The Reluctant Midwife
Page 46
“You probably didn’t notice but your new son has webbed toes.” I pause for their reaction and am surprised when they laugh.
“Oh, we looked for that right away,” Lilly tells me. “All the Bittman men do! B.K. and Little B.K. and Grandpa. We just say it makes them good swimmers.”
Retained
How is it that you always notice the tick of a clock when you are waiting? Tick. Tock. Tick. Tock. Lilly puts the newborn on the breast as easily as a sighted person. B.K. settles his five-year-old in his bed in the next room, then comes back with his guitar and strums a few tunes. He yawns. It’s catching, and Lilly and I yawn too.
Tick. Tock. Tick. Tock. It’s been forty minutes since the birth of their second son.
“Mmmmmm,” Lilly moans, and I look between her legs expecting to see a gush of blood but there’s nothing. “Mmmmmm,” she moans again and I palpate her uterus. It’s rock hard and at the level of her umbilicus.
“I think the afterbirth must be separating. Do you feel an urge to push?”
“No,” Lilly says. “But it actually hurts more than my labor pains. It hurts quite a bit.” I look between her legs again. Still no blood and the cord hasn’t lengthened. B.K. yawns again. It’s almost four A.M.
At four fifteen Lilly sits up on one elbow. “Miss Becky, I have to pee. Could I get up and use the bathroom? These pains are getting worse. I really have to do something!” Beads of sweat are on the mother’s upper lip and her normally pale pink skin is chalky. She pulls her red hair away from her face and it looks like a skull.
I really have to do something, so I check the uterus one more time. It’s now three centimeters above the umbilicus. Not a good sign. There must be blood building up inside.
“B.K., I think we should let Lilly pee. Maybe that’s part of her discomfort, but I don’t really want her to go down the hall. She might faint or something. Do you have an old-fashioned potty, you know, the kind that people use when they don’t have an indoor bathroom?”
“Sure, right here. She used it when she was on bed rest.” He pulls a white enamel receptacle out from behind the door.
I check again for any signs that the placenta is coming. Still no blood between the mother’s legs. “Okay, Lilly, just take it slow and I will be right here if you feel woozy.”
“I am a little dizzy, but just a little.”
Oh, damn. I’m making such a mess of this. I should have gotten her vital signs before she got up. How is it that I know just what to do for a victim of trauma, a sick child, or a surgical patient, but I’m lost at a simple, uncomplicated home delivery?
I think I know the answer. Birth is a potentially dangerous situation, but in this relaxed environment, I lose my way. All this guitar playing and kissing and kids sitting on the bed gets me off track!
Slowly, we sit Lilly up. Slowly, we lower her legs off the side of the bed. Slowly, we help her squat over the commode. B.K. and I turn away so she can tinkle. But it’s not a tinkle. It’s a flood! Lilly pees and pees and pees.
“Mmmmmmm! Miss Becky, I really have to get this damn thing out of me! If you won’t pull it out, I will. Where’s the cord?” Lilly gropes around between her legs.
“No, Lilly!”
She finds what she’s feeling for. “Uggghhh.” Plop. The afterbirth drops into the commode and blood and pee splash over everything. “Oh, thank goodness! But I think I made an awful mess.” Lilly stands up without assistance and sits on a wooden bedside chair. Her uterus is now back to normal, firm, and three centimeters below the belly button.
I stare at the potty, nearly full of red. Would Lilly be upset if she could see this? It’s impossible to estimate the blood loss since the blood is mixed with urine. Maybe two cups of blood, maybe four? I decide to go with three.
“Whew! I feel a lot better! Can I wash up and go to sleep now, Miss Becky? At least I didn’t mess the bed.”
“Sure,” I say as if the whole prolonged third stage of labor was no big deal.
“I can’t wait to tell Mama in the morning. She will be so flabbergasted!” Lilly says, grinning.
When I let myself out the back door, both mother and father are climbing into bed with their newborn between them. On the landing of their back stairs I stand for a minute looking down the alley at the halo of light around the gas streetlamps. Inside I can hear singing, a man and a woman. “Hush-a-bye, don’t you cry. Go to sleep, little baby.”
