Monday, October 13, 2008

Chapter 9 - Beth's Breech Baby

July 1948

In the four months since Solomon had met Sarah O’Hara, he’d found that if he needed her, all he had to do was think of her. At other times she’d just appear to him. He felt as if he could talk to her about anything just like he could talk to Ma about anything.

This morning he shaved, dressed, and went downstairs as usual. He got Beth Terry’s chart out of the filing cabinet to read through it while he ate breakfast. Ma had asked him to help with her appointment this morning. Beth was expecting a baby in August, and it was in the breech position. Ma had tried to turn it last week but hadn’t been successful. and she hoped that Solomon might be able to get the baby into position for delivery.

Beth’s chart said that she was twenty-four years old, and it was her second pregnancy. The first pregnancy was a normal vaginal birth with no complications. The baby had weighed six pounds and twelve ounces. Today she was in her thirty-eighth week.

Solomon had never met Beth. She wasn’t from Rooster Cove, but she’d married a boy from the cove named Calvin Terry. Calvin was a few years older than Solomon. Solomon remembered him from high school. He’d played quarterback on their football team. He played pretty well as Solomon remembered.

Last week when Ma had told Beth that she wanted Solomon to examine her, Beth had balked. She’d said that he was too young and that it would be embarrassing. Ma convinced Beth that, rather than outright refusing, she should meet Solomon first. Ma felt like Solomon’s bedside manner would win her over. At least she hoped that would be the case. She felt uneasy about this breech. She couldn’t put her finger on it, but something didn’t feel right about it. If Beth refused to let Solomon help, Ma was thinking about suggesting that Cal take her to the hospital in Knoxville for delivery.

Ma came into the kitchen where Solomon was eating breakfast and reading Beth’s chart.

He said, “This looks pretty straight forward, Ma.”

“I know it does. I just want ye to look at her, if she’ll let ye.” Ma had already told Solomon about her concerns. Ma had delivered plenty of breech babies, as had Solomon, but she couldn’t shake the feeling that something was amiss with this one.

“If you feel uneasy about this, there’s a reason,” he said. “I trust your judgment. And if turning the baby makes Beth go into labor, I’ll stay with you. Dr. Wall will understand.”

“Thank ye, son,” Ma said.

Solomon added as he brushed toast crumbs off his shirt, “Ask Beth to empty her bladder before the inversion and get a urine specimen too. I’ll take it to the clinic to check for protein and glucose.”

“That’s a good idea,” Ma said. She saw that he was wearing a faded old shirt. “Son, will ye put on yer doctor’s coat? It will make Beth more comfortable.”

“Sure,” he said. Solomon usually only wore the white coat at the clinic. But Ma was right; it probably would look more professional since Beth was already worried about his being too young.

The screen door screeched when Beth opened it. “Hey Beth, come on in,” Ma said. She followed Ma Patsy into the exam room. Ma motioned to the chair across from her desk, “Have a seat, hon.”

“Thanks,” Beth said taking a seat.

“Have you had any changes since last week?” Ma asked.

“Jest that it’s gittin’ harder to breathe,” Beth said. “It feels like my baby’s wedged up under my ribcage.”

Ma was checking Beth’s blood pressure when Solomon knocked lightly and came into the room. He wanted to meet Beth before she was in the vulnerable position of being on the exam table in a gown. He knew she’d be more comfortable meeting him sitting in a chair with her clothes on. He put out his hand to her and said, “I’m Solomon Sepaugh, and you must be Miz Terry.” He was wearing his white coat as Ma had suggested. His stethoscope was stuffed into his pocket, and he was carrying a book.

Beth took his hand and said, “Pleased to meet ya.” She looked at him briefly, and then dropped her head in shyness. She thought, Oh God, why did you have to make him so handsome?

Solomon pulled up a chair and sat down beside her. He opened the book and said, “Miz Terry, I want to show you a picture of a breech baby.” It was a pen and ink drawing of a uterus with a baby in the breech position.

Beth gasped, “Is that what I look like inside?”

“Yes,” he said, “your baby is in this position.” Solomon flipped over a few pages and showed Beth another picture. It was another pen and ink drawing of a uterus with a baby in the correct head-down position. He said, “We need the baby turned like this so the head comes out first.”

