The Amish Midwife

FOUR


I averted my eyes but knew my reddening face gave me away. “How about dessert?” I asked brightly. I turned toward the hutch and, speaking over my shoulder, said, “Mrs. Miller, your lemon meringue looks delicious.” As my guests served themselves from the top of the hutch, James shot me a questioning look. I mouthed, “Later” and turned my head away.

After dessert Sophie said she had a mother to check on and she would talk to me soon. James assured the guests that he would clean up; we both knew most of them needed a nap by now. One by one they left, telling me I was in their prayers and whispering “God bless you” as they descended the back steps, gripping the rickety rail.

That left me and James staring at each other in a kitchen full of dirty dishes.

“What’s going on?” he asked again.

I positioned the plastic plug over the drain. “I told Sophie I needed to get away, and she came up with a wild idea.” I started the water.

He pulled the plug from the drain and clutched it against his side. “You want to go away?”

“Get away. I felt that way last night.” I honestly didn’t know how I felt today—except numb. I pointed at his hand and then back to the drain. He tossed the plug into the sink.

I inserted it again and squirted out some detergent. “And then Sophie got a phone call about a midwife this morning.” I told him the whole story as I trailed my hand through the water, stirring up the bubbles.

“Why do you feel like you need to get away?” His voice was hurt as he bent down and retrieved the wooden dish rack from under his side of the sink.

I eased a stack of china into the basin and without looking at him said, “Sophie thinks I need to find my birth family.”

“Oh.” His voice was gentle now. “Are you ready for that?” James was the one who had been studying abandonment and attachment issues. I was the one who had been trying, at all costs, to avoid talking with him about those things.

My chin began to quiver as I scrubbed a plate and lowered it into the rinse water.

“Did the box bring all this up for you?” He swished the plate around and placed it in the rack.

“I’ve wanted to search since high school.”

“You never told me that.” His voice sounded hurt.

“I feel more alone than ever.”

“You have me.” His voice was tender.

I nodded.

James and I had been partners in chemistry lab in high school. Back then, he was the bad boy, partying on the weekends, smart-mouthing our teachers at school, and teasing me about my cap and modest dresses whenever we were together. His parents divorced when he was a baby, and his dad remarried and started a new family. By high school James didn’t have much of a relationship with his father at all. His poor mother was so busy making a living that James had enough freedom to get himself in trouble on a regular basis.

Though I found him intriguing—and smart, much to my relief, given that he was my lab partner—he made me nervous with his wide grin and reputation as a partyer. Then one day, several months into our junior year, he surprised me by asking if he could come over to study. I told him no. He showed up that night anyway and sweet-talked his way into the house. Dad helped us with our chemistry, something he’d been doing with me all semester, and when we were finished James brought up his English essay on conflict resolution. Dad was happy to help with that too, eventually explaining at length the Mennonite stand of nonresistance. Before James left, Dad asked him to go to church with us the next Sunday. Much to my horror, he accepted.

Slowly, as James insinuated himself into my home and my church, the two of us went from being enemies to being friends. For the sake of that friendship, we kept things platonic back then. Nine years later, we reconnected when he called me after he found out while at church about Dad’s diagnosis. Soon he asked me out to dinner, and in no time we were dating.

“We should finish the dishes so you can get back home and study,” I said now.

Though I was using tomorrow’s midterm test as an excuse, we both knew that I wanted to be alone, that I wanted this conversation to be over. How could I tell James he wasn’t enough? That I needed something more to fill my empty soul?

He left soon after that, hurt clearly shining in his eyes. I hurried to pack my things. My plan was to go back to Portland for a week and then return here to Dad’s place to go through his things before I decided whether to sell the house.

After Mama’s death I prayed to God even more than I had before. I never told Him how I felt about her dying; instead, I told Him all the things I would have told her, a sort of cosmic joke on Him. Because He allowed her to die, He had to suffer my endless chatter. But gradually I stopped sharing. And sometime, by high school, I’d mostly stopped praying too. Not altogether. Communing with God was a hard habit to break, and from time to time I would catch myself blurting out—silently—a quick prayer. But even those brief petitions eventually stopped being regular. And they stopped being intentional.

It wasn’t that I no longer believed, but I decided that God wanted us to take as much responsibility for ourselves as we possibly could. For me, that meant concentrating on academics. On the laws of physics and chemical equations and algebraic formulas. On absolutes that made sense. The idea of God didn’t offend my rationality. What did was that there were no formulas and equations I could count on except for the laws of science. I decided I needed to take charge of me.

