Naomi smiled. “You’ve overcome a lot since I first saw you on that train. You’ll overcome this too,” Naomi assured her.

  “One or two more days and then I can resume my life,” May said.

  “It’s not easy to hide this condition,” Naomi said.

  May nodded. “I moved in with Cousin Elena after the New Year. It has been terribly difficult keeping this secret from Momma and Nana,” May said, shame covering her face. “But I just couldn’t . . .”

  “It will be over soon,” Naomi soothed. “You’ll want to bind your breasts to stop the milk. They will most likely hurt for many days, but in a week or two you will be able to leave this in the past and move on with your life.”

  May forced a smile, but it was obvious she was not happy. Who could be, in these circumstances?

  May was in the midst of a strong pain when Naomi returned with water, rags, two novels, and an unfinished baby blanket that a recent patient left behind. She waited for the contraction to pass.

  “It’s going to be like this for most of the day. Let’s see if we can keep you distracted between labor pains. Do you crochet?” Naomi asked.

  “I cannot say that I’m skilled, but I do know how.”

  “Would you like to work on this?”

  Naomi held out a blanket with pale green and yellow squares. Two skeins of cotton yarn were still attached. It was left behind by a woman who delivered a stillborn baby last week. Had they seen the blanket they would have wrapped the infant in it before sending her for burial, but it was too late now. The beautiful cotton was too valuable to simply throw out.

  May reached her hands out for the incomplete blanket. “Thank you. I shall give it a go.”

  “And two books in case you didn’t bring any: a new one, The Bent Twig, and a classic, The Wonderful Wizard of Oz.”

  “You are very kind,” May said.

  “Of course,” Naomi replied. “I will be in and out until you are in constant need of me. Ring this bell if you require anything.”

  “Must I stay . . . oh, here comes another one.”

  May closed her eyes and groaned. Naomi placed a hand of support onto her shoulder. The moaning got louder. She was moving right along. Then it subsided. May exhaled loudly.

  “That was very uncomfortable,” May said.

  “It hurts, but it is not hurting you,” Naomi explained. “Each one brings the baby closer.”

  “Must I stay in this bed?” May asked.

  “Not at all. Most women find it more comfortable to be on their feet. You are welcome to be out of the bed so long as you stay in this room,” Naomi said.

  May nodded, then her eyes widened. “It’s going to hurt more, isn’t it?”

  “I won’t deceive you. It will become more intense. And somehow we women bear it, as women have since the beginning.”

  “I’m afraid I cannot do it.” May teared up.

  Naomi took a deep breath. How many times had she heard those words? Every woman seemed to share that sentiment.

  “You’ll have no option but to bear what comes—that is the nature of birth and life,” Naomi replied, hoping she sounded kind while being honest, though not so frank as to mention death.

  In truth the only choice a woman has in childbirth is how she bears what she’s given. Resisting the pain seemed to worsen it. Some women fought their bodies and others surrendered to the natural course. In the midst of the intensity, Naomi would encourage May to surrender to the experience. She would use touch and calm words; she would model breathing and resting.

  She studied May. Would she resist or surrender? Long ago she stopped believing her own predictions about how each woman would respond to the greatest test of her life. But if she was forced to conjure a guess she expected May would surrender with grace to the unstoppable force of nature.

  Hours later, May stood by the bed, rocking from side to side during a strong pain. Tendrils of dark hair stuck to her shiny face. Naomi stood behind May, pressing into the cave between her spine and pelvic bones. Hours of contractions attuned Naomi to May’s pattern. She waited for the young woman to bleat like a goat, signaling the peak of the labor pain, and the moment Naomi should press as hard as she was able. The sound came, Naomi leaned in as May pushed hard against her fists; then the young woman leaned away with the waning contraction. May panted as the pain released its grip.

  Naomi heard a slight pop and a splash.

  May shouted, “Oh, dear Lord. Oh, dear Lord. What is happening to me?!”

