The Secrets of Midwives (20 page)

I handed Molly her baby, and silence descended. Jimmy cried quietly. Molly stared at her baby and he stared back—an invisible cord of love connecting them. We all felt it. Magic was in the room. Magic that, perhaps, wouldn't have been there at the hospital.

“Would you like to try feeding now, Molly?” I asked. “It might help encourage the uterus to contract and expel the placenta.”

Molly did want to try feeding. I had some medication that would cause the placenta to expel, but my clients generally preferred not to use it. I was inclined to agree with them. The female body was remarkable at managing this process on its own.

I covered the bed in towels, and Jimmy helped Molly lie down. The baby latched on without too much effort, and I sat back and waited for the placenta to come.

Jimmy and Molly looked spent but happy. No matter how I tried, I couldn't envisage this scene in a hospital. Molly, I knew, would have been hysterical, in an environment that terrified her, surrounded by strangers. How wrong it seemed now that I'd even considered doing that to her. Here, on her own bed, she seemed calm, tranquil, and strong. Like every new mother should.

“Okay,” I said after fifteen minutes had passed. “Come on, placenta! Let's see what the holdup is.”

I felt for the fundus, which was contracting, but gently, and kneaded it with my hands.

“Is everything okay?” Molly asked, looking up from her baby for the first time.

“Fine,” I said. “Just giving your uterus a helping hand. Generally, I like the placenta to come out within half an hour. We still have time. Keep feeding. You're doing a great job.”

The baby continued to suckle happily at the breast. Jimmy fell asleep on Molly's shoulder. But ten minutes later, the placenta still hadn't come.

“Still nothing?” Molly asked. I could feel her assessing my face for worry, so I concentrated on keeping it straight.

“Nope. Not yet.”

“Are you worried?”

“No,” I said carefully. “But I would like it to come sooner rather than later. If you're comfortable with it, I'd like to give you a shot, to help it expel.”

She frowned, and I could see the wheels spinning in her head. I doubted she'd be opposed to the shot, but like most of my clients, she wanted to know there was a good reason for its use. “And if we don't use the shot?”

“Well, your placenta might come out on its own. Or there's a possibility that we may have to take you to the hospital. Even if I give you the shot, it won't guarantee that you don't have to go to the hospital,” I added. “But I'd say the medication is your best chance. Up to you.”

“Give me the shot,” Molly said without hesitation.

Three minutes later, Molly had a sharp contraction, and a few minutes after that, the placenta was delivered intact.

I stayed with Molly until the early hours of the morning, then wrote up the birth—for my own records—and began to pack up my things. It was Jimmy's idea for me not to write out the birth certificate. “If we don't tell anyone you were here,” he'd said, you can't get into trouble. We can just say we had the baby on our own. People do that, right? What are they called … free-birthers?” I told him I thought it was a wonderful idea. Too good to be true.

I left Molly a script for Tylenol 3 (the contractions caused by the shot could get quite painful) and promised to be back in a few hours. Then came the awkward part. I'd always liked the anonymity of the follow-up invoice for a few reasons. One, it felt wrong to put your hand out so soon after being part of something so intimate and special with a family. Two, it was usually the last thing on people's minds after welcoming a child into their family. But now that I was off the record, I didn't have the luxury of sending an invoice.

“Uh, Jimmy?” I hovered in the doorway. “Do you have a sec?”

Reluctantly, Jimmy left his wife and son and joined me in the hallway.

“Just about payment. Did you…” I couldn't seem to find the words. “Um, how did you want to … organize this?”

Jimmy's face pinkened. It reminded me that he'd recently been let go from his job. “Oh, yeah, um, sure. Hang on a sec.”

He sloped, teenlike, into the sitting room and unzipped the computer bag that was on the round dining table. He pulled out a wallet sealed with Velcro. “How much was it again?”

I bit my lip. “Um … well, three thousand.”

Jimmy nodded and looked back at his wallet. Already I could see that it contained nowhere near that amount. Desperately, he began to count out the notes.

“How much have you got, Jimmy?” I asked softly.

