Saturday, April 5, 2014

Short Story: The Midwife

This is just a short story I wrote a while back and found recently. Hypothetical future. Enjoy.

The Midwife

“Oh, Zoe, I'm so happy for you!” Kristen exclaimed. She sat forward and took Zoe's hands, sharing an excited smile. Her smile faded as she braced herself for the answer to her next question, as she always did. “So, have you contacted your OB?”
Zoe's eyes shifted to the side. She leaned over and turned her phone off. Kristen's spirits rose immediately. This was what she was always afraid to hope for.
“I'm not filing an Intent to Birth,” she whispered. Really, there wasn't any need, but people feared what could happen if they were caught talking about a natural birth. It wasn't allowed.
“You understand the risks, of course,” Kristen said, lifting her cup of tea and drinking. Zoe nodded, taking a drink of her own tea.
“I don't want to move to Norway,” Zoe said. “I don't like the cold. And my whole family has lived here since before the American Revolution. I shouldn't have to move just to have a baby,”
“I agree, obviously,” Kristen said. “I thought you might feel that way when you told me you'd applied to have your birth control system removed.”
“I had heard that... that you know of a midwife,” Zoe said softly.
“Oh, yes,” Kristen said. “I do.”

Zoe looked at the piece of paper with the address on it and double checked it against the number on the house in front of her. Part of her was so afraid that she wanted to run. Then she imagined the alternative, and she found the courage to knock.

