Hannah Delivered Read online

  Praise for Hannah, Delivered

  “Hannah, Delivered delivers the goods. Compelling, controversial, thought provoking, and beautifully written. I could not put it down.”

  —Patricia Harman, author of The Midwife of Hope River, The Blue Cotton Gown: A Midwife’s Memoir, and Arms Wide Open: A Midwife’s Journey

  “Elizabeth Jarrett Andrew’s novel takes the reader deeply into the essence of the midwife’s calling–honoring connection, passion, and the profound stories of life and love. There is no denial of pain and death here, only the woman, family and midwife, together, asking “what is being born?” From my perspective of straddling the two cultures of homebirth midwifery and hospital obstetrics, Hannah, Delivered illuminates how even a radical homebirth might be the most life-affirming choice possible.

  —Heidi F. Rinehart, MD

  “This novel is delicious to read, from start to finish—a wonderful addition to the literature about midwifery and birth.”

  —Suzanne Arms, author of Immaculate Deception and Founder-Director of Birthing The Future ®

  Hannah, Delivered documents Hannah’s trajectory from midwife wanna-be to solo practitioner with grace, veracity, heart, and passion.

  —Peggy Vincent, Baby Catcher: Chronicles of a Modern Midwife

  Elizabeth Jarrett Andrew

  V I R G I N I A B E A C H

  C A P E C H A R L E S

  Hannah, Delivered

  by Elizabeth Jarrett Andrew

  © Copyright 2014 Elizabeth Jarrett Andrew

  ISBN 978-1-940192-18-5

  All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means – electronic, mechanical, photocopy, recording, or any other – except for brief quotations in printed reviews, without the prior written permission of the author.

  This is a work of fiction. The characters are both actual and fictitious. With the exception of verified historical events and persons, all incidents, descriptions, dialogue and opinions expressed are the products of the author’s imagination and are not to be construed as real.

  Published by

  210 60th Street

  Virginia Beach, VA 23451

  212-574-7939

  www.koehlerbooks.com

  Cover design by Linda Koutsky

  Table Of Contents

  1. The Quickening

  2. The Birth House

  3. Partero

  4. Fear of Falling

  5. Primip

  6. Grand River

  7. Opening

  8. Blood Pressure

  9. Flesh Boundaries

  10. Round Ligaments

  11. Needled

  12. Backseat Driver

  13. What Midwifery Needs

  14. That Bolt of Fabric

  15. Mothering Instincts

  16. False Labor

  17. Aftermath

  18. Good Enough

  19. The Family Fest

  20. At Home

  21. God’s Heartbeat

  22. Insurance Policy

  23. This Is My Body

  24. Gifts

  25. Midwife to the Father

  26. Ministry

  27. Prayer Ruse

  28. The Mischief Maker

  29. Red Owl at Night

  30. Sunday Sermon

  31. Over the Wires

  32. Brink of Extinction

  33. Sage Femme

  34. Nudge

  35. Ambulatory Mamas

  36. Coronations

  37. Insemination

  38. Fabric

  39. Thirty-Eighth Week

  40. Expansive Part

  41. Hour of Patience

  42. The Other Side of Pain

  43. Fathers

  44. Barred Owl Rising

  Author’s Note

  1.

  The Quickening

  HAVE YOU EVER noticed that a midwife’s quickest route to fame is screwing up?

  I’m a lucky exception—my screwiest birth was a success, and that’s what rattled the authorities. A soft-faced mother, a glowing father, a filmy newborn flopping into my hands . . . Birth done quietly, naturally, in the bowels of night, can make medical institutions go ballistic and upend our country’s laws.

  You asked about my night in jail and how I felt the next morning when I found my name headlined on the front page of the Minneapolis Star Tribune. If you want to be my apprentice you need to understand that the sensational births are insignificant compared with the thousand ordinary moments that come before, private moments when we choose life over death and allow ourselves to be imperceptibly changed. These are what make a midwife.

  So yes, I’ll tell you the story.