He looked up, shamefaced. I thought he was going to make something up, say it had been stolen or something, but he just sighed.

“About nine hundred. Could you take it as an installment? When I get another job, I can pay you the rest. I'm sure it won't take me long to find something.”

His face was such a departure from what I'd seen a few minutes earlier. The weight of responsibility was already falling on his shoulders, and I knew too well how hard that could be for a man.

“No, Jimmy. Forget it. You need this money more than I do.”

Jimmy was bewildered. “You mean … you don't want any money?”

The irony of what I was doing wasn't lost on me. Robert was down on me for taking unnecessary risks that could threaten my ability to support my family financially, yet here I was, taking risks for no money at all. Where would Robert's moral compass have stood on this? Was it further evidence of me putting my head in the sand, putting others ahead of our family? Perhaps. But I knew where my moral compass stood. And it was telling me this was the right thing to do.

I smiled. “You keep it. Use it to look after your wife and son.”

 

18

Floss

People tended to show their true colors in a crisis. Running for the hills with their heads covered or diving headlong into battle to save their peers. In my case, there hadn't been a battle—except, perhaps, the one inside my chest. Nonetheless, Lil had shown her true colors. She was a hero. And I'm sure she felt like she'd been to war.

She'd spent the past week ferrying my things over to the hospital, talking to doctors, cleaning the house. She'd called Grace and Neva daily with updates. She'd made so much soup that she filled the icebox and most of the refrigerator. She couldn't have got more than a few hours' sleep each night. Now it was time for me to show her what I was made of.

She perched opposite me on the sofa. Like props, mugs of steaming tea sat in front of us but I knew we wouldn't pick them up. After what I had to say, we'd probably need something stronger. At least, Lil would.

“So,” I said to her. “I suppose you want to know what has been bothering me.”

“I would.” Lil straightened up, her face a painful shade of earnest. “More than anything.”

I sucked in a breath. “Okay,” I said.”Here goes.”

Kings Langley, England, 1954

Elizabeth cradled her baby in the crook of her arm. The baby was small but healthy, with a tuft of copper hair and almost-white eyelashes. Like Evie said, the baby had obviously got what she needed from Elizabeth. And despite what Elizabeth had gone through, she managed to protect her daughter.

“What are you going to call her?” I asked.

“I … don't know.”

I cast my gaze down at the baby—pinker and more perfect than I could ever have imagined. “Well.… she's rosy-cheeked. How about Rosie?”

“No.” Elizabeth's voice was tight. “Not Rosie. Rose is Bill's mother's name.”

I raised my eyebrows. Elizabeth never spoke badly of Bill or his family. But fatigue had a way of bringing out the truth.

“I'll name her after my mother,” she said. “Can you take her?” She tried to hold out the baby, but didn't have the strength to lift her. “I have to deliver the placenta.”

She was right, of course. Still, I was used to new mothers fighting to keep their newborns close, in some cases even when they needed to use the ladies' room. I reached for the little bundle wrapped snugly in the towel and sat on the bed next to Elizabeth so they could still be close. I couldn't resist peeling back the towel for a better look. Her arms and legs were long and lithe like Elizabeth's, and her face was dainty. I couldn't see any immediate resemblance to Bill, a fact that pleased me no end.

I wrapped her up again and watched as the placenta expelled itself. Then, while Evie tended to a minor tear, I held the baby out to Elizabeth again. “Would you like to try feeding?” Although she was likely to have a low milk supply due to her poor nutrition, the sucking would help the uterus contract and return to normal. Information Elizabeth, of course, knew. So I was surprised when she shook her head.

“You don't want to feed?”

“No. I feel sick, Floss.”

“It's probably adrenaline.” I placed the back of my hand against her forehead. “You look a little pale. Why don't you let the baby snuggle against you, listen to your heartbeat—?”

“For heaven's sake, Floss, I don't want her!”

From the stool at the end of the bed, Evie raised her eyebrows, mirroring mine.

“All right, all right,” Evie said. She kept her voice light, but her expression was anything but. She gestured for me to feel Elizabeth's abdomen as her own hands were covered in blood. I did.