Beth said, “That’s what Ma Patsy tried to do last week, right?”

“Right,” he said, “Ma asked me to try this week because my hands are bigger.” He held his hands out to show her. “I’ll put one hand on the baby’s bottom and one hand on the back of his head.” He moved his hands like he was turning the baby. “And I’ll get him to turn a somersault.”

Solomon and Ma were quiet while Beth considered it. She thought, Calvin will have a fit if this glamour boy lays a finger on me. On the other hand, he’ll just be touching the outside of my belly. Finally, she shrugged and said, “Okay, you can do it.”

Solomon stood up and said, “That’s good. I’ll be back in a few minutes.” He wanted to give Ma a chance to prepare Beth and get her on the exam table.

Beth looked at Ma Patsy and took a deep breath.

Ma Patsy smiled at her, “Ye’ll be fine.” She handed Beth an exam gown and said, “Take off all yer clothes and put this gown on. Let it open in the front,” Ma directed her to the bathroom saying, “I need ye to empty yer bladder and give me a specimen in this here cup.”

Beth took the gown and the cup. She came out of the bathroom holding the gown tightly around her belly. She handed the urine to Ma Patsy. She stepped up on the stool at the foot of the table and sat down. Beth was so nervous that she was trembling. Ma Patsy helped her lie back, and then she spread a sheet over her. Ma tied the two ribbons at the top of the gown and reassured, “It’s not gonna be as bad as ye’re thinking. I promise.”

Solomon came into the room. He took his stethoscope out of his pocket and hung it around his neck. Beth had a “deer in the headlights” look on her face. She wouldn’t look at him. Her hands lay on her big belly just under her breasts. Solomon gently put one hand on top of her hands, and he put his other hand on her shoulder. “Try to relax,” he said softly. “When you’re tense, your baby’s tense. I need you both to be relaxed.”

“I’ll try,” she said.

“There’s no hurry. Just let the tension flow out of you.” He looked at Ma and asked, “Would you get a blanket for her?”

“Of course,” she said spreading a white flannel blanket over Beth. “How’s that, hon?”

Solomon’s hand still rested on Beth’s hands under the blanket. He didn’t move for what seemed like a long time. His hands were warm and the blanket made Beth feel safe. When he did move, it was to lift the blanket and sheet just enough to slip both of his hands on top of her abdomen. One hand was high on her belly where it rose from under her breasts. The other was low where it rose up from her pubic hairline. Beth’s feelings startled her. His strong hands on her naked belly felt warm and sensual. A flush of emotion spread over her.

Solomon kept still. He wanted Beth to get accustomed to his touch. His hands radiated serenity. Sarah O’Hara had taught him how to control this gift. Beth shut her eyes and relaxed into serenity.

Ma watched the transformation of Beth. She’d always been amazed when Solomon worked with a patient. It was as if he healed a patient spiritually first.

Solomon leaned close and whispered to Beth, “You’re carrying a little girl.”

Her eyes lit up, “We wanted it to be a girl.”

“I need to listen to her heart beat,” he said. He wanted to let Beth know before he did anything. He knew that he had her trust now. He put the ear tips in his ears and held the stethoscope’s diaphragm against his palm to warm it. Then he slipped it under the blanket and onto her belly. He moved it over her abdomen. He was searching for the best place to hear the baby’s heart beat. When he found it, he lowered his head, closed his eyes, and listened.

Solomon straightened up and pulled the stethoscope out from under the blanket. “Now then,” he said, “let’s see if we can get her to turn a somersault. Do you have a name for her yet?”

“We’ll name her, Maria, after my mother,” she said.

Solomon placed one hand high on Beth’s abdomen and said, “Here’s Maria’s head.” He moved that hand from the top of her abdomen down around her right side. “Here’s her back.” He wedged the side of his other hand between Beth’s belly and the top of her pubic bone. “And here’s Maria’s bottom.” He rubbed back and forth across Beth’s hairline. “I’m going to push Maria’s bottom up and out of your pelvic cradle. This won’t hurt either of you.” He paused a second, “Are you ready?”

Beth nodded yes.

Solomon applied a firm rocking motion to Beth’s lower abdomen. With his other hand, he began to push high on her belly. His hand was behind the baby’s upper back and head. He continued the rocking and pushing motion until he felt the baby begin to turn, and then he helped Maria complete her somersault.

