The Amish Midwife

TWENTY-SEVEN


He seems really nice,” Ada said as I drove down Queen Street, heading out of town.

I agreed, though I was still a little taken aback by his comments about the people praying for Caroline. But the truth was, until recently I might have said the same.

“Did he give you this bag?” she asked, holding up my purse. “It’s a Coach, right?”

I was dumbfounded. “Really? You know what a Coach is?”

“Ya,” she answered. “You’d be surprised at what Amish women know about.” She put it down on the console between us. “It’s nice,” she said. “The purse. So is Sean.” Her voice held a hint of teasing. “Are you two courting?”

I smiled. The word was so old fashioned. So innocent. “No. And we’re not dating, either. I guess you could say we’re just friends.” Of course I was lying. I was contemplating moving to Baltimore, for goodness’ sake.

“How about you?” I asked. “Is anyone courting you?”

Ada blushed. “No,” she answered. “And I’m not dating anyone, either.” She gave me a sly smile and then burst out laughing. I had to laugh with her as I thought of Will Gundy stopping by to visit her while her parents were gone. Maybe we were both lying. Then again, his wife had only been dead three months. Perhaps his interest in Ada was strictly neighborly.

Once the laughter stopped, she asked me about Marta and the case against her. After I told her everything I knew, Ada said she wondered if Lydia’s death had anything to do with her poor health.

“Pardon?” No one had said anything about Lydia being in poor health.

“Ya,” Ada said. “She used to have spells. She was an eighth grader, and I had just started at school. I was sickly myself, so I noticed that sort of thing.”

“What was the matter with her?”

“I don’t know exactly, but she would get tired and have to sit, although she never drew attention to herself. Then, when she was older and out of school, there was a period of time where she didn’t get out much at all, not even to church. The rumor was she was very ill.”

As I came to a stop at the light in Willow Street, Ada gazed out the window at the strip mall. “I wondered if having the twins was too much for her, even though she had them in the hospital. And then she got pregnant again so soon.”

No one had said anything about Lydia going to the hospital to have the twins. Surely she hadn’t had a C-section. If she had, Marta would have insisted she have the next baby in the hospital too, although there were midwives who did deliver a vaginal birth at home after a C-section.

“What does Marta say?” Ada asked.

“Not much. Just that she didn’t do anything wrong.”

Ada sighed. “That’s what Will says too.”

The light turned green and I accelerated. “Do you see him much?” I blushed as soon as I spoke. After all, the man’s wife had died only a few months before.

“You saw him that one day, ya?” Now it was Ada’s turn to blush.

I nodded.

“He was driving by and thought he would stop by to visit Daed. He didn’t know my parents were gone.”

I turned off the main highway onto the country road that led to Klara’s farm.

“He just talked about his girls. How they’re doing.” Her gaze drifted out the window. “He said next time he’ll bring them by. I’d like that,” she said, her voice soft. “I’d like that a lot.”

Given Ella’s interest in Ezra, it looked as though both my cousins—or whatever Ada was—were falling for a Gundy brother.

I thought through that family tree again. Alice gave birth to Nancy, who married Benjamin and gave birth to four kids: Will, Hannah, John, and Ezra.

Will married Lydia, who gave birth to three kids: Christy, Mel, and Mat.

Hannah married Jonas, gave birth to Rachael, and was expecting another baby soon.

John married Sally, who was currently expecting their first child.

Ezra. Well, and then there was Ezra—wild, charming, motorcycle-riding Ezra. I didn’t know whether to smile or cry. Would Ella someday be around the big dining room table feasting and laughing with the Gundys too, alongside him? Or maybe Ada, alongside Will?

Again, I felt a twinge of jealousy.

Marta showed up at the cottage that afternoon, explaining that a woman from her church had dropped her off. I was alarmed, afraid Caroline had taken a turn for the worse, but Marta assured me that the church had rallied and another woman was staying the night and caring for Simon the next morning. She said Caroline was getting better, and they hoped she would be discharged the next afternoon.

My relief must have been obvious because she patted my shoulder. It was the most affectionate she’d been with me.

