one

Minnie O’Toole screamed again, a long piercing wail. Her eyes bulged and her round face shone as red as hot coals. “I’m going to die,” she whimpered when the pain subsided. “The babe and I are both going to die.” She grabbed my hand and squeezed.

I wiped the pretty young woman’s brow with a cool cloth. “Thee isn’t going to die, Minnie. Look at me.” I gazed into her eyes and willed her to listen. “Thee is a healthy nineteen and thy body is meant to give birth. Exactly like every woman anywhere in the world. I’m thy midwife and I’m here to help get this baby out. Now sit up a bit more.” I leaned over, hooked my hands under her armpits, and raised her farther up on her pillows against the plain wooden headboard.

She had been in hard labor for hours and was becoming weak from the effort. I had trudged through the remnants of the Great Blizzard to reach her. It had been scarcely three weeks since the storm buried us and the rest of New England in four feet of cold blowing snow, the worst storm we’d had in this year of 1888 or any year in prior memory.

But the girl’s birth canal still wasn’t fully open. I had finally sent word, asking Minnie’s landlord to use his new telephone to call my doctor friend, David Dodge, with whom I sometimes consulted during difficult births. The midwife I’d apprenticed with, Orpha Perkins, was now too elderly to help.

I heard David enter Minnie’s small flat. “I’m glad thee is here,” I said to him as he walked into the bedroom. He set down a black bag, removed his coat, and rolled up his shirtsleeves. To Minnie I said, “We will be back directly. Try to rest between contractions.” I led David back out into the hall.

“I’m always glad to see you, Rose Carroll.” He smiled at me and winked, an unruly lock of his wavy dark hair falling onto his brow. “How’s my favorite Quaker, with your thees and your thys?”

I blushed. David and I had been courting in recent months, but this was no time for that. “I am well. Now, her name is Minnie O’Toole. Her labor started yesterday morning, but the pains began coming a minute apart about four hours ago.” I opened my pocket watch, which I’d pinned to my left bosom so I could easily check it. “Yes, it’s now six in the morning. They became more intense at about two.”

“And the opening?”

“Still has about a thumb’s width to go. The baby’s heartbeat is fine, although the mother is tiring. She’s neither too young nor too old, so it isn’t her age slowing the labor. Perhaps a fear of supporting the babe holds her back. She has no husband and won’t tell me who the father is.”

David raised dark eyebrows over deep blue eyes.

I ignored his expression. I’m a midwife. As part of my calling, and because I’m a member of the Society of Friends, I serve rich and poor alike, and I don’t refuse to care for women who land in circumstances outside what society expects.

Another scream resounded from the next room. “That cursed man,” she wailed.

I hurried back, followed by David. Women often revealed much during their birthing travails. Perhaps we’d learn the identity of the baby’s father.

“Minnie, this is David Dodge. He’s a doctor at Anna Jaques Hospital in Newburyport. He’s going to help us get the baby out.”

Minnie let the scream go and nodded, panting. Her fine white nightgown was soaked with sweat. I’d noticed she wore expensive clothing and fancy shoes, despite living in a tiny flat at the back of a family’s house.

“I’m glad to have a doctor, but when will these pains be over?” She sounded desperate.

David greeted her. “Let’s check you again. I’m going to feel the baby, Miss O’Toole.” He palpated the baby through her gown, checked the position of the rump and the head. “The head seems engaged and the baby is vertex, so that’s good.”

I already knew the baby was in the proper position with the back of its head at the front of Minnie’s pelvis, but also knew David had to verify it for himself. I knelt and slid my hand up her passageway. I used my knuckles to feel the opening to the womb, then drew my hand back out.

“Thee is ready.” I smiled at her over the mound of her belly. “With the next pain, you must hold thy breath and bear down. Does thee understand? It will help to hold fast to the bedstead.”

She nodded and grasped the iron frame behind her head with both hands. It took only eight pushes and a few more screams for the baby’s head to ease its way out. I cleared the nose and mouth. “Thee is doing wonderfully. With the next pain, bear down hard, please.”

A moment later, Minnie pushed again. But the baby’s body didn’t follow, and its face began to redden. I glanced at David. He frowned and knelt next to me.

“Push again, Minnie,” he urged, but the baby still didn’t birth. “Pull your knees right up by your ears, hold them with your hands. Now.”

Minnie obliged, but grunted as she did so.

“Shoulder?” I asked David. I prayed not. I’d observed a birth during my training where the baby’s shoulder became caught on the pelvic bones and when it was finally born, it had a dead brain. In my eight years of practice, I had gratefully seen only the one case.

“Perhaps. We’ll try the screw maneuver. Have you done it? Your hands and arms are smaller than mine.”

