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Arcadia nodded.
Lydia lowered her hips and sank to her knees, giving way like a sand castle, and on all fours she rested, head hung, eyes closed, as if about to pantomime some animal behavior. “I’m going to push now,” she announced. In the same stewardessy voice, she added, “Everyone please shut up.”
Her tone was wrong and startling, like a struck wineglass with a secret flaw, and at once Garth sat up and gaped at Gwen, blinking, wiping his lips with his sleeve. “What’s wrong?” he said. His eyes came unstuck from Gwen’s, and he looked around, kicking up from the deep-sea trench of a dream, looking for his new baby, finding his wife, who was seeing nothing at all.
“Everything’s fine, sweetie,” Aviva said. “Only we’re going to need Frida Kahlo.”
Gwen went into the kitchen to drink a glass of water and, in the name of asepsis if not pride, eradicate every last whiff of Elsabet Getachew from her hands. No excuse for you—that was sterling dialogue. She strangled the renascent memory of her shame with a pair of latex-free gloves. When she came back into the living room, she saw that Frida Kahlo had been veiled with an orange bath towel. Lydia lay on her back, propped up on an old plaid bolster, pale abdomen shot like an eyeball with capillaries, making a new kind of low growling sound that built slowly to an energetic whoop and flowered in a burst of foul language that made everybody laugh.
“Good one,” Aviva said. “Good one.”
Though Aviva had caught a thousand babies with hands that were steady and adept, now that it was time, she deferred to her partner, to the virtuoso hands of Gwen Shanks, freaky-big, fluid as a couple of tide-pool dwellers, cabled like the Golden Gate Bridge.
As Aviva gave way to Gwen, she tried by means of her powerfully signifying eyebrows to communicate that she felt something in this situation to be amiss, something not provided for in the birth plan, which lay sagging and looped onto itself under the little girl’s chair. Aviva’s apparent psychic ability to know in advance when something might go wrong, especially in the context of a birth, was not merely the statistical fruit of an abiding pessimism. Skeptic that she was, Gwen had seen Aviva make unlikely but correct predictions of disaster too many times to discount. Gwen frowned, trying to see or feel what Aviva had detected, coming up short. By the time she turned to Lydia, every trace of the frown had been blown away.
“Okay,” she said, “let’s see what little old Miss Bella is up to.”
Gwen lowered herself by inches and prayers to the floor and, when she arrived, saw that the inner labia of Lydia Frankenthaler had conformed themselves into a fiery circle. A smear of fluid and hair presented its credentials at this checkpoint, advance man for the imminently arriving ambassadress from afar.
“You’re working fast now,” Gwen said. “You’re crowning. Here we go. Oh my goodness.”
“Lydia, honey, remember how you said you really didn’t want to push,” Aviva said, climbing in alongside Gwen, “well, now I would actually like you to stop. Stop pushing. Just let her—”
“Coming fast,” Gwen said. “Look out.”
There was a ripple of liquid and skin, then with a vaginal sigh, the little girl squirted faceup into Gwen’s wide hands. The small eyes were open, nebular, and dull, but in the instant before she cried out, they ignited, and the child seemed to regard Gwen Shanks. The air was filled with a hot smell between sex and butchery. The father said “oh” and pressed in beside Gwen to take the sticky baby as she passed it to him. Arcadia hung back, aghast and thrilling to the redness of the birth and the life kindling in her father’s hands. They wrapped the baby loosely in a candy-striped blanket, and as Aviva stroked Lydia’s hair and helped to raise her head, Garth and Arcadia made the necessary introductions of mother and baby and breast. That left Gwen, crouched at the other end of the silvery umbilicus, to observe the heavy flow of blood that seeped from Lydia’s vagina in a slow pulsation, like water from a saturated sponge.
It required all of Gwen’s training and innate gift for minimization of disaster not to pronounce the fatal syllables “Ho, shit.” But Aviva caught something in her face or shoulders, and when Gwen looked up from the pulsing blood that had begun to pool in a red half-dollar on the shower curtain, her partner was already on her way around to have a look. Aviva hunched down behind Gwen, an umpire leaning in on a catcher’s shoulder to get a better look at the ball as it came down the pike. She smelled of lemon peel and armpit in a way that barely registered with Gwen by now except as a steadying presence. They settled in to wait for the placenta. The soft click-click of the baby’s nursing marked the passing of several minutes. Aviva reached down and gave a gentle tug on the umbilical cord. She frowned. She made a humming sound deep in her throat and then said, “Hmm.”
