Midwives (1997)

by Bohjalian, Chris

  But Lori Pine was as generous and uninhibited as she was large, and she said she didn't mind having me there at all. "What's one more pair of eyes, Sibyl?" she said to my mother, before starting to wince from a contraction, her head snapping toward me as if she'd been slapped.

  And so I stayed, and got to see Lori Pine's labor and E.J. Pine's birth. My mother and I had arrived about ten-thirty in the evening, and I stayed awake through much of the night and into the next morning. I did doze in the bedding that had been tossed onto the floor, especially when the thunder that had rolled east across the Champlain Valley and the Green Mountains passed over us into New Hampshire, but they were short naps and I was awake at quarter to six in the morning when my mother had Lori begin to push, and again at seven thirty-five when E.J. ducked under the pubic bone for the last time, my mother pressing her fingers against the infant's skull to slow her down and give her mother's perineum an extra few seconds to yawn.

  E.J. was born at seven thirty-seven--like the airplane. Labor was about nine and a half hours, and it was in the opinion of everyone present a breeze. Everyone but me. When I dozed, it was probably because I could no longer bear to watch Lori Pine in such pain and had shut my eyes--not solely because I was tired and my eyes had drooped shut on their own.

  The room was dim, lit only by a pair of Christmas candles with red bulbs David had pulled from the attic for the event just after my mother and I had arrived. Had it not been such a windy night, they would have used real candles, but Lori wanted to labor with the windows open, and David had recommended sacrificing authenticity for safety.

  Lori had started to express her disappointment when she saw David reappear with the plastic sconces instead of wax candles, but then another contraction ripped through her body and she grabbed my mother's arms with both hands and screamed through clenched teeth: a sound like a small engine with a bad starter trying to turn over.

  "Breathe, Lori, breathe," my mother reminded her placidly, "breathe in deep and slow," but by the way Lori's eyes had rolled back in her head, my mother might just as well have told her to march outside and hang a new garage door, and that was the last any of us heard that night from Lori Pine about candles.

  I hadn't really seen an adult in pain until then. I had seen children cry out, occasionally in what must have been agony--when Jimmy Cousino broke his collarbone when we were in the first grade, for example. Jimmy howled like a colicky baby with a six-year-old size set of lungs for speakers, and he howled without stopping until he was taken by a teacher from the playground to the hospital.

  It was a whole other experience, however, to see an adult sob. My mother was great with Lori, endlessly smiling and reassuring her that she and her baby were fine, but for the life of me I couldn't understand why my mother didn't just get her the adult equivalent of the orange-flavored baby aspirin she gave me when I didn't feel well. The stuff worked miracles.

  Instead my mother suggested that Lori walk around the house, especially in those first hours after we got there. My mother had her stroll through her two boys' bedrooms; she recommended that Lori take a warm shower. She asked Lori's sister to give the woman gentle backrubs and massage her shoulders. At one point, my mother had Lori and David looking at snapshots together in a photo album of the home births of their two sons--pictures that had been taken in that very bedroom.

  And while I don't believe witnessing Lori Pine's pain frightened me in a way that scarred me, to this day I do remember some specific sounds and images very, very well: My mother cooing to Lori about bloody show, and the blood that I glimpsed on the old washcloth my mother had used to wipe the sheet. Lori's panting, and the way her husband and her sister would lean over and pant beside her, a trio of adults who seemed to be hyperventilating together. Lori Pine slamming the back of her hand into the headboard of her bed, the knuckles pounding against it as if her elbow were a spring triggered by pain, and the noise of the bone against cherry wood--it sounded to me like a bird crashing into clapboards. The desperate panic in Lori's voice when she said she couldn't do it, she couldn't do it, not this time, something was wrong, it had never, ever hurt like this before, and my mother's serene reminder that indeed it had. Twice. The times late in the labor when Lori crawled from her bed and was helped by my mother and Heather to the bathroom, her arms draped over their shoulders as if she were the sort of wounded soldier I'd seen in the movies who was helped from the battlefield by medics, good buddies, or fellows who hadn't previously been friends. The image of my mother's gloved fingers disappearing periodically inside Lori Pine's vagina, and the delighted sweetness in her voice when she'd say--words spoken in a hush barely above a whisper--"Oh my, you're doing fine. No, not fine, terrific. Your baby will be here by breakfast!"

  And it was. At quarter to six in the morning when Lori Pine started to push, the sky was light although covered with clouds, but the rain had long passed to the east. No one had bothered to unplug the plastic Christmas candles, so I did: Even in 1975, even just shy of eight, I was an environmentalist concerned with renewable resources. Either that or a cheap Yankee conditioned to turn off the lights when they weren't needed.

  Chapter 2.

  The books say conception occurs when a sperm penetrates a female egg, and they all use that word--penetration. Every single one of them! It's as if life begins as a battle: "Let's storm the egg!" Or, maybe, as an infiltration of spies or saboteurs: "We'll sneak up on the egg, and then we'll crawl in through the kitchen window when she's asleep!" I just don't get it, I don't see why they always have to say penetrate. What's wrong with meet, or merge, or just groove together?