Beth squealed with delight. She knew that Solomon had been successful.

Solomon put a lubricated glove on his right hand as he said, “I need to find out how far down in your pelvis Maria’s head is.” He slipped his hand under the blanket and put two fingers into Beth’s vagina. Her eyes widened as she tightened around his fingers. He said softly, “Just relax.” With his other hand on top of the blanket, he lifted Beth’s left knee and rotated it outward slightly to get further into her vagina. “Try to relax,” he said again.

Beth was staring wide-eyed at his face, but he didn’t make eye contact. He stared at Ma’s desk instead. Solomon knew instinctively when to make eye contact with patients and when not to. It was one of the things that made patients comfortable with him. He removed his fingers and stripped off the glove. He said to Ma, “The head’s engaged now. Beth’s completely effaced, and she’s dilated a fingertip.”

“Great,” Ma said.

Beth looked worried.

Solomon said to her, “That means Maria’s ready to be born.” He put the stethoscope to Beth’s abdomen again. “She sounds happy,” he said. He continued to listen until the baby settled down from having been turned.

“That’s it,” he said helping Beth to sit up. He got another gown out of the cabinet and put Beth’s shoes in front of her. He held the second gown up. “Slip you arms in here,” he said. At this point Beth would have obeyed any command he gave. He tied the second gown behind her neck. The two gowns assured her modesty.

“Now, we need you to work a little.” He held her hands as she stepped down. “I want you to walk around the house for about an hour. Go anywhere you want. Every few minutes, I want you to squat down like this,” he demonstrated by squatting down on his haunches, “and bounce a few times.” He bounced like he wanted Beth to do. “This will help Maria settle into your pelvis,” he said.

“If you feel anything different,” he added, “let me know. Sometimes a cephalic inversion starts labor.”

Ma and Solomon left Beth to walk and squat all through the house—from the living room, the dining room, and back to the kitchen and exam room. Ma went into the kitchen and made a peach pie for supper. She loved peach pie when the peaches were fresh off the tree. Solomon sorted the clinic’s mail at Ma’s desk. There were bills to pay and supplies to order.

As Beth passed through the kitchen or the exam room, Ma or Solomon occasionally looked up to ask, “Are you doing okay?” She would nod yes. Once as she passed through the kitchen, she said to Ma, “I need to go to the bathroom.”

“Hep yerself, hon.” Ma said.

Beth went into the exam room. That was the only bathroom that she knew about. Actually there was another one upstairs. Pa Shiver’s working for TVA had enabled him to upgrade and modernize the whole house. Solomon looked up when he saw Beth go into the bathroom. She looked like it embarrassed her that he’d noticed her. He looked at his watch. It had been almost an hour. He got up and went into the kitchen. “Are you at a stopping place, Ma?” he asked.

“Beth’s been walking for about an hour.”

“Sure thing,” Ma said.

When Beth came out of the bathroom, Ma led her over to the examining table. “Hop up here again, hon,” Ma said. Beth stepped up on the stool and sat on the table. Ma helped her lie back and covered her with the blanket.

Solomon smiled real big as he came into the room. “Are you in labor yet?”

“No, but I’m tired from all the walking,” she said.

Solomon adjusted the blanket and gown so he could see her abdomen as he put both hands on it. He felt for the baby’s position. “Maria’s still where she’s supposed to be,” he said taking his stethoscope out. He put the diaphragm against Beth’s abdomen and listened. “She’s doing great,” he said.

Ma said, “Beth, I need to see if ye’re gonna have this baby today.” She put Beth’s feet in the stirrups and dropped the leaf on the table. She felt for the cervix. “Yep, she’s a hundred percent effaced,” Ma said to Solomon. “I can feel little Maria’s head right here just ready to pop out and meet us, and she’s dilated a fingertip.”

Solomon touched Beth’s shoulder as he said, “You may go into labor tonight, or it may be two more weeks. You know how it felt when Maria turned. If you feel anything like that again, you call, okay?” He helped her to sit up. “And if you go into labor, call about that too,” he laughed.

Copyright © 2008 by Robbin Renee Bridges
Coping with Grief through Afterlife Communication

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