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For mothers and babies everywhere, especially my own
Acknowledgments
Thank you to my editor, Jen Enderlin, for your insight and wisdom. Working with you is a joy and a privilege. Thank you also to the team at St. Martin’s, particularly Katie Bassel, Caitlin Dareff, Angie Giammarino, Elsie Lyons, Lisa Senz, Eliani Torres, and Dori Weintraub, for making me look better than I am.
To my agent, Rob Weisbach: Thank you for always making me dig deeper. Heartfelt thanks also to May Wuthrich, for giving me my start.
To Joan Keaney, for reading this manuscript and providing midwifery expertise, and to Grace Owen and Clare Ross, who fielded my questions about high-risk deliveries: Thank you. Any errors are mine, not theirs.
To my critique partners, Anna George and Meredith Jaeger: Thank you for reading and for always asking the tough questions. Also to my first readers, Kena Roach, Angela Langford, Inna Spitzkaia, and Dagmar Logan—for your kind eyes and generous words.
To my girlfriends—the inspiration for the incredible women I create: Thanks for always sharing your flaws, or, as I like to call them, your best features.
To the Carrodus family: Thank you for your quirks and dysfunctionalities. You have given me enough material to fill a lifetime of books.
To Oscar and Eloise—you gave me the words to describe the boundlessness of a mother’s love. Without the two of you, this book would be unwritten.
To Christian, thank you for being my person.
Finally, to those special men and women who dedicate their lives to the safe birth of our babies: We might forget to say it at the time … but thank you.
1
Neva
I suppose you could say I was born to be a midwife. Three generations of women in my family had devoted their lives to bringing babies into the world; the work was in my blood. But my path wasn’t as obvious as that. I wasn’t my mother—a basket-weaving hippie who rejoiced in the magic of new, precious life. I wasn’t my grandmother—wise, no-nonsense, with a strong belief in the power of natural birth. I didn’t even particularly like babies. No, for me, the decision to become a midwife had nothing to do with babies. And everything to do with mothers.
On the queen-sized bed, Eleanor’s body curved itself into a perfect C. I crept up farther between her legs and pressed my palm against her baby’s head. Labor had been fast and furious and I wasn’t taking any chances. Eleanor’s babies liked to catch us off guard. I’d almost dropped her first son, Arthur, when he decided to make a sudden entrance as Eleanor rocked over a birthing ball. She barely had time to gasp before he began to crown and we all had to rush into position. Her second son, Felix, was born in the birthing pool, five minutes after I’d sent Susan, my birth assistant, on break. This time, I was going to be ready.
“You’re nearly there.” I pushed a sweaty strand of hair off Eleanor’s temple. “Your baby will be born with the next contraction.”
Eleanor squeezed her husband’s hand. As usual, Frank had been silent, reverent even. Dads varied enormously on their level of involvement. Some adopted the poses of their wives and girlfriends, panting and pushing along with them; others became so fixated on whatever small task they had been assigned—be it working the iPod or keeping the cup of ice chips full—they nearly missed the birth entirely. I had a soft spot for the reverent ones. They knew they were in the presence of something special.
The baby’s head turned to the right and Eleanor began to moan. The room fired with energy. “Okay,” I said. “You ready?”
Eleanor dropped her chin to her chest. Susan stood at my side as I eased the shoulders out—first one, then the other—until only the baby’s legs remained inside. “Would you like to reach down and pull your baby out, Eleanor?”
Eleanor’s sons had come too quickly to do this, but I was glad she’d get the chance now. Of all the ways a baby could be delivered, this was my favorite. It seemed only right that after all the work a mother did during labor, her hands should bring her baby into the world.
A ghost of a smile appeared on Eleanor’s face. “Really?”
“Really,” I said. “We’re ready when you are.”
I nodded at Susan, who stood ready to catch the baby if it fell. But it wouldn’t. In the ten years I’d been delivering babies, I’d never seen a child slip from its mother’s grip. I watched as Eleanor pulled the black-haired baby from her body and lay it against her heart—pink, slippery, and perfect. The cry was good and strong. Music to a midwife’s ears.
“Ah, how about that?” I said. “It’s a girl.”
Eleanor cried and laughed at once. “A girl. It’s a girl, Frank.”
She was a good size. Ten fingers. Ten toes. Eleanor cradled her baby, still attached via cord, with the perfect balance of tenderness and protection. Frank stood beside them, awe lining his features. I’d seen that look before, but it never got old. His wife had just become more amazing. More miraculous.
Susan beckoned Frank for cord cutting and began giving instructions. Seeing Frank’s expression, I couldn’t help but laugh. Susan had lived in Rhode Island since her nineteenth birthday, but forty years later, her thick Scottish accent meant she was largely incomprehensible to the American ear. On the upside, this made her the ideal person to share confidences with; even if she did disclose your secret, no one would understand. On the downside, I spent a lot of time translating.
“Just cut between the clamps,” I theater-whispered. Susan turned away, but her gray, tight-bound curls bounced on her head, so I was fairly sure she was chuckling.
