Ken Follett - Lie down with lions

Rabia was a little more than a midwife. Delivering babies was her main work, but she also had herbal and magical treatments to increase the fertility of women who were having difficulty getting pregnant. She had methods of preventing conception and bringing on abortion, too, but there was much less demand for these: Afghan women generally wanted lots of children. Rabia would also be consulted about any "feminine" illness. And she was usually asked to wash the dead—a task which, like delivering babies, was considered unclean.

Jane watched her move around the room. She was probably the oldest woman in the village, being somewhere around sixty. She was short—not much more than five feet tall—and very thin, like most of the people here. Her wrinkled brown face was surrounded by white hair. She moved quietly, her bony old hands precise and efficient.

Jane's relationship with her had begun in mistrust and hostility. When Jane had asked whom Rabia called upon in case of difficult deliveries, Rabia had snapped: "May the devil be deaf, I've never had a difficult birth and I've never lost a mother or a child." But later, when village women came to Jane with minor menstrual problems or routine pregnancies, Jane would send them to Rabia instead of prescribing placebos; and this was the beginning of a working relationship. Rabia had consulted Jane about a recently delivered mother who had a vaginal infection. Jane had given Rabia a supply of penicillin and had explained how to prescribe it. Rabia's prestige had rocketed when it became known that she had been entrusted with Western medicine; and Jane had been able to tell her, without giving offense, that Rabia herself had probably caused the infection by her practice of manually lubricating the birth canal during delivery.

From then on Rabia began to turn up at the clinic once or twice a week to talk to Jane and watch her work. Jane took these opportunities to explain, rather casually, such things as why she washed her hands so often, why she put all her instruments in boiling water after using them, and why she gave lots of fluids to infants with diarrhea.

In turn, Rabia told Jane some of her secrets. Jane was interested to learn what was in the potions Rabia made, and she could guess how some of them might work: medicines to promote pregnancy contained rabbit brains or cat spleen, which might provide hormones missing from the patient's metabolism; and the mint and catnip in many preparations probably helped to clear up infections which hindered conception. Rabia also had a physic for wives to give to impotent husbands, and there was no doubt about how that worked: it contained opium.

Mistrust had given way to wary mutual respect, but Jane had not consulted Rabia about her own pregnancy. It was one thing to allow that Rabia's mixture of folklore and witchcraft might work on Afghan women, and quite another to subject herself to it. Besides, Jane had expected Jean-Pierre to deliver her baby. So, when Rabia had asked about the position of the baby, and had prescribed a vegetable diet for a girl, Jane had made it clear that this pregnancy was going to be a Western one. Rabia had looked hurt, but had accepted the ruling with dignity. And

now Jean-Pierre was in Khawak and Rabia was right here, and Jane was glad to have the help of an old woman who had delivered hundreds of babies and had herself given birth to eleven.

There had been no pain for a while, but in the last few minutes, as she watched Rabia move quietly around the room, Jane had been feeling new sensations in her abdomen: a distinct feeling of pressure accompanied by a growing urge to push. The urge became irresistible, and as she pushed, she groaned, not because she was in pain, but just with the sheer effort of pushing.

She heard Rabia's voice, as if from a distance, saying: "It begins. This is good."

After a while the urge went away. Zahara brought a cup of green tea. Jane sat upright and sipped gratefully. It was warm and very sweet. Zahara is the same age as me, Jane thought, and she's had four children already, not counting miscarriages and stillborn babies. But she was one of those women who seemed to be full of vitality, like a healthy young lioness. She would probably have several more children. She had greeted Jane with open curiosity, when most of the women had been suspicious and hostile, in the early days; and Jane had discovered that Zahara was impatient with the sillier customs and traditions of the Valley and eager to learn what she could of foreign ideas on health, child care and nutrition. Consequently Zahara had become not just Jane's friend but the spearhead of her health education program.

Today, however, Jane was learning about Afghan methods. She watched Rabia spread a plastic sheet on the floor (What had they used in the days before there was all this waste plastic around?) and cover it with a layer of sandy earth, which Zahara brought from outside in a bucket. Rabia had laid out a few things on a cloth on the floor, and Jane was pleased to see clean cotton rags and a new razor blade still in its wrapping.

The need to push came again, and Jane closed her eyes to concentrate. It did not hurt exactly; it was more like being incredibly, impossibly constipated. She found it helpful to groan as she strained, and she wanted to explain to Rabia that this was not a groan of agony, but she was too busy pushing to talk.

In the next pause, Rabia knelt down and untied the drawstring of Jane's trousers, then eased them off. "Do you want to make water before I wash you?'' she asked.

"Yes."

She helped Jane get up and walk behind the screen, then held her shoulders while she sat on the pot.

Zahara brought a bowl of warm water and took the pot away. Rabia washed Jane's tummy, thighs and private parts, assuming for the first time a rather brisk air as she did so. Then Jane lay down again. Rabia washed her own hands and dried them. She showed Jane a small jar of blue powder—copper sulfate, Jane guessed—and said: "This color frightens the evil spirits."

"What do you want to do?"

"Put a little on your brow."

"All right," said Jane, then she added: "Thank you."

Rabia smeared a little of the powder on Jane's forehead. I don't mind magic when it's harmless, Jane thought, but what will she do if there is a real medical problem? And just exactly how many weeks premature is this baby?

She was still worrying when the next contraction began, so that she was not concentrating on riding the wave of pressure, and in consequence it was very painful. I mustn't worry, she thought; I must make myself relax.

Afterward she felt exhausted and rather sleepy. She closed her eyes. She felt Rabia unbutton her shirt—the one she had borrowed from Jean-Pierre that afternoon, a hundred years ago. Rabia began to massage Jane's tummy with some kind of lubricant, probably clarified butter. She dug her fingers in. Jane opened her eyes and said: "Don't try to move the baby."

Rabia nodded, but continued to probe, one hand on the top of Jane's bulge and the other at the bottom. "The head is down," she said finally. "All is well. But the baby will come very soon. You should get up now."

Zahara and Rabia helped Jane stand and take two steps forward onto the earth-covered plastic sheet. Rabia got behind her and said: "Stand on my feet."

Jane did as she was told, although she was not sure of the logic of this. Rabia eased her into a squat, crouching behind her. So this was the local birthing position. "Sit on me," said Rabia. "I can hold you." Jane let her weight settle on the old woman's thighs. The position was surprisingly comfortable and reassuring.

Jane felt her muscles begin to tighten again. She gritted her teeth and bore down, groaning. Zahara squatted in front of her. For a while there was nothing in Jane's mind but the pressure. At last it eased, and she slumped, exhausted and half asleep, letting Rabia take her weight.