Chapter 9 #3
“I know something that will help,” Ruth promised as she began leveraging Mrs. Roland into a seated position.
“Slide your legs over like that.” With a grunt, and Nora’s assistance, she managed to help Mrs. Roland until her feet met the floorboards, but just as she was perched at the edge of the bed, Mrs. Roland cried out and clung to the mattress.
Nora’s grip tightened. Mrs. Roland was tall. If she went down, they’d have a terrible time lifting her. Besides, she’d never, ever dropped a patient, and didn’t intend to now.
But before she could lay Mrs. Roland back on the bed, Ruth offered her a corded forearm, helping her take several steps to the foot of the bed.
“Thank goodness you like poster beds. These are dead useful for births.” She guided Mrs. Roland’s hands to the ornate post. “Now, keep a firm hold, and when there’s a pain, lean over as much as you want. I’ll take the weight of your belly.”
Mrs. Roland cried out again, legs shaking beneath her. Ruth pressed one hand into the small of her back and bore up her inflated belly with the other.
“What can I do?” Nora asked Ruth quietly, beneath Mrs. Roland’s low moan.
“Help me hold her up.” Ruth checked the floor. “You must have a water bag made of iron,” she announced to Mrs. Roland. “It still hasn’t come apart.”
“Let me check again. Stay right where you are,” Nora instructed. She crawled into position, reached to check…
Her earlier misgivings left in a rush. “I can still feel the edges, but we’re nearly there.” It was working.
Mrs. Roland leaned forward, grinding her face into the hard wood of the bedpost. Nora put out her hand to stop her, but her teeth were gritted in supreme concentration. Then, without warning, Mrs. Roland shifted backward and squatted toward the floor, her mouth opening in a keening wail.
“What—” Scrambling out of the way, Nora had no time and insufficient strength to right her.
But Ruth didn’t look anxious, and that steadied Nora’s nerves.
With one smooth, practiced movement, Ruth took the spot behind Mrs. Roland and crouched low so it looked like their patient was sitting in her lap.
Her forearms bulged as she squeezed the suffering woman’s hips.
“That helps,” Mrs. Roland gasped.
“Pressure right here, with me, as hard as you can manage,” Ruth said to Nora.
“Supra pubic pressure,” she said reflexively. She’d used it often enough, but never holding a patient like Ruth was.
“Make it stop,” Mrs. Roland pleaded, her face red and swollen.
“It will stop. And you’ll be holding a beautiful babe,” Ruth promised. “Sit down on me. I won’t break.”
Nora would have. She didn’t know how Ruth bore up the weight of a straining pregnant woman.
Mrs. Roland writhed through several more pains before she closed her eyes and announced, “It’s coming.”
“Almost,” Nora said, panic fraying her voice. Last she’d checked, the cervix hadn’t expanded enough. The pressure of pushing could damage it permanently. After taking her hook from her bag, she massaged the top of the baby’s head, finding a safe spot…
Mrs. Roland screamed as the amniotic fluid burst from the ruptured membrane, dropping the baby’s head and eliciting an immediate contraction.
Nora was ready with a towel. After this, they wouldn’t have much time.
“Get her on the bed,” she commanded. “She’ll be ready to push in one or two more pains. ”
“No. No. No,” Mrs. Roland repeated, shaking her head. Instead of staggering onto the bed, she dropped to the floor on her hands and knees.
“Mrs. Roland—” Nora hooked an arm under her shoulders. They must get her off the floor. She heaved upward, but Mrs. Franklin stopped her with a firm hand.
“She’s in a good place right where she is. She can deliver like this.”
“But she—”
Mrs. Roland moaned through clenched lips. Her body shook, her face bright red with the effort of pushing. The baby’s black hair slid into view and then vanished again.
They couldn’t let her birth on the floor. Nora bit her lip, then told herself there was no point in considering her patient’s dignity. Nothing was going to move Mrs. Roland now. She’d been in such pain, but as soon as she’d dropped to all fours, her screaming had stopped.
With the child already crowning, it wouldn’t be long.
Ruth bent low and pressed her fist into Mrs. Roland’s aching back with such strength her arms quivered. “You bring out the baby; I’ll help her through the pains.”
Mrs. Roland leaned onto her forearms, her bottom thrust up as the baby’s face emerged, bloated and purple.
Out of arguments and time, Nora supported the stretching tissues and watched the slick body turn on the next contraction, expelling more fluid and blood.
Mrs. Rowland had stopped screaming and was pushing silently, no strength left for sound.
