The Reluctant Midwife

Blum now stands in the doorway wiping Danny’s tears, but when he takes in the scene, he whips around so the child can’t see. It’s not easy to estimate the amount of blood when it’s spread all over the place, but from all the surgeries I’ve assisted with, it looks like a couple of pints. The human body I remember contains eight to ten. If she loses much more, she’ll go into shock.

I put my hand on her uterus. It’s rock hard but there’s a baby inside, so old Mrs. Potts’s hemorrhage tincture can’t help us. “Daniel, quit blubbering and let’s find out what’s going on. Can you take her blood pressure?” I fly downstairs, grab my medical kit, and return, flinging the cuff and stethoscope across the bed.

“Patience, listen to me. Take slow, deep breaths. I’ll do a vaginal exam and see if we have time to get to Torrington.” I’m surprised to hear myself speak with such authority. I almost sound like a midwife.

“Oh, Becky. The pain. It’s here all the time and it just gets worse with contractions. I feel like I’m going to rip apart.”

“I know, Patience.” I suck in a big breath and blow out through my lips. “I know. But breathe. Breathe like this. In . . . Out . . . In . . . Out.” I demonstrate and she copies while I sit down on a corner of the wet bed, warm with Patience’s life fluid, and pull my red rubber gloves over my shaking hands.

Abruption

“Blood pressure, seventy-six over fifty. Pulse one twenty,” Daniel spits out. He’s quit crying and wipes his face and nose with a clean corner of the sheet.

I slide my fingers into Patience’s vagina and another blossom of blood spurts out. Blum now stands at the door again, but without Danny. Somehow, he’s gotten the child quieted and back in bed, probably gave him a cookie.

“I’m abrupting. I know I am. The placenta is shearing off,” Patience whispers. “I’ve already lost two babies this way.” Another twisting pain comes and she stops to get through it, sweat beading on her brow. The contractions are two minutes apart.

“Only four centimeters dilated,” I report to the group.

“Shit,” says Daniel. “I was hoping for eight or ten.”

“Check our baby. Check the heartbeat.” That’s Patience. She’s weak but still with us, the infant her chief concern.

“Do you think we can make it to Torrington?” Daniel turns to me. “The snow’s really coming down now, but I could put chains on.”

I take Dr. Blum’s stethoscope, place the silver headpiece over my brow, and lean down to listen to the fetal heart rate. At first I hear nothing and hold up my hand to quiet the room. Then from underneath Patience’s rapid pulse, I catch a slower tick tick and tap the air with my finger to show them the rate. Daniel looks at his watch.

“Eighty,” he announces. “Too slow?” Patience starts crying again.

“Oh, save my baby, Becky. I’ll push now! I can push! I don’t care if my cervix rips.” She sits up in bed and another half cup of blood spurts out of her.

“What’s it supposed to be!” Daniel yells at me.

“One hundred and twenty to one hundred and sixty.”

Patience begins to breathe as if she’s been running, gulping for air. “Daniel, turn up the light. It’s getting dark,” she cries and then collapses back on the bed. He reaches over, his face almost as white as hers, and takes her pulse again.

“One eighty, maybe. I can barely feel it.”

Shock

“Time to go,” Hester says, pulling himself together. “We have to cut. We have to do a cesarean section. Here, Blum, give me a hand. We’ll move Patience down to the kitchen. The bottle of ether is in the hall closet. Becky get the table ready and pull it away from the stove. Ether is flammable. Then build up the fire and put on a pot of water.”

“Daddy?” It’s little Danny calling from his room.

“Not now, honey. Go to sleep. Mommy’s sick and we have to take care of her. Be a good little boy.”

“Daniel, can you do this? Patience is your wife,” I question. “Maybe I should do the surgery. I don’t want to, but I think I could. I’ve seen the operation so many times. She’s your wife, Daniel.”

“We don’t have time to argue, Becky. She’s going into shock. Just do as I say. How different can a woman be from a horse or a cow? I’m a veterinarian surgeon. A surgeon. The question is, can you do the anesthesia? That will be critical. Can you do the ether?”

“I have an anesthesia certificate from Walter Reed and I’ve done anesthesia for Dr. Blum.” I whip around and fly down the stairs. (He’s right! We don’t have time to discuss things.)

Within minutes, I’ve laid out Blum’s old surgical instruments, which fortunately were still wrapped in sterile cloth from a year ago. Patience is stretched out flat on the kitchen table and tied down with whatever we can find, apron strings, Daniel’s and Blum’s belts, and the long peach scarf that I wore to the ball.

It’s important that Patience not be able to move when she enters the excitable phase of the ether administration. I take a paper cone and sprinkle the anesthetic on it, not too much and not too little. This is familiar territory to me and I know how many drops from experience. Patience is still unconscious and still losing blood, not cupfuls, but in a slow trickle. There’s a trail of it down the stairs and across the oak floorboards.

Hester has scrubbed with soap and warm water from the reservoir on the side of the cookstove, and so has Dr. Blum, though god only knows what good he will be. Maybe Daniel plans to have him hold a retractor.

As soon as Patience is under, I nod to the doctors. Daniel stands with his scalpel above his wife’s belly and I can see that he really has no idea where to cut, side to side or up and down.

“On a woman you start midline about three inches above the umbilicus and go straight through for another three toward the pubis,” Blum shocks us with his unused voice, a rusty pulley in a well.

Daniel holds the scalpel out to him. “Please, man, I’m begging you. You do it. I know you can! Save my wife. Save our baby if it’s not too late.”

Patience moans and I give her a little more ether. “Daniel, cut! Or Blum! Someone cut now!” I command. “This baby can be out in five minutes.” It’s then that I see something I could never have imagined. Blum steps up and takes over. With one swift movement he slices through Patience’s pale skin.