by Elizabeth Jarrett Andrew
That February a Minneapolis midwife got busted. Maryann, my old mentor, called with the news. “Undercover agents, a forced entry. Held her thirteen-year-old daughter at gunpoint, ransacked her office, took her computer, everything. She’s out on bail now, but holy Jesus.”
It was a blow. Until then, plenty of Minnesotan midwives practiced under the law’s radar. The consequence was a steep fine, something I figured I could handle. But arrest? This was a new development.
“Look out for yourself, honey,” Maryann said.
So I refined my cover. Should the police ask, I did prenatal education and massage. Over the winter I converted the front parlor into a small office with a desk, overstuffed armchair, basket of toys from the parsonage basement, and a massage table. Floral curtains and the east-facing window made the room cheery and expectant. I hid my birth kit behind the altar at Dad’s church.
By early April, I’d already done three births and had one looming. I drove down to St. Paul to have cafeteria coffee with Maryann. We sat at our favorite table. Dirty snow melted on the other side of the plate-glass windows; pedestrians side-stepped the puddles.
“Give me the lowdown,” Maryann said.
Two Christian fundamentalists, neighbors and both in their last trimester, showed up in January. Until they heard about me (from a high school buddy, the small town grapevine working in my favor), they had planned to be each other’s midwife. “You won’t believe it,” I told her. “They gave birth three days apart. When one went into labor, the other started baking a chocolate layer cake and served it up once the baby was born. Warm.”
“Speedy. Did you shine?”
“I guess.”
“Go on.”
My third didn’t really count. A guy I’d grown up with at church had taken his wife as far as the car when she started pushing. He was a dairy farmer, unafraid to catch the baby. They went back to bed rather than trekking the twenty miles to the hospital, and called me.
My current clients included two mothers without health insurance (I was the cheap alternative): a sweet Mexican student at the technical college who I guessed was here illegally, and Katrina, who had called me in December, not an hour after I’d posted my birth class flyer in a women’s bathroom stall at the community college. She and her husband were in Chester Prairie on a professor exchange, Bernard teaching German and Katrina working on a doctoral thesis. Something about orangutans. “She gave me an earful about American prenatal care,” I told Maryann.
“Uh-huh.” Maryann’s enormous gold hoop earrings swung back and forth.
“She’s due in a few weeks.”
Maryann continued nodding. “Folks always fall through the cracks,” she said. “But you’re catching them.”
Yes. This was my work.
So by early April I had slipped into the sanctuary to retrieve my kit three times, all unhindered. A fourth time I just sat, deepening my meditative ruse. The sanctuary breathed around me. My mother was present in the altar cloths and the space’s crippling expectations. She was also absolutely, irrevocably, absent. I couldn’t leave fast enough.
Then one morning the plastic thermometer outside my kitchen window read sixty-two; the bare willows sweeping the Rum River west of town were yellowing with life, and lilac hedges all over the neighborhood were thick with buds. I took down storm windows and hooked up screens—premature, I knew; we could still get a hard freeze, but I wanted to catch the first whiffs of fragrance as soon as they drifted off the bush. The shining office, my business, my return to Chester Prairie all seemed expectant, the way things do at the close of a long Minnesota winter.
After cleaning the parlor I checked the street for my client. Melinda Hollinger had gotten my number through church; her husband, Mike, was a parishioner, one of the ushers, although goodness knows who he’d spoken to. Melinda kept a produce stand at the end of their drive ten miles west of town. I’d never stopped. Rumor was her prices were high—she farmed without pesticides and the neighbors grumbled about her weeds. Melinda hadn’t discovered she was pregnant until her second trimester, the result of an irregular cycle and the failure of birth control. When she called, she’d seemed oddly ambivalent. “I guess that will work,” she replied to my suggested time.
Two backlit forms approached the house, one adult, rail-straight, the other a toddler with his arm stretched upward, stumbling, eyes on his mother. The third being, I knew, was hidden, heart thumping, bones solidifying, intrinsically and unknowingly itself. I love that presence in a pregnant mother, how it’s at once dear and forceful, already asserting itself into relationships, cravings, personal finances and, who knows, world politics, before even sucking its first breath. I love how pregnant women have secret power tucked away. From behind the screen, I sensed Melinda’s child-to-be and warmed with anticipation.
I pushed the door open. “Hello.”