“Now, I can't get in trouble, right?” Zoe asked. The midwife smiled. This was usually the first question asked of her.
“If you do not enter into an Obstetrical Contract, you won't fall under penalty of law if you deliver out of hospital. All of the risk is on me. If you tell anyone about what I do—”
“Oh, I would never do that!” Zoe said, taking her hand. The midwife patted Zoe's hand comfortingly.
“I know, dear, and we'll go over all the possible scenarios where you might need to transfer care later, along with stories to avoid culpability. But if anyone were to discover me, I would be arrested on charges of felony medical infringement and face a sentence of five to thirty years.”
“That's ridiculous!” Zoe snapped, her face flushing with anger.
“I know,” the midwife said with a sigh. “When my grandmother had my mother, women still had a choice in where and how they gave birth in most states. When my mother had me, women still had the choice of how. It's only been twenty years since the Mandatory Cesarean Act passed, and the population is already down ten percent.”
“Ten percent?” Zoe whispered.
“Well, Population Control would really like to see it drop another ten percent, but with it still illegal to perform any invasive procedure without written consent, they're reduced to fining people for having more than two children per couple. And then, of course, there are loophole kids.”
“Yeah, my husband and I aren't comfortable with that,” Zoe said. “We've talked about it, but we're really okay with two children. While it's unusual for a man to challenge for custody, it's been on the rise lately with black market adoption rates going up.”
“There's a bill in the House trying to eliminate that practice,” the midwife told her, “Although it's unknown if it will pass.”
“How?” Zoe asked.
“It provides that a man who sues for custody cannot put his child up for adoption. If he's found to have done so, he faces a twenty-thousand dollar fine or even more. The problem is that Pop Control is fighting it because the way things are now lowers the number of loophole babies for the exact reason you stated.”
“Wow. Well, if it passes, maybe we'll reconsider.”
“Even if it doesn't, there's a loophole to that problem anyway. Right now, a man can sue for custody of his child and automatically win if two or more children are already present in the home. However, if you have your loophole child before you have biological children or between your one allotment and your husband's allotment, he won't win.”
“I never even thought of that!” Zoe exclaimed, laughing. “That's brilliant!”
“I should warn you that if you need to transfer with your second child, you will be required to choose a permanent birth control device,” the midwife added.
“Is there no way around that?” Zoe asked.
“Some obstetricians are willing to do a five year survival clause in their OC, to provide that you aren't required permanent sterilization until your youngest child reaches their fifth year alive, at which time, you have a year to sterilize,” the midwife offered.
“That's sick!” Zoe protested. “It's like some kind of morbid warranty.”
The midwife nodded sympathetically.
“If you choose a vasectomy, you have two options still. If you're willing to pay the third child fine, you can try to conceive immediately, as soon as your husband feels up to it. After all, it takes vasectomies a while to take. That also leaves you open for a loophole baby. Of course, if you transfer during a loophole birth, many OBs make you sign a hysterectomy release for your c-section,” the midwife warned.
“This just all feels so wrong,” Zoe said. “Why is Norway the only place in the world, except for tribal areas, to not make birth into a legal situation?”
“According to my grandmother, it started out small. A few states criminalized midwifery when it was on the brink of becoming socially acceptable. OBs fought hard—buying studies, skewing outcomes—to prove that midwives were dangerous to mothers and babies. The cesarean rate was rising every year and then the ACOG gave the green light to start Obstetrical Contracts, which women were required to sign to use the practice.
“Originally, it was to guarantee exclusivity. The woman couldn't transfer care, but she knew exactly the care she would be getting. It didn't seem like a big deal, since that matched OBs with mothers who wanted their kind of care. Then the standard of care started shifting. There were no OBs that offered births without contracts, and then some hospitals stopped having rooms for labor, advertising as 'c-section only.'
“Next came the bill that legally defined childbirth as a medical procedure. That was the beginning of the end. They used it by the same logic that got midwives out of legal practice. Then came full practices offering nothing but cesarean delivery. Then, the mandatory cesarean act was passed. At this point, midwives were totally illegal and just coming out to protest drew the attention of the law. So we faded into the night. Women didn't want to risk being caught and trapped into an OC or lead the law back to their midwives, so they were afraid to make a lot of noise, too.”
“That's awful,” Zoe said, shaking her head in outrage. “Why did Norway stay separate?”
“They always have,” the midwife answered. “So, do you wish to hire me?”
“What's your fee?” Zoe asked.
“It's five thousand for prenatals and birth.”
“That's it?” Zoe asked, shocked. “It's fifty thousand to birth in a hospital!”
“Surgery is expensive,” the midwife said with a shrug. Zoe sighed.
“Do you accept payments?”
“Of course!” the midwife said cheerfully. “And if five thousand is a real hardship, we can work out barter if we need to.”
“Oh, no, I can afford it,” Zoe said with a smile. “As long as it's not all at once. How much if I have to transfer?”
“It depends on how far you get,” the midwife said. “Usually, we detect the need for transfers at five months, so that would be two thousand.”
“I can't believe how cheap it is!” Zoe said.
“We aren't out to make profit,” the midwife said. “Almost all midwives have some kind of side business to live on. Now, what month are you due?”
“According to the online calculator: October first.”
“Good, I don't have any clients in late September or any time in October right now, so I have no problem taking you.”
“I'm glad,” Zoe said, visibly relaxing.
“Remember that you cannot announce your pregnancy in any public forums, social media, et cetera. If you get followed to me, I'll be out of business, and you'll end up with an OB.”
“Got it,” Zoe said. “Can I know your name?”
“No, I'm sorry,” the midwife said. “But you may call me Ann. And of course, all payments must be in cash.”
“Of course,” Zoe agreed. “How many babies have you delivered?”
“I've caught around three hundred babies,” the midwife answered. “I've been doing this for twenty-five years. I started apprenticing when I was sixteen. I was amazed when I saw my first vaginal birth.”
“How do OBs stop women from having accidental vaginal births?” Zoe asked.
“All mothers are sectioned at thirty-seven weeks, unless they show signs of labor before that. That's why NICUs have to be so advanced. Many babies who are supposed to be thirty-seven weeks along are actually thirty-five and even thirty-seven weekers aren't always ready. Plus, just the cesarean itself raises the risk to the baby's lungs and digestive system.”
“Wait, you mean pregnancy isn't thirty-seven weeks?” Zoe asked.
“Yes. Oh, you didn't account for that?” the midwife asked. “I should have asked. Silly of me. You'll actually be due October twenty-second, then.”
“Wow, that's almost a whole month!”
“It could be even two or three more weeks after that,” the midwife warned.
“Really?” Zoe exclaimed.
“You'll be most likely to go in almost November. Changing your mind?” The midwife gave Zoe a teasing smile.
“No! No, I'm... just surprised is all. I didn't know pregnancy was... forty weeks long!” Zoe shook her head in surprise. “Even forty-two or forty-three? I've never heard of that!”
“Oh, I've seen two pregnancies that went forty-four and forty-five weeks respectively,” the midwife said. “I was really nervous about the forty-five weeker, but her baby, while a bit overcooked, was still nice and healthy.”
“Do... do I have to go that long?” Zoe asked, a small tremor in her voice.
“No, but it's better to let your baby decide when it's time,” the midwife explained. “If you get really uncomfortable and go to forty-two weeks, there are things we can do to tell baby it's time.”
“Oh, good.” Zoe stood up and the midwife stood up as well. Zoe offered her hand and the midwife took and shook it. “Thank you, Ann.”
“You're welcome, Zoe. That's what I'm here for: the truth. Unfortunately, that's something most people are scared of anymore.”
“Oh, I'm scared,” Zoe admitted, “but I want to do this.”
“I'm so glad,” the midwife said. “Do you have an ereader?”
“Of course,” Zoe said. “Why?”
“I have some books that you should read. You don't want to go near most of the books in the bookstores—they just focus on preparing you for surgery and obeying your doctor. These are really old books from the days back when women birthed vaginally seventy percent of the time.”
“I can't even imagine that,” Zoe said. “I'll bring my ereader at the next visit. It's been a pleasure meeting you.”
“It's been a pleasure meeting you, too. Have a happy and healthy nine months,” the midwife wished her. Zoe shook her head in amazement. Nine months! Everyone else she had ever met had always said eight months, except grandmas, who didn't talk much about birth at all.
Maybe they knew as little as she had. She was amazed at the knowledge that time could steal and the cleverness of humans in preserving old information thought to be lost to time. Now if only that wisdom could help her do what she believed her body had to be capable of doing.
She hoped that the ability to give birth hadn't been bred out of her. Zoe supposed Population Control would be happy if it had. Sometimes she wondered just how far they would go to maintain their quotas.
Now that she knew more about the statistics, more than just a fear of surgery drove her. No, now it was a duty. A service to the human race, to remember that biology was as important a science as technology. It only made sense that she, as a biology student, was part of a movement to prove it.
She only hoped that some day, she could share her knowledge with the world that so desperately needed it.

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