As I shoved my things into my suitcase, an empty eeriness settled over the house, and its creaks and groans startled me. I quickly finished packing and zipped my bag. Hurrying down the hall, I heard Dad’s voice call my name. My heart raced as I turned and walked into his bedroom, but the sound I’d heard was only a branch from the maple tree scraping against his window.

By the time I had slung my bags in the back of my Honda CR-V, dusk had fallen. The windmill was statue still, and beyond the backyard the orchard darkened. Even so, the ordered trees offered comfort. I stepped toward them, longing to walk between the wide rows where I played as a child while Dad worked. But then that moment of twilight, where the world is neither light nor dark, lit upon the orchard and grief swept over me again, stealing my breath and leaving me weak. I turned and climbed into my car instead.

Fifteen minutes later, after having driven south on I-5, backtracking to the coffee shop by the Woodburn outlet mall, I powered up my laptop and googled “Amielbach”—unsuccessfully. My search for “Abraham Sommers” produced several possibilities, including a couple with ties to Switzerland—although none to Pennsylvania or Indiana—but as I followed them, I couldn’t determine which would be associated with the box or Amielbach or with me. It was quite the puzzle.

Giving up on that for now, I quickly skimmed my emails. There were a few work-related messages, including several condolences from colleagues and a photo of a baby I’d delivered the month before, sent by the new father with a sweet thank-you. I filed it with all the other pictures, and then I closed my computer, picked up my latte, and headed for the car, moving past the series of store windows with their shiny displays.

In all honesty, I wasn’t a big shopper. It was hard to break my childhood frugality. I’d decorated my apartment nicely but inexpensively, and with the exception of a single pair of jeans, I didn’t go for designer clothes. As I moved past the row of outlets now, however, I could feel my steps slowing. Finally I came to a stop, deciding that I could afford to treat myself to something nice for a change.

I’d never been inside the Coach purse store, even though women at work talked about the deals they had found there. I just couldn’t bring myself to spend oodles of money on a bag when I could get one for a fraction of the cost somewhere else. I’d grown up with simple dresses, practical shoes, and inexpensive purses, but today I felt that spending some money on myself might make me feel better. Plus, it would be nice to have a designer bag if I did travel. Or if I met my birth mother. In an instant I picked back up on my fantasies from high school. As I walked through the doorway of the Coach store, I imagined meeting her. She’d be happily married by now, of course. Living in the suburbs of Philly. A professional woman. A lawyer or financial planner or something like that. It was hard for me to imagine that she’d had more children. Maybe she and her husband had decided not to. He wasn’t my father, but out of respect for me…

“Good evening.” A clerk greeted me.

I responded, thankful I still had on my dress clothes and heels. At least I looked the part of a savvy shopper.

Another clerk welcomed me a second later. As I browsed through the store, the fantasy began again. I would meet my biological mother at a nice restaurant in downtown Philadelphia—unless she’d moved to Manhattan. Then I’d go there. I’d wear slacks and a silk blouse and high heels to show I was proud of the height she—or maybe just my grandmother—had passed on to me. I’d look like her. Finally, I’d look like someone. She’d have blond hair and brown eyes and a wide smile, and she would hug me right away. Her husband wouldn’t be with her because, selfishly, she’d decided to have me all to herself the first time we met.

I sighed. My fantasies hadn’t changed much since high school. I picked up a tote bag. Two hundred sixty-five dollars.

James would think it was ridiculous. He’d paid for college entirely on his own with a few scholarships and grants. He’d had to take off several semesters, working as hard as he could to save money to keep going. He would think it immoral to spend so much on something so trivial.

I looked at another wall of tote bags and then turned toward the back of the store. A sky blue shoulder bag caught my attention. Three hundred fifty-nine dollars. It had two outside pockets plus several inside.

“Here’s a wallet that goes with it,” the second clerk said. It was the same color as the tote and cost one hundred twenty-nine dollars. Mama had one that looked a lot like it when I was little, although she bought hers at a flea market.

I left the store with the Coach shoulder bag and the Coach wallet both secure in a Coach shopping bag. I felt a little better. At least for the moment.

Twenty-four hours later I was the provider on call for my clinic. I was the youngest practitioner in our center, even though I’d been practicing for almost three years. Two of our clients were in labor at Emanuel Hospital, babies 245 and 246 by morning, God willing.

This was a much different environment than what I’d witnessed assisting Sophie, but I learned a lot watching her, such as not to take up a lot of space at the birth, and that what was happening was never about me—it was about the baby, and then the mother, and then the father. I learned to simply tell a woman who said she couldn’t go on that she could. I learned that some women scream through childbirth and some women don’t. I learned that the ones who don’t aren’t in any less pain than the ones who do. From Sophie, I learned that giving birth was a natural, normal part of life. It was something I struggled to remember working at Emanuel with its fetal monitors, intrauterine pressure devices, ultrasounds, suction tubes, oxygen lines, IVs, blood transfusions, anesthesiologists, obstetricians, surgeons, and neonatologists.

