The Midwife of Hope River (7 page)

“Mrs. Potts, can we get her bottom up in the air? I need her buttocks to be higher than her chest, upside down almost. Some pillows?”

Despite her apparent fragility, the old lady has quite a voice, and she whips into action. “Samantha, Mildred, Emma!” she calls as if with a bullhorn. “We need every pillow from the bedrooms upstairs, and I mean now.”

I have no idea which of the three ladies lives in this well-appointed log home, but within two minutes the room fills with feather pillows. I wince, seeing the lace-trimmed pillow slips. They won't look so nice with blood on them. “Bitsy, get rid of those nice covers. Can we get some towels too?”

My helpers assist me to build a pile of pillows about two feet high, which we cover with towels. I then have Emma and Mildred lift Cassie's bottom up on the cushioned platform. It sinks down, of course, but I've still achieved my objective. As the patient's buttocks go up, the baby recedes and only the wrist and hand stick out. When we see the fingers move, everyone cheers and the mother smiles for the first time.

“Mrs. Potts,” I address the elderly midwife, “I'm going to flex the arm at the elbow and push the hand in. Then I'm going to push up on the shoulder. When I tell you, can you guide the head down? Maybe one of these ladies can help if you get tired.”

The old lady rolls up her sleeves. “Here, Mildred.” She takes one of the tall woman's hands and places it under her own arthritic fingers exactly where I want it. This birth is becoming a real community event.

“Everyone ready? Cassie, don't push! Don't push until we get the head in the birth canal and get rid of the pillows. Mrs. Potts will tell you when it's time. Once you begin to push, don't stop for anything.”

I think of the cord, the possibility that it's wrapped around the baby's neck. Except for the arm hanging out, this is so much like Delfina Cabrini's birth at the King Coal camp. The woman called Samantha begins to sing in a low voice,
“Joshua fit the battle of Jericho, Jericho, Jericho.”
A fighting song!

“Joshua fit the battle of Jericho and the walls came tumbling down.”
The other ladies join in, even Bitsy, everyone but Mrs. Potts and me. I'm way too busy worming my way up the birth canal.

This time, because of the tilt, the shoulder is much higher and I'm almost up to my elbow when I begin to nudge it to the left with two fingers. Mrs. Potts senses what I'm doing and begins, at the same time, to slowly guide the head down on the right. It helps that the patient has had several babies; I have room to work in.

Cassie is getting more and more uncomfortable, and Bitsy tells her to pant. The laboring woman's eyes are so big I think they might pop, but she doesn't cry out. She just pants like Bitsy instructs her and I wonder how my new assistant knows how to do this; she's only seen one birth, Katherine MacIntosh's.

By the placement of Mrs. Potts's and Mildred's hands, I can tell that the head's coming down nearer and nearer to the brim of the pelvis. To make room, I slowly slip my hand out, and the head follows easily into the space.

“Okay, push now, honey,” Grace Potts commands. “Push with all your heart!”

The aunties whip the pillows away and help the mother sit up in bed just as the head with long black curls crowns at the opening.

“Sweet Jesus! I'm gonna faint,” the shorter of the trio exclaims and feels for a chair as the baby shoots out, dragging an afterbirth that looks like a two-pound calf liver. The cord is only eight inches long! Quick as a wink Mrs. Potts ties it off and hands the baby to Mildred, who wraps the tiny crying girl in a clean towel.

“Praise Jesus!” “Thank the Lord!” everyone exclaims.

Another healthy baby. If I believed in God, I would bow down . . .

 

Hemorrhage

The blood that follows within minutes is the real emergency—as if an arm presenting weren't bad enough. I start massaging the womb, talking to it as if it could hear. “No, you don't. You stop bleeding! Stop it right now!”

“Get your fist back in there,” Mrs. Potts orders. I know what she means, but I've never done it before. It's called, by DeLee, bimanual compression. There's a picture of the procedure in my obstetrics textbook. “Use your other hand on the outside. Fold the floppy uterus over your fist and hold on tight.” The older midwife spits out her instructions as she fumbles behind her for a small brown bottle on the dresser. “Drink this,” Mrs. Potts commands. Bitsy holds the flask to Cassie's lips.

