by Amy Waldman
On one such night, an especially cold one, Parveen woke to shouts and merciless banging on the compound door. She sat up, breathless with alarm. They’d come for her. The children huddled into her in fright, and she braced herself; there was nowhere in the room to hide. Waheed was descending the steps, calling out to see who was there, and she froze, waiting to see whether he would open the door, whether he would surrender her.
Now he was shouting for her. “Parveen, come! Parveen!”
Even knowing that the story of Crane’s kidnapping was false, that was all she could think of: a black bag over her head, the terror that she would die this way, so far from her family. It was as if Crane had cued her responses, her imaginings, and she couldn’t divert them onto another track. She put on her coat, hugged the children, and walked slowly out her door even as Waheed urged her to hurry.
Then her head cleared enough for her to understand what he was saying. The man at the door was brother-in-law to Latifa, whom Dr. Yasmeen had instructed Parveen how to help. Still stunned at this reprieve from her kidnapping and execution, Parveen nearly smiled, but she sobered as Waheed spoke. Although Latifa, who was six weeks from her due date, had been fine at her last checkup with Dr. Yasmeen, earlier in the evening she’d gone into labor and quickly delivered. Now the complications had begun.
Parveen returned to her room to grab the small kit, containing, among other items, surgical gloves, razor blades, cotton, and soap, that Dr. Yasmeen had prepared for this eventuality. She took a kerosene lantern from Waheed and followed the brother-in-law through the dark lanes, sucking lungfuls of clean cold air. As they walked hurriedly, she recollected the night she’d arrived here, when she had trailed Issa blindly. It was all so familiar now. She knew the turns the paths took, she knew who lived behind which door, she even knew the wood the doors were made from and where those trees grew. The noises of the animals no longer startled her, and their smells, even their dung, no longer repelled her. The map of this place had settled inside her. She was, in a fashion, home, a sentiment that was heightened by her relief at not being under threat tonight. She wasn’t sure why she’d doubted Waheed. He wouldn’t have surrendered her.
Inside the main room of the house, a fire burned orange in a corner, and shadows flickered against soot-stained walls. Latifa lay alone on a mound of dirt shrouded with blankets and rags. Parveen held up her lantern and gasped—the cloth beneath, around, and over her legs was crimson, a skirt of blood. The blood itself didn’t surprise Parveen; the doctor had warned her. But she wasn’t prepared for the force, the horror, of there being so much of it, and her childhood wooziness at the sight of her own blood briefly returned, made worse by the noxious, briny mixture of odors—blood, urine, feces, straw, and dirt—that hit her next. Alien cries and whimpers emanated from Latifa. Her skin was colorless, her eyes wildly lit.
From the shadows, hunched over a tiny bundle, the dai emerged to say, almost triumphantly, that it was she who had delivered the baby. Casting an eye to Parveen, she tossed a small object, the size of a pinkie, into the fire. A sound like popping corn erupted; then smoke, its scent foreign and herbaceous, boiled up. She chanted something about the evil eye—“eye of nothing, eye of relatives, eye of enemies”—and then said, “Whoever is bad should burn in this glowing fire.”
Did she mean Parveen? The smoke, the smell, the words entranced and disoriented her. But she centered herself and studied the soaked cloth, trying to estimate how much blood Latifa had lost. Enough to soak a sheet, and still more was leaking from her into a dark pool. Parveen had a passing wish to capture it in a cup or container, although she knew that blood, decanted this way, had no value. She was watching a life drain, which meant that every moment she wasted weakened Latifa further. The perineum had to be cleaned. (It calmed Parveen to attach the medical terms the doctor had given her to what she saw, since the language connected her to countless practitioners more experienced than she was who, through time, across the world, had confronted the same sight. It wasn’t a mound of clotted blood and pubic hair and skin and sliminess with the scent of salty wet seaweed. It was the perineum.) Using gloves and sterilizing wipes from the small kit Dr. Yasmeen had prepared, she cleaned the area, only to see it covered by blood again almost instantly.