Melinda pressed her callused hand in mine; with mute judgment, she surveyed my five-feet, ten-inches of Swedish farm stock, denim jumper and flat sandals. Her look made me feel like a first-year apprentice again, desperate to please. Disconcerted, I knelt down to greet the boy, who was maybe two-and-a-half. “Hello, there.”
“Kevin, are you going to say hi to Hannah?” Kevin rubbed his cheek against his mother’s thigh.
Women usually sequester a part of themselves during pregnancy, dividing their attention between the outer world and the dark churning interior. But not Melinda. In her twenty-second week, belly just beginning to push against a navy stretch-top, she perched on the edge of my overstuffed armchair with such perfect posture that the chair, which I’d dragged in from Goodwill and which other women sank into gratefully, seemed a bad idea. She held her jaw at a tough angle. Her bare arms were thick with muscles. Her stare was critical and uncompromising.
The frizz of Melinda’s curls, barely tamed by a stubby braid, caught the sunlight from the window behind her. At her feet Kevin rustled through the basket of Lincoln Logs, toddler-sized Legos, fabric dolls, and a rusted slinky left over from my childhood.
“How are you feeling?” I began.
“Fine. Everything’s fine.”
I groped unsuccessfully through memories of our phone conversation for a more engaging start. “You weren’t looking to have another child?”
“No.” Melinda broke her stare, glanced at Kevin’s tow-head, and corrected herself. “Well, yes. Mike and I both want more children. We’re on a farm, Mike comes from a big family, I love kids, and we want siblings for him.” Kevin found the one matchbox car in the basket and raced it along the paths in the braided rug, brrrming throatily. “But after his birth I swore I’d never do it again.”
“What happened?”
Melinda’s green eyes stripped me of my midwife trappings—the jumper, the pencil, the manila folder. “I said from the start I wanted a natural birth. Dr. Jorgenson knew it, Mike knew it. I told the nurses I didn’t want an epidural and not to ask. Hell, I’m an organic farmer. I didn’t want to load up my baby with drugs before he was born.”
Under her gaze, blinking seemed a weakness.
“My water broke at home. They’d said to come in then, but I didn’t want to, I wanted to labor more first. Mike had a fit. I warded him off for a while, maybe six hours, but then he called, and, no surprise, they tell him to get my butt in there. They didn’t want more than twelve hours of active labor to pass. That scared me, so I agreed.” She glanced at her lap. “Wouldn’t you know, my labor stalls. We’re barely in the door and they’re hooking me up to the baby monitor. I’m friggin’ stuck.”
“The stranded beetle position.”
“Ha.” Melinda’s brow softened. “Exactly. Hell, even bats have sense enough to give birth upright. What’s with the twelve-hour thing?”
I was surprised; most hospitals allow twenty-four. “They’re worried about infection. There’s a greater risk once the sac isn’t protecting the fetus. The trouble is, longer labors don’t introduce bacteria. Foreign objects do.”
“Like drilling wires into my baby’s head?”
I nodded.
“They let me labor a little more, but by that point I was so exhausted that when they checked and I was only three centimeters, the fight in me drained out. I’d asked Mike to be strong when I lost it and instead he’s freaking out, saying things like ‘No one should have to go through pain this bad’ and ‘It’s just an epidural.’ As soon as that needle sunk in my spine, this cold crept over me and it wasn’t my birth anymore. My body went on auto-pilot. Jorgenson ended up using a vacuum extractor. I didn’t have a birth; I had a medical procedure.” She yanked her chin up a notch, pinning me with her eyes. “Reminded me of having an abortion.”
I hesitated. “When?”
“College. I swore I’d never dismiss my intuition again, and then…” She glanced at Kevin, then down. Her arms, freckled and pink, were folded between her breasts and belly. Kevin thrust an odd clump of red and green Legos into her lap. “Look what you made!” Melinda said, her voice harsh and unchanged. “Can you make me a truck now? A dumpster truck?”
“Dumpster twuck.” Kevin’s face brightened. He turned back to the pile of plastic pieces.
“So when he’s born, they whisk him away without telling me why. As far as I know, he’s missing a lung or something. My tongue’s thick and there’s part of me that didn’t care. That was the drugs. When they faded, I was furious.” She still was; her anger sprung from her like her untamed curls. “I could hear him screaming in the next room. He needed me, I needed him, and there was no…” she mouthed the word fucking “reason for Jorgenson to be in the way.” She smoothed Kevin’s hair as he played. “I’ve done my research now. When Mike said there was a rumor going around that you did homebirths, I wanted to check you out.”
