I feel like a fool and maybe a dangerous one. What makes me think I can be a midwife with only a few years’ apprenticeship and no Mrs. Kelly to guide me? On the other hand, the baby’s alive . . .

I show Bitsy how to gently massage Katherine’s womb every ten minutes so that it stays rock hard. She’s a quick study and repeats everything I say. Then I show her how to inspect the placenta for any missing pieces and how to weigh the baby in the old-fashioned hanging scale that Mrs. Kelly left me.

Finally I sit back in one of the satin chairs and observe the new family. The mother is already breastfeeding. When I pull up the fringed window shade, the sunlight bursts into the room.

This child will be stronger than any of us.

October 30, 1929. New moon high in the daytime sky.

Seven-pound live-born male, thought to be dead. Name: William MacIntosh the second. Son of William MacIntosh the first and Katherine Ann MacIntosh. Active labor, five minutes. Pushing, one minute. Blood loss minimal. No birth canal tears. I had to breathe for the baby three puffs. Also present, Mary and Bitsy Proudfoot, the MacIntosh servants, and the father, although he fell down in a faint.

2

Home

To be a midwife was never my goal. As a girl, I imagined myself an explorer in the Amazon or maybe an around-the-world traveler and journalist like Nellie Bly, yet here I am, a thirty-six-year-old widow, wanted by the law in two states, living alone in the mountains of West Virginia, too old and too obstinate for courting.

I drag my bicycle up on the porch steps, exhausted from little sleep, and watch as Mr. MacIntosh turns his Olds around, thankful that he offered me a ride home. It’s one of those crisp, clear, cloudless days of autumn, with little boats of white clouds sailing across the blue sky, and my two brown-and-white beagles tumble from under the house whining and jumping up on my legs. “Hi, Sasha! Down, Emma! Miss me?”

The female, Emma, is named for the radical anarchist Emma Goldman and the male for her lover, Alexander “Sasha” Berkman. Those monikers were as familiar to me as Santa Claus and Jesus Christ a few years ago. That was back when I worked with the unions in Pittsburgh. Now here I hide, lost to that world.

I press my forehead on my periwinkle blue door, so glad to be home but dreading the emptiness. When Mrs. Kelly and I moved to this farm at the base of Hope Mountain, her grandmother’s home place, a little over two years ago, we thought of coating the weathered clapboards white, but after paying two hundred dollars for the adjoining ten acres, we couldn’t afford it and decided to paint just the door. I found the gallon of periwinkle marked down at Mullin’s Hardware in Liberty.

As I enter the house, I reach down to ruffle Emma’s fur, then stop to admire my parlor. Though it’s small and nowhere as elegant as the MacIntoshes’, I like the space better and it pleases me that everything in the room is handmade or cast off. It was from my mother that I got the desire to make things pretty, from my grandmother my sense of thrift.

There’s the secondhand davenport Mrs. Feder gave us for helping with the birth of her daughter-in-law’s twins. I’ve covered it with a blue-and-white quilt that I made myself in the flying goose pattern. There’s a pine table I pulled out of the cellar and sanded till it looks almost new. There are shelves of worn chestnut barn boards for books and a potbellied stove in the corner. (The cookstove and the heater stove, an oak rocker, two iron bedsteads with feather mattresses, and the bicycle were all that we found when we moved here.)

Other than that, there’s just the ornate black-and-gold mantel clock that Mrs. Kelly brought on the train from Pittsburgh and the piano, a used dark upright I bought for thirty dollars when the Mt. Zion Church purchased its organ. That was back when I could get work now and then and still had some cash. Now the jobs have dried up, and, let’s face it, there’s not much money in delivering babies.

Whether a birth is long or short, I’m always done in when I get home. I step out of my shoes, flop down on the sofa, and glance at the painting on the whitewashed pine wall above me.

My baby’s father painted that oil portrait when I was sixteen. Lawrence was a student at the Art Institute of Chicago then. In the picture, a girl stands on a pier overlooking Lake Michigan with a strand of long loose auburn hair across her face. Her head is thrown back and she’s laughing. That girl was me, Elizabeth Snyder. I adopted my alias, Patience Murphy, when we left on the run from Pittsburgh, and the name fits now, has a nice ring. Patience Murphy. Patience the midwife . . .

Lawrence, my first husband—I call him my husband, though he died before we could marry—was a scene designer when I was a chorus girl at the Majestic Theatre. I had lied to get the job, told everyone I was eighteen, and got chosen out of a queue of girls because of my voice. The House of Mercy Orphanage was probably glad to be rid of me. One less mouth to feed.

I throw some wood on the coals in the heater stove, fill the teakettle with water from the bucket, and pull the rocker up to the fire. Light fills the room through the two tall front windows.

Why didn’t my baby live? Katherine’s lived.

I think I know the answer, have read about it in DeLee’s heavy text. My afterbirth, or placenta, as Dr. DeLee refers to it, separated too early, an obstetrical emergency, and they didn’t do cesarean operations routinely then, certainly not on an orphan like me. I experienced two deaths in two weeks: Lawrence’s in the train wreck and then the baby’s. I still don’t know how I made it, didn’t crumble into dust. Somehow I went on, as we all have to go on; stuffed my grief in my pocket like a chunk of black coal and stumbled forward. I carry it still, but over the years the lump has grown smaller, harder, like a diamond.

The girl from so long ago stares out across the inland sea. Birth and death, so intertwined. Love, birth, death, my trilogy.

There’s a distant moo from the barn. My animals! I had stayed for breakfast at the MacIntoshes’ . . . sausages, biscuits, and home-canned peaches with maple syrup, a real celebration breakfast, Big Mary called it. We three ate in the kitchen, Bitsy, Mary, and I, after we helped Katherine clean up and dress in a dark blue silk robe so that she and Mr. MacIntosh could enjoy breakfast together.

Now it’s past noon, the chickens haven’t been fed, and poor Moonlight’s udders must be bursting! The cat, Buster, is okay because I leave a bowl of milk on the stoop and he can find field mice and chipmunks. My beagles can hunt, but the critters confined to the barn this time of year are helpless. I grab a clean metal bucket from the pantry, step into the high black rubber boots I keep on the enclosed back porch, and curse myself for my forgetfulness.