Five minutes later we are rolling along Bucks Run in the midwife’s dusty Olds. The oaks, maple, and hickory are covered in leaves now, a beautiful blur of summer green, but my stomach is tight, and I wonder why I agreed to this. Was it just to be nice to Patience? We owe her a lot. Was it out of some kind of sense of duty as a nurse? Was it the lure of sharing Patience’s fee? I hate to think it was only the latter. I’m getting to be a money-grubber. Poverty will do that to you. Once you’ve been broke, you’re always looking for a dime.

I’m about to ask Patience about Danny’s birth, what the experience had been like for her, when she makes a sharp turn to the left, bumps across a creek through a foot of water, and pulls up in front of a dingy white two-story farmhouse with what looks like a chicken coop attached to the side.

A man waves wildly from the front steps, then runs back inside as a woman screams. Patience is already in motion.

Double Trouble

“Becky!” Patience calls.

“Right behind you.” I enter the upstairs bedroom as a disheveled, unshaven father in coveralls backs out. He looks down, wipes tears from his eyes with a red bandanna, and runs down the hall.

“Asepto suction,” commands Patience.

I know what she’s asking for and find it wrapped in white cloth at the bottom of her birth satchel, a glass syringe with a red rubber bulb that’s used to suck out the newborn’s nose and mouth. As I hand it over, I get a look at the baby and my stomach drops. It’s a tiny limp male, around five pounds, covered in meconium, baby poop.

Now I understand Patience’s urgency. If the newborn aspirates the brown stuff that’s been floating around in his mother’s womb, he can get pneumonia and die. If she can manage to get it out of his airway before he breathes, his chances are better. Gently she places the pointed glass tube in his mouth and then his tiny nose, sucking out only clear fluid, no meconium.

“Thank you, Lord,” the midwife mutters. “Here, get him going.” She hands me the wet infant and pulls out her fetoscope to listen for the second twin’s heartbeat.

“Okay, little one. Let’s hear you cry. Open up those lungs.” I give him a few pats on the butt and he wails.

“Is he okay? Is he all right?” sobs Lucy Mitchell. Her face is red and sweating, her golden eyes wet with tears. “I tried to wait for you, but he was coming and I couldn’t stop.”

Patience listens to the second twin’s heartbeat as she consults the pocket watch hanging on a ribbon around her neck. “One hundred and fifty-two beats per minute, just fine.”

“One hundred and fifty-two,” I repeat out loud, to remember the rate, then reach over and take the mother’s pulse. “One hundred and ten.” That’s fast, but then she just delivered a baby unattended, which would be enough to accelerate anyone’s heartbeat.

“Can you help get the baby nursing, Becky? It will bring on the next set of contractions. Sometimes there’s a delay after the first twin, as the womb reorganizes itself. I need to do a vaginal exam to feel what’s coming. I think it’s a head, but I’m not sure.”

Lucy doesn’t need any help from me; she takes her nipple, gently strokes it against the newborn’s cheek, and the baby opens his mouth, just the way nature intended.

“What will you need next, Patience? Scissors? Sterilized string to tie off the cord? Anything else?”

“That should be it. Oh, some more sterilized pads and Mrs. Potts’s bleeding tonic. You know about that?”

I find a small brown bottle and hold it up to the light.

“It’s a tincture of motherwort, pennyroyal, and blue cohosh to make the womb contract after the afterbirth is delivered,” Patience explains. “I keep it ready at every delivery, but don’t often use it. Twins are a special case though. The womb has been so stretched with two babies, it might need help contracting down afterward, but you probably know all this.” She turns and takes off the rubber gloves, carefully arranging them on one of the sterile pads.

“Did you feel the presenting part?” I whisper, not wanting to alarm Mrs. Mitchell if the presentation isn’t head down. Even Dr. Blum knew that frightening the mother could stop her contractions.

“No. It’s too high,” Patience whispers back and then in a louder voice. “We will just have to wait. . . . Clarence,” she calls. “You can come back now. Everything’s okay! Come see your new baby boy. You can bring the children.”

My eyebrows shoot up. The children! Lucy is still half naked. Quickly I pull a blanket over the woman’s bare legs. Certainly this never happened when Dr. Blum did a delivery!

Clarence Mitchell, having recovered himself, enters softly. He’s a fair-haired fellow with a sunburned face, a few whiskers, and a band of white on his neck where his shirt collar usually covers his skin.

“Wife, you done good! Right healthy,” he says about the baby and surprises me when he sits down next to her on the side of the bed. The couple’s little boy and girl climb up too and Patience seems unfazed.

“Only the first baby is out. The labor will start up again soon,” Patience explains as she plunks down on the other side and pulls the baby blanket down a bit so the children can see. “Look at that little sucker,” she says. “He knows exactly what to do, just like a calf or a foal.”

“Can we touch him?” asks the girl, who must be about six. She strokes the baby gently on the back with one finger. Timidly, I find a corner on the very full bed and sit down with them.

“Mmmmmmm,” groans Lucy with a contraction, but there’s a smile on her face. “Mmmmmm.” It doesn’t look like pain, almost pleasure.

“The labor is starting again. Let me listen to the next baby’s heartbeat and then it will be time to walk,” Patience says.

“We’ll move out of your way, then,” the father announces, leaping up.

Snow Globe

“Mmmm,” the mother moans again and takes the midwife’s arm. They walk and then stop, walk and then stop. While contracting, Lucy stands staring into space, rotating her hips. There is peace and a timeless feeling, as if nothing else matters.

Finally, I work my way across the room and in a hushed voice ask Patience, “Shouldn’t we get her back in bed?”

“It’s okay,” Patience tells me. “It’s not time yet. Lucy’s voice hasn’t dropped. When her voice changes the baby will come. I’ll check her in ten minutes,” she adds, consulting her gold timepiece.

***

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