FRIDAY, DECEMBER 11
A man barges into the birthing room. He throws the door back, then flings off his coat in a single, smooth movement. I see this only out of the corner of my eye, however, because my patient—young Grace Sewell—is wailing and thrashing on the bed. This is her first labor, and she fights against every pang, then sobs through every respite. We have been at it all night and are both exhausted.
“Out! All of you,” the man orders, and, because I recognize his voice, I ignore him.
I have not taken instructions in a birthing room since being apprenticed to an old, rusted battle-axe of a midwife in Oxford. Her name was Elspeth Horne, and everything I know about midwifery I learned from her. Thirty years have passed since then, and it will take more than the likes of one presumptuous man to make me shrink back from a patient.
“Did you hear me?” he asks.
“Yes,” I say, not turning. For the first time in three hours, Grace is silent. She is only startled, and it won’t last long, but for the moment her mouth is shut. Miracles never cease.
“Then why are you still here?” he demands.
“I do not leave my patients. And I do not answer to you.”
“This woman is no longer your patient. She is mine. I have been called in to replace you.”
I stand then, taking in every inch of Dr. Benjamin Page’s pompous six
feet.
“And this patient of yours, do you even know her name?” I ask. “Mrs. David Sewell.”
“Her Christian name, Doctor. The one that actually belongs to her. Do
you know it?”
He sniffs. “Her name is irrelevant.”
“Like it was irrelevant with Joshua Burgess?” I point at Grace. “You might not think a name matters in a room like this, but I assure you, it is vital.”
I arrived at the Sewalls’ the night before, having crossed the frozen river on foot, just before dusk. I was accompanied by the shop boy who works for David Sewell and had expected him to lead me to a private home across the street, but instead he took me right into the chandlery, where David was pacing back and forth behind the counter, looking very much like his older cousin, Henry, the town clerk.
“Where is Grace?” I asked, looking around the dim store at the piles of coiled rope and barrels of oil, the shelves filled with nails and bolts and boxes of soap.
He pointed to the ceiling.
“It is called an appartement,” he’d said, exaggerating the French pronunciation, as he led me up the stairs at the back of the shop. “In England they call them ‘flats,’ but I prefer the European term. They’re everywhere in Boston. A very convenient way to live and work.”
He opened the door, then, and led me into the second-floor home that sat above his place of business. It consists of two small bedrooms and one larger room combining the kitchen, dining, and living area. His young wife was there, rocking slowly in a chair, lips pursed, and brow knotted. Her sour-faced mother sat beside her and held her hand.
“It hurts,” Grace had told me. “I didn’t think it would hurt.” “What did you think, then?” I asked, kneeling beside her.
“I don’t know that I thought much about it all. This part was never explained to me.”
I glanced at the girl’s mother—the very proper looking Mrs. Hendricks. “There was no need to alarm my daughter before she was ready.”
“I tend to think of it as preparing them, not alarming them,” I told her. “I have prepared her to be a lady,” Mrs. Hendricks sniffed. “Not that
you can tell by this backwater village that her husband has chosen.”
In reality, Grace had only been in the early stages of labor. So early, in fact, that had she been properly educated by her mother about the realities of childbirth, no one would have bothered to call for me until dawn. But I had sat up with the girl, regardless, timing her contractions all night. They came every thirty to forty-five minutes and lasted twenty seconds. Hardly birth pangs at all. And all the while I listened to Mrs. Hendricks complain about the long, hard journey from Boston, her difficulties on the bad rural roads, and her opinions of them as well.
The girl was inexperienced, and scared, and—when I performed an internal examination—barely dilated. Yet as the night hours dragged on, both Grace and her mother became more intimidated by the process. Impatient with the results and doubtful of my ability.
At some point, when I slipped out to use the privy, Mrs. Hendricks must have convinced David to send the shop boy for Dr. Page. And now he is here, trying to order me from the room.
“Let me see her,” Page demands, attempting to edge me away from the
bed.
“You will not manhandle me.” I swat at his arm. “Cross to the other
side of the bed if you wish to examine her. But I will not leave my position.”
“Very well. I shall have to educate you, then.” He turns to Grace. “It is unfortunate how many country women confuse false labor for the real thing.”
“I beg your pardon—” I interrupt. “Because it is obvious—”
“Her pains are now regular and promising.”
“That this is a false labor,” he says.
“Oh, for the love of God, Grace, do not listen to this man. I have been with you all night. Your labor is early but real.”
The girl is of the stiff and straight variety. Well-bred and nicely mannered. If not pregnant, she would be slender and shapeless. Excellent posture. Tiny waist. Nose straight enough to be a ruler. Hair like a pane of glass. Grace Sewell has been bred to look nice in a gown and do as she is told. The problem is that she has always taken her orders from those with a pedigree and a formal education. So it makes sense that when she looks to Dr. Page and his fine coat, she finds comfort and familiarity. Whereas all she has gotten from me during these long hours of the night is an assurance that she must be patient, that the baby will come when it is ready, and that there is nothing to be done in the meantime but wait and walk and sleep if she can.
Mrs. Hendricks rises from her chair and joins him at the side of the bed. “What is your opinion, Doctor?”
“I believe,” he says, setting his medical bag on the bed beside Grace and unzipping it, “that your daughter is suffering in the way that all women of higher birth suffer.”
She waits for him to continue, her eyes round and her mouth curved into a moue of attentiveness, hanging on every word.
“It has been known for centuries that wealthy and beautiful women— those who lead delicate lives and are of an upper strata, such as your daughter—suffer a great deal more during childbirth than”—he looks at me
—“common women.”