Potts is in total control now and the blood is slowing, so I try to remove my hand.

“Not yet,” she directs.

I go back in and hold on when I see the hemorrhage start up again.

“Vinegar,” Potts demands, and the shortest of the three ladies trots to the kitchen, returning with a small ceramic jug. The midwife pours the pungent liquid over one of my sterilized rags and hands it to me.

“Clean her uterus out. There must be clots. The vinegar will help stop the hemorrhage while the blue cohosh and shepherd's purse tincture that we gave her takes effect. Any time a woman has pain with no progress, be ready for this. If the bleeding doesn't stop pretty quick, we'll try ice.”

At the sight of so much blood, the three musketeers, Mildred, Samantha, and Emma, have backed out the door with the baby. Bitsy takes Cassie's hand, softly singing
“Joshua fit the battle of Jericho . . . Jericho . . .”
into her ear to keep her calm.

“Ice?”

“Ice in the uterus will cause the blood to contract.” I think she means blood vessels, but I don't ask. I've read about surgeons using ice to stop a hemorrhage during a cesarean section, but it always seemed to me it would cause such shock that a woman would die of chill instead of blood loss.

Mrs. Potts takes Cassie's wrist while she stares at her gold wristwatch, the kind nurses have, and her lips move as she counts the patient's pulse. “You are such a good girl, Cassie. We'll have you fixed up in a minute.

“Go, ahead, bring the rag out and all the thickened blood you can find,” the elderly lady instructs me. When I do what she says, I find myself holding a handful of clots the size of chicken gizzards. Mrs. Potts then takes over and from the outside squeezes the uterus like she's wringing out a dishrag. More clots plop out, and I wipe them up.

“All right, then!” the old midwife calls. She takes a big breath and kisses her patient on the top of her head. “You can stop rubbing now. Bitsy, check every few minutes and make sure the womb stays firm.” My assistant—I think of her that way already—knows what to do from Katherine's birth. Tears are streaming down both sides of Cassie's face. “Let's give the mama her baby and get it on the teat. That will help them both feel better.”

 

Still shaking as I wash up at the kitchen sink, I take a big breath. Bitsy cleans up the bedroom, and Mrs. Potts dresses the infant's cord. Outside, the sky lifts the pink hem of its nightdress along the eastern edge.

“Here, honey.” Mildred, who turns out to be the baby's granny and the mistress of the house, hands me one of her clean housedresses to wear over my top. She points down the hall. “You can change in my bedroom.”

“Mr. Miller! Reverend Miller! All clear!” She calls out the back door to her husband and the menfolk hiding in the barn. “Come on in. Food's on the table!”

By the time I've tidied up, the three cooks are harmonizing in the kitchen.
“There's a rainbow 'round my shoulder and a sky of blue above.”
A catchy Al Jolson song. The older midwife pads down the hall, smiling, and shocks me when she does a little boogie at the kitchen door. In the parlor she sits down to reorganize her birth kit, so Bitsy and I sit down beside her.

“I try to keep everything fresh,” she tells us, giving instructions as if she's talking to herself. “You never know when you might be called again . . . not that I go out as often as I used to.” Her little brown eyes sparkle at Bitsy, then at me, and I wonder which of us she's training. “Do you need some of my bleeding medicine? I have an extra bottle.” She holds a glass vessel out and I take it, grateful for the gift.

“What's in it, again? Is it something I could make myself, or is it private?” In the Appalachian Mountains cooks jealously guard their recipes for black velvet cake, potato salad, fried chicken, and sticky buns. It might be the same with medicinal tonics.

“Don't be foolish. If it could help save a mother's life, of course I'd want you to have it.” She proceeds to write down, on a torn piece of wrapping paper, the herbs she uses and how to prepare them as Mildred pokes her head into the hall.

