The Amish Midwife - By Mindy Starns Clark Page 0,111

next afternoon.

My relief must have been obvious because she patted my shoulder. It was the most affectionate she’d been with me.

That evening as Marta and I did the dishes, I brought up the subject of Lydia and her general health.

“She was fine,” Marta said. “Her blood pressure ran a little high but not dangerously so.”

“She had plenty of energy?” I asked as I dried a plate.

“I wouldn’t say plenty, but she had enough to do what she needed to do.”

I asked if she’d had a C-section with the twins.

“No.”

I bit my lower lip as I dried another plate and then said, quickly, “Do you still have her chart or was it taken by the DA?”

“The DA’s office made a copy and took that. I still have the original.”

“Mind if I take a look at it?”

Marta turned her head toward me. “Why ever so?”

“I’m curious, that’s all.”

She shook her head. “There’s nothing in her chart. My lawyer hired an expert to go over it, and it offers no more information to the case.”

I put the plate in the cupboard, bumping it against the stack. She hadn’t told me yes, but she hadn’t told me no, either.

Marta pulled the plug to the sink. “I’m tired.” She yawned, covering her mouth with her forearm. “Poor Simon was up half the night crying for Esther. David and I took turns with him, but we weren’t who he wanted.”

I didn’t dare go out to the office while Marta was still up. It would be too obvious. Then I remembered that I had appointments in the morning. I decided I could wait to look at Lydia’s chart then.

Sometime during the night I had a text from James asking how Caroline was again. I saw it in the morning and texted him back. Better. Thx for praying.

My first appointment was at nine, but I was in the office by eight thirty and pulling the Gundy, Lydia file from the cabinet. In midwifery a mother’s chart, besides keeping all the information on hand for the midwife, is the legal document of care. It safeguards both the caregiver and the mother. From what I’d seen, Marta’s records were clear, concise, and accurate.

I worked my way backward through Lydia’s chart, starting with the death of the baby. 4:32 a.m. stillborn baby boy delivered by C-section at Lancaster General…4:10 a.m. mother DOA at Lancaster General…mother on life support, taken by ambulance to Lancaster General…EMTs arrive at patient’s home…CPR administered for 15 minutes…patient stops breathing, eyes roll back…3:05 a.m. called 911 against patient’s wishes…baby’s heart tones at 95…patient instructed that transfer to hospital is necessary; patient declines…patient’s blood pressure 160/110…Marta should have called 911 once Lydia’s blood pressure spiked, but it might have only been another minute, just long enough to check the fetal tones, which were dangerously low. At that point, in a hospital, the mother would have been whisked down the hall for a C-section.

I kept reading. 2:45 a.m. urge to push… 10 cm dilated… Labor had started at ten thirty p.m. the day before, January 29. At the appointment the week before, Lydia’s blood pressure had been 120/90, not too bad for a woman nine months pregnant. The cervix was thinned and dilated to two. The baby’s head was in a good position. There were no indications, at that point, that Lydia’s and the baby’s lives were in danger. I kept flipping back through the chart. At one appointment Lydia’s blood pressure was 140/110, and Marta had instructed her to see her doctor. At another her pulse was elevated, 120.

I flipped to the birth of the twins. They had been delivered by a doctor at the hospital and not by Marta, but the chart from the birth had been copied from hospital records and included here anyway. According to the notes, Lydia’s blood pressure was fine through the ten-hour labor and also through the delivery. It seemed like a best-case scenario situation for the birth of twins.

Christy’s birth was nine years before the twins’, and there was no explanation for the gap. No record of miscarriages, stillbirths, or lost babies. Labor had been longer, fifteen hours, but not bad. There was no indication of high blood pressure, although Lydia’s pulse had run high at a few appointments. Gravid 2 was marked at the top, which meant Christy was her second pregnancy.

Her second pregnancy?

I thought about that and finally decided that maybe she’d had a miscarriage before. Because Amish women often didn’t seek medical attention until well into their second