“You want a homebirth?”
“No question.”
“How does Mike feel about it?” When she’d set up the appointment, I’d invited them both.
“Mike. He thinks a midwife is better than nothing.” Her fingers drummed on the arm of the chair. “Besides, it’s my body.”
She wielded the feminist maxim like a weapon. Melinda reminded me of Sunny, who not only caught her second and third babies but cut an episiotomy on herself during labor just to see if it was true that the body produces its own anesthesia. It does. Mid-contraction, at the height of pushing and pain, Sunny bent over with surgical scissors and snipped. When I heard that, I thought, holy crap. Melinda’s fierce self-reliance troubled me, perhaps because I couldn’t imagine it for myself or perhaps because I had an inkling I’d suffer its consequences. I shifted in my seat.
I steered our conversation toward the safer terrain of Melinda’s medical history, the ambiguity of her due date (she and Mike speculated that conception had been mid-November, which meant roughly mid-August), and nutrition. Her health and diet were ten times better than mine—all those greens right out of the garden. I gave her my handouts and talked her through the scope of my practice: low risk pregnancies only, no malpresentations, no multiples, births in the thirty-seven to forty-two week window… “You’re aware homebirth isn’t entirely legal here?” I asked.
“Minnesota’s screwy.”
“It means I’m putting myself out on a limb.” I’d determined the best way to protect myself from the law was flat-out honesty. “That’s why I need to be strict about my protocol. I’m using the Minnesota Midwifery Guild’s guidelines because they’re similar to New Mexico’s and that’s what I trained under. They’re important; they help me maintain a high standard of care. It means we need to collaborate, in every way. I’d like both you and Mike to read this informed consent carefully, ask me any questions, and sign it. Next appointment, we’ll find a time when you both can be here. To discuss if this is a good fit.” I’d worked hard on the release. Maryann, Sunny, Maria, and a Minneapolis lawyer had all reviewed it. Firm boundaries that excluded the risky cases gave me freedom within the cases I took. If the state and the Medical Board were unwilling to define safe, normal birth, I would do it myself.
Melinda set the papers on the armrest. I hesitated. “You should also know that Bill Jorgenson is my back-up doc. I wish I could offer you an alternative, but he’s the only OB in town. If there’s any complications at the birth, he’d be the one you’d see.”
Melinda’s face hardened. “Then there won’t be complications.”
We listened to the plastic clack of Legos. I noticed my fingers clenching the pencil and loosened them.
“I’m not interested in homebirth at all costs,” I said. “There are times when the hospital’s essential. Even if you’re right and all goes well, we need a contingency plan.”
Melinda took Kevin’s latest red and blue amalgam in both hands. “What a great truck! Are these the wheels?” She swung her gaze back at me, jade with amber darts. “Tell me what a birth with you would look like.”
So I described how I encourage movement, eating and drinking, how I listen to the baby’s heartbeat with a fetoscope or Doppler, don’t limit who can be in the room, ask for family involvement in decision-making, support labor in whatever position is working best, use intervention only when necessary, and facilitate bonding and breast feeding immediately after birth—the spiel. “If you feel at ease,” I told her, “you’re statistically more likely to have a safe birth. My job is to help make that possible.” When I mentioned the home visits, once prenatal and twice post, Melinda leaned in.
“I knew this could happen,” she whispered. “I was sure there were other ways.”
This is the moment I savor in initial appointments, when the woman arrives at a clearing and realizes that the path she’s been walking is only one of many. The possibility of homebirth awakens our dormant instincts—birth can be as ordinary as an April morning; a woman’s capacity for motherhood resides in her every cell; we can surrender to the body’s wisdom. Melinda’s eyes sparked.
I knew then we’d work together.
We did an exam and said our goodbyes. I scratched down some notes (including the fact that Bill Jorgenson induced after only twelve hours of labor; bit by bit, I had to figure out how he worked), and asked myself my new-client test question: If something went wrong and the state got involved, would this woman stand by me? Mutual trust was my only insurance policy.
Melinda was adamant. She would fight for homebirth with or in spite of me. I filed the chart in my metal cabinet, locked the drawer, and hid the key.
(An excerpt from Andrew’s soon-to-be published novel, Hannah, Delivered)