“Come on, Auntie Potts! You're first to eat and then Patience.” I smile at their thoughtfulness and am a little surprised when I enter the kitchen. In this household, at least after the hard work of birthing, the women eat first. Three black men stand back, leaning against the wall or the counter, eyeing the food. There's Thomas, our escort; Darwin Washington, the father of the new baby; and an older gentleman I take to be the reverend. Then there's the women bustling around, a sea of black and brown faces, with mine as white as the full moon in October. I note that no children are present and decide that in this tight-knit community, there would be plenty of willing attendants down the road.

As if she lives here, Bitsy steps up to the table and begins to serve collards and mashed potatoes, along with meat sandwiches on homemade white bread. Mildred takes a breakfast tray into the bedroom for Cassie and Darwin.

“They give her a name yet?” Thomas asks when Mrs. Miller returns.

“Couldn't be more fitting.” The grandma laughs, glancing out the window toward the crystalline trees. “An old-timey West Virginia name.” Everyone stops chewing and waits. “Icey.”

 

“Good-bye.” “God bless.” “Thank you so much, girls!” We are standing on the porch staring out at the glitter that covers every twig and branch. The holly bush by the Millers' front door is sheathed in ice. Even the power lines that come up the drive droop low and are hung with icicles. Reverend Miller, the grandfather of the infant, stands and stares across the yard. “We don't have much,” he says, shaking hands with me, “but what we have is yours. Please call on us for anything.”

I cannot help comparing this joyful scene with the Cabrinis' isolation in the coal camp or the MacIntoshes' seclusion in their brick mansion. The feeling in this happy home gives rise to thoughts of my time in Pittsburgh with the suffragettes, radicals, and union organizers of both colors, and a shadow passes over me. Gone are those days, and they can never come back. I must stay here, on the edge of the world . . .

When the sun rises over the mountain, we are blinded by light.
“Morning has broken,”
I sing the old song.
“Like the first morning . . . Blackbirds have spoken . . . like the first bird.”

 

November 28, 1929. Quarter moon waning.

Arm presentation delivered with Mrs. Potts, colored midwife of Hazel Patch. Female infant. Icey Washington. Second baby of Cassie and Darwin Washington. I had to go inside and push the arm back and out of the way while Mrs. Potts held the head down. No vaginal tears. After the birth, the arm was very swollen and blue but seemed to bend without making the baby cry. I was proud of myself for figuring out what to do, but then there was heavy bleeding. Mrs. Potts showed me how to do womb compression, which I had read about, and she gave me her recipe for an herbal tincture. Weight 6 pounds, 15 ounces. Present, Mrs. Potts, Bitsy, who was a great help, and all the Miller women and the other ladies, whose full names missed me.

Afterward I explained everything to Bitsy, just like Mrs. Kelly once taught me. How you have to watch women who've had more than five babies for malpresentation and hemorrhage. Their womb is so stretched that a baby can flop around any old which way in there and it doesn't clamp down well afterward. Bitsy paid attention as if someone's life might depend upon that knowledge . . . which it someday might.

Payment, one fine ham and a sunrise.

Winter

10

Solitude

“I don't think I should go!” Bitsy worries as I step out of my high boots after feeding Moonlight. She has just taken a bath in the washtub in the middle of the kitchen, and her body, wrapped up in a sheet, steams when the cold air hits the room.

“Of course you should! The arrangement's been made, and the MacIntoshes are counting on you. Besides, you'll have time to spend with your mother. I'm sure she misses you. Katherine and the baby too.” I take my chair and reach for my plate of corn bread and baked beans, salted with the last of the Millers' ham.

“But I worry about you all alone way out here, Miss Patience.”

This really irks me.
“Miss
Bitsy,”
I spit out, “I've told you before to drop the ‘Miss Patience.' You're not my servant. Anyway, I got along last winter alone and I can do it again for a few weeks this year. You'll go and have a good time while Mr. MacIntosh pays you.”

This part I wonder about, since he's never had the money to pay
me.

