I stand in front of her to block the way. “It really can’t be recommended. Women in labor never go outside, certainly not in the snow. You might catch pneumonia. Now how would that be when you have a new baby?”

Livia isn’t listening. She’s moving toward the door with determination, and if I don’t move, she may plow me over.

“Can’t you stop her?” I plead with the others. Daisy shrugs and throws a man’s plaid bathrobe over Livia’s shoulders. As I follow the little band through the parlor, I see who’s been singing.

It’s the Reverend and Mildred Miller; Homer, the father; the horseman; and three other ladies kneeling in front of the sofa. Cypress, the grandma, breaks from the birthing team to join the prayer group, but I grab my worn wool coat and the rest of us press onward.

Outside, the temperature is not as cold as I’d thought, but the snow swirls around us like feathers. Then it occurs to me: what if by some miracle, the baby starts to come? I run back inside for a blanket, not that it’s likely to happen, but I’d rather be prepared.

Livia heads toward the split cedar fence with Daisy and Georgia, the three looking up as if they’ve never seen snowflakes before. The mother-to-be stops, reaches out to touch the inch of white on the rail, takes some and washes her face. She bends her head down and licks it with her tongue. The others, laughing, follow her example. It looks so fun, I’d like to do it myself, but someone has to be sensible.

Livia takes off her robe and steam rises up as the snowflakes fall on her hot body. She puts one foot up on the lower fence rail and leans back to catch the feathers in her mouth and that’s when it happens.

“Ugggggh,” she groans, as if she were the earth pushing a whole tree out of the ground. “Uggggggg!”

Both young women turn toward me, mouths open. “Get her back in. Get her in!”

We make it as far as the living room. Here, Cypress throws a quilt on the floor. Mrs. Miller puts a pillow under Livia’s head and I catch a healthy male child, already crying.

The preacher, Homer, and the horseman, who I later realize is Nate Bowlin, the guy who helped the preacher bring us some wood, stand in the corner, faces turned away, murmuring a prayer.

“Thank you, Lord Jesus!” says Cypress, taking the infant and wrapping it in a kitchen towel. “If you can’t shift the baby, shift the mother!”

The third stage of labor is a blur. I deliver the afterbirth, cut the cord, get Livia back in bed, and examine both the mother and baby. Then, while everyone celebrates with apple cider and sandwiches that Mildred has brought from her house, I slip out into the dark yard and walk toward the fence. Tiny flakes tickle my face as I look into the gray sky and let the tears come.

I have lived under the presumption that there is great pain in this life and you must move carefully or you will get hurt, but I see today that sometimes pain brings great joy, like labor contractions bring us the baby.

I walk over to the fence, lean forward, and lick snow off the cedar rail. And the joy makes up for it all.

January 8, 1935

Male infant, 6 pounds, 9 ounces, born to Livia and Homer Lewis of Hazel Patch. The labor was a hard one. I arrived and it seemed as if the birth would happen any minute—a crown of dark hair was already showing—but the mother pushed for two hours and still had no baby.

Embarrassed to have to do it, I asked one of the support ladies to run through the snow to call Patience for advice and she brought back the strangest suggestion. “If you can’t shift the baby, shift the mother.” It was Livia’s grandmother who interpreted the message. The midwife meant we had to try all kinds of positions until something changed.

I see now the wisdom in that. If I were with Dr. Blum and we had an obstructed labor he could just do a cesarean section and pull the baby out, but without a surgical option you have to be creative. The whole thing made me wonder how many of the cesareans we did were truly necessary if we had just let the woman out of bed and helped her to move and try different things.

In the end it was Livia who led the way. She insisted, despite my objection, on going out in the snow, and when she propped one foot up on the fence rail, something happened and the baby shot out.

There were a couple of minor tears near the top of the introitus, but they were superficial and didn’t need stitching. Blood loss was heavy, 400 cc, but I didn’t have to use Mrs. Potts’s hemorrhage medicine. Present, besides Livia and her husband, were her support team, Grandma Cypress and women friends Daisy and Georgia. (The Reverend, Mrs. Miller, and several other church members prayed for us in the living room.)

We were promised another load of wood as payment and Cypress presented me with a handwoven sweet grass basket, half as big as a washtub, something she had learned to make from her aunties when she lived in Charleston, South Carolina. I left feeling exhausted but elated, as if I were carried on the wings of great love.


January 19, 1935

“Scalpel,” Daniel orders, after shaving and then cleansing the bovine’s side with betadine. He holds his right hand out and I, like a good surgical nurse, hand him the knife. We are standing in a dim barn just off Salt Lick a few miles past Horseshoe Run. Walter Pettigrew, the farmer, holds a kerosene lantern over his head. His neighbor, a bull of a man named Mr. Simple, holds the rope around the Jersey’s neck.

The vet talks as he works. “If you have to do a cesarean section on a cow, try to do it with the animal standing. If they go down on you, it’s a lot more work and more dangerous too. For cattle, local anesthesia is sufficient.”

“I would have called you sooner, Doc,” Pettigrew interrupts, “but we ain’t got much money and what I have I need to feed the kids. I thought maybe if I left her alone she could do it.”

“I understand, Walt. Things are tough all over.”

“Now watch this,” Hester goes on. “I’ve cut through two layers of muscle with the scissors. . . . This is the hard part. . . .”

With his bare hand he reaches into the animal’s body clear up to his armpit and struggles around. All I can say is, delivering a 90-pound calf is much harder than a human infant.

Thirty minutes later, our gear already stored in the trunk of the Ford, we’re leaning against the back stall as the cow and her baby get acquainted. The calf butts her mother’s udders and latches on. Daniel laughs and nudges me with his elbow. “I love that. Never get tired of it.”


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