Midwives (1997) Page 8

  Nevertheless, the image of Sibyl Danforth running around northern Vermont with a big bag full of illegal drugs and syringes wasn't a helpful one in a court of law.

  Ironically, when my mother returned to the Bedfords' bedroom, Charlotte seemed better. Her blood pressure was returning to normal, as was her baby's heartbeat: one hundred, one-ten, then a reassuring one hundred and twenty little thumps per minute. Charlotte had stopped bleeding, and she certainly wasn't showing any symptoms of shock. Her skin wasn't clammy, her complexion seemed fine, her attitude was good. There would be no need, after all, for oxygen or an intravenous drip. There would be no need for Pitocin.

  "I believe I am fine now, Sibyl," she said, the weariness in her voice tinged with hope.

  Charlotte may have meant to convey nothing more with this statement than the idea that her pain, for the moment, had become tolerable. Bearable. Endurable. But in Charlotte's tone my mother had heard more. In Charlotte's voice my mother had heard a loving testimony to the power of prayer: As my mother had been slipping so badly outside among the falling drops of cold water and ice that each step since had caused her an excruciating splinter of pain, Asa and Charlotte and even Anne had prayed. Asa had knelt by the side of his wife's bed, her long, pallid fingers wrapped in his hands, and together they had prayed for her bleeding to cease and her pain to subside; they had prayed that the baby inside her would live, and their lives would be blessed by its presence.

  Anne said at the trial she had never heard as much love in a man's voice as she did in Asa Bedford's that early morning.

  My mother was at once comforted and moved. She no longer feared placental abruption. "Well," she said simply, "let's get that little baby out of you." It was, according to the note that she scribbled, three minutes after two in the morning.

  My mother sat Charlotte up on the bed between Asa's legs and had her lean against him once more: Her back was against his chest, and his back, in turn, was against the headboard. Asa's arms could reach the inside of his wife's thighs and hold her legs apart as she pushed, so the baby would have room to descend. Charlotte's head and neck and spine were aligned, and she sat upon a firm throw pillow my mother had recently purchased at a tag sale, then washed, so her bottom was a couple of inches above the mattress.

  My mother did not believe the baby had spun during its descent. Consequently, she anticipated the child would emerge facing the ceiling, instead of the ground, and the back of its head would continue causing Charlotte pain as it made its final journey through her pelvis.

  Charlotte had labored once before and she had attended some of my mother's birthing classes, so she knew how to breathe and push. She knew how to ride a second-stage contraction, and make the most of each one. She knew when to hold air inside her and push, and when to relax and take shallow, light breaths.

  For an hour Charlotte pushed through each contraction, with my mother and Asa and Anne encouraging her to push an extra second or two each time:

  "You can do it, a little more, a little more, a little more, a little more!"

  "You're doing fine, just fine! Perfect!"

  "'Nother second, 'nother second, 'nother second!"

  "My, oh my, you're great, Charlotte, the best, the best!"

  "You can do this, you're doin' great, doin' great, doin' great. Doing great!"

  "Come on, come on, come on, c'mon, c'mon, c'mon, c'mon!"

  I saw my mother deliver enough babies to know she was an inspiring coach and a mesmerizingly energetic cheerleader. And I also saw the way a majority of fathers would allow my mother to provide most of the verbal confidence. My mother was just so good at it.

  But who said what between two A.M. and six A.M. would matter greatly to the State, and they insisted--and my mother and her attorney never denied--that Asa and Anne said most of the "You're doing fines," while my mother said most of the "Little mores" and "'Nother seconds."

  Charlotte would close her eyes and clench her teeth as she pushed, and the lines on her face extending out to her temples would grow sharp. Like all mothers about to deliver a baby, Charlotte strained and struggled and no doubt worked as hard as she possibly could. Sometimes her face grew blue when my mother pressed her to bear down even harder.

  "'Nother second, 'nother second, 'nother second!"

  "My, oh my, you're great, Charlotte, the best, the best!"

  After Charlotte had been pushing for almost a full hour, my mother had her rest for twenty minutes. Charlotte was again experiencing the fear that she wasn't going to be able to push this baby out, and she was scared. My mother reassured her that the baby was doing fine, and so was she.

  The baby's head, my mother said in court, had made progress during that hour, although the autopsy would be inconclusive. The medical examiner could never be sure how far the baby had descended, and it was certainly impossible for him to say with confidence where it had been at three or four or five in the morning.

  At three-fifteen, Charlotte resumed pushing. With her jaw locked tight but her lips parted, she continued trying to push her baby into the world. Sometimes her head would be back against Asa's shoulder, and sometimes her chin would fall down toward her own chest.

  "You can do it, a little more, a little more, a little more, a little more!"

  "You're doing fine, just fine! Perfect!"

  She tried, my mother said, as hard as any woman she had ever seen. The surges sweeping through Charlotte's body were long, and my mother persuaded her to make the most of each peak.

  And between them Charlotte would catch her breath, and then she would try again.