That evening as Marta and I did the dishes, I brought up the subject of Lydia and her general health.

“She was fine,” Marta said. “Her blood pressure ran a little high but not dangerously so.”

“She had plenty of energy?” I asked as I dried a plate.

“I wouldn’t say plenty, but she had enough to do what she needed to do.”

I asked if she’d had a C-section with the twins.

“No.”

I bit my lower lip as I dried another plate and then said, quickly, “Do you still have her chart or was it taken by the DA?”

“The DA’s office made a copy and took that. I still have the original.”

“Mind if I take a look at it?”

Marta turned her head toward me. “Why ever so?”

“I’m curious, that’s all.”

She shook her head. “There’s nothing in her chart. My lawyer hired an expert to go over it, and it offers no more information to the case.”

I put the plate in the cupboard, bumping it against the stack. She hadn’t told me yes, but she hadn’t told me no, either.

Marta pulled the plug to the sink. “I’m tired.” She yawned, covering her mouth with her forearm. “Poor Simon was up half the night crying for Esther. David and I took turns with him, but we weren’t who he wanted.”

I didn’t dare go out to the office while Marta was still up. It would be too obvious. Then I remembered that I had appointments in the morning. I decided I could wait to look at Lydia’s chart then.

Sometime during the night I had a text from James asking how Caroline was again. I saw it in the morning and texted him back. Better. Thx for praying.

My first appointment was at nine, but I was in the office by eight thirty and pulling the Gundy, Lydia file from the cabinet. In midwifery a mother’s chart, besides keeping all the information on hand for the midwife, is the legal document of care. It safeguards both the caregiver and the mother. From what I’d seen, Marta’s records were clear, concise, and accurate.

I worked my way backward through Lydia’s chart, starting with the death of the baby. 4:32 a.m. stillborn baby boy delivered by C-section at Lancaster General…4:10 a.m. mother DOA at Lancaster General…mother on life support, taken by ambulance to Lancaster General…EMTs arrive at patient’s home…CPR administered for 15 minutes…patient stops breathing, eyes roll back…3:05 a.m. called 911 against patient’s wishes…baby’s heart tones at 95…patient instructed that transfer to hospital is necessary; patient declines…patient’s blood pressure 160/110…Marta should have called 911 once Lydia’s blood pressure spiked, but it might have only been another minute, just long enough to check the fetal tones, which were dangerously low. At that point, in a hospital, the mother would have been whisked down the hall for a C-section.

I kept reading. 2:45 a.m. urge to push… 10 cm dilated… Labor had started at ten thirty p.m. the day before, January 29. At the appointment the week before, Lydia’s blood pressure had been 120/90, not too bad for a woman nine months pregnant. The cervix was thinned and dilated to two. The baby’s head was in a good position. There were no indications, at that point, that Lydia’s and the baby’s lives were in danger. I kept flipping back through the chart. At one appointment Lydia’s blood pressure was 140/110, and Marta had instructed her to see her doctor. At another her pulse was elevated, 120.

I flipped to the birth of the twins. They had been delivered by a doctor at the hospital and not by Marta, but the chart from the birth had been copied from hospital records and included here anyway. According to the notes, Lydia’s blood pressure was fine through the ten-hour labor and also through the delivery. It seemed like a best-case scenario situation for the birth of twins.

Christy’s birth was nine years before the twins’, and there was no explanation for the gap. No record of miscarriages, stillbirths, or lost babies. Labor had been longer, fifteen hours, but not bad. There was no indication of high blood pressure, although Lydia’s pulse had run high at a few appointments. Gravid 2 was marked at the top, which meant Christy was her second pregnancy.

Her second pregnancy?

I thought about that and finally decided that maybe she’d had a miscarriage before. Because Amish women often didn’t seek medical attention until well into their second trimester, a lot of miscarriages were likely missed. It could be that Lydia had had an unconfirmed one. I flipped to the next page.