The dai claimed to have delivered the placenta too but Parveen wondered if pieces had been left behind, which could cause bleeding. She asked Latifa if she’d taken the pill, misoprostol, that the doctor had provided her with. It would make the uterus contract enough to empty it of any leftover fragments, the doctor had said.
The dai answered: Latifa couldn’t remember where she’d put the pill.
Parveen bit back her frustration, regretting that the family hadn’t fetched her sooner. Bring the placenta, she told the dai, so that she could check for missing pieces.
The dai made no haste to comply, though she ultimately did so. In the dai’s mind, Parveen knew, the placenta was meant to be buried, not studied.
To Parveen it looked like a bloody, dark piece of raw meat. Its edge was jagged. Again she cleaned the perineum, then put on a surgical glove and, ignoring Latifa’s moan, pushed her hand all the way up to the uterus, shoving away the memory of helping her mother clear gizzards and organs from raw chickens. She found and extracted stray pieces of spongy, gelatinous placenta and puzzled them into place. The blood kept coming. Postpartum hemorrhage, she thought. The uterus needed to contract.
Remembering that Dr. Yasmeen had said breastfeeding could help, Parveen pulled off her bloody gloves and commanded the dai to give her the baby. Grudgingly, she did.
The infant girl felt ethereal, dandelion-light, like a precarious halo of seeds a mere breath from dispersal. She seemed, beneath her swaddling, hardly bigger than Parveen’s palm, the features in her pinched face so delicate they could have been squeezed out of a dropper. Clumsily, Parveen brought the infant to Latifa’s nipple as the dai hissed from behind: “It’s dirty.”
The colostrum, she meant. Like many Afghan villagers, she believed the thick, sticky early milk was unclean, probably because of its yellow-orange color. In a newborn’s first days, mothers in the villages often gave sugar water or sometimes cow’s milk instead, with predictably disastrous results. Dr. Yasmeen had tried to disabuse every pregnant woman she saw of this notion, explaining the nutritional riches the colostrum contained.
In this case, it didn’t matter; the baby, too small, too weak, couldn’t latch on, not even when Parveen overcame her pride and asked the dai to help. Parveen’s hands began to tremble. There was a malevolent presence in the room, and she understood that it was death, could almost see him sitting with his legs crossed on an imaginary chair in the corner, cleaning his fingernails while he whistled a tune. No rush, his posture seemed to say. He could wait for both the mother and her child. But once the time came, there would be no appeal. Dashing through the darkened lanes on the way to this house, Parveen had watched the clouds swallow the moon. A life could vanish as fast.
She handed the baby back to the dai, yanked on a new pair of surgical gloves, and laid her left hand on Latifa’s skin where she determined the top of her uterus to be, just as Dr. Yasmeen had taught her. The odor of blood was so overpowering Parveen could taste it. “Here we go,” she said brightly, and with her right hand she pushed back into Latifa, disregarding her cry of pain and surprise, up through the wet, ragged, stretched tissues of the birth canal, until her fist found the uterus. Whereas in her lesson at the clinic it had been firm, now it was flabby and slack. To make it contract, which would slow the bleeding, she kneaded her fist against it while pressing down with her left hand from the outside on the upper uterus. Push, press, push, press. She did this for a while, then checked the bleeding; it continued, and so she resumed. Push, press, push, press. The focus required cleared her head. Until then, despite the tenuousness of Latifa’s life, the ghastly pallor of her face, and the blood, the relentless blood, Parveen had been thinking about herself—how she would perform, how she woul
d be judged, the repercussions for her. Now she set all that aside. At stake were two lives, the one ebbing under her hand and the fragile new one struggling to survive.
Dr. Yasmeen had said to put the newborn in the incubator if she came more than a few weeks early. She was six weeks premature, so her lungs might not be fully developed, especially with the poor nutrition on which her mother had been subsisting. Naseer had shown Parveen how to use the machine, giving what seemed at the time hilariously detailed explanations for every step, wanting to discuss each possible complication. She wished she’d paid more attention. No one but her knew how to operate the incubator. She needed to take the infant herself, and soon, but she couldn’t leave Latifa. It felt as if time itself were kneeing her in the back. Push, press, push, press. At last, with her left hand on Latifa’s abdomen, she sensed a change in the uterus: it was beginning to harden. Once she was sure, she pulled out her right hand to check the bleeding. It slowed. Then it stopped.
