To this, Elizabeth agreed. We paced the floor of the bedroom for an hour. Back and forth, stopping every couple of minutes to rock through the pain. Other than the pop and crackle of the fire, the silence was absolute. Usually that was how I liked it. Silence is the laboring mother’s music. But tonight it gave my mind too much room to think. And after an hour of it, I couldn’t stand it any longer.

“Elizabeth.”

Elizabeth frowned, lifted her head.

“What is wrong with you? No more excuses. You’re to tell me. Right now.”

She sank onto the bed and started to drop her head, but I caught her chin and held it. I could feel Evie behind me, perhaps ready to tell me that this wasn’t the time, but I wasn’t going to listen. I’d already waited too long.

“Nothing,” Elizabeth said. “Nothing’s wrong. It’s my fault, really.”

“What’s your fault?”

“I’ve got fancy tastes,” she said. “You used to say that yourself, Floss, remember? And Bill, he’s not a rich man.”

Elizabeth had a contraction, and Evie and I remained silent, waiting.

“It’s hard for him,” Elizabeth said when the contraction was over, “having another mouth to feed. I can hardly expect to be fed like we were at the boardinghouse. It’s tough, country life.”

Evie leaned forward. “But he does feed you?”

“Yes.” There was a pause. “Yes, of course. It’s just that … sometimes I get greedy.”

Elizabeth wouldn’t meet my eye. I couldn’t for the life of me figure out what she meant. Elizabeth wasn’t greedy. And I didn’t have a clue why she’d think she was.

“What are you saying?” I asked gently.

Elizabeth looked from me to Evie and then to her lap. “Just … when Bill’s not happy with me … he doesn’t give me food.”

The fire cracked into the silence. My mouth formed around questions that I couldn’t seem to project. Perhaps because there were so many. How could a man not give his pregnant wife food? Why would he do that? How long had he been doing this? Why didn’t I see it? And, most important, Why wouldn’t Bill be happy with you?

“Does he at least give you housekeeping money?” I asked eventually. It was the only question I felt I could speak without bursting into rage or, worse, tears.

Elizabeth looked taken aback. “Of course not. We don’t have that kind of money.”

I could hardly believe my ears.

“What kind of money do you think he’s spending at the pub, Elizabeth?” I cried, then bit back my frustration. It wasn’t Elizabeth I was angry with. When I spoke again, my voice was softer. “You don’t deserve this. Bill is controlling everything about you, who you see, what you eat.…” I trailed off when Elizabeth closed her hands around her stomach. A chill traveled down my spine. “You didn’t fall, did you?”

Elizabeth kept her head down. It was all the answer I needed.

Back in my days as a student-nurse, we’d looked at a case study of a toddler who’d been starved by his mother for not behaving. When he died, at age five, he weighed less than an average one-year-old. But there was no sign of physical beating, not even a bruise. When I’d asked the matron about it, she’d said … Abuse comes in many ways. The only universal thing about it is the perpetrators’ need to control.

I suddenly remembered the padlock on the larder doors. I whipped around and strode to the kitchen without a word.

“What are you doing, Floss?” Evie called after me.

An axe rested against a stack of wood next to the fireplace. I snapped it up. “Making Elizabeth a snack.” The axe was small but heavy. It hit the arm of the padlock on the first go, knocking it clean off the door handle.

“Floss!”

As I suspected, the cupboards were full of food. Dry biscuits, sugar, flour, butter, eggs. There wasn’t time to bake anything, so I threw a handful of crackers on a plate, slathered them in butter, and raced back to the bedroom. Elizabeth ate a couple, for my sake more than hers, I suspect. After that, I kept trying to force more on her, but she declined.

Thirty minutes later, Elizabeth felt the urge to push. At Evie’s instruction, I brought in a large pail of boiled water for hand washing. I placed it on the bureau.

“Okay, Elizabeth,” Evie started. “I want you to slide down so your bottom is at the end of the bed, then roll onto your side. Help her, Floss. Then, when you feel the next contraction, I want you to give me a big push. Understand?”

“I’m a midwife, Evie, I know—” The next contraction took her breath. Her face twisted.

“Good girl,” Evie said. “Very nice. The head is coming.”

I moved down to the end of the bed so I could see. The head was coming, and fast. The next contraction came, and the next after that, each time easing the head out a little more, and each time, pushing Elizabeth a little further than she could go. I’d seen a lot of exhausted mothers go through this stage of labor, but Elizabeth’s condition was worrying me. A couple of times between contractions, her eyes rolled back in her head.

“It’s crowning. Just hold on. Breathe!” Evie urged. “Come on, Elizabeth, breathe. Floss, I need you down here. Grab the towel and bring it here, then wash your hands.” Evie had one hand on Elizabeth’s knee and the other on the baby’s head. “Good girl. Now put the towel down in front of me.”

I grabbed the towel, then washed my hands in the hot water. I dried my hands on another towel and knelt at the end of the bed next to Evie. Elizabeth whimpered.

“You’re nearly there,” Evie said. “Floss, get the instruments ready—the clamp and the scalpel, please. Elizabeth, pant. You know how it’s done.”

I collected the clamp and the scalpel, keeping my eyes on the baby. I couldn’t take my eyes off it. Even though I could see only the top of its little head, something magical was happening. Gently, the head eased out, revealing a tuft of bloody, matted hair.

“The head is out!” I exclaimed.

Evie’s forehead remained lined, but her lips loosened into a slight upturn. “You are so close, Elizabeth. Your baby will be born in just a minute.”

Elizabeth closed her eyes and nodded, psyching herself up. Her eyes remained closed for several minutes, long enough for me to wonder if she’d fallen asleep—or passed out. I was just rising to check her when her eyes sprang open and she moaned.

“This is it. Push,” Evie encouraged. “Come on, love. That’s wonderful. Here it comes.”

I watched in silence as the baby turned and a little face appeared. “Oh, Elizabeth. I can see the face.”

Elizabeth’s face unfolded, and for a heartbeat, she looked young and healthy, the Elizabeth I knew and loved. “Really? You can see the face?”

“I can. It’s a beautiful face.”

Elizabeth’s face crumpled again. She was struggling. Her red face shimmered with sweat. Evie appeared unflustered, going about her business, focused completely on the baby being born. I watched as she slipped her fingers around the baby’s neck and guided the shoulders out, rotating as she went. The rest of the baby quickly followed, landing in the warm towel that I had laid out. Evie held the vernix-covered baby upside down by the feet. There was a tiny cry. My insides collapsed.

“Congratulations,” I said as Evie passed the baby to Elizabeth. “You have a daughter.”

*   *   *

A chorus of familiar, hushed voices roused me from sleep. “Thanks so much for calling us, Lil. How is she doing?”

It was Neva’s voice I could hear, and then Lil’s, reciting the prognosis from the doctor. A minor myocardial infarction. Too weary to open my eyes, I just let their words wash over me.

“What have they given her?” Grace spoke now—I recognized her bossy, professional tone. Clearly the news of my heart attack had frightened her, and she wanted to feel back in control. I heard my chart being lifted off the foot of the bed. “Aspirin, beta-blockers, nitroglycerin—”