The aunties whip the pillows away and help the mother sit up in bed just as the head with long black curls crowns at the opening.

“Sweet Jesus! I’m gonna faint,” the shorter of the trio exclaims and feels for a chair as the baby shoots out, dragging an afterbirth that looks like a two-pound calf liver. The cord is only eight inches long! Quick as a wink Mrs. Potts ties it off and hands the baby to Mildred, who wraps the tiny crying girl in a clean towel.

“Praise Jesus!” “Thank the Lord!” everyone exclaims.

Another healthy baby. If I believed in God, I would bow down . . .

Hemorrhage

The blood that follows within minutes is the real emergency—as if an arm presenting weren’t bad enough. I start massaging the womb, talking to it as if it could hear. “No, you don’t. You stop bleeding! Stop it right now!”

“Get your fist back in there,” Mrs. Potts orders. I know what she means, but I’ve never done it before. It’s called, by DeLee, bimanual compression. There’s a picture of the procedure in my obstetrics textbook. “Use your other hand on the outside. Fold the floppy uterus over your fist and hold on tight.” The older midwife spits out her instructions as she fumbles behind her for a small brown bottle on the dresser. “Drink this,” Mrs. Potts commands. Bitsy holds the flask to Cassie’s lips.

Potts is in total control now and the blood is slowing, so I try to remove my hand.

“Not yet,” she directs.

I go back in and hold on when I see the hemorrhage start up again.

“Vinegar,” Potts demands, and the shortest of the three ladies trots to the kitchen, returning with a small ceramic jug. The midwife pours the pungent liquid over one of my sterilized rags and hands it to me.

“Clean her uterus out. There must be clots. The vinegar will help stop the hemorrhage while the blue cohosh and shepherd’s purse tincture that we gave her takes effect. Any time a woman has pain with no progress, be ready for this. If the bleeding doesn’t stop pretty quick, we’ll try ice.”

At the sight of so much blood, the three musketeers, Mildred, Samantha, and Emma, have backed out the door with the baby. Bitsy takes Cassie’s hand, softly singing “Joshua fit the battle of Jericho . . . Jericho . . .” into her ear to keep her calm.

“Ice?”

“Ice in the uterus will cause the blood to contract.” I think she means blood vessels, but I don’t ask. I’ve read about surgeons using ice to stop a hemorrhage during a cesarean section, but it always seemed to me it would cause such shock that a woman would die of chill instead of blood loss.

Mrs. Potts takes Cassie’s wrist while she stares at her gold wristwatch, the kind nurses have, and her lips move as she counts the patient’s pulse. “You are such a good girl, Cassie. We’ll have you fixed up in a minute.

“Go, ahead, bring the rag out and all the thickened blood you can find,” the elderly lady instructs me. When I do what she says, I find myself holding a handful of clots the size of chicken gizzards. Mrs. Potts then takes over and from the outside squeezes the uterus like she’s wringing out a dishrag. More clots plop out, and I wipe them up.

“All right, then!” the old midwife calls. She takes a big breath and kisses her patient on the top of her head. “You can stop rubbing now. Bitsy, check every few minutes and make sure the womb stays firm.” My assistant—I think of her that way already—knows what to do from Katherine’s birth. Tears are streaming down both sides of Cassie’s face. “Let’s give the mama her baby and get it on the teat. That will help them both feel better.”

Still shaking as I wash up at the kitchen sink, I take a big breath. Bitsy cleans up the bedroom, and Mrs. Potts dresses the infant’s cord. Outside, the sky lifts the pink hem of its nightdress along the eastern edge.

“Here, honey.” Mildred, who turns out to be the baby’s granny and the mistress of the house, hands me one of her clean housedresses to wear over my top. She points down the hall. “You can change in my bedroom.”

“Mr. Miller! Reverend Miller! All clear!” She calls out the back door to her husband and the menfolk hiding in the barn. “Come on in. Food’s on the table!”

By the time I’ve tidied up, the three cooks are harmonizing in the kitchen. “There’s a rainbow ’round my shoulder and a sky of blue above.” A catchy Al Jolson song. The older midwife pads down the hall, smiling, and shocks me when she does a little boogie at the kitchen door. In the parlor she sits down to reorganize her birth kit, so Bitsy and I sit down beside her.

“I try to keep everything fresh,” she tells us, giving instructions as if she’s talking to herself. “You never know when you might be called again . . . not that I go out as often as I used to.” Her little brown eyes sparkle at Bitsy, then at me, and I wonder which of us she’s training. “Do you need some of my bleeding medicine? I have an extra bottle.” She holds a glass vessel out and I take it, grateful for the gift.

“What’s in it, again? Is it something I could make myself, or is it private?” In the Appalachian Mountains cooks jealously guard their recipes for black velvet cake, potato salad, fried chicken, and sticky buns. It might be the same with medicinal tonics.

“Don’t be foolish. If it could help save a mother’s life, of course I’d want you to have it.” She proceeds to write down, on a torn piece of wrapping paper, the herbs she uses and how to prepare them as Mildred pokes her head into the hall.

“Come on, Auntie Potts! You’re first to eat and then Patience.” I smile at their thoughtfulness and am a little surprised when I enter the kitchen. In this household, at least after the hard work of birthing, the women eat first. Three black men stand back, leaning against the wall or the counter, eyeing the food. There’s Thomas, our escort; Darwin Washington, the father of the new baby; and an older gentleman I take to be the reverend. Then there’s the women bustling around, a sea of black and brown faces, with mine as white as the full moon in October. I note that no children are present and decide that in this tight-knit community, there would be plenty of willing attendants down the road.

As if she lives here, Bitsy steps up to the table and begins to serve collards and mashed potatoes, along with meat sandwiches on homemade white bread. Mildred takes a breakfast tray into the bedroom for Cassie and Darwin.