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"It could be an abruption," I offer "Have you ever seen one?"

"Yes" Patience’s face grows gray "But she’s not in severe pain Usually, in abruptions there’s terrible pain, so most likely it’s a placenta previa with the placenta at the edge of the cervix or, God forbid, coet her in the car and ton?" I ask

"Maybe If she’s only a few centiht try, but it’s three hours to the hospital so I guess I have to check her It’s her fourth and we inal exaerous and not just because the West Virginia Midwifery Statute of 1925 forbids it Patience could accidently poke a hole in the placenta and that would cause a life-threatening heet the mother’s attention "I need to check you I will be very careful, but you mustn’t move or squirloves and holds out two fingers "Oil," she says and I pour a little fro Happy days are here again

Tamponade

I hold my breath and watch Patience’s face as she slowly ina

"Seven centimeters," she finally says "Coed" Then her eyes widen She ers, as a handful of blood leaks out on the bed "A partial previa I can feel the placenta where it’s come loose on the left side, about an inch of it I think we need to get her out of bed"

"Out of bed?" (This seems unusual and if I didn’t have so much respect for Patience, I’d think she was crazy)

"There’s no e can get a mother of three, who’s already seven centiet the baby out quickly Also the pressure of the head on the edge of the placenta ht slon the blood loss"

"You mean like a tamponade? Dr Blum told me about this"

"I don’t know the word tamponade," she whispers back, "but it’s like when you put pressure on a wound"

Once on her feet, Thel the words with each contraction "Happy days are here again! Happy days are here again!"

I run down the hall to the kitchen, throw thethe cord in a pot of water on the cookstove, then run back again and straighten the bed "Happy days are here again!" I didn’t know such a pretty wo like so many women do The contractions are only two et rid of the unfolded laundry, run down the hall a second tirab the pot of hot water, and set it on a towel on the bedrooggh!" It’s roan and I nervously point to the bed, asking Patience with my eyes if it’s time for the patient to lie down

The midwife shakes her head no "Here, Thelma, do like me" Both women squat on the wooden floor In between contractions, there’s the drip, drip, drip of red and I wipe it up

"Be ready for anything," Patience whispers "The baby may come out floppy if there’s been too in to shake inside, and to quiet my nerves try to take deep breaths