“He promised he'd give you five dollars for helping Mary over the holidays,” I continue my argument. “Five bucks would go a long way this winter. Maybe you can even bring home some more coal and tea. Maybe some sugar and flour. That's cash money, and you know we need it.”

“But it's
Christmas.
You shouldn't be alone.”

“Really, it doesn't bother me. I don't believe in all that.” I know this hurts Bitsy. We've talked religion a few times, how I grew up Presbyterian but lost my faith a long time ago. She grew up in the A.M.E. church, African Methodist Episcopalian, and hates to hear me talking like a sinner.

The discussion is cut short by the sound of an automobile laboring through the mud on Wild Rose Road, and Bitsy runs upstairs to get ready. Mr. MacIntosh is here, right on time, and after he wipes his feet, he takes a seat on the edge of the sofa. He takes a deep breath and looks around curiously.

“How are Katherine and the baby?” I ask to fill the silence.

“Good. Great.” He strokes his sandy mustache. Must have been a real looker when he was young, as handsome as Katherine is beautiful, but worry now alters his face. “Her mother and sisters are coming up on the train from Baltimore for the holidays. Bitsy will be a big help.” Despite their new poverty, the MacIntoshes will put on a big show for their relatives. Upstairs Bitsy clumps around, packing her few belongings.

“Radio out of Wheeling says a massive storm's coming,” William says, changing the subject. “Big snow from the southwest. They're always the worst, the ones from the south. You better get some more wood in.” It's the second time recently that some fellow has felt the need to advise me about basic survival.

I glance toward the window. The shadows of low gray clouds skim over the mountains. He could be right, but the ground's still bare and the sun shines intermittently. In five minutes, Bitsy is dressed in a full-length navy coat, a hand-me-down from Katherine MacIntosh, and standing on the porch with tears in her eyes. I hold out her Christmas present, a pair of green mittens that I knit for her, and she hugs me so tight I lose my breath. It's the first physical sign of affection she has shown, and I find myself grinning. Except by a few of my mothers, I don't get hugged often.

“Really, Bitsy, I'll be okay.”

Then the sound of the auto fades as it takes the bend on Raccoon Lick and I'm alone. Still no snow, but the air is colder and the pale dove sky has turned slate. “Alone,” I say out loud as I smile, then tidy the kitchen, bring in more wood, and get out my yarn to begin knitting a pair of brown mittens for Thomas.

While I work, I keep an eye on the clouds.

 

December 18, 1929. Rising moon, half full.

Called to another birth, not four hours after Bitsy left with William MacIntosh.

Female infant, Dora, 6 pounds, 9 ounces, born to Minnie Boggs, only 14 years old. She surprised me by delivering quickly. Labor eight hours. I only made it for the last hour. Small tear, no repair. Blood loss minimal.

Minnie wanted to get up and bathe right away, but I said no. Not for one week. Her granny and mother agreed with me, but I doubt she will do what I say. Her husband, Calvin Boggs, ten years her senior at 24, has no control over her either. I found myself missing Bitsy. She would have been a comfort going out after dark, but she's at the MacIntoshes' helping Big Mary with Christmas.

 

Mercy

I pull up a chair, balance my cup of peppermint tea on the windowpane, and stare out at the gray day. Spending a few hours with fourteen-year-old Minnie reminds me of my year at the House of Mercy in Chicago. Gray. That was the color of everything, or that's how I remember it. Gray walls. Gray uniforms. Gray gruel for breakfast. Gray sheets.

The girls in my dormitory were a mixed lot and, despite their poverty, were nearly as spunky as Minnie. Most were children of immigrants, Polish, Italian, Russian, Irish, new to the country and struggling with English. When their parents died of consumption, cholera, or an industrial accident and they had no family in this new land, there was nowhere else for them to go. Some were thieves, pickpockets, or child streetwalkers. Some were disabled, defective, and unwanted. A few still had one parent who visited.

