“You see what I’m saddled with by my worthless sister?” Um Salih complained to the guard. “The girl wants to be a midwife, yet cringes at the cries of a woman in labor.”

“It’s not exactly music to my ears either, Mother,” the man answered uncomfortably. Stopping in front of a barred wooden door, he turned a heavy key in the rusty lock, pushed the door open, then stepped well away to let the midwife enter. Laila was half sitting, half lying on a mat of straw, her flowing robe stained with blood and birth fluids. For an instant, Amira didn’t recognize her.

Barely nineteen, Laila looked twice that. Her eyes were glassy with pain, her breath a series of short, ragged gasps.

Um Salih set down her basket and rolled up the sleeves of her dress. Calling out to the waiting guard, she demanded boiling water. “Boiling, not just heated, do you hear? And hurry—this child will not wait while you drag your feet.’’

When the guard’s footsteps could no longer be heard, Amira removed her veil and put a finger to her lips. “Don’t say my name, Laila,” she whispered. “I’m supposed to be Um Salih’s niece.”

“You’re really here?” said Laila hoarsely. For the first time, something like hope lit her eyes. “Save my baby,” she pleaded. “Don’t let him be given away. Please. Please, you must make sure he has a good life. You must.”

“I promise, I promise,” Amira whispered, gently stroking her cousin’s forehead. “It’s all taken care of. Malik has seen to everything. But don’t say his name, Laila, I beg you, don’t say his name!”

From her basket, the midwife took a clean linen square. Upon it, she placed the tools of her trade—a tube of antibiotic ointment, a tube of lubricant, packets of herbs, a needle and surgical thread, a pair of stainless-steel scissors.

Into a small drinking glass, she emptied the contents of an herb packet, then added some pure drinking water from a large bottle she carried.

“Here,” she said, handing the glass to Amira. “Give her a little at a time. Not too much, mind you, or she’ll vomit it up.”

In spite of the admonition, Laila gulped the herbal mixture greedily, desperate for relief from her suffering.

A moment later, her back arched. From high inside her throat came a long, keening wail that raised the hairs on Amira’s neck. It was the sound of pain and relief and unspeakable sorrow. She took her cousin’s hand. “Squeeze it,” she said. “When you feel pain, let me take some of it.” With her free hand, she wiped Laila’s face with a wet cloth, cooling her parched lips.