  Naomi stepped back and looked between the two white calves below the hospital gown. A dark puddle marred the linoleum. Labor was moving along . . . and the dark smear told her the baby might not be handling it well.

  With calm in her voice that belied her concern, Naomi said, “Your waters have broken—a wonderful sign that you are closer. I’d like to take a listen while you are in bed, if you don’t mind.”

  May’s glassy and confused eyes stared at Naomi. The baby might not have time for Naomi to wait for a reply. She gently tugged May until the young woman crawled onto the mattress in front of her. She lay curled on her right side.

  Naomi grabbed the wooden tool that would allow her to listen to the baby’s heartbeat. She pressed the larger opening of the Pinard horn low over May’s uterus and leaned over, placing her ear against the smaller opening. She closed her eyes to block out all stimulation, allowing her to concentrate on the subtle sound entering her ear.

  Whoosh . . . whoosh . . . whoosh.

  The familiar sound of a fetal heartbeat registered—but too slow.

  “May, let’s get you on your other side. To see if baby likes it better.”

  “Is she . . . ?”

  Naomi didn’t reply, but pulled at May’s arm to turn her over to her left side.

  She leaned over May’s belly again with the Pinard horn and concentrated. Whoosh. Whoosh. Whoosh. Whoosh. Naomi exhaled in relief. That was better.

  “The baby,” Naomi explained, “is happy like this. I’m sorry, but you won’t—”

  “Aaahhhh,” May shouted. “Ahh, ahh, ahh . . .”

  Naomi listened through the contraction, juggling the horn and pressing against May’s lower back to provide a small measure of comfort. The baby’s heart rate slowed, slowed, slowed . . . as the pressure built. Naomi’s heart beat hard, waiting for the uterus to release. When it ended, the swoosh of the baby’s heart came closer, closer, closer until it sprang back to normal; Naomi exhaled in relief.

  “Is the baby okay?” May asked, fear in her voice.

  Naomi nodded and smiled in reassurance. Naomi learned long ago not to say more than was necessary at this point in labor. By all she could assess this baby was doing well enough in this position, but there was so much she could not measure. In a few hours they would know the outcome of this birth. She’d seen what seemed to be perfectly normal births end with a blue baby that never took a breath or too much bright-red blood come after the placenta. Most births ended with a baby and mother separated into two whole and healthy beings, but she could not predict which ones would not have that outcome.

  The contractions kept coming and coming, pain Naomi was glad to see, though it was so rough on a laboring mother. May moaned with each one, handling the intensity as well as any woman could. Naomi was impressed with the young woman’s strength and calm.

  Hours passed with May lying on her side as her cervix slowly was opened by the force of nature. Naomi gave her sips of water, wiped her brow, and listened through the horn. All was going as well as could be wished for. The baby’s heart rate dipping with the contractions and accelerating during the rests. Naomi looked for the telltale signs that this baby was ready for May to join her will to the contractions.

  “Dear God. Dear God!” May exclaimed.

  She grabbed Naomi’s hand and squeezed hard. She stared right into Naomi’s eyes, May’s colored eyes wide and filled with panic.

  “Tell my Momma and Nana Lisbeth I love them,” she whispered. “And I’m sorry.”

  Naomi took a deep breath. She smiled, just a little, showing her calm in the face of May’s distress.

  “You will tell them yourself,” she soothed. “This is all normal. You will get through this and see them soon. Are you feeling pressure? Like you wish you could use the toilet?”

  May nodded. “I’m sorry. I can’t hold it in anymore.”

  “Don’t hold it in,” Naomi explained. “That’s your baby ready to come out. You help now. You use your muscles to push.”

  “Really?”

  “Yes.”

  When the next contraction came, May grunted and pushed along with it.

  “I’m going to see what’s going on from your other end,” Naomi said.

  She released May’s hand to look between her legs.

  “I’m going to place my fingers inside you,” she explained, though it was likely May would hardly notice at this point in labor. She didn’t have to go far to feel the head. She felt around the fontanel. This was a great position. It likely wouldn’t be long.