Lilly’s dark world is not dark at all.
October 10, 1934
Birth of Lilly and B.K. Bittman’s second son, 6 pounds, 6 ounces. (I missed the actual delivery; it went so fast and the baby hadn’t been named by the time I left.)
Lilly, blind since birth or early infancy, said she was singing as she pushed the baby out and that the birth wasn’t painful at all. Hard to believe, but who am I to doubt her? This is the second time a patient has sung during labor and it should be written up in a medical book!
Little B.K. saw the whole thing and wasn’t even disturbed. He asked to help cut the cord and I let him, a radical act for me, but he was so involved and curious, I couldn’t see the harm.
The problem was the placenta. I was so intent on caring for Lilly and the baby, I neglected to get it out in a timely manner, almost causing the mother harm. I am sure that it was balled up in her vagina the whole time and she was building up blood behind it, but I waited more than fifty minutes before letting her get up to go to the potty and then it came out quite easily.
Baby was perfect in every way except the webbed toes, and I was afraid they would be upset when I told them, but they only laughed. Webbed toes are apparently a trait in the Bittman males. They are good swimmers.
October 10, 1934
Syndactyly! The word erupts, unbidden, from my mouth like hot lava out of a volcano!
Syndactyly is the medical term for webbed toes. I would tell Becky that little-known medical fact, but then she would realize I’ve been reading her journal. A sin, I know, but I can’t help myself.
I’ll explain how it happened.
The second week after we moved to the Hesters’, while Becky was off at the CCC camp, Daniel and I got back early from the fields. As usual, he went up to see Patience and, having nothing else to do, I went into Becky’s room. I found comfort there, the smell of her lilac lotion, a soft female presence.
Lying on my stomach on her green-and-blue patchwork quilt, the edge of something hard under the mattress rubbed on my arm and when I investigated, a flat book dropped out on the floor. I knew at once what it was and, opening the pages, saw Becky’s neat script. I couldn’t help it. Who could? I started to read.
“Oh, we looked for that right away,” Lilly tells me. “All the Bittman men do! B.K. and Little B.K. and Grandpa. We just say it makes them good swimmers.”
Retained
How is it that you always notice the tick of a clock when you are waiting? Tick. Tock. Tick. Tock. Lilly puts the newborn on the breast as easily as a sighted person. B.K. settles his five-year-old in his bed in the next room, then comes back with his guitar and strums a few tunes. He yawns. It’s catching, and Lilly and I yawn too.
Tick. Tock. Tick. Tock. It’s been forty minutes since the birth of their second son.
“Mmmmmm,” Lilly moans, and I look between her legs expecting to see a gush of blood but there’s nothing. “Mmmmmm,” she moans again and I palpate her uterus. It’s rock hard and at the level of her umbilicus.
“I think the afterbirth must be separating. Do you feel an urge to push?”
“No,” Lilly says. “But it actually hurts more than my labor pains. It hurts quite a bit.” I look between her legs again. Still no blood and the cord hasn’t lengthened. B.K. yawns again. It’s almost four A.M.
At four fifteen Lilly sits up on one elbow. “Miss Becky, I have to pee. Could I get up and use the bathroom? These pains are getting worse. I really have to do something!” Beads of sweat are on the mother’s upper lip and her normally pale pink skin is chalky. She pulls her red hair away from her face and it looks like a skull.
I really have to do something, so I check the uterus one more time. It’s now three centimeters above the umbilicus. Not a good sign. There must be blood building up inside.
“B.K., I think we should let Lilly pee. Maybe that’s part of her discomfort, but I don’t really want her to go down the hall. She might faint or something. Do you have an old-fashioned potty, you know, the kind that people use when they don’t have an indoor bathroom?”
“Sure, right here. She used it when she was on bed rest.” He pulls a white enamel receptacle out from behind the door.
I check again for any signs that the placenta is coming. Still no blood between the mother’s legs. “Okay, Lilly, just take it slow and I will be right here if you feel woozy.”