Primigravida was marked, indicating her first pregnancy. Continuing backward through the file, I read Marta’s notes about that birth, a healthy baby boy, though no date was listed. In fact, I realized, none of the entries related to this first birth had dates next to them. Odd. It wasn’t like Marta to be so sloppy. At least, from what I could tell, the birth and pregnancy were uneventful. Turning the pages, I finally came to the very first entry in the file, when Lydia was five months pregnant with her first child.

Smoothing the pages back into place, a wave of grief washed over me. Will had lost his wife and not one but two sons. I closed the chart as my first patient of the day opened the door. But instead of the person I was expecting, I saw Hannah, Will’s sister.

I quickly turned Lydia’s chart over on the desk, hiding her name.

“Do you have a minute?” she asked.

I glanced at the clock. I had five. I nodded.

“Will was headed to the feed store, so I hitched a ride. I’ve been having nightmares. I know it’s because of Lydia, but I keep dreaming this baby dies. And that Rachael dies. And that Jonas dies.” I hadn’t met her husband yet. “I’m hardly sleeping, and I wake exhausted from my dreams.” It wasn’t unusual for women to think they were dreaming excessively. In reality they were waking excessively and remembering their dreams. Although I was sure the content of a pregnant woman’s dreams did tend to be bizarre, likely due to fluctuations in hormones.

I talked with her about exercise and showed her a few breathing techniques. Then I gave her a bottle of valerian tincture and told her to mix it with water or juice. “And talk about how you’re feeling with someone.”

She tilted her head as she took the bottle and looked confused.

“Or write it down. But you can’t keep it bottled up inside, Hannah. This has been a huge loss for all of you.”

“She had a premonition.” She sighed and shook her head. “I’m not saying I’ve had a premonition. I’m just saying I’m having nightmares.” She stepped toward the door. “But Lydia was afraid something bad was going to happen.”

I’d heard of that before, but usually there was nothing to it. “Hannah.” I wasn’t sure how to phrase my question. “Did Lydia have any miscarriages or stillbirths?”

She shook her head.

“Did she lose any other babies?”

“No.” She appeared absolutely sincere. “Why?”

“Oh, I’ve just been trying to figure out what happened that night.” I smiled and stepped toward the door after her. “I’ll see you Monday.” She’d just started her ninth month and so would have appointments on a weekly basis from now on.

“See you then. And thank you,” she replied.

Before closing the door behind her, I looked out, noticed Will waiting in the buggy, and gave him a wave. He waved back, a smile on his face, completely unaware that I had been in here snooping through his late wife’s medical records. Heat burning my cheeks, I hurried back into the office to refile Lydia’s chart.

I did pray for Hannah, and I also prayed I’d have a chance to talk with Will in person, alone, when I was at the Gundy and Kemp farm. Three days later I headed over there, surprised to find that just driving down the lane made my heart race. I knew Will had bought this farm from Burke Bauer, the man who Mammi claimed was my biological father. If that was true, then that meant this had once been my father’s home, my family’s land. Trying to wrap my head around that, I made my way past the greenhouses and parked beside the smaller residence. As I climbed out and grabbed my bag from the trunk, the back door to the big house opened and Will stepped onto the porch.

“Hello,” I called out.

He shaded his eyes against the morning sun and then smiled once he recognized me.

“Hannah has an appointment,” I said.

“Ya. She’s over here.” He started down the stairs. “She’s having a difficult time, thinking about Lydia and all.”

I nodded.

“Oh, that’s right. You already know. I took her by your place Friday.” He pulled his straw hat over his red hair. “Seems everyone is having a hard time.”

“How is Christy?”

“Quiet.” He was standing opposite of me on the walkway now.

“Is she depressed?”

“Maybe. But mostly she just seems worn out. Like it’s an effort for her to walk across the room, let alone do her chores.”

“Is she going to school?” I put my medical bag on the concrete at my feet.

“Some.”

“Have you taken her to the doctor?”

He shook his head. “No, but I was thinking I should.”

“That’s a good idea. Make sure you explain how Lydia died. Tell them that a cause hasn’t been determined, even though an autopsy was done.”

He bent down and picked up my bag, but before he turned back to the house, I asked if he would mind answering a few questions about Lydia.