Once the placenta had been delivered and the baby had breast-fed, I tended to Eleanor, settled the baby, and debriefed with the night nurse. When everything was done, I stood at the door. The room was calm and peaceful. The baby was on Eleanor’s bare chest getting some skin-on-skin time. Frank was beside them, already asleep. I smiled. The scene before me was the reason I’d become a midwife and, in my opinion, the real magic of childbirth. No matter how arduous the labor, no matter how complete the mother’s exhaustion, the men always fell asleep first.
“I’ll see you all tomorrow,” I said, even though I wanted to stay.
Eleanor waved at me, and Frank continued to snore. I peeled off my gloves and was barely into the corridor when fingers clamped around my elbow and I started to fall. I thrust out a hand to catch myself, but instead of hitting the ground, I remained suspended in midair.
“Hello, gorgeous.”
Across the hall two young midwives giggled. I blinked up at Patrick, who held me in a theatrical dip. “Very cute. Let me up.”
Patrick, our consulting pediatrician from St. Mary’s Hospital upstairs, was forever coming down to our birthing center, getting the nurses all excited with his ridiculous gestures. But I didn’t bother being flattered. Yes, he was young and charming—and good-looking in a disheveled, just-rolled-out-of-bed kind of way—but I knew for a fact that he dro
pped the word “gorgeous” with more regularity than I used the word “contraction.”
“Your wish, my command.” In a heartbeat I was back on two feet. “I’m glad I ran into you, actually,” he said. “I have a joke.”
“Go on.”
“How many midwives does it take to screw in a lightbulb?” Patrick didn’t wait for an answer. “Six. One to screw in the lightbulb and five to stop the ob-gyn from interfering.” He grinned. “Good one, right?”
I couldn’t help a smile. “Not bad.”
I started walking and he fell into step beside me. “Oh … Sean and I are heading to The Hip for a drink tonight,” he said. “You in?”
“Sorry,” I said. “Hot date.”
Patrick stopped walking and stared at me. That’s how unlikely it was that I would have a date.
“I’m kidding, obviously. I’m going to Conanicut Island to have dinner with Gran and Grace.”
“Oh.” His face returned to normal. “I take it you’re not getting along any better with your mom, then?”
“Why do you ‘take’ that?”
“You still call her Grace.”
“It is her name,” I said.
I’d started calling her Grace when I was fourteen—the day I delivered my first baby. It had seemed strange, unprofessional, to call her Mom. Saying Grace felt so natural, I’d stuck with it.
“You sure you can’t come for one drink? You haven’t come for a drink for months.” He adopted a pouty expression. “We’re too boring for you, aren’t we?”
I pushed through the door to the break room. “Something like that.”
“Next time, then?” he called after me. “Promise?”
“Promise,” I called back. “As long as you promise to learn some better jokes.”
I was confident it was a promise he wouldn’t be able to keep.
* * *
I arrived in Conanicut Island at ten to eight. Gran’s house, a shingle-style beach cottage, was perched on a grassy hill that rolled down to a rocky beach. She lived on the southern tip of the island, accessible only by one road across a thin strip of land from Jamestown. When I was little, my parents and I used to rent a shack like Gran’s every summer, and spend a few weeks in bare feet—swimming at Mackerel Cove, flying kites, hiking in Beavertail State Park. Gran was the first to go on “permanent vacation” there. Grace and Dad followed a few years ago and now lived within walking distance. Grace had made a big deal about “leaving me” in Providence, but I was fine with it. Apart from the obvious fact that it meant Grace would be a little farther away from me and my business, I also quite liked the idea of having an excuse to visit Conanicut Island. Something happened to me when I drove over the Jamestown Verrazzano Bridge. I became a little floppier. A little more relaxed.
I stepped out of the car and scurried up the grassy path. I let myself in through the back door and was immediately hit by the scent of lemon and garlic.
Grace and Gran sat at the table in the wood-paneled dining room, heads bobbing with polite conversation. They didn’t even look up when I entered, which showed how deaf they were both getting. I wasn’t exactly light on my feet lately.
“I made it.”
They swiveled, then beamed in unison. Grace, in particular, lit up. Or maybe it was her orange lipstick and psychedelic dress that gave the effect. Something green—a bean, maybe?—was lodged between her front teeth, and the wind had done a number on her hair. Her bangs hung low over her eyes, reminding me of a fluffy red sheepdog.
“Sorry I’m late,” I said.
“Babies don’t care if you have dinner plans, Neva,” Gran said. A smile still pressed into her unvarnished face. “No one knows that better than us.”
I kissed them both, then dropped into the end chair. Half a chicken remained, as well as a few potatoes and carrots and a dish of green beans. A pitcher of ice water sat in the center with a little mint floating in it, probably from Gran’s garden. Gran reached for the serving spoons and began loading up my plate. “Lil hiding?”
Lil, Gran’s painfully shy partner of nearly eight years, was always curiously absent for our monthly dinners. When Gran had announced their relationship and, as such, her orientation, Grace was thrilled. She’d yearned her whole life for a family scandal to prove how perfectly tolerant she was. Still, I had a bad feeling her avid displays of broad-mindedness (one time she referred to Gran and Lil as her “two mommies”) were the reason Lil made herself scarce when we were around.
