Midwives (35 page)

Charlotte’s brother-in-law hugged his wife against his chest with one arm, and slowly she settled down. Stephen and the trooper resumed their debate, and although my mother was absolutely convinced that the idea hadn’t even crossed Rhodes’s mind that morning that a crime might have occurred, the trooper just kept repeating, “A woman was dead, and I knew the medical examiner would be the one to determine the cause of death.”

Later that day Peter Grinnell told me that as pleased as Stephen had been when Charlotte’s sister finally quieted down, Bill Tanner was probably even happier: The last thing the prosecution wanted was a mistrial because some family member couldn’t stop crying.

Two weeks before the trial began, I listened to my mother on the phone with Stephen Hastings. It was late: The dinner plates were tucked in the dishwasher, my father was upstairs in bed. My mother had already taken a bath.

“Sure, I’ve met male midwives,” she was saying, and I wondered if she knew I was nearby. She was curled up on the couch in the den in a cotton nightgown, and I’d come downstairs for a history book I’d left on the kitchen counter.

“No, not anymore,” she continued. “I don’t think there are any more right now in Vermont or New Hampshire. The few there were went on to other things.”

I might have gotten the textbook and then left, but I heard her giggle, and the sound of her laughter had become so rare that I was unable to leave without hearing more.

“You’d be terrible, Stephen, just god-awful. You view breasts like a teenager. I hate to think of the way you’d handle a prenatal! You’d have too much fun … Yes, but it’s not that kind of fun … Maybe someday I will, sure … With books and pictures … With books and pictures only …”

I’d seen my mother flirt lightly with the men she and my father had known for years, the male halves of the couples that formed their circle of friends, but I’d never imagined her flirting with one on the phone. Perhaps because my father was absent, perhaps because she was wearing a thin, almost transparent nightgown, this seemed more illicit to me, and I found myself frozen in something like wonder.

“It’s not an aphrodisiac, I promise. I don’t think male ob-gyns go home hot and bothered, do you? … Well, you’re a pervert … Then maybe you’re all perverts! But I don’t really think so. Fortunately, the kind of men who become midwives or ob-gyns don’t have your uniquely weird one-track mind,” she said, and for a brief moment her voice had the sparkle that once brightened most of her conversations.

“Hold on, will you, Stephen?” she said suddenly. “Connie? Is that you, sweetie?”

I stood perfectly still until she started speaking again. When she did, finally, I turned and tiptoed back up the stairs as fast as I could.

Perhaps because I had a vision in my mind of how most of my mother’s midwife friends dressed—the jeans and the sweaters, the big boots and the sandals, the endless number of peasant skirts that must have come from walk-in closets the size of bedrooms—I was unprepared for the two women who testified just after lunch: a midwife, followed by an ob-gyn who had once been a midwife.

The midwife, Kimberly Martin, even looked like a doctor to me. She was wearing a woman’s blue business suit, and she had short, fashionably teased hair. It was easy to see her in loose hospital scrubs.

I also noticed she had an engagement ring on her finger but no wedding band, which surprised me as well: She was probably a good ten years older than my mother, and apparently about to be married.

“How long have you been a certified nurse-midwife?” Tanner asked her.

“Fourteen years.”

“Would you tell us what it means to be a certified nurse-midwife?”

“First of all, we’re all registered nurses. That’s basic. We have formal medical training. Secondly, we’ve all graduated from one of two dozen advanced-education programs around the country that focus on women’s health care and midwifery. Third, we’ve all passed the certification exam given by the American College of Nurse-Midwives. Finally—and personally, I believe this is very important—we all meet the requirements of the health agencies or medical boards of the state where we practice.”

“And you have still more training, don’t you?”

“Well, yes, I have a master’s. From Marquette.”

“Are you a member of the American College of Nurse-Midwives?”

“I am. This year I’m also part of the Division of Accreditation.”

Tanner smiled as if he was pleasantly surprised, and I wondered if he hadn’t known this detail. “How many nurse-midwives are there in this country?” he asked.

“About twenty-five hundred.”

“Do most nurse-midwives deliver babies at home?”

“Oh, no, just the opposite’s true. The vast, vast majority of us work in hospitals or birthing centers—almost ninety-five percent of us.”

“What about you?”

“I have delivered babies at home, but I haven’t since I was much younger. I prefer birthing rooms in hospitals.”

“Why did you stop delivering babies at home?”

“In my opinion, it’s needlessly risky.”

“Did you have a bad experience?”

“Thank God, I didn’t.”

“What made you think it was dangerous?”

“Education. The more I learned about obstetrics, the more I realized that allowing a woman to have a baby at home exposed everyone—mother and infant—to completely unnecessary hazards.”

…

“You said roughly ninety-five percent of nurse-midwives work in hospitals and birthing centers. So that means roughly five percent don’t?” Stephen asked Kimberly Martin.

“Yes.”

“That five percent: Do they work in homes?”

“Yes.”

“Do they have a higher infant mortality rate than the rest of the group?”

“No, they don’t.”

“About the same?”

“The numbers are small, so it’s hard to make a statistical comparison.”

“Bearing in mind the numbers are small: About the same?”

“Yes.”