I also learned that, even though a birth was never about me, each time I searched for something. A reaction from the mother when she held her baby for the first time. A look from the infant as she searched her mother’s eyes. Acceptance from the father. Joy from the grandmother. After every birth I asked the mother to email me a photograph of her baby. Most of my patients did. I kept the photos on my laptop and sometimes clicked through them, one after another. I’d been a part of each one’s incredible journey into this world.

When I arrived that Thursday night, a fifteen-year-old was laboring in suite four. I frowned. Another teenage birth. I hadn’t seen her in our practice, which probably meant she hadn’t received much prenatal care. Maybe she’d come to us late. I read the chart. The girl was considering adoption. The baby was three weeks early. I grimaced. A juvenile primigravida—meaning a first-time pregnancy—and early. She certainly wasn’t the youngest I’d seen, but still my heartbeat quickened.

I pushed up the sleeves of my lab coat and headed down the hall, my blue clogs clicking against the shiny linoleum. The labor nurse stepped out of the doorway as I reached the suite.

“How are things going?” I asked.

“Good. She’s a trooper. Already dilated to seven.”

“Any support?”

The nurse nodded. “Her mom is with her. They make a good team.”

My heart softened a little.

“I’ll be back in a little bit.” The nurse hurried across the hall.

I pushed through the door and introduced myself. The girl’s name was Tonya, and she stood by the edge of the bed. Even at full term she looked small, except for her belly, which jutted straight out like a shelf. She wore her dark hair in a high ponytail with a pink ribbon, and her fingernails were painted fuchsia. Her mother, Tammy, shook my hand and met my eyes, assuring me that things were going well. They had taken a birthing class together and were prepared. Tonya rolled her eyes, but then a contraction gripped her. “This stinks,” she muttered, grasping the headboard with one hand.

“You’re doing great, honey,” Tammy cooed. Taking note of the circles under her eyes and the rumpled state of her flowered blouse and brown slacks, I knew she had been at this for a while, helping her daughter through the pain.

Tonya moaned deeply as her contraction intensified.

The first delivery I ever saw had been atypically peaceful and serene, a mainstream mother who had chosen to use a midwife because of her non-mainstream ideas about birthing. When the woman’s husband rubbed her back or stroked her hair, she told him thank you. Every time a contraction came, she leaned against him on their antique bed in their old farmhouse, endured it in silence, and smiled when it was over. When it was time to push, she closed her eyes, and after only two contractions out popped a baby girl, eyes wide, taking it all in. After the father cut the cord, Sophie wiped the baby off, wrapped her in a flannel blanket, and handed her over to the eager parents. They cuddled her together, and then mother and child melted back into the bed as one. Soon, the father brought their two-year-old son upstairs, where the boy snuggled with his mom and sister, patting both of their heads with his chubby hands. I recalled that I spent most of the afternoon standing in the bedroom doorway trying not to cry. Sophie remembers me helping the mother walk to the shower, stripping the bed, starting the laundry, and making toast with jam for the two-year-old.

That was the first. After that came many more, though of course their reasons for using a midwife varied. There were modest Mennonite mothers, Hispanic migrant moms, poor mamas without insurance, and a few like that first mother who simply wanted to give birth in their own home, on their own terms.

In my senior year of high school, I took anatomy and a medical career prep class, planning to be a labor and delivery nurse. But when I read in our textbook about the world of the nurse-midwife, I knew that was what I wanted.

Once Tonya’s contraction came to an end, I told mother and daughter both that I would be back in a while to check on how things were progressing. Stepping into the hall, I moved toward the room of my second mother in labor, a patient of mine, Jane Hirsch. I had delivered Jane’s first baby, a boy named Jackson, almost three years before. Baby number 9. Jackson now went to a co-op preschool, and Jane worked part time in a law practice that specialized in nonprofits. This time around I had really enjoyed doing her prenatal visits, watching the interactions between mother and son. Though dad often seemed a bit preoccupied with his work, Jane was a hip and fun and devoted mom, the kind I wanted to be someday.

“How are you?” she asked as I entered the room. Jane’s long hair was twisted up on her head, her face was much fuller than when I saw her last, more than a month ago, and her belly stuck straight up in the middle of the bed.

“Good,” I answered. “How are you?”

She shook her head. “You have to tell me about you first. You were off work for three weeks. I was terrified I might have to go through this without you.”

