“Jesus,” she whispered, whether in prayer or from simple astonishment, I couldn’t tell. Then her face clenched into a knot and she curled over her belly with a bestial noise.

I kept my hand on her, but bent down to one side and peered up through the hollow of the birthing stool. A narrow slice of pale crown showed for an instant as she pushed, then disappeared.

I felt the spurt of excitement that always came with imminent birth, and my hand tightened on her belly. Another spurt came, this one of sudden fear.

Something bloody was wrong. I couldn’t tell what, but something was very wrong. I straightened up, and as the pain released its grip, I rose and took the woman by her shoulders, helping her to sit up. There were no towels to hand; I lifted my skirt and wiped her face with my petticoat.

“How long have you been pushing?” I asked.

“Too long,” she said tersely, and grimaced. I bent and looked again, and without her shadow obstructing the situation, I saw that she was dead right. The perineum was nearly purple and very swollen. That was it: the child was stuck, the crown of its head battering with each spasm, but not able to come further.

“Jesus H. Roosevelt Christ,” I said, and both her eyes popped open in astonishment. “Never mind,” I said. “When it lets go”—for the next pain was coming, I could see it in her face—“lean back against the wall.”

Her husband—I assumed that must be the man who’d slapped Agnes—seemed to have gone outside and was apostrophizing the night in an incoherent mix of Cherokee and English.

“Right,” I said, as calmly as possible, and put off my cloak and shawl. “Let’s just see what we have here, shall we, Susannah?”

There were splashes of blood on the dirt floor, but it was dark, with large, visible clots—just bloody show. She wasn’t hemorrhaging, though there was a slick of blood on her thighs. Her waters had broken some time earlier; it was hot and the small room smelled like a Jurassic swamp, fecund and reeking.

The contractions were coming every minute, powerful ones. I had only moments between them in which her belly relaxed enough for me to palpate it, but on the second try I thought I felt … the muscles of her belly tightened like an iron band, and I counted under my breath, hands still on her. Relaxation … I knew where the head was, was the child facing backward? I pressed hard on the relaxed belly, trying to find the curve of the spine …

“Ngg!”

“It will be all right. Count with me, Susannah … one, two …”

“Rrrrggh!”

I counted silently. Twenty-two seconds and the contraction eased. Spine … there was the blunt point of an elbow, and there, a curve that had to be the child’s spine … only it wasn’t.