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Monday, September 02, 2019

Another (longer) excerpt from What Heals the Heart -- a difficult childbirth

Today's excerpt from What Heals the Heart, my upcoming historical romance, comes about one-fifth of the way in. It shows Joshua at work once again, in a more dramatic context than the excerpt I posted earlier. It also shows another reason, besides haunting wartime memories, that Joshua might hesitate about seeking a wife.


The farmer stood in Joshua’s doorway twisting his hat. “It’s been more than two days, and the baby’s not come yet. She’s had three before, and no trouble. She didn’t want to send for you, said it’s women’s business, but . . . I finally told her I was coming to fetch you.”

Joshua gulped down the cold coffee he always kept on hand. He would need all his wits about him this night. “You go on back to your wife and tell her I’m on my way.”

Heading to the livery stable for his horse, Joshua ruminated on the ironies of his practice where babies were concerned. Some families, generally the wealthier ones or those determined to show how modern they were, would call him in when the woman’s mother and sisters or a midwife could handle things perfectly well. Others, like this farmer’s wife, resisted the idea past the point of reason, sending for him only when things had become desperate.

He had delivered one dead baby. That had left him with a wholly different nightmare his brain could use to torture him. But so far, he hadn’t lost a mother.

The coffee had cleared his head enough for him to notice his surroundings. He led Nellie-girl out into the balmy spring night and imagined the farmer saying, years from now, to a little boy or girl, “It was a fine night like this one when you come into the world . . . .”

Nellie-girl hadn’t been out for three days, so she had energy to spare, frisking about and then cantering along at a good clip. They got to the farm only a few minutes after the farmer. An older woman waited in the yard as Joshua rode up, a shawl wrapped around her and her arms crossed tight on her chest. “My daughter’s upstairs. We’ve sent the young ‘uns to my sister’s. I think maybe the baby’s turned wrong way around.”

Joshua followed the woman so close that he almost tripped on her heels. “Did her water break?”

“This mornin’.”

Joshua cursed silently to himself. There was some chance of turning the baby, but it would have been a bigger chance if her water hadn’t broken. Whatever her mother had noticed that clued her in, it was a damn shame she hadn’t noticed it sooner.

A hoarse cry, like a grunt but louder and longer and higher, came from down the hall as they reached the second floor. A woman in labor, if she made noise at all, could sound like nothing else Joshua had heard or imagined. It sent prickles down his spine. And if he didn’t school his imagination, he would be picturing women he knew, girls at Mamie’s or shopkeeper’s wives or the usually self-contained Miss Brook, in the throes of such suffering.

Just before he entered the room, the older woman clutched his wrist and faced him, with all the fear she must have been hiding from her daughter writ plain on her face. “Can you save my baby? Can you bring her baby into the world?”

Maybe, by the time he’d been a doctor for twenty years, he’d have a better feel for whether to lie. He could hardly say, “I have no idea.” Even “I hope to God I can” was probably not enough. So he said, “That’s what I’m here to do.”

If he failed to do it, she could curse him later. He moved around her and headed for his patient. His patients.

He plunked his bag on the floor and pulled out his smock, shrugging it on. Even an easy birth was a messy business. Then he approached the bed. The laboring woman seemed oblivious to his presence until he bent to take her hand. “I’m Doc Gibbs. I’m here to help.”

She lay there pale and sweaty, the bedclothes under and around her all rucked up from her thrashing about. She squeezed his hand so tight he thought another contraction was starting, but her face showed only exhaustion and worry, no pain. She said hoarsely, “Ma thinks the baby’s coming out wrong. Is it?”

“I’ll find out.” He gently moved the bedclothes away from her. “I’m going to be touching your belly now.” She nodded weakly.

He ran his hands over her, pressed lightly here and there. “Your ma appears to be right.” He hesitated. “I’d like to take a look down where the baby’s coming, to see how far along you are in opening the way. And I may need to touch you there, to be sure.”

She turned away, her face contorted in protest — or in pain. Another contraction was starting. The pillows muffled her words, but he could hear. “Must you?”

“I should. I really should. I need to know how much time we have to get this baby turned around.”

