Autumn

1

Stillbirth

“How long do you think my baby’s been dead?” Katherine turns toward me, and I can tell she’s still crying.

“Five days, maybe less,” I answer my patient. “I heard the heartbeat when I checked you last Friday, and you said the baby moved during church. Shut your eyes now. Try. You need to rest.”

I place my new leather-bound journal on the maple table, lean my head back, and gaze across the dark room. Fire crackles in the blue-tiled fireplace, flickers on the armoire, the canopy of the birth bed, and the wallpapered walls. A watery image in the dressing table mirror catches my eye. It’s me, a small woman with long auburn hair, a straight nose, and a round chin, pretty enough but not beautiful.

I’m sitting at the bedside of Mrs. Katherine MacIntosh, the wife of William, owner of the MacIntosh Consolidated Mines. Yesterday was Black Tuesday, that’s what they’re calling it. Wall Street fell, and then I had to tell the MacIntoshes that their unborn baby was dead. The crash, a faraway earthquake, rumbled even here in Appalachia, and I’m thankful I don’t keep my money in the bank; not that I have any.

As I desperately searched for signs of life in Katherine’s womb, moving my wooden fetoscope over her round belly, up and down and then across, a line of customers fought to get their money out of the First Mountain Federal in Liberty. The queue of men snaked down Chestnut and around the corner to Fayette, though any fool who strolled along Main and saw the closed shops should have known what was coming. When the coal mines begin to shut down in Union County, everything else does.

“Hold me, Patience. I’m so cold.” Katherine reaches for my hand and pulls me toward the bed.

Mary Proudfoot, the MacIntoshes’ cook, and her grown daughter, Bitsy, are asleep in their room by the kitchen, curled around each other like kittens. William MacIntosh snores in his bedroom down the hall. This room is not chilly. It’s Katherine’s heart that is cold, knotted up like a chunk of ice thrown up on the banks of the Hope River. It doesn’t seem proper for a midwife to sleep with her patient, but if I rest a few hours, what harm can it do? I’ll need my strength to get us all through this.

I breathe out a long sigh, carefully place my wire-rimmed glasses with the journal, kick off my slippers, move over to the bed, and fold myself around Katherine, giving her comfort where there is no comfort, remembering Pittsburgh when, in the winter, I used to sleep with Mrs. Kelly and Nora.

I’d like to tell this mother about my own stillborn baby, the one I carried when I was sixteen, the very same baby whose father died before he was born, but I can’t add to her burdens.

I pull the covers over Katherine’s shoulder and put my arms around her as she sobs in her sleep. The loss of this child is all the sadder because her first son, not yet two, a little blond boy just learning to talk, died of pneumonia last winter.

Her contractions are mild and come every ten minutes.

Dream

At 6:30 A.M., as light crawls under the heavy drapes illuminating the rose carvings on the tall maple armoire and the pattern on the red-flowered carpet, Katherine sits straight up in bed, her hand on her belly.

“I felt it,” she says. I rub sleep from my swollen eyes, thinking she dreams.

I’d listened for the sound of the infant’s heartbeat with my wooden horned fetoscope for a full hour yesterday as the room got quieter and Katherine’s eyes rounder. There was nothing to hear but the rumbling of the woman’s bowels. No tick-tick-tick of a baby’s heartbeat. No baby kicks, either. I’d even called for Dr. Blum—tall, thin, hair thinning on top—and he listened for another thirty minutes . . . still nothing. Katherine screamed when I first told her the baby was dead, and when the physician nodded agreement, patted her hand, and took her husband out of the room, she screamed again.

The sound of that wail goes right to your heart. I’d only heard it once before, at Manny McConnell’s delivery in Pittsburgh, when Mrs. Kelly, the midwife, told her the twins had expired, but you never forget. Even if you were outside on a warm summer evening and heard it through an open window, you would know what I mean.

Downstairs, on William MacIntosh’s new RCA console, we could hear the faint voice of a newscaster describing what was happening to the stock market. Then, before I had time to discuss the case with Dr. Blum, he was called away to attend a sick child and left the stillbirth to me. I was the midwife, and she’d signed up to deliver at home instead of in his small private hospital. He must have thought I’d know what to do.

Katherine is still kneading her white belly like bread dough, pushing it back and forth. “I felt it,” she says. “I felt something!”

I stretch and sit up. “It was probably just a gas bubble or maybe a labor pain. Do you need to go to the bathroom?”

In addition to electric lights, the MacIntoshes have an indoor latrine and running water. In town this is not unusual, but in most of rural West Virginia both electricity and plumbing are still rare.

“I felt it. I did. I know I did.”

“Katherine . . .” I straighten my rumpled flowered shift, embarrassed at the impropriety of sleeping with a patient, and put on my glasses. “Let’s go to the toilet. I’ll listen for a heartbeat again after you’ve relieved yourself, but don’t get your hopes up. Your baby’s spirit has gone back to Heaven.” I talk like this, as if I’m a believer, but in truth I haven’t been to church, except for funerals and weddings, since my husband, Ruben, died on Blair Mountain along with 150 other union men. This was back in the fall of ’21, a bad time.

“I think I felt it . . . something woke me.” She’s no longer sure.

In the MacIntoshes’ water closet, I study the apparatus. The high porcelain potty has a round polished oak seat, more like a piece of furniture than a commode. When Katherine finishes, she pulls the brass chain and water rushes in to rinse out the contents.

Stepping out of the small green mosaic-tiled room, my patient turns. “I have to go some more!” She’s a tall woman, taller than I, with the face of a film star and a rumpled short blond bob like Jean Harlow. The pregnant woman lifts her white embroidered nightdress and plunks down on the seat again.

I let out my air, glance at the rumpled covers, and decide to straighten the bed. While I’m fluffing the feather pillows, I hear a low grunt. “Uhhhhhg!”