Such force, in a woman who’d already given birth three times, should have shot the baby out like a greased pig. It hadn’t, and now I was sure what was wrong.
“The twins are tangled together,” I said, as calmly as I could. I pressed her stomach and felt movement—one twin, at least, was still alive. I was drenched with sweat and my mouth was dry. Someone had set a cup of water near me; I hadn’t noticed. I picked it up and drank, to get enough moisture to say what had to be said next.
“Susannah,” I said, leaning forward to look into her eyes. “The babies can’t get out. I can’t get them out. If we keep doing this, they’ll die—and you might die, too.” Easily. I took a deep breath; her hand had come down to rest on mine, atop her rigid belly.
“Wait,” she whispered, and clenched my hand as we all rode the next contraction. When it relaxed, she was panting, but squeezed my hand lightly and let go. “What … else?” she said, between gasps.
“I can cut you open and take the babies out,” I said. “It will be awful and it will be painful, but—”
“It can’t be worse’n this,” she said, and then did laugh, hoarse as a crow. I lowered my head and rested my forehead for a moment against her belly, controlling my own emotions, preparing myself. “Will I die, then?” she said, her voice quite matter-of-fact.
“Very likely,” I said, straightening up and matching her tone. I wiped a sleeve across my face and shoved the loose hair out of my eyes. “But it might save the babies. I’ll do my best.”
She nodded, and clutched my shoulder fiercely as the next contraction came on.
“Save ’em,” she said, as soon as it passed, and dropped her head, breathing like a winded horse.
The energy of emergency flooded me and I stood up, looking about the cabin for the first time. It was tiny and sparsely furnished, with one bedstead and a pallet rolled up at the foot. A table and benches—and a cauldron on the fire, steaming, thank God. And much to my surprise, Jamie, calmly unrolling the bundle that held my surgical knives on the table.
“Where did you come from?” I said. And added, glancing round the cabin, “Where’s Mr. Cloudtree?”
“Cold as a dead trout,” he said, nodding toward the half-open door. “Drunk, I mean.” I caught a glimpse of a small white face through the gap—Agnes, eyes huge with fear. “Mind your brothers, lass,” he said calmly to her. “It will be all right.”
I made what I hoped was a smile toward Agnes and stepped closer to the table. I started pulling things out of my kit as fast as I could.
“Did you hear what I said to her?” I asked, low-voiced, with a nod at Mrs. Cloudtree’s grunting form.
“I did,” he said, equally low-voiced, “and so did the wee lass.” He glanced at the door; Agnes was still there. When she saw me looking, she sidled in.
“The boys are asleep with Pa in the shed,” she said in a rush. “I can help, please let me help!”
“Agnes?” said Susannah faintly, raising her head. Before I could say anything, Agnes had shot to her mother’s side and was hugging her round the shoulders. Tears were pouring down her face, but she was saying, “It’ll be all right, Ma, Mr. Fraser says so.”
Susannah raised one arm as though it weighed a ton and slowly pushed back her sopping hair with her wrist to fix an eye on Jamie.
“You say so, Mr …. Fraser?”
“Aye, I do,” he said.
She went purple and bit her lip, breathing heavily through her nose, head hanging. When the pain let go, she raised it as though it were as heavy as the big iron cauldron.
“Your wife says … I’m gonna die.”
“Aye, well, I’ve got more faith in her than she does, but I suppose it’s your choice who to believe.” He glanced at me, hands half-curled for action. “What d’ye want to do, Sassenach?”
“She needs to be lying down.” My mind was made up and I already had what I needed laid out on the bench. “Can you get her onto the bed? Quickly.”
Susannah had been panting, eyes closed. At this, her eyes sprang open and she straightened, clutching her belly.
“Not the bed! You ain’t gonna spoil my good featherbed! Gaaaarrg!” She curled up like a shrimp again. Agnes was breathing so hard I thought she might faint, but no time to worry about it.
“The floor, then,” I said briefly. “Hurry. Stand back, Agnes!”
Between us, Jamie and I heaved her up, turned her, and laid her down as carefully as we could. She was tremendously heavy, very ungainly, and slick with sweat, though, and came down on the pounded dirt with a solid bump, at which she uttered a wild cry and Jamie said something very blasphemous in Gaelic.
“Bloody hell,” I said, under my breath, and reaching for the bottle of dilute alcohol, I pushed the soggy folds of her shift up and sloshed it over the huge belly, fish white and striped with purple-red stretch marks.
“All right,” I said, and snatched the heaviest of my surgical scalpels. “Jamie, hold her—oh, you’ve got her, good.” Muttering “Jesus, Mary, and Bride, bloody help me …” I laid the blade at the base of her navel.
But before I could make the incision, she screamed as though the touch of cold metal had been a cattle prod, jerked her knees up, then drove her heels down into the dirt, arched her back, thumped down again, and …
“What the devil’s that?” Jamie said, trying to look over the obstruction of Mrs. Cloudtree’s belly.
“It’s a head,” I said. “Jesus H. Roosevelt Christ. Push, Susannah!”
She hadn’t waited for instructions. With a ferocious noise, she pushed, and the baby did shoot out like a greased pig. I caught him—was it a him? Yes, it was—in my apron. I thumbed his nose and mouth clear, turned him over, and thumped his wet back lightly. The tiny buttocks squeezed together in protest, relaxed and let out a small spurt of dark fecal matter, but he was making regular huffing noises, sounding much like his mother, though not nearly as loud.
“Agnes!” I shouted. She was already at my shoulder as I turned and I detached my apron, wrapped it hastily round the infant, and thrust him into her arms.
“Shall I cut the cord, Sassenach?” Jamie was squatting by my other side, sgian dubh in hand.
“Yes,” I said breathlessly, and forgot about it, thrusting my hand into the birth canal, hoping for another head.
No such luck. Limbs everywhere, in the tight, slippery dark. I closed my eyes to see better, feeling urgently for a foot. Just one, I prayed. Just one foot … And then a powerful contraction came on, quite different, like an ocean wave rolling through Susannah’s body, but slowly enough that I managed to get my hand out of the way. And there it was. A tiny foot, its limp toes tinged with unearthly blue.
“Bloody, bloody, bloody …” I realized that I was muttering senseless things and clamped my jaw tight. I knew it was too late, but there was nothing else to be done. Once more I reached up, fumbling into the dark, and this time found the other foot without trouble. Without trouble because the baby wasn’t moving.
A sense of remoteness came over me, and I closed my eyes and swallowed, feeling the solid stillness of a tiny body come into my hands. They call it stillbirth because it is. Not because the child is dead, but because everything—everything—goes quiet. A tiny, still girl. I knew she was gone, but stubbornness made me lift her and try to push breath into the still lungs, my fingers on the tiny chest, hoping against hope … but she was gone.