  "Come on, come on, come on, c'mon, c'mon, c'mon, c'mon!"

  A few minutes past four in the morning, my mother had Charlotte rest a second time. She could see Charlotte was exhausted, and she could see Charlotte's confidence was failing.

  There are two general medical definitions for prolonged second-stage labor: a second stage that has lasted two and a half hours, and a second stage that has continued a full hour without further descent of the head.

  My mother insisted that the baby had indeed descended during Charlotte's second effort. By four in the morning, she said later, the child had negotiated the ischial spines and much of the pelvic outlet: It had merely to navigate the pubic bone and then it would crown.

  Near four-thirty the urge to push became overwhelming, and Charlotte told my mother and her husband that she wanted to try once more. And so she did. She pushed as hard as she could, she pushed with all of the strength she could find, she pushed so hard that when she would finally exhale, she would grunt like a professional tennis player at the moment her racket is slamming ferociously into the ball on a baseline backhand.

  For brief seconds at the height of Charlotte's pushing, my mother could see tufts of the child's dark hair, but the baby always seemed to slip back.

  Did my mother consider giving up, and attempting what she knew was probably impossible--navigating the icy roads that separated them from the hospital? My mother said that she did, although she never suggested such a thing to Anne. But even Asa testified that between five and six o'clock in the morning, my mother limped to the bedroom window and pulled the gauzy drapes away to look outside.

  "Was that a sand truck I heard?" she asked once in that hour, a remark that her attorney argued was proof she was daydreaming longingly of a cesarean delivery performed by a doctor in Newport.

  But from the Bedfords' bedroom window, the driveway still glistened like glass, and the rain and ice had continued to fall. My mother's car still sat by the snowbank, a grim reminder of what the roads were like, and she had only to glance down at the cuts on the palms of her hands to remember how difficult it was to move on foot on that ground.

  And, Stephen Hastings pointed out, my mother had not actually heard a sand truck: No town trucks had tried venturing onto the roads in or around Lawson between two-fifteen and six-thirty in the morning. And even at six-thirty, Lawson road crew member Graham Tuttle would testify, the roads were "ju
st plain awful. I drove right on top of the yellow line, sanding and scraping just a single lane. I didn't dare stay on my side of the road, or I'd have wound up in a ditch."

  Obviously Charlotte had no choice but to try and push the baby out in her bedroom, and so while my mother may have wished with all her heart that they could go to the hospital, she never suggested the idea to Asa. She never broached the idea of a cesarean section at North Country Hospital, because she knew they had no real hope of getting there.

  Besides, my mother really believed Charlotte was making progress. The baby was close, she thought. It might be just one more contraction and determined push away.

  And so Charlotte tried. She never pushed again for very long, she never worked through wave after wave of contractions. But as the sun was rising somewhere high above the rows of clouds bringing ice and rain to their corner of Vermont, rising somewhere so far behind the curtains of black and gray that the skies wouldn't lighten until close to seven in the morning that day, Charlotte used all the strength she could muster to try and push her baby past the pubic bone.

  Sometimes my mother changed Charlotte's position. Sometimes Charlotte labored squatting. Sometimes she labored with her back upright, but lying slightly on her side.

  "You can do it, you can do it, can do it, can-do-it, can-do-it, do-it, do-it, do-it, do-it!"

  At ten minutes past six, in the early minutes of her fourth hour of pushing, Charlotte Fugett Bedford suffered what my mother was convinced was a ruptured cerebral aneurysm--or what she would refer to in her own mind as a stroke. She imagined that the intracranial pressure of Charlotte's exertions had caused a small vessel inside the poor woman's brain to burst.

  Asa and my mother, right up until that moment, were still telling Charlotte she could do it, she could get that little baby through her and into the bedroom with them:

  "My, oh my, you're great, Charlotte, the best, the best!"

  "'Nother second, 'nother second, 'nother second!"

  Asa had moved between his wife's legs to catch the child, while Anne and my mother were at her sides, holding her. Abruptly, while struggling in the midst of a contraction, Charlotte's chin shot up from her chest as she pushed with whatever energy she had left, she opened her eyes, and then exhaled with a small squeal. Her husband saw her eyes roll up, then close. My mother and Anne felt the body grow limp in their arms as Charlotte lost consciousness.

  She seemed to go fast. Respiratory distress began almost immediately. My mother was about as well trained as the volunteers on the town rescue squad, and she tried to revive Charlotte. She knelt beside her and blew deep into the woman's lungs through her mouth, attempting to restart her breathing; she pushed down hard upon Charlotte's chest with the heels of her hands, shouting, "One and two and three and four and five and six and seven and eight and nine and ten and eleven and twelve and thirteen and fourteen and fifteen!"

  Fifteen compressions and two breaths. Fifteen compressions followed by two breaths.

  There didn't seem to be a pulse, and my mother pleaded with Charlotte to breathe as she worked. She was crying as she counted aloud, and she begged the woman to fight for her life.