  It begins with a mother, as do all midwives’ stories: my beautiful mother, her silvery blond hair clipped back, hands clasped, the wedding ring a bit loose on her finger, her cheeks more heavily blushed than she would have liked, her mouth relaxed. Against white satin her practical wool skirt and chunky shoes seemed dowdy. Before the doors opened for the viewing, I hesitated over her, shocked, regretful, trying to trace my origins back into her elegant body. She seemed so self-contained. I wanted desperately to touch her hands, but didn’t.

  She’d been collating the church newsletter, walking around a Sunday school table piled with multicolored pages with her Elsie Circle friends, stacking one sheet of mundane church happenings beneath the next and smacking them with the stapler, just as she’d done on the fifteenth of every month for as long as I could remember. Those women had worn a path into the Berber carpet over the years. She collapsed—an aneurism. She was sixty-one. After the funeral, her friend Maggie placed one frail hand on my shoulder and handed me a stack of pastel pages. “Her body hit the floor first, dear,” she said. “Then these floated down, like angels’ wings. You should have them.”

  I’d taken the unstapled pages and passed them to Leif. Later, when he slid them to me across the kitchen table, we couldn’t stop laughing at the absurdity, but in that moment after the service, I was numb, robotic, shaking hands with the parade of Chester Prairie folk in their gravest summer church clothes, nodding at condolences I couldn’t comprehend. I kept glancing sideways at Dad, who despite wearing a suit and tie seemed naked without his clergy robes. The narthex closed in on me. I’d known this same stranglehold as a teenager, only now, standing shoulder-to-shoulder with Dad, I felt strangely complicit.

  Here I was once again, the pastor’s daughter, object of sad, sympathetic smiles. Mom, I kept reminding myself, was not down in the kitchen filling warming pans with ham and mashed potatoes. Mom would not dote on Leif over dinner, nor would she fold my hand around a paper bag of soup containers, left-over roasted chicken, and fresh-baked cookies when we headed home. Leif hovered respectfully behind my right shoulder; I was glad for his company. I couldn’t wait to relax into his arms, and yet I wanted Mom more.

  Mom had adored Leif, and now she wouldn’t be at our wedding. Leif’s quiet Danish demeanor made up for what I had worried would be three serious counts against him—that he sweated for a living, preferred to go birding on Sunday mornings, and cohabited with me. But Leif grew up two towns west of Chester Prairie. He had straw-blond hair and limbs like a yoga instructor. We’d bonded in community college English class when we discovered we were both recovering Lutherans. Leif had been my passport to freedom. After graduation we rented a studio apartment in St. Paul and consoled one another in the early, overwhelming days of job hunting and city driving. I scored a desk job in a big city hospital, Leif began trimming trees for St. Paul, and we toasted our liberation with cheap champagne.

  I loved seeing Leif tethered to high elm limbs, swinging from branch to branch with his chainsa
w. When he came home after work, he smelled of gasoline and sap. I picked woodchips from his hair. Sometimes he brought me abandoned bird nests. When we visited the parsonage, Mom poured him black coffee in her best china and inquired about his parents. Dad glowed as though Leif were the son he’d always wanted. With Leif I knew the rare satisfaction of having done something right.

  Down in the church basement, I ate pickles for lunch while Mom’s friends relayed fond anecdotes (“She was a dear, bringing over hot dishes when Toby was sick”) and Dad worked the room with his shoulders strangely hunched. Once the crowd thinned, I couldn’t bring myself to return to the parsonage where Dad would stoically wander from room to room, touching Mom’s knickknacks as though for the first time. I told them I needed to be alone and drove out to Little Long Lake.

  The lake had been my refuge ever since I’d been old enough to walk a mile on my own. In a town where kids avoided me because I was the pastor’s daughter, where I monitored my every decision for fear of reflecting poorly on my father, the lake was a wide, expansive breath. It dissolved me. Upheld by glacial melt, anything was possible.

  I parked at the public boat launch. Our bags were still in the trunk. I pulled out my suit and changed in the port-a-potty at the edge of the lot.