Her tone pierced the bubble of family happiness up by Lydia’s head. Garth looked up sharply. “Is it all right?”
“It’s fine.”
Gwen ripped back the Velcro straps of her hypodermic kit, unrolled it, and felt around with her left hand for the vial of Pitocin.
“Right now,” Aviva said, “the placenta is feeling a little shy, so we just all want to really encourage the uterus to do some contracting for us. Lydia, you just keep right on nursing her, that’s the very best thing you can do. How’s that coming?”
“She went right on!” Lydia cried. Everything was wonderful in the world where she had taken up residence. “Great latch. Sucking away.”
“Good,” Gwen said, practicing the business of syringe and vial in a mindful series of ritual taps, sinking the vial onto the shaft of the needle, reading the tale of liquid and graduation. “Keep it up. And just to make sure it all gets nice and tight and contracted in there, we’re going to give you a little Pitocin.”
“What’s the deal?” said Garth. He craned forward to see what was happening between his wife’s legs. There was not, say, an ocean of blood, but there was more than enough to shock an innocent new father awash in a postpartum hormonal bath of trust in the world’s goodness. “Oh, goddammit. Did you guys fuck something up?”
He swore stiffly but with a sincere fury that took Gwen by surprise. She had pegged him as the gently feckless type of Berkeley white guy, drawstring pants and Teva sandals worn over hiking socks, sworn to a life of uxorial supportiveness the way some monks were sworn to the work of silence. Gwen didn’t know that Garth and Lydia had quarreled repeatedly over the idea of home birth, that Garth had viewed Lydia’s insistence on having their baby at home as the latest in a string of reckless and unnecessarily showy acts of counterconventionality that included refusing, to date, three separate proposals of marriage from Garth. Garth believed in hospitals and vaccines and government-sanctioned monogamy and had absorbed from his poor black and Latino clients powerful notions of the sovereignty of bad luck and death. He had suffered no ill fortune throughout the length of a tranquil, comfortable, and fulfilling life and so at any moment anticipated—even felt that he deserved—the swift equalizing backhand of universal misfortune.
“It’s okay, Dad,” Gwen said. “It’s going to be okay.”
“Yeah?”
“Oh, yeah.” She laid it on, but only because she could do so in good conscience. This kind of hemorrhaging was not unusual; the Pitocin would kick in momentarily, the uterus would contract, the mysterious bundle of the placenta, that doomed and transient organ, would complete its brief sojourn, and that would be that.
“I mean, well,” Garth said. He appeared to consider and decide against speaking the words that had entered his mind, so as not to cause alarm, then said them anyway: “It’s just that it looks kind of bad.”
Gwen’s eyes snapped onto the little girl, but Arcadia seemed to have decided not to know anything except the baby sucking at her mother’s left breast and the feel of her mother’s hand in hers.
“That’s mostly just lochia,” Gwen said. “Lining, mucus, all that good stuff. It’s normal.”
“Mostly,” Garth repeated, his tone both flat and accusatory.
“How about you run get us some towels, Dad,” Aviva suggested. “And lots of them.”
“Towels,” Garth repeated, clinging to the rope of his desire to be useful.
“Definitely,” Gwen said. “Go on, honey. Go on and get us like every damn towel you got. Also, yeah, some sanitary pads.”
Gwen had a more than adequate supply of pads in her bag, but she wanted to give him a concrete mystery to grow entangled in, hoping that might keep him busy for a few minutes. Whenever she asked Archy to bring her a Tampax, he always got this look on his face, somewhere between intimidation, as by an advanced concept of cosmic theory, and dread, as if mere contact with a tampon might cause him spontaneously to grow a vagina.
Garth went away muttering, “Towels and sanitary pads.”
Aviva called Aryeh Bernstein. “Sorry to bother you,” she said. She gave him the essentials, then listened to what their backup OB had to say about Lydia Frankenthaler’s placenta. “We did. Yep. Okay. All right, thanks, Aryeh. I hope I won’t have to.”
“What did he say?”
“He said more Pitocin and massage.”
“On it,” Gwen said.
As Aviva prepped another push, Gwen laid her hands on Lydia’s belly and felt, blindly and surely, for the hard shuddering uterus. She sank her fingers into the crepey flesh of Lydia’s abdomen and kneaded with dispassion and no more tenderness than a baker. She disbelieved in the mystical power of visualization according to strictures of her 97 percent rule, but that did not prevent her from imagining with every flexion of her fingers that Lydia’s womb was clenching, sealing itself up, condensing like a lump of coal in Superman’s fist to a hard bright healthy diamond.
