“No, you don’t, Katherine!” I know that sound well. I jump over the needlepoint footstool, trip on the edge of the red-flowered carpet, and skid across the shiny wood floors in my sock feet. It’s the grunt of imminent birth.

Nothing’s ready! Katherine showed no signs that she was in hard labor or any labor at all. Maybe that’s how it is with stillbirths; the woman’s body desperately wants to get rid of the baby. I wouldn’t know. In the births I’ve attended before, the infants were alive, at least for a while.

I have packets of needles with suture in case Katherine tears, I have clean cloth pads, I have sterilized scissors, I have oil to help the vagina stretch, but everything’s wrapped in my satchel downstairs, where I left it by the front door.

“Bitsy!” I call. “Bitsy! Mary! Help!” A door downstairs flies open, and bare feet pound up the stairs. “Somebody bring Mrs. Kelly’s bag.” The feet pound back down again. I don’t know why I said “Mrs. Kelly’s bag.” Mrs. Kelly, my mentor, my unofficial guardian, my friend, died a year after we moved to West Virginia, and I’m alone again.

“Mr. MacIntosh!” Ordinarily I don’t have fathers in the room when women give birth—they can’t take the intensity—but I need someone fast.

The husband arrives in his white-and-blue-striped pajamas, rubbing his eyes. He’s a big man with short sandy hair and a mustache, a handsome guy with the build of an ex-athlete gone to seed. Mary and Bitsy, still in their nightclothes, their eyes white and wide in their brown faces, their dark braids flying, crowd in behind him.

“William, bring clean sheets, towels, anything.”

I’m dragging Katherine back to bed when her water bag breaks. She understands now that it’s not a bowel movement but a dead baby coming.

Katherine growls again and squats on the floor. She’s unconcerned about the expensive red carpet, aware only of the terrible pressure, the need to push. I put my hands under her bottom and am startled to feel a head right there, as round and hard and warm as a living baby’s head.

I’d read, in Mrs. Kelly’s worn text The Principles and Practice of Obstetrics by Joseph DeLee, that stillborn babies, when held in the womb for more than a week, start to decompose, and I had expected to feel something starting to get squishy.

“No, you don’t, Katherine! Up on the bed.” I twist her around and guide her backward. Bitsy lowers her down and gets clean towels underneath her. Mr. MacIntosh still leans against the rose-covered wallpaper, his face so white it would make the sun blind.

There’s no time to pull on the special-order rubber gloves I just purchased from Stenger’s Pharmacy, so I place my bare hands like a crown around the head. Katherine grips the sheets, wide-eyed and frightened, staring up at the chandelier. I motion to Bitsy to lift the woman’s head.

“Look in my eyes, Katherine. Look at me! With the next pain I want you to pant. The head is right here. You don’t have to push. Your womb will do the pushing. If you pop the head out, you’ll tear.” Out of the corner of my eye, I catch sight of the father as he swoons and slides down the flowered wall, but we let him lie there.

“Okay, Mary, be ready with a towel to wrap the baby.” I’m not worried about keeping the dead infant warm; I’m thinking that the child may be deformed or the skin already peeling.

The head, with dark hair, turns and emerges between my hands, first the brow, then the chubby cheeks, then the chin. “Pant, Katherine, pant!”

There’s a cord around the neck, but it’s loose. Once, twice, I loop it over.

“Now the shoulders. Just a gentle push.” I give the wet, lifeless infant to Mary, the cook, whose hands shake so hard I fear she might drop it. “Hold steady now. Hold tight.”

The limp baby boy, gray blue as Lake Michigan, is placed in the towel, and I drape the tail end over the body. At a glance, he looks perfect and the cord wasn’t too tight. I wonder why he died. Maybe a heart defect, I’ve heard that can happen. Or a missing kidney.

The cook, a six-foot-tall, big-bosomed colored woman, hasn’t moved. Her arms, outstretched, like the limbs of a maple, still hold the corpse. What do you do with a dead baby? Take it to the kitchen? Put it into the new white cradle? I had never thought of this.

While I wait for signs that the afterbirth is separating, I motion Mary over and lift up a corner of the towel again. The dead baby’s eyes are glazed and wide open.

Then the ribs move, just a tremble like an old lady’s hand. Holy cow! If I hadn’t been staring I wouldn’t have seen it, a sucking-in action.

“Give me that baby!” I grab the wet infant, almost dropping him on the bed, then, without hesitation, kneel as though I’m praying, put my mouth to his tiny blue lips, and breathe for him three times the way I saw Mrs. Kelly do once. Three tiny puffs.

As the air fills his lungs, Katherine’s son coughs weakly and lets out a mew. He turns from blue-gray to pink, starting in his face and trunk and then out to his hands. Katherine rolls slowly on her side. “My baby,” she whispers. “My baby. My baby!” She’s sitting up now, reaching out, crying over and over “My baby. My baby!” And the baby is crying for his mother too. I lay him on her lap so she can see his little face.

“Praise Jesus!” sings Mary, her hands clutched to her chest, holding her joyous heart in.

Bitsy, who’s sharp as a briar and half the size of her towering mother, has the good sense to cover the crying newborn with another dry towel and rub him all over. I finish cutting the cord and deliver the afterbirth, all the time staring at the Madonna and Child. William MacIntosh, who has missed the whole event, wakes up from his faint and crawls across the carpet toward the bed.

“Mother of God! It’s alive?” he asks, turning to Bitsy, unwilling, I imagine, to trust the blunt-headed midwife who had told him his baby would be dead.

I recall Katherine’s proclamation that she had felt the baby kick a few minutes before. I’m new at this, but it wasn’t just me. Dr. Blum, the family physician, confirmed the absence of a heartbeat. Now I wonder . . . had the unborn child been lying in Katherine’s womb with his limbs curled up in a way that we couldn’t hear his heart with my wooden fetoscope or even the physician’s new metal one? Even in the best of positions it’s hard to hear that faint sound. Had the cord been pinched, causing the fetal heart to slow so that I confused it with the mother’s pulse?