“I haven’t, but I saw Orpha perform it, explaining to me as she did so.” I closed my eyes for a brief moment, holding Minnie and her baby in the Light of God, after the manner of Friends. And myself, for attempting this urgent procedure. I had to act fast and correctly. I took a deep breath and opened my eyes.

“Go in and turn the shoulders,” David said in a low urgent tone. “If you must break a shoulder bone, do it. Bones heal; brains don’t. I’ll catch the birth.” In a normal voice he said, “Miss O’Toole, refrain from pushing for a moment.”

“What is happening?” Minnie cried. “Is there something wrong with my baby? Why hasn’t he come out yet?”

I slid my right hand in through the warm wet opening past the head, producing a deep moan from Minnie. Sure enough, one shoulder was in the canal but one seemed to be stuck. I grasped the tiny bones and turned. I felt movement. I slid my arm out. The baby came with it in a gush of fluid and landed in David’s large hands. My relief made me a touch weak.

He held the tiny boy up so Minnie could see. “Here he is.” The baby took a breath and let out a hearty cry. David smiled. “Perfect,” he whispered to me. “No need to break a bone?”

I shook my head. I pushed my glasses back up the bridge of my nose with my clean hand. I took another deep inhalation and let it out. This was the business of midwifery. Women giving birth go down into death and bring forth life. Usually. It was my job to help it be so.

David and I cleaned the baby. I tied off and then snipped the cord. He was pinking up nicely and breathing well. I wrapped him in a blanket and handed him to Minnie. She wiped tears from her cheeks with her free hand. She stroked his face.

“Thee will have another pain soon when the afterbirth comes out,” I said. “What will thee name him?”

“I don’t know yet.” She grimaced. “What’s happening now?”

“Your body is expelling the afterbirth. It’s normal. Hand the doctor the baby and then bear down.”

David cradled the warm bundle while Minnie pushed out the placenta into a bowl I held waiting. I examined it.

“It’s all there,” I said. A woman could bleed and even die if a portion of the placenta was retained in her womb.

David handed the baby back to Minnie. “Congratulations, Miss O’Toole. You have a healthy baby boy. Thanks to an expert midwife.”

Minnie nodded, her eyes only for her new son.

“I’ll be off,” David said to me. “I have rounds at the hospital on Thursdays.”

“Thank thee for assisting.” I smiled at him.

“You did it all yourself.” He bade Minnie farewell and left.

After I cleaned her and then washed up, I spent more than an hour making sure she was able to nurse the infant and instructing her on her own care.

“Will thee have help?” I’d noticed a stack of neatly folded diapers on the dresser and several new infant dresses atop a soft yellow baby blanket edged with satin binding, all of a quality that matched Minnie’s fine nightdress. The father must be an attentive one, whoever he was.

“My sister is coming soon.” Minnie couldn’t take her eyes off her baby. She stroked his dark hair and cooed to him.

“Good. I’ll visit thee again tomorrow.”

She thanked me. “That pouch on the dresser is your payment.” She pointed to an embroidered bag.

Where had she found the money? I put that thought to the back as I extracted two dollars from the pouch and gathered my things. After I left, I walked slowly along High Street carrying my birthing satchel. Spring in Massachusetts was late arriving this year, despite it being already Fourth Month, or what non-Quakers called April. Tightly wrapped flower buds guarded themselves against another snowstorm. The Fifth Day dawn lit up only a fuzz of green on the trees, and piles of snow remained on the north side of buildings.

Shovelers had valiantly tried to clear the paths in our town after the blizzard. When I was summoned to a birth the day after the storm, I’d had to strap on my snowshoes to make it only three blocks away. I’d been lucky the baby boy had made an uncomplicated entrance into our world. David could never have navigated the few miles northwest across the bridge over the wide Merrimack River from the bustling shipping town of Newburyport to assist the delivery on that day. I could conceivably call on John Douglass, a doctor who attended births in town, for assistance, but he wasn’t as kindly toward midwives as I would have liked.

I yawned at the long night behind me. I’d be able to nap for only an hour or two before my clients began arriving for antenatal visits. As I walked, I mused on how David was becoming much more than a friend over recent months. I was feeling quite sweet on this slender doctor only a few years older than I, with his clear skin, sparkling eyes, and gentle manner. I had invited him to join my late sister’s family and me for dinner last week, and he’d seem to quite enjoy the company of the lively but motherless family.

I still missed Harriet a year after her sudden death. She’d been my guide, my dearest friend, and my model of how to be a good mother, although I myself was making no progress whatsoever on that front. I was an excellent assistant to mothers, but I was neither married nor in possession of offspring of my own. And at twenty-six, I was getting a bit past the so-called marriageable age.