I knelt down and looked up into the woman’s face. A bloodshot blue eye stared back at me through the snarled wet hair. An eye glazed with exhaustion—but still an intelligent, conscious eye; she saw me.
“My name is Claire,” I said, and laid a hand on her belly. She was wearing a filthy shift, so transparent with sweat that her protuberant navel showed through it. “I’m a midwife. I’ll help you.”
“Jesus,” she whispered, whether in prayer or from simple astonishment, I couldn’t tell. Then her face clenched into a knot and she curled over her belly with a bestial noise.
I kept my hand on her, but bent down to one side and peered up through the hollow of the birthing stool. A narrow slice of pale crown showed for an instant as she pushed, then disappeared.
I felt the spurt of excitement that always came with imminent birth, and my hand tightened on her belly. Another spurt came, this one of sudden fear.
Something bloody was wrong. I couldn’t tell what, but something was very wrong. I straightened up, and as the pain released its grip, I rose and took the woman by her shoulders, helping her to sit up. There were no towels to hand; I lifted my skirt and wiped her face with my petticoat.
“How long have you been pushing?” I asked.
“Too long,” she said tersely, and grimaced. I bent and looked again, and without her shadow obstructing the situation, I saw that she was dead right. The perineum was nearly purple and very swollen. That was it: the child was stuck, the crown of its head battering with each spasm, but not able to come further.
“Jesus H. Roosevelt Christ,” I said, and both her eyes popped open in astonishment. “Never mind,” I said. “When it lets go”—for the next pain was coming, I could see it in her face—“lean back against the wall.”
Her husband—I assumed that must be the man who’d slapped Agnes—seemed to have gone outside and was apostrophizing the night in an incoherent mix of Cherokee and English.
“Right,” I said, as calmly as possible, and put off my cloak and shawl. “Let’s just see what we have here, shall we, Susannah?”
There were splashes of blood on the dirt floor, but it was dark, with large, visible clots—just bloody show. She wasn’t hemorrhaging, though there was a slick of blood on her thighs. Her waters had broken some time earlier; it was hot and the small room smelled like a Jurassic swamp, fecund and reeking.
The contractions were coming every minute, powerful ones. I had only moments between them in which her belly relaxed enough for me to palpate it, but on the second try I thought I felt … the muscles of her belly tightened like an iron band, and I counted under my breath, hands still on her. Relaxation … I knew where the head was, was the child facing backward? I pressed hard on the relaxed belly, trying to find the curve of the spine …
“Ngg!”
“It will be all right. Count with me, Susannah … one, two …”
“Rrrrggh!”
I counted silently. Twenty-two seconds and the contraction eased. Spine … there was the blunt point of an elbow, and there, a curve that had to be the child’s spine … only it wasn’t.
“Bloody fucking hell,” I said, and Susannah made a noise that might have been a groan or an exhausted laugh. The rest of my attention was focused on the thing under my hand. It wasn’t the curve of a spine, nor yet of buttocks. It was the curve of another head.
It vanished with a new contraction, but I kept my hand doggedly on the spot, and as soon as the spasm waned, I felt frantically, to and fro. My first panicked thought—a memory of a double-headed infant, seen in a jar of spirits of wine—disappeared, succeeded by something that was partly relief, partly new alarm.
“It’s twins,” I said to Susannah. “Did you know that?”
She shook her head to and fro, slow as an ox.
“Thought … maybe. You … sure?”
“Oh, yes,” I said, in a tone that made her laugh again, though the sound was cut off abruptly by the next contraction.
The relief caused by the thought that we probably weren’t dealing with a gross deformity was fading fast, replaced by the next thought—if the first baby wasn’t moving, it was perhaps caught in an umbilical cord, possibly dead, or entangled with its twin in some fashion.
Further palpations, pushing when I thought I had an idea what I was pushing on, groping for a mental picture of what might be going on inside … but even the best midwife can tell only so much, and the only thing I was reasonably sure about was that the placenta—one placenta, or two? If it was one, it might rip loose with the first birth and then we’ll have an abruption that will kill the mother—hadn’t yet detached, though given the position of the baby’s head, there could easily be gallons of blood backed up behind the infant … No. I looked up at Susannah’s face. No, if she were hemorrhaging, she’d be white and losing consciousness. As it was, she was bright red and clearly still fighting.