They heard cabinets slamming in a bathroom somewhere with a panicked air of comedy, and then a glass broke, and the girl jumped. It was not impossible that Gwen jumped, too. Aviva held steady, guiding the second needle into Lydia’s vein.
“Hey, there, Arcadia,” Gwen said. “How you doing?”
“Good.”
“You got a nice strong grip on your mom’s hand, there?” The girl nodded, slow and watchful. Gwen winced at the false tone of cheeriness she could hear creeping into her voice. “Know what I’m doing? I’m massaging your mom’s uterus. Now, I know you know what a uterus is.”
“Yes.”
“Duh. Of course you do, smart as you are.”
“Oh, uh, Gwen, um,” Lydia said, and she sank back deeper against the plaid bolster, her head lolling like a flower on a broken stem. Her left arm with the baby curled in its crook subsided, and there was a loud smack as the small mouth popped loose. “Oh, man, you guys, I don’t know.”
“Any change?” Aviva said.
“Some.”
Gwen tried not to look at her partner as Aviva went over to her flight bag, a gaudy pleather thing blazoned with the obscurely ironic legend SULACO, and broke out the bags, barbs, and tubing of an IV kit. Gwen crouched, up to her elbows in the dough of the woman’s life, knowing that everything was going to be all right, that it was a matter of hormones and massage and a husband judiciously sent to find Kotex and bath towels. She also knew that she suffered from or had been blessed with a kind of reverse clairvoyance, the natural counterpart to her partner’s predictive pessimism. Gwen was resistant to if not proof against clear signs of danger or failure. Not because she was an optimist (not at all) but because she took failure, any failure, whether her own or the universe’s, so personally. If a bridge gave way outside of Bangalore, India, and a bus full of children plunged to their deaths, Gwen felt an atom-sized but detectable blip of culpability. She had been taught firmly that you could not take credit for success if you were unprepared to accept blame for failure, and one useful expedient she had evolved over the years for avoiding having to do the latter was to refuse—not consciously so much as through a reflexive stubbornness—to acknowledge even the possibility of failure. And that was what she would have to accept if she looked up from her wildly bread-making hands and saw Aviva, with that grim measuring gaze of hers, holding up the bag of intravenous saline to catch the sunshine, her mouth drawn into a thin defeated line.
“Don’t fall asleep, Mommy,” Arcadia said. “Here comes Daddy with the towels.”
Gwen hurried along the corridor, bleeding from a fresh cut on her left cheek, trussing her belly with one arm, trying to keep up with Aviva, who was trying to keep up with the single-masted gurney on which Lydia Frankenthaler was being sailed toward one of the emergency-room ORs by a crew of two nurses and the EMT who had accidentally slammed the ambulance door on Gwen’s face. The EMT hit the doors ass-first and banged on through, and the nurse who was not steering the IV pole turned and faced down the midwives as the doors swung shut behind her. She was about Gwen’s age, mid-thirties, a skinny ash-eyed blonde with her hair in a rubber-band ponytail, wearing scrubs patterned with the logo of the Oakland A’s. “I’m really sorry,” she said. She looked very faintly sorry. “You’ll have to wait out here.”
This was a sentence being passed on them, a condemnation and a banishment, but at first Aviva seemed not to catch on, or rather, she pretended not to catch on. As the Alice Waters of Midwives, she had been contending successfully and in frustration with hospitals for a long time, and though, by nature, she was one of the most candid and forthright people Gwen had ever known, if you sent her into battle with another nurse, an intake clerk, or most of all an OB, she revealed herself to be skilled in every manner of wheedlings and wiles. It was a skill that was called upon to one degree or another almost every time they went up against hospitals and insurance companies, and Gwen relied upon and was grateful to Aviva for shouldering the politics of the job so ably. She envied the way it seemed to cost Aviva nothing to eat shit, kiss up, make nice. Catching babies was the only thing Aviva cared about, and she would surrender anything except her spotless record for catching them safe and sound. She had, Gwen felt, that luxury.
“No, no, of course, we’ll wait,” Aviva said in a chipper voice. She made a great show of gazing down at herself, at her white shirt with its chart of blood islands, at the chipped polish on her big toenail. With the same partly feigned air of disapproval, she surveyed Gwen’s cheek, her played-out saggy-kneed CP Shades. Then Aviva nodded, granting with a smile the whole vibe of dirt and disorder that the partners were giving off. “But after we clean up and scrub in, right? then it’s no problem, right”—leaning in to read the nurse’s badge—“Kirsten? If you want to check with Dr. Bernstein, I’m sure . . .”
