The Secrets of Midwives (27 page)

By the time I returned, the baby's left leg had emerged as far as the knee. Grace looked like she was using every last ounce of energy to stay calm. “Mom, I need instructions. What do I do?”

I touched Grace's shoulders. “The most important thing is that as long as delivery continues spontaneously, you need to keep your hands off. If you pull, even a little, you can interfere with flexion of the head or stop it rotating effectively. Worse, it can cause nuchal arms, where the baby wraps its arms around its neck, making it impossible to deliver vaginally. So do not touch the baby at all. Understand?”

Grace nodded, but her jaw was tight. I understood. It felt unnatural to see the baby coming and not be able to touch it. It must have felt even more unnatural when the baby was your grandchild. Silently we watched as the tiny leg emerged from Neva. Grace's hands hovered a few centimeters back from the baby. “Now what?” she said. “I really do nothing?”

“Nothing,” I confirmed. “Just wait.”

The leg continued to come. I felt a little sick. I'd delivered a breech before, but never a footling. It was what we referred to while studying as a complicated delivery. Far from ideal under these circumstances. If things didn't go to plan … well … I couldn't think about that. The baby rotated as it descended, and Grace and I watched silently as the left buttock appeared, then the right. Then—pop—both legs were out. So far, so good.

“When you see the umbilical cord, pull down a small loop to prevent traction on the cord later in the delivery,” I told Grace.

Grace did as I asked. The baby was out as far as the torso. But the most difficult part was still to come.

“With the next contraction, I want you to push, Neva,” I said. “Hard as you can.”

Neva nodded, gripping the couch. And when the next contraction came, she pushed. I held my breath and, I'm sure, so did Grace. The contraction finished. Two more contractions came and went. Neva pushed and pushed. Still the shoulders did not appear. I cursed under my breath.

“The shoulders aren't delivering spontaneously, so you'll need to assist,” I said to Grace. Any hope for a smooth, straightforward birth was gone. Now I just prayed for a safe birth. “The anterior arm can be delivered by sliding two fingers over the baby's back,” I said, “along the humerus to the elbow. Then you can sweep the arm around in front of the baby's face and chest. Do the same for the other arm.”

If Grace was feeling anxious, it didn't show. I marveled as she delivered the arms. It was a tricky technique, but it was as though she'd done it a hundred times before.

“Good,” I said. “Very good.” Now the entire baby was out, apart from the head. “Okay, Grace. Is the head engaged?”

Sweat drenched her face. “I … I don't know.”

“Can you see the baby's hairline?”

Grace looked. “No. I can't.”

I looked at the baby, its little torso supported by her right hand. “Let go of the baby.”

Grace looked at me like I was crazy.

“Let it go,” I repeated. “If you let the body hang, the weight will pull the baby down and, with any luck, engage the head.”

Tentatively Grace let go of the baby, leaving it to dangle from Neva. Grace's body became still. I doubted she was breathing.

“Good,” I said. “With the next contraction, Neva, I want you to bear down with all your might, okay?”

Neva nodded, gripping the sofa. Another contraction came and went. I willed Lil to get back. Things were moving fast, and if anything went wrong, we'd desperately need those instruments.

“Okay, Grace,” I said, turning back. “Is the head engaged now?”

Grace looked, then shook her head. I squeezed my hand into a fist.

“What is it?” she asked.

I hesitated before speaking. “I'm just a little concerned about the biparietal diameter of the head.”

I didn't need to say any more. If the baby's head was too large to pass through Neva's pelvis, she would need a C-section. Without one, Neva and the baby would die. Grace knew that. Unfortunately, Neva did too.

“No!” Neva cried. “My baby—”

“—will be fine, darling,” Grace said simply. “And so will you. I'll make sure of it.”

Neva calmed immediately. Strangely, so did I. There was something about Grace. She
seemed
in control. Grace, who lived for adrenaline, was, as it turned out, wonderfully cool under pressure.

“Mom,” Grace said to me. “What are our options?”