“How about maternal mortality? Do you see a greater incidence of maternal mortality among midwives delivering babies at home?”

“No.”

“In fact, did any nurse-midwife in your organization see any woman die in home childbirth last year?”

“I don’t think so. But that doesn’t diminish—”

“In fact, none died, Miss Martin,” Stephen said, cutting the woman off before she could elaborate on her answer. “Did you know Bell Weber?” he then asked.

“I did.”

“Would you tell us who she was?”

“She was a nurse-midwife. She died this summer in a car accident.”

“Did she deliver babies at home?”

Martin nodded. “In Maryland.”

“Was she a member of your group?”

“Until she died.”

“Was she on the Division of Accreditation with you?”

“Yes.”

“Was she on any other committees for the American College of Nurse-Midwives?”

“She was chairing the home birth committee.”

“Your organization has a home birth committee? Really?”

The midwife looked annoyed with Stephen, disgusted at the flippant way he’d asked the question. “Obviously we have such a committee.”

“Is that because some midwives in your group still choose to practice there?”

“Yes.”

Stephen nodded. “Does the American College of Nurse-Midwives formally oppose home birth?”

“No.”

“Thank you.”

Kimberly Martin was followed by another woman who had once caught babies in people’s bedrooms, and then, apparently, decided this wasn’t a particularly good idea. A few minutes after she began answering Bill Tanner’s questions, I must have looked worried or nervous, because Patty Dunlevy turned to me and whispered that we had experts, too, and ours would be every bit as impressive as these people.

But that afternoon it was hard for me to believe we’d have anyone as accomplished as Dr. Jean Gerson. Thirty years earlier Jean had been a young midwife delivering babies at home; now she was an ob-gyn affiliated with a teaching hospital in Boston, a faculty member at Boston University’s School of Medicine, and the author of two books on prenatal care.

She had also written extensively about the history of birth in America. It was she who reminded us early in her testimony that while labor is natural, it’s dangerous: “Let’s face it,” she had added, “there was a time when women and babies died all the time in labor.”

Dr. Gerson had reviewed the medical history Charlotte Bedford had supplied my mother the summer Veil was conceived, and she had examined the records my mother had kept, charting the woman’s progress. And she told the jury that no responsible person, doctor or midwife, would have allowed Charlotte Bedford to labor at home. It was clear based on her first labor that she was a poor candidate for home birth, and it was evident during the pregnancy that she was too frail for the ordeal. She wasn’t gaining enough weight, and she was anemic.

Moreover, Dr. Gerson was positively telegenic. She was a handsome, dignified woman who smiled when she spoke, the sort of person who was instantly likable at even the sort of distance—figurative as well as literal—that separated defense and prosecution tables in a courtroom. Years later when I was in medical school, I would recall her face and her voice, and I would find myself wishing I had gone to B.U.

Ironically, a part of my mother’s defense was the fact that Charlotte was indeed an imperfect candidate for a home birth, but not because she was anemic: Stephen planned on making an issue of the fact that Charlotte had been treated for hypertension in Alabama but had never shared this information with my mother. And so when he stood to begin his cross-examination of Dr. Gerson at the end of the day, the sun so far to the west that the courtroom was lit almost solely by the big chandelier and the sconces along the walls, we all expected the two would have a brief and perfunctory conversation.

“Are many pregnant women anemic?” Stephen asked her, and I was surprised by the energy that still filled his voice. It may have been because I had been up so late the night before, and it may have been due to the stress, but I was exhausted. I couldn’t imagine where Stephen got his strength.

“I wouldn’t say many are ‘anemic,’ but I would say that many experience some small degree of anemia,” she answered.

“Why is that?”

“When a woman is pregnant, her blood volume increases. Sometimes it increases by as much as half. And so there’s a natural dilution, and a natural anemia.”

“Is it treatable?”

“Yes.”

“How?”

A newborn baby in the back of the courtroom started to whine and fuss, and I heard the sound of the long zipper on the front of his mother’s dress. I saw many of the jurors glance reflexively in the woman’s direction, and then Judge Dorset looked that way, too. Almost instantly all of the men turned away when they saw the woman place the nipple on her full breast into the infant’s mouth, deciding to stare intently at Stephen or the doctor instead.

“Iron tablets. Ferrous sulfate, usually.”

“Any side effects?”

“Indigestion sometimes. Often constipation.”

“You said you’ve reviewed how Sibyl treated Charlotte Bedford’s anemia, correct?” Stephen asked.

“That’s right.”

“What did Sibyl do?”

“She had her take iron tablets.”

“Did her condition improve?”

“Not enough to merit—”

“Did Charlotte Bedford’s condition improve?”

Dr. Gerson offered a broad smile that suggested to me—and I have to imagine to the jury as well—that she wouldn’t stoop to Stephen’s level of discourtesy and debate. If he wanted to interrupt her and cut her off, her smile said, fine. It made no difference to her.

“Yes,” she said.

Stephen asked the court officer who was standing beside the rolling cart upon which Bill Tanner was piling his evidence for the medical records the State had just entered. He then handed the physician two sheets of paper lined with boxes and graphs.

“Do you recognize these?”

“They’re the records your midwife kept of the deceased.”