The Midwife of Hope River

Lilly

The third time I tiptoe down the hall, Mrs. Wade follows. “Can I peek too?” I nod reluctantly. At least she’s getting the idea that we want to disturb them as little as possible. When a laboring woman has found a successful routine, you don’t want to break it.

In the dim room, lighted only by a gas lamp, Lilly now swings her hair and moans, then closes her sightless eyes and takes a deep breath.

“They’re getting stronger, Mama, but don’t worry.”

“Okay, sweetheart. I’m so proud of you.”

“How did she know you were standing with me?” I ask when we’re back in the kitchen.

“Smell,” the patient’s mother answers. “She says my distinct smell is like bread baking. Will she need a birth bath?”

That takes me aback. Then I remember Prudy’s wild labor and how I invented the “birth bath” just to get Mrs. Wade, Priscilla Blum, and my nervous friend Becky out of the way. Apparently, she now thinks a bath is the latest thing for women before they deliver.

“Do they have a tub?”

“Just a little one. Nothing like the Ott home.”

“Well, we’ll see. It couldn’t hurt, but she might not need it. Prudy was awfully tense. Lilly is loose as a goose, which is what you want . . . until pushing. Then you hope the woman can bear down like she means it.”

By the sounds in the bedroom, I can tell that the contractions are coming one after the other. “Can you boil the water? It might be soon.” Mrs. Wade stands up and bustles around, glad to be put into action, and I slide back into the bedroom.

“Oh, Patience, I don’t know if I can do this!” Lilly complains when she hears me approach. “It hurts like the dickens!”

“It won’t be much longer. If it helps, you can lean on the baby a little, nothing too forceful. No holding your breath.” I picture just a rim of the cervix left, and I’ve found that at this stage, between letting go and bearing down, it helps to give the patient something to do. Any time now, I expect her voice will drop and we will know that the baby is coming.

Bitsy stands back and puts one arm around my waist. We both find pleasure in watching a woman who’s comfortable with her body. Each time a contraction comes, Lilly’s blind eyes get big and she takes a few breaths, then holds on to her husband and rocks back and forth.

“Should I get out of the way soon?” B.K. asks nervously. “There’s a shipment of canned goods down in the store that need shelving—”

“No, sir, Mr. Bittman!” This is Lilly. “I want you here. You helped make this baby, you can damn well help me get him out!” That seems to settle the matter. B.K. shrugs. Bitsy catches my eye. Now we know for sure that birth is imminent. When a well-bred woman begins to curse, she’s nearly ready.

“It’s fine either way, B.K.,” I reassure him. “I’ve had several fathers stay for the delivery, and they were very helpful. That’s one thing about giving birth at home. In the hospital, the papa would never be allowed in the delivery room, they’d be afraid he’d faint, but here we can do what we want. If your being in the room will help Lilly, we don’t mind.”

B.K. stares at the bottles of tincture and olive oil, the sterile packs of scissors and cord, the packages of rags we’ve laid out on the bureau and turns, overwhelmed, but before he can slip away another contraction comes on and he’s called into action as Lilly’s leaning post.

The beginning of the pushing stage isn’t clear; no dramatic “Uggggh!” But after our patient has been bearing down in earnest for an hour, I call Mrs. Wade to bring the hot water. It isn’t Mrs. Wade but Mr. Wade, eyes averted, who carries in the steaming cast-iron kettle.

“How you doin’, honey babe?”

“Want to stay, Daddy?” Lilly asks, surprising us.

“No, ma’am!” he says good-naturedly, backing out of the room. “I’ll be in the parlor with my head under a pillow.”

“Lilly knows Pa by the smell of his tobacco and the sound of his size-thirteen shoes,” Mrs. Wade explains, slipping past him from the hall.

“I can hear you, Mama!”

The soon-to-be grandmother puts her hand in the shock of red curls and pulls gently. “We are never going to get the knots out of your hair.”

Just to be dramatic, Lilly thrashes her hair around like a cabaret singer. Then a contraction hits, and she goes back to work.

Caulbearer

Bitsy smooths the covers, giving me the signal that she thinks it’s time to get the patient into bed, but I shake my head no. Lilly hasn’t complained of burning at the opening, so I think the baby’s not there yet.

“Oh, honey, oh, honey,” Mrs. Wade fusses, watching her daughter’s face turn beet red and the veins bulge out on her neck. “I’m so sorry you have to go through this.”

“It’s okay, Ma. How do you think babies get born?” Lilly says with a laugh between contractions. B.K. rolls his eyes sympathetically toward his mother-in-law.

Finally I intervene. “Would you want to lie down for a minute, Lilly? See if it’s time?”

“Do you think it could be?”

“Soon, yes. I think so.”

The patient waddles over to the bed. B.K. lowers her down in front of him and is wedged against the headboard with his wife almost in his lap. When she spreads her legs, my mouth falls open and Bitsy and Mrs. Wade gasp. It is not a hairy little head sitting at the vaginal opening but a strange smooth wet orb, unearthly, the intact water bag. I’ve never seen a baby born in the caul before. The new mama reaches down to feel it.

“Is this the head? Is everything all right? It’s so squishy.” Lilly’s fingers are her eyes, and she keeps tapping the bag, confused. B.K. turns away, afraid to look.

“It’s the baby’s sac. Your water still hasn’t broken. The old midwives say it’s a lucky sign, to be born in the caul. Keep pushing!”

Lilly does what I tell her, and I step back to give Bitsy an opportunity to catch the baby. She’s done most of the labor coaching, and it’s clear from the birth at Hazel Patch a few days ago that I won’t always be at her side.

My partner moves in with her sterile gloves on, and I pull on mine too. The head, or the head inside the water bag, emerges slowly, and the bag gets bigger and bigger but doesn’t pop. The slippery sac gradually dilates everything until the baby, water bag and all, slips into Bitsy’s hands. She looks at me as if to ask “What now?”