  --from the notebooks of Sibyl Danforth, midwife

  WHEN THINGS GO WRONG in obstetrics, they go wrong fast. They fall off a cliff. One minute mom and fetus are happily savoring the view from the top, and the next they're tumbling over the edge and free-falling onto the rocks and trees far below.

  I would hear physicians use those sorts of analogies all the time when I was growing up. And of course virtually every ob-gyn the State paraded before the jury when my mother was on trial had his or her personalized version of the labor-as-aerial-act speech.

  "Most of the time, labor is like going for a drive in the country. Nothing unusual will occur. But sometimes--sometimes--you'll hit that patch of black ice and skid off the road, or a dump truck will lose control and skid into you."

  "The vast, vast majority of the time, labor doesn't demand any medical intervention. It's a natural process that women have been handling since, well, since the beginning of time. But we've lost our collective memory of the fact that although labor is natural, it's dangerous. Let's face it, there was a time when women and babies died all the time in labor."

  Their point was always the same: Women should not have their babies at home with my mother. They should have them in hospitals with physicians.

  "A hospital is like an infant car seat: If something unexpected should occur and there's some kind of collision, we have the tools to pull the baby out of the oven," one doctor insisted, mixing metaphors and mistaking a uterus for a kitchen appliance from Sears.

  In the late 1970s and early '80s, my mother was one of a dozen independent or "lay" midwives in Vermont who delivered babies at home. Virtually no doctors did. The cost of malpractice insurance for home birth was prohibitive, and most ob-gyns really believed it was safer to bring children from womb to world in a hospital.

  My mother disagreed, and she and different doctors often waged their battles with statistics. As a little girl I would hear phrases and numbers rallied back and forth like birdies on badminton courts, and I was fascinated by the grimness behind the very clean, clinical-sounding words. Maternal morbidities. Neonatal mortalities. Intrapartum fatalities.

  The word stillborn fascinated me. Still born. At nine or ten, I assumed it conveyed a purgatory-like labor, a delivery that went on forever.

  "Is he still being born?"

  "Indeed, he is. Horrible, isn't it? They're now in their third
year of labor ..."

  My mother believed that home birth was safe at least in part because she refused to deliver any high-risk pregnancies at home. Women with very high blood pressure, for example. Diabetes. Twins. She insisted on hospital birth for those women, even when they pleaded with her to help them have their babies at home.

  And she never hesitated to transfer a laboring mother in her care to the hospital, if something was--as she once described the feeling to me--making her heart beat a little faster than she liked. Sometimes it would be due to my mother's sense that the labor hadn't progressed in hours, and her patient was exhausted. Sometimes my mother might recommend a transfer because she feared a more dangerous turn was imminent, one of those things the medical community euphemistically describes as an "unforeseen occurrence": the placenta separating from the uterine wall before the baby has arrived or such signs of fetal distress as a falling heartbeat.

  In all of the years that my mother practiced, the records would reveal, just about four percent of the time she took her laboring women and went to the hospital.

  There's no question in my mind that my mother and the medical community disliked each other. But she would never have let their conflicts jeopardize the health of one of her patients. That's a fact.

  I could begin my mother's story with Charlotte Fugett Bedford's death, but that would mean I'd chosen to open her life with what was for her the beginning of the end. It would suggest that all that mattered in her life was the crucible that made my family a part of one tragic little footnote to history.

  So I won't.

  Besides, I view this as my story, too, and why I believe babies became my calling as well.

  And I am convinced that our stories began in the early spring of 1980, a full eighteen months before my mother would watch her life unravel in a crowded courtroom in northern Vermont, and at least a full month before the Bedfords would even arrive in our state.

  Here's what I recall: I recall that the mud was a nightmare that year, but the sugaring was amazing. That's often the case. If the mud is bad, the maple will be good, because mud and maple are meteorological cousins of a sort. The kind of weather that turns dirt roads in Vermont into quicksand in March--a frigid, snowy winter, followed by a spring with warm days and cold, cold nights--also inspires maple trees to produce sap that is sweet and plentiful and runs like the rivers swollen by melted snow and ice.

  My mother's and father's families no longer sugared, and so my memories of that March revolve more around mud than maple syrup: For me, that month was largely an endless stream of brown muck. It covered my boots to my shins in the time it would take to trudge fifty yards from the edge of our once-dirt driveway to the small cubbyhole of a room between the side door and the kitchen, which earned its name as a mudroom in those days: The floors and walls would be caked with the stuff. When the mud was wet, it was the dark, rich color of tobacco; when it dried, the color grew light and resembled the powder we used then to make chocolate milk.

  But wet or dry, the mud was everywhere for two weeks in the March of 1980. The dirt roads became sponges into which automobiles were constantly sinking and becoming stuck, sometimes sinking so deep that the drivers would be unable to open their doors to escape and would have to climb through the car windows to get out. Yards became bogs that slowed running dogs to a walk. Virtually every family in our town had laid down at least a few long planks or wide pieces of plywood to span the puddles of mud on their lawns or to try and link the spot of driveway on which they parked their cars with their front porches.