  The south and west ends of Little Long were swampy, bordering the sparse woodlands of a county park. Houses sat to the north and east, their lawns littered with boats, picnic tables, and half-inflated inner tubes. Given the heat the beach was strangely silent, but it was early September, a weekday, and kids were in school. A few maple leaves floated at the lake’s edge. Geese had left their slimy mess and webbed prints all over the sand. I strode into the shallows, grateful for the sharp cold.

  With a gasp and push I was under, madly paddling and kicking until I could breathe again. Then I stopped, my arms and legs splayed, all of me suspended. Air was a warm bubble in my chest. Where is Mom now? Released back into creation, surely, part of the water’s chill, the comforting sun, the enormous darkness holding me. I hadn’t connected with her dead body but now I imagined a cord spiraling like pondweed from my center downward through tannin-stained sunlight into muck, into her. The cord swayed in the lake’s currents. Quiet pressed my eardrums. Here, finally, I knew her. I accepted the silence, the water’s embrace, and the sustenance seeping up, up.

  * * *

  Not two weeks after Mom’s memorial service, there was a rush on the maternity ward. Birth always comes this way, coupled in a twisted dance with death. You don’t learn that in medical school.

  I was a health unit secretary, thirty-two years old, and I had admitted five women that night since my coffee at eight. I kept misplacing things—files, messages, my keys. The phone’s perpetual buzz and nurses’ requests, usually so stimulating, now grated on my nerves. I couldn’t wait to get home to Leif for our Friday night ritual. He would warm Chinese takeout in a two hundred-degree oven. We’d crawl into bed, eat egg rolls, and have sex while ignoring a movie. I trusted Leif not to mention Mom.

  You have to understand: Back then I navigated the world in a tiny bubble of competence. Now I see that Leif was a safe bet and what I’d thought was an adventurous job—Spanish and Hmong spoken in the hallways, doctors passing me orders, new babies wailing from the nursery—was dead-end and secretarial. In school I’d earned a business degree and an accounting certificate because, unlike the looser liberal arts subjects, success had measurable outcomes. I could organize a ledger or file drawer; I could manage orders and schedules. As it turns out, being capable gets results but isn’t exactly an inspiring life goal.

  I’ll grant myself one thing, though: I had heeded a barely discernable nudge when I sought out hospital work. I wanted to care for people. I did it the best way I knew how—by­­­­­ pushing paperwork.

  That night I was still clumsy with grief. Nearly every room on the ward had a laboring woman, and we were grossly understaffed. Maryann, the midwife on duty, steamed down the hall, muttering darkly and shooting nasty looks into the full rooms. She rested her huge brown elbows on the counter and pointed at the calendar. “Give me that.”

  I spun my chair and lifted the pharmaceutical wall calendar from its hook.

  Maryann was the first nurse midwife to work at St. Luke’s Presbyterian. Whenever she leaned her fierce face into mine, I suspected she saw through my city-savvy façade to my small-town self, the kid who put herself through college by ringing up broccoli and baking soda at the Red Owl—or, that night, the girl who just wanted her mama back. There was little Maryann didn’t notice.

  She removed her reading glasses from her hair, perched them on her nose, and found the date. “Knew it!” she mumbled and harrumphed back to the nurses’ station.

  A small black circle marked the day. At our last staff meeting, Maryann had argued for increasing the number of doctors on call during full moons, but two of the younger OBs had made a stink, saying she was superstitious and that was no way to determine a schedule. I was surprised. We’d always made adjustments for the full moon when I worked down in ER. I suspected the docs were wet behind the ears. Maryann had muttered, “Lazy schmucks.”

  The elevator opened and another patient entered, this time off the street—no insurance, no prenatal care. I took her information and rang for a nurse.

  An hour later, as I moved my magnet from the “in” to the “out” box and slipped into my jacket, Maryann and the single doc on call were frantically crisscrossing the hallway. “You!” Maryann shouted, mid-stride. “I need another pair of hands.”

  I froze. In seven years of hospital work, I’d never set foot in a room with a laboring patient.