Gran sighed. “You know Lil.”
“Mom’s not the only one who can bring a partner along, Neva,” Grace said. “If you’d like to bring a guy alo—”
“Good idea.” I stabbed some chicken with my fork. “I’ll bring Dad next time.”
Grace scowled, but one of my favorite things about her was that her attention span was short. “Anyway, birthday girl. How does it feel? The last year of your twenties?”
I speared a potato. “I don’t know.” How did I feel? “I guess I’m—”
“I’ll tell you how I feel,” Grace said. “Old. Feels like yesterday I was in labor with you.” Grace’s voice was soft, wistful. “Remember looking down at her for the first time, Mom? All that red hair and porcelain skin. We thought you’d be an actress or a model for sure.”
I swallowed my mouthful with a little difficulty. “You’re not happy I followed you into midwifery, Grace?”
“Happy? Why, I’m only the proudest mom in world! Of course, I still wish you’d come and work with me, doing home births. No doctors hovering about with their forceps, no sick people ready to cough all over the precious new babies—”
“There are no doctors or sick people at the birthing center, Grace.”
“Delivering in the comfort of one’s own home, it’s just…”
Magical.
“Magical,” she said, with a smile. “Oh! I nearly forgot.” She reached for her purse and plucked out a flat, hand-wrapped gift. “This is from your father and me.”
“Wow … You shouldn’t have.”
“Nonsense. It’s your birthday.”
Gran and I exchanged a look. Of course Grace had ignored the no-gifts directive—the one thing I’d wanted for my birthday. I hated gifts: the embarrassment of receiving them, the awkwardness of opening them in public, and, if it was from Grace, the pressure of ensuring my face was adequately arranged to demonstrate sheer delight, a wonder that I’d ever been able to get through life before this particular ornament or treasure.
“Go on.” She pressed her hands together and wriggled her fingers. “Open it.”
An image of my thirteenth birthday flashed into my mind—the first time since elementary school that I had agreed to a party. Maybe the fact that I was in the middle of my second-ever period and was cramping, bleeding, and wearing a surfboard-sized maxi pad in my underwear skewed my judgment. Grace wasn’t happy when I insisted we keep it small (just four girls from school) and she was positively brokenhearted when I refused party games of any sort, but she didn’t push her luck. With hindsight, that should have been my first clue. My friends and I had just gotten settled in the front room when Grace burst in.
“Can I have your attention, please?” she said. “As you know, today is Neva’s thirteenth birthday. We are celebrating her becoming a teenager.”
She looked like a children’s stage performer, smiling so brightly that I thought her face might crack into three clean pieces. I willed her to vanish in a cloud of smoke, taking with her the previous thirty seconds and the crimson crushed-velvet dress she had changed into. But any notion that this might happen faded along with my friends’ smiles.
“My baby is no longer a baby. Her body is changing and growing. She’s experiencing the awakening of a vital force that brings woman the ability to create life. You may not know this, but the traditional name for first menstruation is ‘menarche.’”
Panic broke out; a swarm of moths over my heart. I no longer wanted Grace to disappear and take the last thirty seco
nds—I wanted her to take my future. To take Monday, when I would have to go to school and face the fact that I was a social outcast, now and forever. To take the coming few weeks, when I would have to go about my life, pretending I didn’t hear the whispers and snickers.
“In some cultures,” she continued, oblivious, “menarche inspires song, dance, and celebration. In Morocco, girls receive clothes, money, and gifts. Japanese families celebrate a daughter’s menarche by eating red rice and beans. In some parts of India, girls are given a ceremony and are dressed in the finest clothes and jewelry the family can buy. I know for you young ones it can seem embarrassing or, heaven forbid, dirty. But it’s not. It is one of the most sacred things in the world, and not to be hidden away, but celebrated. So, in honor of Neva’s menarche, and probably some of yours too—” She smiled encouragingly at my friends. “—I thought it might be fun to do like the Apache Indians here in North America, and—” She paused for effect. “—dance. I’ve learned a chant and we can—”
I can’t believe I let it go on for as long as I did. “Mom.”
Grace’s smile remained in place as she met my eye. “What is it, darling?”
“Just … stop.”
I barely breathed the words, but I know she heard them, because her smile fell like a kite from the sky on a windless day. A steely barrier formed around my heart. Yes, she’d gone to a lot of trouble, but she’d also left me no choice. “Dad!”
Our house was small; I knew he would hear me. And when he appeared, his frantic expression confirmed he’d heard the urgency in my voice. He surveyed the room. The horrified faces of my friends. The abundance of red everywhere—Grace’s dress, the balloons, the new cushions, which amazingly, I had only just noticed. He clasped Grace’s shoulders and guided her out, despite her determined protest and genuine puzzlement.
But now, as Grace hovered over me, I didn’t have Dad to help me. I turned the gift over and began to open it tentatively, starting with the tape at one end.
The Secrets of Midwives Page 1