  My mother parked her station wagon just off the paved road at the end of our driveway, as she did often in the winter and early spring, to ensure that she could get to her patients in a timely fashion. Nevertheless, there were still those occasional births when even my determined mother was unable to get there in time. The section of our old house she used as her office had one whole wall filled with photos of the newborn babies she'd delivered with their parents, and one of those snapshots features a baby crowning while the mother is attended by her sister. The sister is pressing a telephone against her ear with her shoulder while she prepares to catch the child. My mother is at the other end of that telephone, talking the sister through the delivery since a snowstorm had prevented either her or the town rescue squad from getting to the laboring woman before the baby decided it was time to arrive.

  That spring, even a city with nothing but paved streets and solid sidewalks like Montpelier--the state capital--somehow developed sleek coats of mud on its miles and miles of asphalt and cement.

  But the sugaring was good and the syrup crop huge. My best friend Rollie McKenna had a horse, and although the two of us were never supposed to ride her at the same time, we did often, and that March we rode up to the Brennans' sugarhouse after school at least three or four times so we could smell the sweet fog that enveloped the place as Gilbert and Doris slowly boiled the sap into syrup.

  Of course, there were other reasons for riding into the hills where the Brennans had hung hundreds and hundreds of buckets on maple trees. We also rode there because the roads we took to the sugarhouse would lead us past the town ball field where Tom Corts and his friends would smoke cigarettes.

  At twelve (and fast approaching thirteen), I would ride or run or walk miles out of my way to watch Tom Corts--two years older than I and therefore in the ninth grade--smoke cigarettes. I probably would have gone miles out of my way to watch Tom Corts stack wood or paint clapboards. He wore turtlenecks all the time, usually black or navy blue, and they always made him look a little dangerous. But his hair was a very light blond and his eyes a shade of green that was almost girlish, and that made the aura of delicious delinquency that surrounded him almost poetic. Tom was the first of many sensitive smokers with whom I would fall deeply in love, and while I have never taken up that habit myself, I know well the taste of smoke on my tongue.

  Tom Corts smoked Marlboros from the crushproof box, and he held his cigarettes like tough-guy criminals in movies: with his thumb and forefinger. (A few years later when I, too, was in high school, one of Tom's younger disciples, a boy in my grade, would teach me to hold a joint in that fashion.) He didn't inhale much, probably no more than necessary to light the cigarette and then keep it burning; most of the time, the cigarettes just slowly disappeared between his fingers, leaving ashes on the dirt or mud of the ball field, the sidewalk, or the street.

  Tom had a reputation for driving adults wild, although rarely in ways they thought they should--or could--discipline. I remember the first hunting season when he was given a gun and taken into the deep woods with the older males in his clan, he shot one of the largest bucks brought down that year in the county. The men's pride in their young kin must have shriveled, however, when they saw how Tom mugged for the camera in the picture the owner of the general store took of the boy and the buck for his annual wall of fame. Tom wrapped one arm around the dead deer's neck and pretended to sob, and with his other hand held aloft a sign on which he'd named the deer, "Innocence."

  It was also widely believed in town that Tom was the ringleader behind the group that somehow acquired cans of the sizzling yellow paint the road crews used to line highways, and one Halloween coated the front wall of the new town clerk's office with the stuff. The building, a squat little eyesore that not even the selectmen could stand, was a mistake the whole town regretted, and neither the constable nor the state police worked very hard to find the vandals.

  On any given day, Tom was as likely to be seen somewhere reading a paperback book of Greek mythology--unassigned in school--as a magazine on snowmobiling; he was the sort of wild card who would skip a class trip to the planetarium in St. Johnsbury, but then write an essay on black holes that would astonish the teacher.

  Initially, my father disliked Tom, but not so much that he ever discouraged me from trying to get the boy's attention, or suggested that it might be a bad idea for Rollie and me to try and ingratiate ourselves into his circle. I think my
father--the sort of orderly architect who would stack his change by size every single night of his adult life, so that on any given morning I could find atop his bureau small skyscrapers of quarters and nickels and dimes--thought Tom ran a little too wild. My father came from a family of achievers--a line of farmers who actually prospered in Vermont's rocky soil, followed by two generations of successful small-business men--and he thought Tom's bad pedigree might be a problem. Although he knew Tom was very smart, he still feared the boy might end up like most of the Cortses in Reddington: working by day at the messy automotive garage that looked like a rusted-out auto graveyard, while trying to buy Budweiser with food stamps at night. It probably wasn't a bad life if you kept your tetanus shots current, but it wasn't the life my father wanted for his only child.

  My mother understood why I found Tom cute, but she, too, had her reservations. "There are probably worse mushrooms in this world than a boy like Tom Corts," she once warned, "but I still want you to be careful around him. Keep your head."

  They had both underestimated Tom, as they'd see the next year. He was always there for me when I needed him most.

  In the mud season of 1980, Rollie's horse, Witch Grass, was twenty years old, and while her best years were well behind her, she was a good horse for us. Patient. Undemanding. And slow to accelerate. This last character trait meant a lot to us (and, I have to assume, to our parents), because we had given up our formal lessons a year earlier, tired of being told to sit up straight, post, and canter.