  “Now!”

  I rehung my jacket and locked the cupboard. Raised voices from 146B reached the front desk.

  Embarrassing to admit it now, but I’d always blocked out the screams and groans behind the ward’s closed doors and imagined instead TV births, the woman laboring on her back, demurely covered with a paper sheet, the husband sweating and holding her hand—maybe not violins in the background but at least a routine of pain and arrival. Instead I saw an older Hmong woman and two teenagers chatting cross-legged on the bed, another woman wringing out a washcloth in the open bathroom, and, on the far side of the bed where there was barely enough floor space, Maryann crouched beside a naked woman. The mother was on hands and knees on the linoleum. Her brows were contorted, her eyes strained, but otherwise she seemed under as much duress as with a bowel movement. Maryann’s left hand was spread across the woman’s tiny back. Her right hand hovered between the woman’s spread legs. Yellow liquid pooled on the floor.

  My muscles went slack.

  “Get me some chux pads and close that door,” Maryann ordered.

  The nurses must not have resupplied the room. Adrenaline surged, and my limbs swung into action. From the hall supply closet I pulled a stack of pads and raced back.

  “Here,” I said, even though Maryann’s hands were full with a wet black-haired head. The mother gasped.

  “One downside and one up. Gloves!”

  Avoiding the sight of the woman’s naked body, I found a box of latex gloves and took an inordinate amount of time fumbling them on. The cotton chux pads were lined on one side with blue plastic. I opened two and sidestepped between the bed and birth huddle to get to the puddle of urine.

  “You’re doing great,” Maryann cooed to the mother. “Okay, push now.” The sister translated, unnecessarily.

  Shaking, I reached around the woman’s legs and Maryann’s big arms to lay down a pad. I didn’t know how to get it under her knees, so I placed it and the second on top of her calves just as she grunted, jerked her body back, and the baby somersaulted out in a burst of blood.

  One human being emerged from another! There he was, glistening, brown, a breathing creature cupped in Maryann’s palms. He thrashed his arms and, finding no uterine walls to push against, snapped open his eyes. They were black pools rimmed with long, sticky lashes.

  He looked at me
first.

  Maryann ordered me to hand her the bulb syringe, and I groped my way into awareness. The baby began to wail. His grief at the harsh air could have come from me, it felt so close. Finally a nurse arrived, chiding, “Hannah! Why are you here?” Maryann snapped, “Doing your job,” and I was shooed out.

  On the winter street, tears freezing on my face, I reached into my jacket pocket for my bus pass and finally noticed the latex gloves on my hands, blood splattered, like an extra layer of skin. I peeled them into a trash can. The baby, that stunningly aware, miniscule body, had erased everything: my mortification at the woman’s nakedness, my aversion to blood and urine, the awkwardness of squatting so close. My fear of Maryann. The strangeness of being the only white woman in the room. The unbearable reality of being motherless.

  Suddenly, I knew that baby had emerged from the same place my mother had gone. I didn’t believe in heaven but how else could I explain that profound sense of continuity? He filled a hollow place in me, forcefully, irrevocably.

  Later, Maryann said I had caught the birth bug. Her story’s not so different from mine, only she was stuck in a traffic jam outside of Chicago. As she tells it, the combination of a Cubs game and a tractor-trailer accident had the freeway stalled for fifteen miles. The July heat was relentless. Most cars had their air conditioners blasting. Maryann’s station wagon was a clunker; her kids hung out the windows panting like dogs. Her husband had turned off the ignition. The next lane over, “within spitting distance,” another car with open windows held a couple in obvious distress.

  “The lady moaned like a ghoul,” Maryann told me, “and her husband kept saying, ‘No! Don’t!’ ” When Maryann realized what was happening, she jumped out and offered her help despite having no medical training. Knowing Maryann, I imagine she just took over, setting the woman up in the back of their station wagon and sending her kids running down the line of cars looking for a doctor. “When that sweetpea popped her little head out,” Maryann said, “I got high. Been a birth junkie ever since.”