Gwen could see the nurse trying to determine whose responsibility it was in this situation to be the Asshole, which was of course the purpose of Aviva’s gambit. Sometimes that awful responsibility turned out to be endlessly deferrable, and other times you got lucky and ended up in the hands of someone too tired or busy to give a damn.
“Bernstein’s stuck in traffic,” Kirsten said. “The attending’s Dr. Lazar. I’ll check with him. In the meantime, why don’t you two ladies go ahead and have a seat.” She told Gwen, “You’re going to want to have a seat.”
You have a seat, bitch. That’s my patient maybe bleeding to death in there.
“No, thank you,” Gwen said. “I prefer to stand.”
Her relations toward authority, toward its wielders and tools, were—had to be—more complicated than her partner’s. She could not as blithely subordinate her pride and self-respect to the dictates of hospital politics, distill her practice of midwifery, the way Aviva did, to the fundamental business of the Catch. But Gwen knew, the way a violinist knew tonewood, how to work it. She had grown up in a family of doctors, lawyers, teachers, cops. For many years her father was an assistant district attorney for the city of Washington, D.C., and then a lawyer for the Justice Department. Both of her mother’s sisters were nurses. Her uncle Louis had been a D.C. patrolman and plainclothesman and was now the chief of security for Howard University, and her brother, Ernest, ran a lab at George Mason. To the extent that Gwen had been hassled in her life by representatives of the white establishment, she had been trained to get the better of the situation without compromising herself, sometimes by dropping a name, sometimes by showing a respect that she genuinely felt or could at least remember how to simulate. Mostly by letting the doc or the officer feel that she understood how it was to be on the job.
“But truly, thank you, Kirsten,” Gwen added, reaching for chipper like a note that was just beyond her range. “We really appreciate your taking the time. We know how busy you are.” She smiled. “And maybe I will sit down a minute, at that.”
As though doing Kirsten a favor, Gwen lowered herself into one of the plastic chairs bolted to a nearby wall.
“Definitely want to have somebody look at that cheek,” the nurse said, her brittle tone expressing solicitude for the cheek less, Gwen thought, than for her own worn-out, urban-population-serving self.
“Oh, thank you so much for your concern,” Gwen said. Struggling a little harder, knowing from the way Aviva was looking at her, that she was starting, in Aviva’s phrase, to leak. “Now, please, honey, go ask the doc when we can see our patient.”
It must have been the “honey.”
Kirsten said, “She’s not your patient anymore.”
This was not technically true. As a result of years of hard work, steady and sound practice, slowly evolving cultural attitudes in the medical profession, and long, unrelenting effort begun by its founder and senior practitioner, by the summer of 2004, Berkeley Birth Partners enjoyed full privileges at Chimes General Hospital, with every right to assist in and attend to the care of Lydia Frankenthaler, who would remain a patient until such time as Lydia herself decided otherwise. But Aviva and Gwen had come this evening in an ambulance, giving off a whiff of trouble, with an unnecessary police escort they had managed to acquire along the way. Like a pair of shit-caked work boots, they were being left outside on the porch.
“We’ll wait here.” Aviva stepped in with the perfect mixture of unctuous sweetness and professional concern, spiking it lightly, like a furtive elbow to the ribs, with a warning to Gwen to seal all leaks or else shut the hell up. “As soon as you talk to the attending, you come find us, okay, Kirsten?”
Gwen followed Aviva into the bathroom, fighting the urge to apologize, wanting to point out that if you were white, eating shit was a choice you could make if you wanted; for a black woman, the only valid choice was not to.
In silence at separate sinks, they washed their hands and faces and rued the ruination of their shirts. The reverberation of water against porcelain intensified the silence. In the mirror, Gwen saw her partner staring at the bloodstains with an emotion between horror and hollowness, looking every one of her forty-seven years. Then their eyes met in the reflection, and the defeated look was gone in an instant, smuggled off, hooded and manacled, to the internal detention facility where Aviva Roth-Jaffe sent such feelings to die.
“I know,” Gwen said. “I was leaking.”
“Literally,” Aviva said, coming in to get a look at the damage the ambulance door had done to Gwen’s cheek. It had stopped bleeding, but when Aviva touched it, a fresh droplet formed a bead on the cut’s lower lip. The cut was about the size of a grain of pomegranate, pink and ugly. It would leave a scar, and Gwen was prone to keloids, and so forever after, she thought, she would have something special to remind her of this wonderful day. In her mind, she replayed her stumble, the optic flash as her face struck the steel corner.