  "You can do it, dammit, I know you can, you can, you can, you-can! Please!" Anne said my mother demanded of the apparently dead woman.

  Did she perform at least eight or nine cycles as my mother said, or four or five as Asa recalled? That is the sort of detail that was disputable. But at some point within minutes of what my mother believed had been a stroke, after my mother concluded her cardiopulmonary resuscitation had failed to generate a pulse or a breath, she screamed for Asa and Anne to find her the sharpest knife in the house.

  Asa would say in court that he did as she asked without thinking, he would say he had no idea what my mother intended to do with the knife. He would say he believed at the time that my mother was going to use the knife to somehow try and save his wife's life. My mother was a midwife and he was not, my mother knew CPR and he did not. My mother was in charge. And he was not.

  Perhaps he was anticipating a tracheotomy. Perhaps not. Perhaps in reality he knew. Perhaps not.

  Anne would insist she went with Asa for different reasons at different times. Once it was because she couldn't bear to stay in the room with the dead woman. Once it was because she was afraid to stay in the room with my mother: My mother suddenly seemed insane to her.

  For whatever the reason, Asa and Anne ran downstairs to the kitchen together, and Asa pulled from the wooden block back on the counter beyond Foogie's reach a knife that was ten inches long, six of which were a steel blade, rounded along the cutting edge like an arrowhead. The handle was wood, stained the dark green of an acorn squash to match the block that held it.

  When they returned, my mother said through her tears, "I can't get a pulse, Asa. I can't bring her back."

  "Can't you do more CPR?" Asa asked, dropping the knife on the foot of the bed.

  "Oh, God, Asa, I could do it for days, but she'll still be gone. She's not coming back." My mother was sitting beside Charlotte, who was still flat on her back on the bed.

  As Asa had much earlier that evening--the night before now, really--he knelt by the side of that bed. He rested his head on his wife's chest, and staring up at her face, he stroked her bangs, still wet from the sweat of her hard labor. He murmured her name, and my mother squeezed his shoulder once.

  And then my mother moved with a suddenness that frightened both Asa and Anne.

  "Let's go," she said, still sniffling, "we've got no time." With the same hand that had squeezed his shoulder only seconds before, she picked the knife up off the sheets.

  What she did not do--and when the state's attorney went over this in the courtroom with Anne, her testimony made even me doubt my mother for a brief moment--was ask Asa what he wanted to do. She never asked the father if he wanted her to try and save the baby. If he had said no, she could have done it anyway, if that's what she wanted; but if he had said yes, she at least would have had complicity.

  And she never placed the Fetalscope back upon Charlotte's stomach to see if there was still a fetal heartbeat. Of course, the baby would prove to be alive, but not checking one last time before she did what she did--it surprised and shocked even the novice midwife.

  And from the moment Asa and Anne returned to the bedroom until the moment my mother began to cut, she never checked one last time to see if Charlotte had a pulse or a heartbeat. Maybe she had--as she said under oath--checked just before they returned with the knife. But neither the father nor the apprentice witnessed my mother make sure Charlotte was dead before she plunged a kitchen knife into the woman.

  "What do you mean?" Asa asked my mother, after she said to him that they had no time. He saw her wipe her eyes, and he would say later there was something about the motion that suggested to him my mother had just had some sort of breakdown. It was a frantic gesture, as if she thought she could heave tears across a room.

  "The baby's only got a few minutes, and we used most of them on Charlotte!"

  "What are you going to do?"

  "Save your baby!" My mother's voice was shrill, both Asa and Anne thought, and Asa said in court he wondered if she was hysterical. My mother insisted that if her voice was shrill, it was not because she was hysterical: It was because she wanted to snap Asa to attention.

  "Save the baby?"

  "Save your baby!"

  My mother had already pushed the old nightgown in which Charlotte had been laboring up around her neck when she had been trying to restart her heart, so there were no clothes to remove before performing the cesarean section. Asa stood up and walked behind my mother as she turned on the reading lamp by the bed for the first time that night.

  "Is she dead?"

  "God, Asa, yes! Of course!"

  Was she? We'll never know for sure. The medical examiner would be one of many state witnesses who would say it was medically possible that Charlotte Fugett Bedford's heart may have stopped for a moment, but my mother'
s diligent CPR had revived it--and, for a time, revived the woman. But there was no doubt in Asa's or Anne's minds that my mother believed Charlotte was dead.

  When my mother said to Asa that--yes, of course!--his wife was dead, he nodded, and my mother took that motion as an assent. Certainly Asa made no effort to stop her. He lumbered slowly to the window without saying a word and looked into the sky, which seemed destined to remain dark forever.

  My mother would say later that in the early-morning hours of March 14, she performed the emergency cesarean because she couldn't bear to see two people die. She just couldn't bear it. And Charlotte was dead without question.

  Was my mother wrong? Anne thought so, just as the medical examiner certainly believed there was room for doubt. Asa was standing by the window when my mother made the first cut, but he said later that--like Anne--he saw blood spurt.