  Another contraction came; May pushed with it, and Naomi felt the head move downward. May’s instincts and her body were going to get this baby out soon.

  “I’m going to find another midwife to join us. It’s much easier with two once the little one arrives,” Naomi said.

  “Stay with me,” May begged.

  “I’ll only go to the doorway, to the bell in the hall.” Naomi rubbed May’s leg. “You can see me the entire time.”

  Naomi sounded for assistance and then returned to May.

  “Your baby . . .”—she corrected herself—“this baby is going to be here very soon.”

  Nurse Hand, Naomi’s favorite colleague, came into the room. She readied a blanket, suction bulb, and scissors. Then she stood by as May continued pushing this baby into the world.

  “I can see the head,” Nurse Hand said to May. “Would you like to reach down to touch it?”

  May shook her head. With the next contraction Naomi used her fingers to stretch the taut fold of skin around the baby’s scalp. The dark-haired head slowly emerged, further and further until Naomi could see a bit of forehead. The labor pain ended, leaving the baby’s head partway out.

  The bluish tint on the baby’s skin alarmed Naomi.

  “May, you are nearly there. The head is almost entirely out. With the next wave I want you to use every ounce of strength you have.” Naomi looked at Nurse Hand, her eyes wide, telegraphing the nature of the situation.

  “This is it, May,” Naomi said. “Your last pain. Keep the pressure strong.”

  May inhaled and joined her muscles to the force of her body. Naomi used her forefingers and her thumbs, stretching the skin around the head with all her might. When she released, the baby’s head slid through the tight opening. The whole head was out. She tugged at the baby as the contraction stopped.

  “Keep going, keep pushing,” she instructed.

  May did as she was told, while Naomi pulled at the base of the neck; one shoulder emerged and then the other rushed out, followed by the entire body.

  Naomi turned the baby over and rubbed the limp, blue body. Suddenly the infant jerked and took a breath. Her lungs filling with air, she cried in life.

  Naomi smiled. “A girl. You gave birth to a girl.”

  She rested the slippery baby on the bed between May’s legs. She smeared off the mixture of vernix, meconium, blood, and amniotic fluid. Nurse Hand passed her sharp, sterile scissors. Naomi waited for the cord to stop pulsing to cut it—separating this newborn and May. Then she wrapped the tiny baby in a clean cloth, ready to pass her to Nurse Hand. May reached out for the bundle, her instinct strong, despite the fact she would be giving this child to a new mother. Naomi placed the baby in May’s outstretched arms. May’s eyes glowed, wonder and joy poured out, as she gazed at the infant.

  Naomi returned her attention to the delivery of the placenta, grateful Nurse Hand was able to attend to May and the newborn child. Fortunately, it came quickly and complete with a safe amount of bleeding. She finished her duties between May’s legs, and returned her attention to May’s mind and heart.

  Naomi explained, “Most babies are awake and hungry for this hour or so right after delivery—and then they sleep off the ordeal. We want to get food in her while she’s awake.”

  May nodded.

  “I can give her a bottle in this room, you may give her a bottle in here, or you can send her to the nursery,” Naomi said.

  May’s lower jaw quivered. Naomi felt tears push at her own eyes. For some women, the ones who just wanted to be away from the newborns, this was an easy decision, but May looked torn. Naomi patted the young woman’s hand.

  May said, “I will feed her”—her voice broke high—“this one time.”

  Nurse Hand gave a nod, left, and returned with a bottle.

  Naomi gave May as much privacy as she could while staying in the small room. She made herself look busy tidying up though there was little left to do.

  May spoke to the little baby, almost too quietly to hear. “I want you to have the best life possible. I know God will find you a good mom and dad who can give you more than I can by myself. I love you and will think of you every day, for always.

  “Naomi,” May called.

  Naomi turned around. Tears poured down May’s cheeks. Naomi’s heart clenched in sympathy. This was the most painful choice a woman could make—raise a child you didn’t believe you could adequately care for or surrender a child you already loved to another family.