I stared at the wall. I'd been asking myself the same question. “If the head is stuck, we might be able to turn it in a way that will allow it to pass through the pelvis.” I thought about it some more. Yes, it could work. The risk of a serious tear to Neva was increased, but we didn't have a lot of choice. “This is important, so I need you to listen carefully: We need to turn Neva over so I can apply pressure to her abdomen when she starts to push.”

Neva was already turning from all fours into a reclining sitting position. Grace helped her. I said a silent prayer.

“Now, Grace. Let the baby straddle your right hand … Yes, like that. Now, I want you to slide your middle finger into the baby's mouth and your other fingers over the baby's shoulders. Perfect. Now, with your other hand, press against the back of the baby's head. I'll apply pressure on the outside of her belly at the same time. All right?”

The door clattered shut and Lil appeared beside me with the delivery bag. I opened it and lay out the clamp, the cord, the gloves. I got everything unpacked just in time for the next contraction.

“Okay, Grace—push the head up slightly, rotate, and then pull down. Understand?” I looked at Neva. “Push, dear. Push as hard as you possibly can.”

Neva touched her chin to her chest and squeezed. At the same time, I pressed hard on the outside of her belly. The bones in her neck stood out like kindling.

“It's coming,” Grace said, her voice barely a whisper. “The head. It's coming.”

It was only then I realized my cheeks and blouse were sodden with tears. I felt movement under my hand as the baby's head moved down. Grace lifted the baby's torso as the head emerged. The baby was out.

Grace placed the baby straight into her mother's arms. The raven-haired babe let out a soft mew. “Congratulations, dear,” I said to Neva as an overwhelming sense of déjà vu swept over me. “You have a daughter.”

 

27

Neva

The first thing I recognized when I opened my eyes was the nursing chair in the corner. I was in a maternity suite at St. Mary's Hospital. The second thing I recognized was the person sleeping in the nursing chair. Patrick.

“Hey.”

My greeting came out as a hoarse whisper, but he sprang to life immediately. He came to my side and pressed the buzzer by my bed. “Hey.” He cleared his throat. “How do you feel?”

I looked past him and scanned the room for a bassinet. “Where's my baby?”

“She's in the nursery with your mom and Gran. She's fine. Your mom hasn't put her down since she was born. We were much more worried about you. You had a third-degree tear and lost a lot of blood. You were pretty out of it when they brought you in.”

My eyes found Patrick's. “She's fine? You're sure?”

“I examined her myself. She's six pounds two ounces. Completely healthy.”

Patrick was doing his confident pediatrician thing. I'd seen him do it with hundreds of parents over the years, and it never failed to put them at ease. It was even working on me. A little.

Two nurses I didn't recognize appeared in my room. “We've paged Dr. Hargreaves. How do you feel, Neva?”

“Fine. I want to see my baby.”

“Leila is getting her,” said the nurse, slipping a blood pressure cuff over my hand and dragging it up my arm. “In the meantime, let's have a look at you.”

The mention of Leila's name made me look at Patrick. It might have been my imagination, but he looked like he wanted to smile. He took a seat on the side of my bed while the nurse took my temperature and read my blood pressure. When it was time to check my bleeding, the nurse glanced at Patrick, clearly expecting him to excuse himself. He didn't. I tried not to read too much into it, but my heart sang.

“Six pounds two ounces?” I asked as the nurses did their thing under the sheet.

“Yep,” he said. “She's a good size.”

I paused. “Full term?”

He nodded slowly and I could see he had already done the math. “Possibly even overdue.” He remained silent while I took that in. “She's beautiful,” he continued. “Looks like you, except her hair is black and her skin is olive. She looks sort of … Spanish or Greek or something.”

“Italian,” I whispered.

“Yes.”

I stared at the sheet in front of me, so plain and blank, yet suddenly swirling.

“Anyway, I'm glad you're okay,” he continued. “I was worried there for a minute. Your mother is a hero, doing a vaginal footing delivery at home. Someone suggested she should be nominated for an award.”

This snapped me out of it. “They did?”