“I am a little dizzy, but just a little.”
Oh, damn. I’m making such a mess of this. I should have gotten her vital signs before she got up. How is it that I know just what to do for a victim of trauma, a sick child, or a surgical patient, but I’m lost at a simple, uncomplicated home delivery?
I think I know the answer. Birth is a potentially dangerous situation, but in this relaxed environment, I lose my way. All this guitar playing and kissing and kids sitting on the bed gets me off track!
Slowly, we sit Lilly up. Slowly, we lower her legs off the side of the bed. Slowly, we help her squat over the commode. B.K. and I turn away so she can tinkle. But it’s not a tinkle. It’s a flood! Lilly pees and pees and pees.
“Mmmmmmm! Miss Becky, I really have to get this damn thing out of me! If you won’t pull it out, I will. Where’s the cord?” Lilly gropes around between her legs.
“No, Lilly!”
She finds what she’s feeling for. “Uggghhh.” Plop. The afterbirth drops into the commode and blood and pee splash over everything. “Oh, thank goodness! But I think I made an awful mess.” Lilly stands up without assistance and sits on a wooden bedside chair. Her uterus is now back to normal, firm, and three centimeters below the belly button.
I stare at the potty, nearly full of red. Would Lilly be upset if she could see this? It’s impossible to estimate the blood loss since the blood is mixed with urine. Maybe two cups of blood, maybe four? I decide to go with three.
“Whew! I feel a lot better! Can I wash up and go to sleep now, Miss Becky? At least I didn’t mess the bed.”
“Sure,” I say as if the whole prolonged third stage of labor was no big deal.
“I can’t wait to tell Mama in the morning. She will be so flabbergasted!” Lilly says, grinning.
When I let myself out the back door, both mother and father are climbing into bed with their newborn between them. On the landing of their back stairs I stand for a minute looking down the alley at the halo of light around the gas streetlamps. Inside I can hear singing, a man and a woman. “Hush-a-bye, don’t you cry. Go to sleep, little baby.”
Lilly’s dark world is not dark at all.
October 10, 1934
Birth of Lilly and B.K. Bittman’s second son, 6 pounds, 6 ounces. (I missed the actual delivery; it went so fast and the baby hadn’t been named by the time I left.)
Lilly, blind since birth or early infancy, said she was singing as she pushed the baby out and that the birth wasn’t painful at all. Hard to believe, but who am I to doubt her? This is the second time a patient has sung during labor and it should be written up in a medical book!
Little B.K. saw the whole thing and wasn’t even disturbed. He asked to help cut the cord and I let him, a radical act for me, but he was so involved and curious, I couldn’t see the harm.
The problem was the placenta. I was so intent on caring for Lilly and the baby, I neglected to get it out in a timely manner, almost causing the mother harm. I am sure that it was balled up in her vagina the whole time and she was building up blood behind it, but I waited more than fifty minutes before letting her get up to go to the potty and then it came out quite easily.
Baby was perfect in every way except the webbed toes, and I was afraid they would be upset when I told them, but they only laughed. Webbed toes are apparently a trait in the Bittman males. They are good swimmers.
October 10, 1934
Syndactyly! The word erupts, unbidden, from my mouth like hot lava out of a volcano!
Syndactyly is the medical term for webbed toes. I would tell Becky that little-known medical fact, but then she would realize I’ve been reading her journal. A sin, I know, but I can’t help myself.
I’ll explain how it happened.
The second week after we moved to the Hesters’, while Becky was off at the CCC camp, Daniel and I got back early from the fields. As usual, he went up to see Patience and, having nothing else to do, I went into Becky’s room. I found comfort there, the smell of her lilac lotion, a soft female presence.
Lying on my stomach on her green-and-blue patchwork quilt, the edge of something hard under the mattress rubbed on my arm and when I investigated, a flat book dropped out on the floor. I knew at once what it was and, opening the pages, saw Becky’s neat script. I couldn’t help it. Who could? I started to read.