  “Will you please say a prayer over her,” May pleaded. “Then I’ll be ready to say . . . goodbye.”

  Naomi swallowed and nodded. She crossed to the bed, placed one hand on May’s shoulder and one on the bundle of baby. She bowed her head, closed her eyes, and took a deep breath.

  “Dear God, in the name of Jesus we pray for your mercy and love. Please look over this baby in need of your care. Find her the most wonderful home where she will be cherished and loved—and given guidance to become a good servant to You and to all of mankind. Bring peace to May’s heart and assure her of your unending forgiveness and unending goodness. Amen.”

  “Amen,” May repeated. “Thank you.” She looked at Naomi. “She will be well taken care of, right?”

  Naomi nodded. “We screen our families very well. There’s a barren mother longing to hold a baby in her arms, and this baby is the answer to her fervent prayers. God works in mysterious ways. We cannot understand the whole; we can only do our best to listen to Him for our next step on our path.”

  Naomi sounded more certain than she felt. It was her job to notice what each patient desired most and give her the evidence that it was the right choice. She could have just as easily assured May she would be the best mother for this baby, regardless of her marital status. Naomi believed it was best for children to grow up in a family where they are wanted. Only May knew if she wanted this baby.

  “Can I give . . .” May’s voice broke. She cleared her throat and blinked back tears. “May I write a short note for her?”

  Naomi replied, “Yes, I will get you a card.”

  When Naomi returned May was staring down at the baby. One finger gently traced the infant’s eyebrows, chin, and earlobe. Naomi was the same with her own three children. Each a miracle and yet ordinary. Somehow they grew inside her. Their bodies and her body knowing what to do.

  Naomi handed the card and a fountain pen to May. The young woman took the paper and wrote without hesitation. She must have been thinking it through for a while. Naomi resisted the urge to read it without permission.

  May blew on the words to dry the ink.

  The young woman read it out loud: “‘I loved you from the beginning. Your new family will give you a better life than I ever could. May Wagner.’ Does that sound right?”

  “It’s a lovely sentiment,” Naomi said. “And I should have told you that you cannot sign it. No identifying information is allowed. I apologize.”

  Naomi handed May another card. She always brought several, as it was rare that they only used one. May wrote the note again—without her signature. The green-and-yellow blanket she’d finished crocheting while laboring was spread over her legs. The tiny baby lay in the middle of it. May took one corner and wrapped it over the baby’s left shoulder and then wrapped another over the right. May laid the card on the sleeping child’s chest.

  May placed her hand on the card and closed her eyes, and her lips moved—in a silent blessing, a prayer, or a message. The bottom of the cotton blanket was just long enough to fold over and tuck around, completing the swaddle.

  May lifted the baby, and kissed each of her cheeks and her forehead. “Goodbye. I love you.”

  She held the baby out. Naomi’s heart twisted in shared sorrow. She took the baby from May’s arms and carried her to the nursery. Sometimes decisions that were right were still painful.

  Less than an hour later, Dr. Briggs barged into the quiet room. The old white man regularly offended Naomi. He was certain his understanding of medicine provided the best and only course of action, but he put no value on the complexity of the human heart. His science skills were commendable, but his compassion was lacking and his arrogance was both infuriating and occasionally dangerous.

  Without introduction or pause, he spoke from halfway between the doorway and the bed, nearly shouting to make his point: “The baby has defects that will make it unsuitable for placement with a family. We will be transferring it to the home for the feebleminded. You need to be sterilized so you do not bring more defective children into the world.”

  And then he left.

  Naomi’s stomach lurched so hard she feared she might vomit. She swallowed back her bile, and stared at the young woman recovering from her labors. The doctor’s words were harsh—and untrustworthy. Naomi examined the baby at birth and saw nothing grossly amiss. The infant took the bottle with ease, her face was well shaped, and she appeared typical in every way.

  “Is that . . . ? What?” May stammered. Then she sobbed. Tears streamed from the young woman’s eyes. Naomi placed an arm around her. May leaned against her and cried.