She pulled her horse to a stop in front of the ramshackle cabin belonging to Abe and Karen Sandler. She’d never made a house call this far out of town, but she needed the excuse today. A long ride, even in the name of professionalism, had done wonders for her peace of mind. And Karen Sandler needed to be checked on.
After tying her horse to a forlorn pine tree, she wound her way through tall, unkempt grass, and rapped on the splintered wooden door. No answer, either by footsteps or voice.
“Mrs. Sandler. It’s the midwife. I’m just calling to check on you. May I come in, please?”
Creak. Groan.
The door opened. Karen stood inside, ragged blue shawl around her shoulders, graying brown hair in straggles around her face.
“How are you today, Mrs. Sandler?” Annie gave a professional smile. “I’m just here to see how you’re doing. Make sure you’re feeling all right and so forth.”
The woman smiled, the upward turn of her lips accentuating the hollowness in her cheeks and lack of luster in her eyes. “I’ve been having twinges all day. ’Spect that’s just me gettin’ old. A forty-five-year-old woman ain’t got no business havin’ a baby. Abe’s so excited, though. Guess that makes it all worth it.”
“Of course it does.”
Karen stepped aside, and Annie entered the one-room cabin. Her stomach gave a momentary lurch. Of course, she’d seen women bear children in less-than-pristine living conditions before, but this … Dirt floor. Rumpled bedlinens atop a cornhusk mattress. Food-encrusted dishes lying scattered on a crude log table. Something scurried toward the corner of the room. Mercy, was that a rat?
“How have you been feeling? Anything I should be aware of?”
Karen’s only answer was to pale and clutch the edge of the table. Concern welled through Annie.
“Why don’t I help you lie down, and we’ll listen to the baby’s heart?” Supporting Karen’s arm, Annie helped her onto the sagging mattress.
It only took a simple examination for fear to rise hot in Annie’s throat. She swallowed hard. “How long have you been like this?”
Karen pulled down her threadbare dress. “A day. Abe went out hunting a few hours ago, and I was glad for him to be away. He doesn’t like to see me hurting. ’Spect it reminds him of the war. Why?” Her faded eyes searched Annie’s. “Is something wrong?”
“My examination shows me … I mean, it appears that … you’re in the early stages of labor.” Three months too early, she didn’t add.
“That’s bad.” Karen’s eyes took on a frantic gleam. “I ain’t ever had a baby before. Will it be all right?” The woman placed a protective hand over her abdomen, as if to hold back the child from entering the world. Another pain seized her, and she ground her teeth.
“Let’s concentrate on getting you settled.” Annie pressed her fingers to the woman’s pulse. High. Too high. And her skin … Feverish.
Help. She needed help. A first-time birth three months early meant almost certain death for the child. All she could do was save the mother. A forceps delivery would be best. But Annie wasn’t a doctor.
“Do you know when Abe is expected to return?” Lord, please let it be soon.
Karen shook her head. “Maybe in an hour. Maybe tomorrow.”
Annie drew in a long breath. She couldn’t leave Karen. Not for the time it would take to ride back to Hartville, even at a gallop. No. She would do the best she could alone.
Hours dragged by. The contractions strengthened. Karen’s fever worsened. She writhed on the mattress, screaming, her body fighting against itself.
“Breathe, Karen. Don’t fight the pain.” Annie pressed a cool cloth to the woman’s sizzling forehead.
Lord. Please send Abe. Soon. I need Travis’s help. I can’t save this mother alone.
“Just help my baby! Please, save my little girl.” A strangled cry rose from Karen’s throat.
Tears formed in Annie’s eyes. How could she tell this woman the truth? How could she face Karen once her baby was born dead?
“I’ll do my best.” The words sounded brittle in the dank air of the cabin. “We’ll both do our best.”
The end came quickly after that. Heartbreakingly so. Annie placed the tiny blue body in a blanket and laid it on the table. She rushed to Karen’s side again. The mother was all that mattered. She felt the woman’s pulse. Low. Dangerously. Karen’s breath came in short, weighted gasps.
“How’s my baby? Is it a little girl?”
Annie nodded. “You were right, Karen. A little girl.” She lifted the sheet to examine the woman.
Her heart slammed against her chest. Blood pooled on the dirty linen.
A hemorrhage.
No. Please, God, no.
Karen’s heart rate dropped. The metallic scent of blood overpowered the air.
“Abe. Where is he?” Karen’s voice came out in a gasp.
“Still not back.” Annie prepared a dose of ergot, one of the few remedies she’d seen work in cases like these. The afterbirth needed to arrive, fully intact, for the hemorrhage to stop.
“Why won’t he come? I need him. He needs to see the baby. Do him so much good … see his little girl.”
The gush of red continued. A convulsion racked Karen’s body. It was at moments like these, Annie felt exactly what she was. Totally powerless. Powerless to save the baby. Powerless to stop the bleeding.
Powerless to keep Karen Sandler from passing from this world into the next.