“That is absurd,” I tell him. “If you knew anything about women, much less birth, you would know the female body works the same regardless of class.”
“And how many well-bred women have you delivered, Mistress Ballard? How many ladies? Or governors’ daughters? How many wealthy women have you sat beside?” Dr. Page does not wait for me to finish drawing the breath that will school him on how many hundreds of women I have delivered, from all walks of life, before he plunges ahead, “As I
thought. Now get out of the way and let me assist this woman so that I may relieve her of these false pains.”
“Thank you, Doctor,” Mrs. Hendricks says, voice breathy and submissive. “What can you do for her?”
“Administer laudanum. She will sleep and her pains will cease.”
“Grace,” I make my appeal directly to the girl now, “medical textbooks do suggest laudanum for a false labor. Your labor is still early, but quite real, and this medicine will do you great harm.”
Dr. Page clenches his jaw. “I am confident in my diagnosis.”
“A diagnosis determined by what?” I demand. “You have not once checked her. Internally or externally.”
“By observation. And medical skill. Remember which of us,” he turns to Grace as he finishes, “has the medical degree in this room.”
Grace looks at her mother, confused and terrified. “What should I do?” “Listen to the doctor, darling. He went to school for this.”
It is decided then, and I watch in horror as Dr. Page pulls out a bottle filled with reddish-brown liquid. “Fifty drops ought to do it,” he says.
“That will knock her unconscious!”
“How else do you expect her to sleep? You’ve kept her up the entire night, chattering and performing needless examinations.”
Dr. Page pulls out a dropper from a small velvet bag and begins to measure the drops into a tiny goblet. “Here,” he says after a few moments, handing the cup to Grace, “drink.”
“Please do not take that medicine,” I all but yell.
But Grace Sewell tips the cup backward and drains the contents into her mouth. Shivers at the bitter taste. Swallows with a delicate gulp. Wipes her mouth with the back of her hand. Within moments her eyes are heavy and she’s breathing slowly.
Dr. Page puts his things away and buckles his bag. “Have her husband call for me when the real pains begin. Though I do not expect that to be for some days yet.”
I watch him go but say nothing as I do not want to discourage his departure. The sooner that fool leaves, the sooner I can care for Grace.
Mrs. Hendricks glares at me. “Aren’t you leaving as well?”
“Absolutely not. Your daughter,” I say, pointing to where the girl lies, sprawled on her back, “will soon be deep in the throes of labor. But she has been rendered unconscious by that idiot. It will be a miracle if he hasn’t killed her and the child both.”
“You don’t really think that—”
“Of course I damn well do!” I shout, and am gratified by the look of horror on Mrs. Hendricks’s face as she shrinks backward. “Why do you think I argued with him? I will stay exactly where I am until I know that your daughter and grandchild are well. But if they aren’t, you will have Dr. Page to thank for that. Remember that the next time you panic and call a man to do a woman’s job.”
*
Grace sleeps for nine hours. I sit beside her the entire time, fretting, my fingers on the girl’s wrist, counting each heartbeat. They are too slow, the contractions too weak. Not nearly what is required to press a child into the world. But they do not stop, and that is its own kind of miracle.
Finally, Grace begins to sweat. Each contraction hardens her belly, and she moans deep in her throat. It is the kind of sound a soldier makes when he lies near the cusp of death on a battlefield. Of a wounded animal in the forest. It is the sound of a woman arriving at transition—that painful shift between labor and birth. At first it is a panting. Then a whistling, followed by a groan from deep inside her chest. If she were awake, I could prepare her for what comes next.
When Grace starts to gag, I have only seconds to sit her upright and lean her over before she vomits a foul brown plume onto the bed. Grace is covered. Her clothes are covered. The bedding is covered. But she is finally awake and instantly aware that her body is deep in the work of birthing her child.
The voice comes from behind me. “Mrs. Ballard, I…”
When I look to Mrs. Hendricks, I can see her throat working hard to swallow the apology.
She looks away. “Can Grace manage the rest of her labor?”
Stupid, prideful woman, I think.
“Yes. But thanks to you, she is no better equipped to handle the next birth. She will only remember the worst of this one,” I say, then order her away to gather warm water and clean linens.
“What happened?” Grace asks as the last of the laudanum fades from her system.
“I believe that you have learned exactly what kind of doctor Benjamin Page truly is. Now”—I look her directly in the eye as I begin to help her out of the soiled gown—“will you allow me to assist you with the thing that I do best?”
She nods. Swallows. Begins to cry. “Yes.”
“Good. Your mother is bringing us a wash basin. And then we are going to meet your baby.”
*
When Dr. Page comes running up the chandlery steps two hours later, I meet him at the door to Grace’s bedroom. The girl is sitting up in bed, holding her new son with a sense of wonder and pride.
When Page tries to push past me, I set a hand on his chest. “You are not needed here.”
“That is my—”
“No. She’s my patient.”
“You would do well to learn your place, Mistress Ballard.”
I laugh at him. “I have been in my place for many, many hours now. You, on the other hand, knocked a woman unconscious and abandoned her to the ill effects of a dangerous drug. As a result, you were not present when she began to vomit in her sleep. Had I not been in my place, she would have died. But I am curious about one thing, however,” I say.
He looks in alarm to the bed. “What?”
“Did you even bother to learn her name while you were gone?”
Any humility that might have been rising to the surface after learning his error is wiped away by a sudden flash of pride. “There was no need.”
“Then you have learned nothing. Her name is Grace. And if you were an educated man—as you claim—you would know that the name means ‘unmerited favor.’ Which is exactly what God has shown by allowing both her and the child to survive your ministrations.”
I close the door in his face.