Parveen allowed herself one sob of relief before hurrying to tell Latifa’s husband, who was waiting just outside the door, to bring clean blankets to warm his wife. He was also to send word to Waheed to get the clinic ready and the generator running. The newborn needed to be put in a special machine that would keep her warm—“Like being inside her mother,” Parveen explained—and help her grow more. They would bring Latifa to the clinic too when she was strong enough to be moved.
Parveen went over to the dai, who stood against a wall, and held out her arms. The dai squinted up at her. At last she passed the bundle, and their hands briefly touched beneath the infant, whose eyes were closed. In terror Parveen fingered open the wrapping to confirm the child’s breathing. Yes, it was there, though rapid and shallow. She slid her hand inside the blanket and smoothed her fingers over the head to verify that it was intact. “Don’t worry,” she told Latifa, who appeared distressingly listless. “We’ll take care of her.”
“I’m not so worried,” she whispered, faintly enough that Parveen had to bend her ear to her mouth. “She’ll live, or she won’t.”
Parveen couldn’t tell whether Latifa was fatalistic or, having borne her fourth girl, indifferent to yet another daughter’s fate. Her husband, too, seemed concerned mostly for his wife, which redoubled Parveen’s dedication to the child. The husband followed Parveen, thanking her with profuse courtesy and unconcealed anxiety, as she went down the stairs and into the courtyard. How much would her help and this machine in the clinic cost? he was asking. He would pay what he could, but he didn’t have much.
He didn’t need to pay her anything, Parveen said, and nothing for the clinic either. It was for circumstances like this that it had been built. What she wanted was to make him agree that Latifa could have an IUD implanted. Another delivery would likely kill her, and her husband was probably desperate enough at this moment to consent. But to extract such a promise now would be every bit as paternalistic as the village men themselves were, and he would likely break it anyway.
“I must be paid,” the dai caviled from behind, reminding them that she’d delivered the child.
And nearly let the mother die, Parveen thought. Was her fury at the dai’s grasping what Crane had felt? “Go inside and care for Latifa,” she ordered. Instead, the dai trailed her to the compound door, at which point Parveen chased her off with a pledge to bring her money the next day. “But leave the family be,” she warned. “Let them use what money they have to buy meat for Latifa so she can feed her baby.”
“If the girl lives it will be because of God,” the dai said, “not because of you.”
Parveen hurried through the cold, dark lanes with her bundle. Ahead of her, the clinic blazed with light, looking exactly as she’d imagined it would before her arrival in the village. This buoyed her, as did finding Waheed waiting inside. Her head scarf had come off at Latifa’s, and he stared at the dried blood crusted on her clothes, her face, her hair. She told him how to scrub his hands, and once he’d done so she gave him the baby to hold so she could clean herself. He bore the infant up tentatively, like a piece of hot bread. Parveen swiftly washed her hands, then took the child upstairs and switched on the incubator, which blinked to life. As she waited for the interior temperature to rise, she unwrapped the infant and placed her inside her own clothing, on her skin, to warm the tiny body. The newborn’s sleepy eyes blinked open, and she nuzzled into Parveen, gaping, gaping, searching by some atavistic instinct for a breast. Not finding one, she squalled, her first sound in the world a hollow cry. When the incubator was ready Parveen placed the baby inside and watched her miniature limbs flail and coil beneath the bright light. What a shock birth was, less a passage than an ejection. An eviction.
The baby slept. While she did, Parveen opened a can of formula and mixed it with water that had been boiled, then cooled. She’d observed Dr. Yasmeen cup-feed a newborn, but she was nervous. When the baby woke, Parveen lifted her out of the incubator and held her close. Then ever so gently she placed the rim of the cup against the edge of the tiny lips and waited until her tiny pink tongue began to lap.