The shoulders emerged and Nora took hold of the infant, who blinked, fingers splayed wide, then squalled indignantly.
“I need another towel.”
Ruth was already beside her, taking the baby and swabbing her off. “Do you see how easy that was?”
Easy seemed hardly the appropriate word.
“What is it?” Mrs. Roland asked, voice muffled against her arms.
“A girl,” Ruth said, and carried the baby to her mother’s side. Mrs. Roland laughed shakily, dissolving into tears.
“Let’s get you and your mama up to the bed now,” Ruth said, setting the baby in the middle of the mattress. The infant stopped crying and scrunched into a tight ball, eyes refusing to let in the offending light of day. Nora helped Mrs. Roland to her feet.
“I thought I was going to die,” she said, wiping tears from her eyes.
“No, no, love,” Ruth said. “There was never any danger, but those kinds of pains might make you think so. But you’re finished now, with a beautiful daughter.”
“Not even a tiny tear. No stitches,” Nora said, smiling.
“Most of mine never do,” Ruth said, busy arranging the bedcovers. “My aunt was a great midwife. She taught me the hands and knees.”
Nora chewed on the inside of her cheek, replaying the birth. Unconventional. Visually disturbing, but effective.
***
Lady Woodbine sent them home in Mrs. Roland’s coach, their ears full of praises.
“I’ve read about that technique, but it was different from anything I’ve seen,” Nora said quietly.
“Some women, like Mrs. Roland, will find the position their babe needs by themselves,” Ruth said.
“It does work against gravity.” Nora pursed her lips. “The baby was coming out uphill.”
“But less swelling after—in the nethers.” Ruth scrambled for her recently collected knowledge. “The vulva.”
Nora nodded. It made sense. Less continuous force against the perineum. “There’s something about it,” she mused, gathering her thoughts, “that’s a bit medieval. Like a squatting stool.”
“Medieval?” Ruth frowned. “You sound like those ignorant doctors. Squatting is one of the best ways to give birth.”
The carriage jarred with a quick stop, and Nora tightened her grip on the vaporizer beside her. “Squatting and bottom up?”
“If Dr. Adams had attended that birth, he’d have kept her flat on her back in agony,” Ruth pointed out. “Some even hold women down. I’m just glad they sent for you and me.”
Nora swallowed guiltily. She’d have turned Mrs. Roland to her side but never allowed her out of bed.
“It would have kept all the weight and irritation right on her back, and she’d have been too frightened to push when the pains came.” Ruth shook her head. “I’ve seen it. Women refusing to push when the pain is too unbearable. It can have terrible effects.”
“I always roll them to the side.” Nora’s voice dropped. “But I’ve never encouraged crouching or kneeling.” Or permitted it, either.
“You pushed on her back. That was well done.”
A sop. Like when she was sixteen and fearful, but needed by Horace to help some patient with something.
Ruth inhaled. “I don’t have the things you have. Vaporizers and such. But I do know how to help in a case like this. You must let the baby drop away from the spine completely. Otherwise—”
“The nerves remain compressed,” Nora finished, the anatomical picture forming in her mind, like a landscape coming into focus as the fog lifts.
When Mrs. Roland dropped to the ground, the child had swung forward.
And when Mrs. Roland had lowered her head and leaned on her arms with her bottom in the air, the child had shifted even farther from the spine.
“That makes excellent sense.” She smiled at Ruth and fanned the heavy summer air.
“When we get home, I can show you what happened inside her body after you let her get on the floor.”
Ruth’s eyes narrowed in confusion. “I already know what happened—”
“I mean the medical explanation. When you can see the actual nerves and spinal structure, you’ll be even more impressed with yourself and be able to explain the process more convincingly.
” Nora was already selecting which anatomy books she’d pull off the shelf.
Only three blocks from home, and she nearly sat on her hands in impatience.
“Who would I need to convince?” Ruth asked.
Nora gave a tight-lipped smile. “All those doctors who are too pompous to sit beside you in a lecture, so proud of their degrees and Latin. They have a lot of learning to do.” Her lips softened. “So do I.”
Ruth shook her head. “I can’t tell them. They’d never listen.”
Nora frowned. “Maybe not.” She tapped her fingers against her opposite wrist, remembering Dr. Adams stalking out of her lecture, chin high, nose almost scraping the ceiling. “But I can.”
This was an intriguing case. She’d write it up and submit it to her favorite publication, the Provincial Medical & Surgical Journal. She’d had letters and papers published in there before. It would give her colleagues something to talk about. Perhaps even change a few minds.