“My father passed.” Unwanted tears sprang into my eyes.

“Oh, Lexie.” She reached out her hand. “I’m sorry.”

I was glad that her husband, an up-and-coming executive, wasn’t there to witness my being so unprofessional. “It’s okay,” I said, giving her hand a quick squeeze and then withdrawing it. “It was expected.”

“But still…”

I nodded and then forced myself to smile. “Have you had your epidural?”

“Just.”

“And where’s the hubby?”

“In the cafeteria.” She laughed. “Lucky him.”

Food was another one of the differences between a home birth and a hospital birth. At home the mom could eat yogurt and fruit and soup to keep up her strength. In the hospital, with one in three births ending in a C-section, food was withheld because a full stomach could be a sick stomach in surgery.

The monitor beeped, and Jane and I both looked at it. She was having a contraction—a good strong one. She held up her arms and waved her hands. “I hardly feel a thing,” she said. “Just some pressure.”

Some people have a memory for faces. I have one for births. Even though Jane’s first baby was 235 births ago, I remembered his arrival perfectly. She had arrived at the hospital too late to have an epidural. That was her top priority this time.

“Who’s with Jackson tonight?” I asked.

“Grandma. My mom. She’ll bring him up in the morning.”

Jane and I chatted a little longer, and then I headed back across the hall to check on Tonya.

She was on the bed now, sitting cross-legged.

“Do you want a drink of water?” Tammy asked.

The girl frowned and shook her head.

“How’s it going?” My voice was subdued.

“Fine,” Tonya growled, stretching out one leg and then the other. The monitor showed a contraction coming on. I waited to see what she would do. It didn’t take her long to climb off the bed with her mom’s help. Her face contorted, and she took a deep breath. Tammy stepped behind her and began rubbing her shoulders. I expected the girl to push her mother away, but she didn’t. She groaned a little as the contraction ended.

“Let’s check you.” I helped her back onto the bed.

She was at ten centimeters, ready to push. She was a trooper, not what I’d expected at all.

“I’m almost there?” she asked.

“We’ll soon see. It’s different for every—” I almost said mom, but because she might be relinquishing the baby, I said, “—one. Sometimes a woman pushes for quite some time.” Up to three hours. “But other times the baby delivers after just a few pushes.” I didn’t add that was usually the case for second and third babies. I took off my gloves, dropped them into the garbage, and then decided to stay with Tonya for the next few contractions to see how quickly things went. It would be hours before Jane delivered.

Every once in a while I offered a word of encouragement while Tammy bustled around, dimming the lights, offering Tonya water, and timing each contraction. Even though she had the urge to push, it wasn’t strong yet, not the way it would be soon. She leaned back against the pillows on the bed, her painted nails resting atop her belly, between contractions.

“Here comes another one,” Tammy said, switching her gaze from the monitor to the clock. Tonya pressed her hands down on her knees and pulled forward. I stepped to the side of the bed and held one of her legs. She scrunched up her face and then started to grimace.

“Eighty-five seconds,” her mother announced.

“You’re doing great,” I said.

“It hurts.” She collapsed back against the pillows.

“It’s supposed to,” her mother said, matter-of-factly. I wondered if perhaps it was the mom who had decided Tonya shouldn’t have an epidural. Maybe she wanted her to feel all the pain.

The OB nurse came in, and I slipped across the hall to Jane’s room. She and her husband were watching the news. “How’s it going in here?” I parked myself in front of the computer and read the nurse’s notes. Thanks to the epidural, her contractions had slowed.

“Doing great,” Jane answered.

Her husband and I chatted for a minute, and then just as I was getting ready to leave, a scream jolted the night.

“Be back soon.” I walked quickly to the door and scurried across the hall. Tonya was pushing with all her might.

The OB nurse held one of her legs and her mom the other. I snapped on clean gloves as the nurse grinned and said, “I thought that holler would bring you running.”

The baby’s head crowned with the next contraction. “Tonya, you’re amazing. Another push or two and—” I stopped myself from saying your baby. “And the baby will be here.”

It took only one more push for an absolutely perfect little girl to slip into my hands. She looked up at me with wise old eyes and then hiccupped before I grabbed the suction. She hiccupped again and then began to whimper. She was tiny—probably just more than six pounds—but good sized for being three weeks early.

“Time of birth is 11:57 p.m.,” the nurse said.

I grabbed a warm receiving blanket and swaddled her. Baby number 245.

Tonya collapsed back against the pillows as tears raced down her face, pulling streams of black mascara after them. “I want to hold her,” she said. Her arms reached out toward me.