He sighed. “Sure.”

“Did she go to the doctor about her high blood pressure after Marta told her she should?”

He shook his head. “And she never told me Marta said she should.” He placed both hands on the handle of the bag. “She hated doctors, hospitals, all of that. Her mother died young despite being under a doctor’s care. Then Lydia had a bad experience herself before we got married.” He paused. “We had to force her to go to the hospital when she was ready to have the twins. But when Marta told her she needed to go to the hospital during labor this last time, she refused. By the time Marta called the ambulance, it was too late.”

“I’m really sorry.”

“Ya. I know. So am I.” His brown eyes were kind. “And I’m really sorry for the mess Marta is in because of this.”

I took a deep breath. “Can I ask you one more question?”

He nodded.

“Can you tell me about Lydia’s first baby?”

“Christy?”

“No.” I hesitated. “The one before.”

“Who told you about him? Marta?” His voice was confused.

“No, I was doing some filing and ran across some old notations in her office.” I didn’t want to admit that I’d intentionally read through Lydia’s chart. Because I was part of the practice, I hadn’t exactly broken the law, but that still didn’t justify what I had done. If Will wanted to, he could file a grievance against me. But because he was Amish, I knew he wouldn’t, and I was taking advantage of that.

He glanced off toward the greenhouses and then back at me, his head tipped downward. “Ask Marta about it if you want to,” he said. “But just know this. I had no part in that first baby.”

My conversation with Will weighed heavily on me as I examined Hannah. When I was finished, I noted in her chart that she was fifty percent effaced, two centimeters dilated, and the baby was in a breech position. I showed her exercises to do to turn the baby and told her that if it didn’t, she would need to deliver at the hospital.

“Marta does breech home births,” she said, pushing herself up to a sitting position and then clumsily swinging her bare feet to the floor.

“I know, but I don’t,” I said, looking her straight in the eye. “Rest as much as you can. It will be best if the baby waits another week or two. And do the exercises faithfully.”

Hannah said she had slept better the night before and that her mother and grossmammi had the girls over at her parents’ house for the day. “There’s always so much activity over there, so many hands to help. It tires all of them out.”

I thought of Ezra, and of Sally and John, and of Sally’s sister, Ruth. The girls were lucky to have so much going on. I had an appointment with Sally the next day. I couldn’t believe I’d been in Lancaster County a couple of days short of a month.

“How about Christy?”

“She went to school today. The first time this week.”

I asked Hannah if she was okay being alone, and she assured me she was. Her husband and Will would be in for lunch, and her mother would bring the girls back after their naps.

I left the house thinking about Lydia. Marta told me that the home had been built by Will, his father, and his brothers after Will and Lydia had married. She must have felt like a queen, albeit a queen with a secret. It looked like the Lantzes weren’t the only family in Lancaster County hiding the past.

But it seemed Marta was a common denominator in both.

The next afternoon, I finished up a delivery—baby number 262, seventh for me in Lancaster County, and the second child of a twenty-eight year old mother, living in Strasburg proper. The husband kept his carriage in the garage and the horse grazed the double lot next door. As I said goodbye, I focused on the image of the mother, two-year-old brother, and baby girl in my mind, all on the bed with the father lovingly standing watch, committing the scene to my memory. As I pulled out of the driveway though, I took a photo of the house with the open garage and horse nearby, getting a kick out of the townie Amish family.

I stopped by the old Gundy place and examined Sally on my way home. As I did, I realized that her baby and Hannah’s would be just a couple of months apart, cousins much closer in age than even Rachael and the twins.

Sally was doing fine and had lots of questions for me. Ruth stayed outside. The weather was warm, and it seemed she was gardening, but I think mostly she was on the lookout for Ezra.

A few minutes later, as I headed back to Marta’s, Chuck called and I flipped my phone open to speakerphone. “The tests are back,” he said.

“What’s the verdict?” I so wanted to be Ada’s half sister, more than I’d ever wanted anything.

Chuck cleared his throat. “You think you’re the Amish girl’s cousin, right?”

“Well, I suspect we may be half sisters.”

“Oh.”

