THERE WERE OPTIONS, most of them horrifying to contemplate. If there was danger of a placental abruption, I could do an emergency cesarean and possibly save the child—but Marsali would die. To deliver the child slowly, via induction of labor, was to risk the child, but was much safer for Marsali. Of course—and I kept this thought to myself—induction of labor raised the risk of hemorrhage. If that happened …

I could perhaps stop the bleeding and save Marsali—but would be unable to help the infant, who would likely also be in distress. There was the ether … a tempting thought, but I reluctantly put it aside. It was ether—but I’d not used it, had no clear idea of its concentration or effectiveness, nor did I have anything like an anesthetist’s training that would allow me to calculate its effects in such a dicey situation as dangerous childbirth. For a minor operation, I could go slowly, judge the patient’s respiration, and simply back off if things seemed to be going wrong. If I were in the middle of a cesarean section and things went pear-shaped, there was no way out.

Marsali seemed preternaturally calm, as though she were listening to what was going on inside rather than to my explanations and speculations. As we came near the Big House, though, we met Young Ian, coming down the hillside with a clutch of dead rabbits, dangling by their ears, and she sharpened to attention.

“Ho, cousin! How is it, then?” he asked cheerfully.

“I need Fergus, Ian,” she said without preliminary. “Can ye find him?”

The smile faded from his face as he took in Marsali’s paleness, and my support of her.

“Christ, the bairn’s coming? But why—” He glanced up the pathway behind us, clearly wondering why we had left Marsali’s cabin.

“Go and find Fergus, Ian,” I cut in. “Now.”

“Oh.” He swallowed, suddenly looking quite young. “Oh. Aye. I will. Directly!” He began to bound off, then whirled back and thrust the rabbits into my hand. Then he leapt off the path and tore down the hillside, rocketing between trees and vaulting fallen logs. Rollo, not wishing to be left out of anything, flashed past in a gray blur and hurtled down the hillside after his master like a falling rock.

“Don’t worry,” I said, patting Marsali’s arm. “They’ll find him.”

“Oh, aye,” she said, looking after them. “If they shouldna find him in time, though …”

“They will,” I said firmly. “Come on.”



I SENT LIZZIE to find Brianna and Malva Christie—I thought I might well need more hands—and sent Marsali to the kitchen to rest with Mrs. Bug, while I readied the surgery. Fresh bedding and pillows, spread on my examination table. A bed would be better, but I needed to have my equipment to hand.

And the equipment itself: the surgical instruments, carefully hidden beneath a clean towel; the ether mask, lined with fresh thick gauze; the dropping bottle—could I trust Malva to administer the ether, if I had to perform emergency surgery? I thought perhaps I could; the girl was very young, and quite untrained, but she had a remarkable coolness about her, and I knew she wasn’t squeamish. I filled the dropping bottle, averting my face from the sweet, thick scent that drifted from the liquid, and put a small twist of cotton in the spout, to keep the ether from evaporating and gassing us all—or catching fire. I glanced hastily at the hearth, but the fire was out.

What if labor was prolonged and then things went wrong—if I had to do this at night, by candlelight? I couldn’t; ether was hideously inflammable. I shoved away the mental picture of myself performing an emergency cesarean section in the pitch-dark, by feel.

“If you have a moment to spare, this would be a bloody good time to have a look-in,” I muttered, addressing this remark collectively to Saints Bride, Raymond, and Margaret of Antioch, all presumably patrons of childbirth and expectant mothers, plus any guardian angels—mine, Marsali’s, or the child’s—who might be hovering about in the offing.

Evidently, someone was listening. When I got Marsali boosted up onto the table, I was terribly relieved to find that the cervix had begun to dilate—but there was no sign of bleeding. It didn’t remove the risk of hemorrhage, by any means, but it did mean the probability was much lower.

Her blood pressure seemed all right, so far as I could tell by looking at her, and the baby’s heartbeat had steadied, though the baby had stopped moving, refusing to respond to pokes and shoves.

“Sound asleep, I expect,” I said, smiling at Marsali. “Resting up.”

She gave me a tiny smile in return, and turned onto her side, grunting like a hog.

“I could use a bit of a rest, myself, after that walk.” She sighed, settling her head into the pillow. Adso, seconding this motion, leapt up onto the table, and curled himself into her breasts, rubbing his face affectionately against her.

I would have slung him out, but Marsali seemed to find some comfort in his presence, scratching his ears until he curled up under her chin, purring madly. Well, I’d delivered children in much less sanitary surroundings, cat notwithstanding, and this was likely to be a slow process; Adso would have decamped long before his presence became a hindrance.

I was feeling a bit more reassured, but not to the point of confidence. That subtle feeling of wrongness was still there. On the way, I’d considered the various options available to me; given the slight dilatation of the cervix and the now-steady heartbeat, I thought we might try the most conservative method of inducing labor, so as not to put undue stress upon mother or child. If emergency intervened … well, we’d deal with that when and if we had to.

I only hoped the contents of the jar were usable; I’d never had occasion to open it before. Laminaria, said the label, written in Daniel Rawlings’s flowing script. It was a small jar of dark green glass, corked tight, and very light. When I opened it, a faint whiff of iodine floated out, but no scent of decay, thank goodness.

Laminaria is seaweed. Dried, it’s no more than paper-thin slips of brownish-green. Unlike many dried seaweeds, though, Laminaria doesn’t crumble easily. And it has a most astonishing capacity to absorb water.

Inserted into the opening of the cervix, it absorbs moisture from the mucous membranes—and swells, slowly forcing the cervix further open as it does so, thus eventually causing labor to start. I’d seen Laminaria used, even in my own time, though in modern times it was most frequently employed to assist in expelling a dead child from the uterus. I shoved that thought well to the back of my mind, and selected a good piece.

It was a simple thing to do, and once done, nothing to do but wait. And hope. The surgery was very peaceful, full of light and the sounds of barn swallows rustling under the eaves.

“I hope Ian finds Fergus,” Marsali said after a period of silence.

“I’m sure he will,” I replied, distracted by an attempt to light my small brazier using flint and steel. I should have told Lizzie to have Brianna bring matches. “You said Fergus hadn’t been home?”

“No.” Her voice sounded muffled, and I looked up to see her head bent over Adso, face hidden in his fur. “I’ve scarce seen him at all, since … since the men came to the malting floor.”

“Ah.”

I didn’t know what to say to this. I hadn’t realized that Fergus had made himself scarce—though knowing what I did of eighteenth-century men, I supposed I could see why.

“He’s ashamed, the wee French gomerel,” Marsali said matter-of-factly, confirming my supposition. She turned her face, one blue eye visible above the curve of Adso’s head. “Thinks it was his fault, aye? That I was there, I mean. Thinks if he was better able to provide, I shouldna have had to go and tend the malting.”

“Men,” I said, shaking my head, and she laughed.

“Aye, men. Not that he’d say what the trouble is, o’ course. Much better go off and brood about it, and leave me to hame wi’ three wild bairns!” She rolled her eyes.