When the baby was back in the incubator, Parveen stayed fixed to her side. She’d latched onto this rickety existence: the purity of her smell, the pinkness of her mouth, her jerky movements; her fuzzy head, her fleshy tonsure; her curling fingers and the delicate shells of her fingernails; her responsiveness to being held, the way her waving arms would suddenly compose; her kitten-like way of eating. As dawn approached, Parveen spoke aloud, casting stories, facts, poems, even songs into the incubator as if to hook the child more firmly to life. By degrees the infant’s color improved ever so slightly, or so Parveen told herself. She was desperate for signs the baby would live.
In the morning, the village women began to come in such large numbers that Parveen had to force most of them to wait downstairs, taking up only a few at a time. Some of them tapped on the glass of the incubator until Parveen cried, “Stop!” Any noise was magnified inside, Naseer had warned—those taps would be as jarring as a ringing phone. Others reached through the portholes to touch the baby until Parveen explained the risk of infection. Surrounded by these faces, the infant seemed less human than a specimen under glass. Again and again Parveen explained the machine’s functions, which were to provide warmth so the baby could fatten, quiet so she could rest, and a barrier to protect her from germs. Americans had once been as suspicious of incubators as the village women were, Parveen assured them. One of her professors, in fact, had once shown a slide of babies lined up in incubators on the Atlantic City boardwalk, where they’d been put to convince the public of the merits of the machine.
Around midday Latifa’s husband carried her to the clinic and up the stairs to the maternity ward. Her complexion was pallid, her speech still weak, but seeing her settled on a hospital bed, the other women eyed her enviously. With assistance from Bina, Parveen gave her a sponge bath, then helped her beneath the blankets. Latifa looked around in a daze; it was the first real bed she’d slept on. Parveen drew the curtains closed on windows that framed a view of the mountains and then chased the women from the room.
She was eager to have Dr. Yasmeen come so she could share every detail of the previous night with her, receive her accolades as well as her guidance. But Wednesday was five days off. She tried to channel the doctor, to think of what else she should do. Food, she realized; Latifa needed to eat, and eat well. She ran to Waheed’s to fetch the money hidden in her room, then gave it to Bina to buy large quantities of meat, vegetables, and bread, asking her to organize the women to cook it. Perhaps, she hoped, she could get a few good meals into other undernourished women too. By the second day after the delivery, color was returning to Latifa’s cheeks and she could sit up a bit. Parveen showed her how to raise her head or feet by manipulating the bed’s handheld control. The other women—Bina, Saba, Ghazal—stared open-mouthed at this thing moving of its own accord, then they climbed on top and clutched the sides as if it were a bucking bronco.
“Off! Off! W
atch out for Latifa!” Parveen shouted over their hysterical laughter. Then she unplugged the bed and promised that when Latifa was better, they could all have rides of their own.
Shokoh, whose pregnancy was now in its third trimester, reclined on another bed in the ward, trying to make clear to the other women that, as a city girl, she knew how it was done. She wanted to give birth at the clinic, she told Parveen, and she would put her baby in the incubator too.
Parveen explained that it would be better if this wasn’t necessary.
“Or maybe I’ll just stay here until the baby comes,” Shokoh told Bina, who cut her with a look.
Latifa’s milk had come in, but the baby was still too weak to suckle, and Bina warned that if the child didn’t get started, the milk would dry up. Parveen knew little about breastfeeding other than what she’d observed in the village and at the clinic with Dr. Yasmeen. She vaguely remembered her sister struggling at first with the latch, a word that at the time had amused her. Now, though, she regretted that callousness. Here, as in many matters, Bina and the other women became her tutors. Bina suggested that Latifa nurse her sister-in-law’s twins to keep the milk coming until her own child could feed. After that, every couple of hours, one of the babies would be brought to the clinic to nurse from her.
They were crowdsourcing this baby’s survival, Parveen would think as her adrenaline surged. Then she’d crash, teary and spent from lack of sleep, and want nothing so much as to collapse. She tried to measure the baby’s heart rate but didn’t really know what she was looking for.
It seemed Wednesday would never arrive, but at long last, the day was at hand. Soon Dr. Yasmeen would spell Parveen from her duties and shower her with praise.