“Am I right?”

“Maybe you two should come in. We could talk in person, and the two of you can tell me about your family tree.”

I grimaced. “That’s what I’m trying to figure out.” I slowed as I approached a school, careful to keep my eyes on the road, not the phone in my lap.

“I can talk to you this afternoon,” Chuck said. “I’m here till four.”

I thanked him and told him I would get back to him with a time as soon as I could. I closed the phone, an odd apprehension gripping at the pit of my stomach. Turning off the road into the parking lot of a toyshop, I dialed Ada’s cell. She picked up on the third ring, her voice quiet.

I explained what was going on and asked if she could sneak up to the end of the lane and go to the hospital with me.

“I think so,” she said. “I’ll be there in ten minutes. I’ll text you if I can’t make it.”

I waited for five minutes, afraid she couldn’t get away, but then there she was and out of breath, even though she’d only been walking.

“Are you okay?” I asked as she climbed into the car.

She nodded, but it took her a couple of moments until she was settled enough to speak. “I’m just tired, that’s all.”

Before pulling out onto the road, I called Chuck to let him know we were on our way. We met at his office, all three of us crowding into the cramped room. His desk was stacked with papers, and his bookcases were overflowing with books double-shelved and wedged in haphazardly. I hoped he had been more organized with our results. He sat down in his chair and reached for a small white board, propping it on his desk.

“Okay, so you thought you were cousins, right?”

I nodded. “Our mothers are sisters.”

He asked each of us the names of our moms and then started a family tree, working from the bottom up.

“And your fathers are?”

“Mine is Alexander,” Ada said.

Chuck drew a circle and wrote an A in the middle and then connected it to Klara’s name.

“And I’m not sure who mine is,” I said. “But the name Burke Bauer has been mentioned.” I didn’t want to just spring on Ada my hope that Alexander was my father. If he was, Chuck would soon tell us. If he wasn’t, there was no reason to mention it at all.

He drew a circle, added a B, and connected it to Giselle’s name. Then he turned his attention back to us.

“What can you tell me about prior generations?” Chuck asked. “Do you know if your family traces back to the original Amish settlers of Lancaster County?”

“Our mothers came here from Indiana about thirty-five years ago,” I said. “I don’t know a lot before that, but I think our maternal great-grandmother emigrated to the U.S. from Switzerland in the mid-1870s.”

“Okay.” Chuck looked back at the board. “What was her name?”

“Elsbeth,” I answered.

“And our grandmother is Frannie,” Ada said.

He added both names slowly. I couldn’t help but think he was stalling.

“So what’s up?” I asked as he finished.

He turned back toward us, gripping the marker tightly.

“This is a little awkward, but I’m sure it’s true.” He let go of the marker and it rolled across his desk, landing on the floor. He didn’t seem to notice. He clicked on the mouse in front of him, opening a document on his computer. “Cousins share an eighth of the same DNA, although it’s higher among families that intermarry. From analyzing the strands of hair—and by the way, the one you gave me wasn’t yours.” He was looking straight at me. “It’s hers.” He nodded toward Ada.

He started to go on, but I leaned forward in my chair and told him to wait a second. I was puzzled at how Ada’s hair could have ended up in my box, considering that my parents had whisked me away to Oregon when I was still an infant and Ada hadn’t even been born yet. In fact, she wouldn’t come along for another two years.

“Are you sure?” I asked, thinking that the only way that the lock of hair could have been Ada’s was if it had been sent to us later. I had always been under the impression that our families had had no further contact once my adoption was final, but now I realized that wasn’t correct, that someone here must have been in touch with my parents and mailed a lock of Ada’s hair to Oregon after she was born.

“Positive.” He stared at the screen again. “Anyway, you share much more DNA than cousins.”

“Half siblings, right?” I was sure my voice was as elated as I felt, even though I was trying to be sensitive to Ada.

Chuck shook his head.

I sighed.

“Full siblings,” he said.

I lurched forward. “You’re kidding.”

Ada grabbed my hand.

“I’m not kidding. It’s not a fluke you look so much alike. You’re sisters.”