“Feels a little boggy,” I said.

Evie peeled off her gloves and rinsed her hands in the bucket of warm water by her feet, then took a seat at Elizabeth's side. I picked up the baby and moved out of the way.

“Can you look at me, love?” Evie said to Elizabeth. “Elizabeth, can you look at me?” When Elizabeth still didn't look, Evie grabbed her chin and turned it to face her. Her eyes were unfocused. “Floss, put the baby in the bassinet.”

Evie didn't yell, but the urgency in her voice made the hairs at the base of my neck stand on end. She felt Elizabeth's forehead with her palm, then reached for the thermometer on the bedside table. I raced to the bassinet and set the baby down.

“Go to my bag. There's some sterile gloves in the top, put them on. I want you to very carefully check the opening to her cervix. Just do exactly as I say.”

Although I was only a junior midwife, I knew enough to know that I should be worried. I somehow got my shaking fingers into the gloves and lowered myself onto the stool at the end of the bed.

“Okay,” Evie said. “You're feeling for a lump, a blockage, a clot. It might be small, it might not.”

Elizabeth's knees had fallen apart and I started my examination. Any concerns I had that I wouldn't know what a clot felt like were put to rest when I felt a soft mass at the entrance to the cervix. I circled the base of it. It was a clot; of that I was certain. A large one.

“Okay. I want you to pull it out.” Evie's voice was calm but urgent.

“Evie—” I said, “—it's big.”

“Just give it a gentle tug. If it's a clot, it will come free.”

I nodded, gripping the mass between my knuckles. I winged a prayer, then tugged. There was a large spurt of bright red blood from Elizabeth's vagina—enough to soak the towel beneath her bottom. It was followed immediately by a second spurt.

“Dear Lord,” I said. “She's hemorrhaging!”

“Get hold of her cervix!” Evie yelled, kneading Elizabeth's abdomen from the outside. “Hold it closed and massage. Massage, Floss! We need to get it contracting or she will bleed to death.”

I did as Evie asked, forcing my gaze from Elizabeth—lying peaceful-looking on the bed—to the rivers of blood that streamed from her. Come on! I kept massaging.
Our Father, who art in heaven …
Beside me, Evie also prayed. We needed prayers. The flow seemed to be slowing. Usually, I would locate the nearest phone to call the flying squad, but that wasn't an option now. It was a two-mile bike ride to the nearest phone booth, and Elizabeth wouldn't last that long.

“She's contracting,” Evie said, after a few—five?—silent minutes had passed. “How is the bleeding?”

“I can't see any bleeding,” I said. “But my hand is in there, it's hard to tell.”

“Take your hand out, Floss. I'll keep massaging from the outside. We need to know what is happening.”

I hesitated. “Are you sure?”

She nodded.

“Okay.” Slowly, I released the neck of the uterus, and a gush of blood followed my hand.

“So?”

“It's heavy.”

Evie pushed me out of the way, reaching inside Elizabeth now with an ungloved hand. I massaged Elizabeth's abdomen. Her uterus felt spongy. Panic hit; a fist to the gut.
Contract, Elizabeth! Contract
. I kneaded the fundus aggressively. Elizabeth was drenched in sweat and pale. Too pale. She was in shock. “Evie—should I try to get the baby to suckle, do you think?” I asked. “To help the uterus contract?”

Evie was barely visible at the end of the bed, but I saw her shake her head. I could hear her panting with effort. It would be okay. It
had
to be okay.

A minute passed, then another.

We continued massaging, inside and out, in silence.

Ten minutes passed.

Evie's panting slowed, then stopped.

Fifteen minutes passed.

My breathing also quieted.

Elizabeth was still, like she was asleep.

The silence was eerie. I watched what I could see of Evie's face, waiting for direction. Her frown, etched so deeply into her forehead before, had disappeared, replaced by a … a different expression.

“Evie?” I asked. There was a wobble in my voice that, for some reason, I wanted to conceal. As if its presence were admitting something I wasn't ready to admit. “What … what do you want me to do?”

Evie met my eye over Elizabeth's belly. Her expression was frighteningly blank.