“Mmm hmm. Look, I'm sorry about—”

“Here she is!” In the doorway, Leila stood behind a bassinet. Through the clear plastic I could see a mess of black hair and a pile of pink and white striped blankets.

“Someone has been eager to see her mommy,” she said. She reached into the bassinet and cradled the tiny bundle under her bottom and head. She came around the bed. “Congratulations. She's a beauty.”

Leila's voice was like elevator music—I could hear it, but it was irrelevant, barely noticeable. All my attention was concentrated on the person in her arms. My daughter. She was more perfect than I could have imagined. I reached for her. In my arms, she weighed almost nothing, like a cloud of cotton candy or a bunch of daisies. I opened my mouth to tell her something, anything. But there were no words.

I was right, I realized. When I reassured mothers that it didn't matter how the baby came out, I was right. Right now, I didn't care if this baby had been beamed down to me from outer space. The special moment had happened. She was mine. And I was hers.

“She's got your chin,” Patrick said.

“You think?” I puckered my chin. “I've never paid much attention to my chin. Is it a good chin?”

He smiled with something resembling fondness. “It's a very good chin.”

“It's a
perfect
chin.”

Grace stood in the doorway, an award-winning grin on her face. She was still dressed in the clothes she'd been wearing last night—the paisley skirt now had a sizable bloodstain on the left side. A fluorescent pink elastic dangled from a few strands of hair. She'd been through hell. Without warning, fat tears began to slide down my cheeks.

Grace crossed the room in three large steps. “Don't you cry or you'll make me cry,” she said. In fact, a few tears had already escaped. “It's a happy day. I'm a nana.”

We beamed at each other through tears, then dropped our eyes to the baby.

“Does she have a name?” Grace asked.

“Not yet. I only had a boy's name picked out.”

“What was the boy's name?”

“Robert. Robbie.”

“Your father would have loved that. But ladies are his lot in life, it seems. So no girls' names, then?”

“Nope.”

In truth, I'd pretty much decided on Florence a few months back. It had occurred to me that Mom might have been offended being overlooked, but at the time I hadn't cared. Now I did.

“We'll think of something,” I said, and then I noticed that Patrick had slipped out of the room. “I mean … I'll think of something.”

“He's probably just gone to the bathroom, darling.”

I looked back at Grace and saw understanding in her eyes. She nodded encouragingly. But I didn't share her optimism.

“Neva,” Grace asked. “I want to ask you something. Why didn't you tell me? About the pregnancy and the father? I understand why you wouldn't tell Patrick, or people at the hospital. But why not me? You know I wouldn't have judged you, don't you?”

“Yes,” I said. “I do know that.”

“Then … why? You don't have to answer—”

“No. It's okay.” I closed my eyes and exhaled. “It might sound strange, but … I felt like if I talked about it, it wouldn't be mine anymore. I'd barely got my head around it myself, and I knew if I shared it, you'd want to be involved. But this wasn't something I wanted to share. I thought that if I didn't keep it close, I'd lose it. Not the baby but … my way. And I wasn't willing to do that. Not with my baby.”

I opened my eyes, steeling myself for the look of hurt on Grace's face. But it wasn't hurt I found. It was something resembling … pride.

“Does that make sense?” I asked.

She cupped her hand over mine. “Nothing has ever made more sense. Protecting your baby, listening to your instincts—that's what being a mother is all about. Sounds to me like you're going to be a good one.”

“Mom, don't make me cry again.”

It was the first time in years that I had called her Mom. It felt surprisingly right.

Suddenly I remembered that I hadn't told her the full story. “But, Mom, the baby was full term. Which means Sean isn't the father. The father is a guy I went on one date with, a month before anything happened with Sean. Not married. An accountant. An Italian guy who wears sensible shoes. A guy who now has a serious girlfriend.”

I waited for Mom to scream, pursue me for more information, or do something outrageous. But she didn't. She just waited.

“So I need to tell him about her,” I said.

“You mean now?”

I nodded. “It's already far too late.”

“Okay.” Grace stood. I couldn't believe this restrained, accepting woman was my mother. “Do you have his number?”