Those were the saddest. Their widowed mother or father, working twelve hours a day in a sweatshop or tannery, still couldn't afford to keep them at home, like the redheaded sisters from Ireland, nine and seven, who cried when their mother came on Sunday and then cried again when she left.

I'd been doted on, growing up in Deerfield, so I nearly drowned at first in that sea of despair, but I quickly learned to swim and those two years in the House of Mercy changed my life. Living with the poor, the lonely, and the discarded embroidered them into my heart.

To survive I made myself useful and ingratiated myself with the nuns by singing the youngest girls to sleep and reading to the older ones. I sang hymns: “Rock of Ages,” “Will the Circle Be Unbroken?,” “Come to the Savior Now.” I sang popular tunes: “After the Ball Was Over,” “Ta-ra-ra Boom-de-ay” . . . anything I could think of.

None of the girls had been to school. The sisters gave me a worn copy of
The Fairy Tales of Hans Christian Andersen,
and I read to them at bedtime and on rainy days: “Thumbelina,” “The Little Mermaid,” “The Emperor's New Clothes.” Even the girls who didn't understand English were soothed by my voice. “The Princess and the Pea” was their favorite.

By day I was a laundress, like my mother had been, in the institution's basement. We used newspapers to bundle the sheets, and one morning, at the bottom of page 10 in the
Chicago Tribune,
just under an advertisement for
SEARS MODERN HOMES, ARRIVES BY TRAIN, WITH INSTRUCTIONS AND ALL MATERIALS,
was an announcement of tryouts for the chorus line at the Majestic Theatre.

I was well spoken, could sing, and wasn't unpleasant to look at, so, determined to audition, I waited until dark, then slipped out the side door with my few belongings and the sisters' worn copy of Hans Christian Andersen. It was the first thing I ever pinched but sadly not the last. Under the cover of darkness, I arrived at Mrs. Ayers's boardinghouse, the last place I'd lived after my mother's demise.

“Child!” she exclaimed. “What's happened?” She was wearing a rose silk dressing gown with her hair loose, flowing down her back like black rain. I'd never seen her that way before. Having a man had changed her.

“I know I'm not your responsibility,” I began, “but I beg of you this one kind favor.” I'd read a line like that in the sisters' storybook. “Lend me your best dress for three hours tomorrow.” She took me in with open arms, making sure I understood that it was only for the night, and put me to bed in my old room.

In the morning, Mrs. Ayers, now Mrs. Swartz, pulled a cream ruffled tea dress with lace panels on the sleeves out of a round-topped wooden trunk. It was the dress she had married Mr. Swartz in. We took in the waist with basting thread and her new husband, a kind soul, hired a horse-drawn cab to take me to the Majestic at three.

 

When the driver left me off on Monroe, I pinched my cheeks to give them more color, stared up at the ornate Art Deco–inspired hotel, the tallest building in Chicago, and tried to pretend I was used to such places. I told the man with the tooth missing who stood out in front that I was there for the audition, then found myself a seat in the third row.

A heavily made-up redhead in a low-cut green satin gown was on stage belting out “Sweet Adeline,” and I was glad to have a chance to look around. The colors of the theater were rich and dramatic, with dark gleaming wood, red plush velvet, and silver accents. Box seats rose to the ceiling. I was so enchanted that I didn't hear the gentleman with the clipboard call my name.

“Elizabeth? Elizabeth Snyder!” That was before I took on my alias.

“Oh, me, sir!” (No one I knew ever called me Elizabeth. I'd always been “Lizbeth” to my family. That's my heart's name.)

“Sheet music?”

I felt silly. “I don't have any. I'm doing my mother's favorite song, ‘Oh Promise Me.' The man with the missing tooth rolled his eyes but perked up when I sang without accompaniment, in my clear alto,
“Oh, promise me that someday you and I will take our love together to some sky.”

I never went back to the House of Mercy, not even to visit, and I felt bad about that, about not saying good-bye to the girls, especially the little ones, but I'd left without permission, stolen their storybook, and lied about my age to get the job at the Majestic. If I returned, they might try to keep me.