“You need a stitch,” Aviva said. She leaned in to look at Gwen’s cut. “Maybe two.”
They went out to the ER and, after a few minutes of further genial self-abasement by Aviva, found themselves shown into an examination room with needle, suturing thread, and a hemostat. When it came time for novocaine, Gwen sat on her hands and told Aviva to go ahead and sew it up. “One stitch I can handle straight,” she said.
“Better call it two.”
“Two, then.”
“Aren’t you fucking macho.”
“I’m liable to start crying anyways, might as well give me a reason.” Gwen gasped as the needle bit. “Ow, Aviva, ouch.”
Aviva tugged the thread with a severe gentleness, breath whistling in her nostrils. Gwen focused her attention on the pendant that hung from a leather thong around Aviva’s throat. It had been made by Julie Jaffe in a flame-work class at the Crucible, lovely and enigmatic, a small glass planet, a teardrop of blue alien seas and green continents and polar caps tinted ice blue. For as long as Gwen had known him, Julie had been a mapper of worlds, on newsprint and graph paper and in the phosphor of a computer screen. Gwen recalled having asked him where he found the inspiration for the tiny glass world he had presented her as a Christmas present last year, and she tried to take comfort or at least find shelter from the pain of the suture needle in the memory of his reply: By living there. Then Aviva sank the barb a second time, and that was when Gwen started to cry, no big show or anything, they were both a couple of cool customers, your Berkeley Birth Partners. No sobbing. No whoops of grief. Just tears welling up and spilling over, stinging in the fresh seam of the wound. To be honest, it felt pretty good.
She permitted the tears to flow only as long as it took Aviva to snip the thread from the second stitch, lay down the hemostat, peel off her gloves, and hand Gwen a tissue. Gwen dabbed her eyes and then used the tissue to blow her nose, a nice big honking blast.
“They aren’t going to let us in,” Gwen said bitterly.
“I guess not.”
“Where’s Bernstein?”
“He was in the city. He’s coming.”
“We need to be in there. They’re going to want to do a hysterectomy, I know it. When all they need to do is just wait a little. Lazar. Who’s Lazar?”
“Don’t know him.”
“Tell me she’s going to be all right.”
“She will be all right.”
“I should have noticed it sooner.”
“There was nothing to notice until you noticed it. You noticed it right away.”
Gwen nodded, ducking her head, balling the tissue in her fist. She stood up and paced the room, stopped, hugged herself, notching her arms into the groove over the swell of her abdomen. She sat down, stood up, blew her nose again, and paced the room some more. She knew perfectly well there was nothing anyone could have done, but somehow that only made it feel more imperative to blame herself. It implied no kind of self-exoneration if she felt compelled to blame some other people, too.
“I can’t believe they aren’t letting us in there!”
“Take it easy,” Aviva said in a hushed voice that was meant, Gwen knew, to communicate the fact that she was talking too loudly. But Gwen could tell that she was rattling Aviva, and for some reason, it pleased her to see it. For the second time that day, she had a sense of trespassing on some internal quarantine, crossing a forbidden zone into the pon farr; amok time. It would not be right for Aviva to make her go there alone.
“I’ve had enough of this,” Gwen said. “Aviva, no, seriously. Listen to me.”
“I can hear you loud and clear, Gwen.”
“Come on. You have worked too hard. We have both earned the right to be treated better than this.”
There was the squeak of a sneaker on tiled floor. The partners turned, startled, to the door of the examining room, where a young pink-faced doctor appeared, his head shaved almost to the scalp, leaving only a ghostly chevron of pattern baldness. Dead-eyed, already tired of listening to them before they ever opened their mouths.
“I’m Dr. Lazar,” he said. “I was able to do a manual removal of the placenta. Mrs. Frankenthaler is stable, uterine tonicity looks good. We stopped the bleeding. She’ll be fine.”
The partners stood, perfectly still, tasting the news like thirsty people trying to decide if they had just felt a drop of rain. Then they fell on each other and hung on tight, Gwen half stupid with relief, drunk on it, clinging to Aviva as if to keep the room from spinning.
Dr. Lazar studied the celebration with his flounder eyes and a mean smile like a card cheat with a winning hand. “Do you think,” he said after an interval not quite long enough to pass for decent, “uh, I don’t know, do either of you ladies think maybe you could explain to me how you managed to screw up this birth quite so badly?”
“Excuse me?” Gwen said, letting go of Aviva as the dizziness abruptly passed.
