miners and their families, a clinic, and a store, but this camp, from the looks of it, is a makeshift affair, no unions, no benefits, nothing. The houses are little more than shacks.

  Passing us, a ragged line of men wearing metal hats with lights on the front turn to stare. Their faces are so covered with coal dust, their eyes are the only thing alive, and you can’t tell by looking who’s Scotch Irish, who’s Negro, who’s an Italian brought in by the coal barons to work the black gold. Five years ago, 20 percent of the miners were black, former sharecroppers who found better work and better money by leaving the South. Now, with the closing of the mines, the numbers are way down. Trailing along behind the men are two little boys not more than ten, also wearing miner’s hats.

  When we lived in Pittsburgh, Mrs. Kelly, Nora, and I fought alongside the International Workers of the World, the Wobblies, for the Child Labor Amendment of 1919, but the Supreme Court shot it down. Somehow the judges believed the federal government didn’t have a right to regulate the industrialists and it would be just fine for young children to work in sweatshops or miles underground.

  Trotting hurriedly through the village on the burro, I make note of the lack of outhouses. There’s not one privy anywhere, and when it rains the human waste seeps into the ground and runs downhill to the communal well. Despite the chill in the autumn air, children play barefoot in the yellow-brown creek. A rail-thin woman wearing a thin blue-and-white-flowered feed-sack dress walks out on her stoop and throws the water in her dishpan across her yard.

  At last Thomas halts in front of a sloping black tar-papered shack where a girl of about eight watches the road through the dusty four-pane window. The youngster’s face brightens, and she announces my arrival to whoever’s in the room. From the looks of the place, this is another birth for which I won’t be paid, and it’s not because they lost their money in the stock market, either.

  The dark man helps me off my burro, hands me my satchel, and prepares to leave. “Thanks for escorting me, Mr. Proudfoot.”

  There’s just the flicker of a smile. “Ma’am,” he responds, tipping his hat. That’s all he says; then he’s gone.

  Delfina

  Stumbling up the rickety steps with my birth satchel, I wish Thomas Proudfoot had at least stayed to introduce me. Inside, who knows what I’ll find? But before I can knock, the door flies open.

  “She’s doin’ poorly,” a nervous man says. His little mustache quivers, and his large brown eyes with long lashes illuminate his worried face.

  I take in the room. Newspapers cover the interior walls to keep out the wind. There are two big beds, a worn sofa, a rocker, and a cradle. In one corner, a crude kitchen counter has been put together with shelves of weathered boards. The iron cookstove, a wooden table with six unmatched chairs, and the one lightbulb that hangs on a long cord from the ceiling—that’s all there is.

  I’m surprised to see that the family has electricity, but remind myself that all coal camps do. The mines need electric power to bring mechanical shuttles up on tracks. It used to be donkeys that brought the coal out; before that, men were used as pack animals, and before that, children and females because they were small.

  A woman lies moaning under a tattered brown quilt in one of the rumpled beds. Three little boys dressed in rags sit at the table, hiding their faces, but the girl, still perched on the windowsill, looks right at me. Nobody smiles. Nobody says hello. I’ve entered a Charles Dickens world.

  I skip the introductions. They know who I am. “How long has she been having pains, Mr. Cabrini?” When she hears my voice, the woman on the bed looks up, and I see that she’s about my age, maybe younger. Her curly brown hair is matted on one side, and her face is flushed and sweaty.

  “Since last night.” The man has a strong Italian accent, and I wonder if his wife and children speak any English at all.

  “Is she leaking fluid?” Cabrini shrugs that he doesn’t know.

  “Is your water trickling out?” I direct my question to the woman louder than I need to. Why do we always increase the volume when we think someone can’t understand?

  “Her under-bloomers is wet,” the girl tells me. Obviously, the daughter speaks a little English.

  Four children. The patient may have delivered several more that died at birth or a few months later. Infant mortality is high in the mountains. If a mother has ten children and she’s impoverished, without good sanitation, two, at least, will die. Even in the best of conditions, like those of Katherine MacIntosh, the chance of stillbirth or death within the first year of life is one in ten.

  I turn to the girl. “What’s your mother’s name?”

  “Mama.”

  “Delfina,” the man corrects.

  “Delfina.” I sit down next to my patient and place a hand on her shoulder. “Delfina, my name is Patience Murphy. I’m the midwife.” I dropped my married name, Gordesky, after Blair Mountain, and I say “midwife” with reservation following my blunder at Katherine’s delivery.

  “I know you’re weary and have been in labor for a long time, but could you roll on your back, please, so I can check you?” Her pains, by the change in her breathing, are mild and about every five minutes; she hasn’t had a strong one since I entered the room. This is not a good sign. We want robust contractions to get the baby out, and if the womb is exhausted, it won’t clamp down afterward and the mother will bleed.

  I turn to the mister. “We’ll need boiled water. Have the boys bring a bucket from the well. Send them outside while I figure out what’s going on. Your daughter can stay. I might need her.

  “Can you roll on your back after the next pain?” I ask the mother again.

  The girl says something in Italian, and her mother rolls slowly, dragging her belly along with her hands, then plopping it down. I note the dried blood on the inside of her legs when she pulls up her shift.

  The first
thing I do is listen to the fetal heart rate with my wooden horned fetoscope. I do so with dread, afraid of another stillbirth, but finally find the tick-tick-tick high on the abdomen, higher than I’d expected.

  By Mrs. Kelly’s gold pocket watch, which I wear just as she did, on a ribbon around my neck, the infant’s heartbeat is regular, about 140 beats a minute, and I’m grateful that Delfina’s skin is still cool—no fever yet.

  The next thing I check for is the presenting part. I run my hands over Delfina’s abdomen, searching for the baby’s head. Finally I think I find it, a hard bulge the size of a small acorn squash on the right side, almost out of the pelvis. Too high.

  A couple of explanations come to me: This mother has had more than five children, and her abdominal muscles and womb are so flaccid that even a full-term baby could float around in there any way it likes. Or, and this is potentially more serious, something is blocking the opening, a large fibroid tumor or, even worse, the afterbirth, stuck low in the womb.

  The safest thing to do would be to leave at once for Liberty and get help, but that option isn’t open. We have no transport except Thomas Proudfoot’s burros. And even if the camp boss would drive us, on these steep, winding country roads it would take over an hour to get to the big hospital in Torrington. Finally there’s the issue of money. It’s clear that Mr. Cabrini doesn’t have any. Dr. Blum, in Liberty, has told me before that he can only afford to take paying patients, and God knows what the hospital in Torrington costs.

  I open my case and pull out the new rubber gloves I didn’t have time to use at Katherine’s birth. They’re still clean, sterilized with bleach, and wrapped in roasted newspaper. The only way to find out what’s going on is to do an internal examination, but that’s risky, and also against the law.

  The West Virginia Midwifery Statute of 1925 bans midwives from doing internal exams. We are also “expressly forbidden to assist labor by any artificial, forcible or mechanical means, or administer, advise, prescribe, or employ any dangerous or poisonous drugs.” The local medical societies jealously guard their right to prescribe and treat. In addition, the law requires that we must be “of good moral character.” I smile to myself. That leaves me out.