She gritted her teeth and nodded. A moan, almost a wail, escaped her as he squatted down and examined the birth canal. She was almost fully dilated. Not much time, then.

He stood back up and bent over the woman. “I’m going to be pressing on your belly where the baby is, to get it head down.” He had been concentrating too hard to notice who else was near, but now he looked around and found the woman’s mother hovering in the doorway. “Do you have any wine or spirits? It would relax her and help me with what I need to do.”

The mother turned and called an order to some unseen member of the household. While he waited, Joshua told his patient, “It’ll probably take a few minutes. And it may hurt some of that time. I’m sorry about that.”

The woman actually chuckled. “Well, won’t that be a change. This has just been a picnic so far.”

He smiled back as best he could. Just then a boy came up to the woman’s mother with a glass of dark red wine. Joshua retreated while the mother brought the glass to the bed, helping her daughter sit up enough to drink. “Take it slow, now,” Joshua cautioned her. It’d do no good for her to vomit it up again.

She got most of it down before another contraction started. He waited while she moaned and panted. When she finally relaxed against the pillows, he stepped forward and got started, feeling for the hard smoothness of the head and the narrower bump of the buttocks. It was hard to make himself push firmly enough, knowing it was hurting her, but there was no way around it.

She let out a cry and then grabbed a handful of blanket and stuffed it in her mouth. Joshua pressed steadily with both hands, trying to push exactly as hard with both.

“There we go!” He could feel the baby starting to change position. But damn! There came another contraction. If the cord was in the wrong place during it, the contraction could squeeze it shut . . . .

The seconds might have dragged even more slowly for Joshua than for the moaning woman in the bed. When the abdominal muscles finally relaxed, he got to work again, pushing harder, terrified of the next contraction.

Slowly, slowly . . . and then a little faster . . . the baby yielded to his efforts. As it turned more crossways, the woman let out a shriek. But in a moment more, the baby was moving toward vertical again, this time with the head down where it should be.

Now he had to see whether the baby would stay in position. This process didn’t always take. Sometimes, for whatever reason, maybe the same reason the baby had been breech in the first place, the baby turned butt-down again. But that was the one good thing about this happening so late, with contractions coming every couple of minutes. The baby wouldn’t have much room or time to maneuver itself back into danger.

And twenty minutes later, Joshua got to see a purple head with just a wisp of hair appear, and recede again, and finally crown.

Downstairs again, Joshua collapsed in a kitchen chair while the older woman fixed him a sandwich. He had already removed his smock and rolled it up tight, clean side out. He’d rinse it as best he could once he got home, then take it to Li Chang later in the morning.

The new mother was weak from her ordeal, and her vital signs could have been more reassuring. The baby had been quick to cry and pink up, but its movements were on the sluggish side. He couldn’t say either patient was out of the woods just yet, but all he said to the family was to come get him right away if the mother started bleeding much or either of them came down with fever. He’d come back tomorrow evening, after all concerned had gotten some sleep, to see how things were going.

There were still a few stars overhead when he pulled himself back aboard Nellie-girl and turned her toward home. All over, for now, until the next time. . . . A thought struck him so sudden that he pulled up on Nellie-girl’s reins, startling a neigh out of her. He patted her neck in apology and loosened the reins again. The next time, if Mrs. Blum’s schemes actually came to anything, it might be his own wife lying in a bed, moaning and screaming and tossing around, trying her hardest to bring their baby into the world.

Did every husband, every father-to-be, wonder if it was worth the risk?

Would he be even more terrified than he had been on the battlefield, or assisting the doctors afterward, trying to keep yet one more soldier from dying?

And if the worst happened, would he ever forgive himself for putting the woman he loved in that fatal danger?

When he finally stumbled up the stairs to his rooms, he no longer cared enough to bother with the smock and planned to fall straight into bed. But instead, he found himself looking for the letter he’d gotten from his mother the week before, and reading it over, and kissing her signature.

She had been through all that, or at least something like it, for his sake. And he’d never thought to thank her for it. If he had had the strength to hold a pen and produce recognizable words, he would have written her right now. Instead, he laid the letter on the table where he ate his breakfasts, so he couldn’t possibly forget.


Reminder: the book comes out on October 15, 2019, and may be preordered at this (worldwide) link.

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