The Apothecary Diaries - Volume 4 - Chapter 6

Chapter 6: Breech Birth

“Oh, it moved,” Consort Gyokuyou said, stroking her swollen belly. It was only just beginning to turn cool, yet a thick robe hung from her shoulders. Hongniang got steaming mad if Gyokuyou let herself get even a little bit chilly, and that was a terrible sight to behold.

“Yah! Yaaah!” Princess Lingli yelled when she saw her mother’s belly move. She was on a thick rug on the floor, playing with Maomao the kitten. The other Maomao had patiently trimmed and blunted the kitten’s claws, and had also discouraged her from biting; so as long as Lingli didn’t do anything completely outrageous to the kitten, she probably wouldn’t get herself in trouble. But then again, one never did quite know what a child was going to do. Thus Maomao (the young woman) sat on the rug, watching closely lest the princess do anything naughty. She was always ready to grab the furball by the scruff of the neck if she looked like she might try to bite the girl.

“It’s funny. Babies start to develop a personality even before they’re born,” Gyokuyou said, gazing down at her stomach. “Lingli, she kicked upward all the time, but this child always kicks downward.”

“Downward, ma’am? Always?” Maomao asked, cocking an eyebrow. She snatched up the kitten and tossed her in a basket. The princess objected vociferously, but Maomao simply placed the basket on a table where Lingli couldn’t reach it. Then she went over to Gyokuyou and stooped in front of her. “May I have a look? You don’t mind if I touch your belly?”

Gyokuyou peered at her questioningly. “Not at all, but...is everything all right?” Maomao responded by running her fingers gently along the consort’s belly. As if in response, she felt another kick, down and outward.

Maomao frowned. “Tell me about Princess Lingli’s birth.”

It was Hongniang who answered. “It was remarkably easy, far more so than I would have expected for a first child. I suppose it helped that the princess was somewhat small.” Hongniang was now holding the basket with Maomao in it (Lingli having proven too industrious in her attempts to reach the tabletop), and the kitten could be seen peeking out from under the lid as if she found this all very intriguing.

“Who attended the delivery?” Maomao asked.

“I did,” Hongniang said, though she looked somewhat uneasy about it. “You can’t count on the doctor here, and I’d done some studying, so we made it work, somehow. It’s just...”

“Yes?”

“We had a palace woman with us who had experience doing deliveries, but just when the princess was due, she got quite ill. It was the unluckiest thing.”

Hongniang had been forced to step into the role with very little warning and said she had been at her wit’s end. It was her natural tenacity that had saved the day. “The midwife was an older woman who’d been temporarily retained at the rear palace to assist with the births. But anyone who would get a stomach ache at such a crucial moment—well, she was urged to quit in short order. My understanding is that Consort Lihua was assisted by a different midwife.”

Maomao nodded with interest. Would they retain a midwife this time as well, then?

Something still nagged at her, though. Gyokuyou, seeming to sense her lingering question, smiled at Maomao. “Something on your mind? Please, speak freely.”

Maomao took this as license to voice her doubt in concrete terms. “My concern is whether the midwife would be able to cope if this should turn out to be a breech birth.”

“A breech birth?” Gyokuyou rubbed her belly again, then frowned at what must have been another kick.

“You say the baby always kicks downward. If that is indeed kicking you feel and not punching, then that would mean the child’s head is pointing upward.”

At birth, the head needs to emerge first. The head is the largest part of the child, and it passing through the birth canal first makes the passage of the rest of the body easier. Having the feet come first makes the birth dramatically more dangerous.

“Are we certain it’s a breech birth?” Gyokuyou asked.

“No, ma’am; it’s only a possibility. A more thorough examination might make the situation clearer.”

“Can you do that?”

It was hard for Maomao to answer that question in the affirmative. Her old man, for all he knew of medicine, had really only specifically taught her about drugs. Outside of that particular subject, Maomao’s knowledge consisted mostly of what she’d been able to glean from quietly watching him work.

Gyokuyou realized from Maomao’s silence that a question had been the wrong way to approach the matter. “Do the exam, please,” she said instead.

Maomao glanced up at the ceiling for just a second before she approached the consort. “Let me tell you what it will involve, and then you tell me if you still want me to do it,” she said, and then described the nature of the exam in detail.

“Goodness, really?” Gyokuyou asked, putting a hand to her mouth. The method would have been a matter of profound embarrassment to a sheltered princess; doing what Maomao described to such a person would have been to invite punishment as the worst of villains. But Gyokuyou said, “Well, it’s nothing compared to actually giving birth. Go ahead.”

“Yes, ma’am.”

Such was a mother’s strength. Maomao prepared to begin the examination.

Phew, Maomao thought as she washed her hands after the examination. It involved not only the abdomen, but the genitalia, so even with her warning it wasn’t exactly easy. Ideally, the exam would have been done earlier in the pregnancy, but knowing what it entailed, she’d been avoiding it. Besides, Maomao was no professional; if the baby had been too small, she wouldn’t have been able to tell anything about it.

Her final judgment: there was an eighty percent chance that they were dealing with a breech birth. She’d judged the child’s location by the sound of its heartbeat and the feeling of its kicks.

Babies in breech sometimes changed positions on their own as they grew. The fact that the child was still upside down at this point in Gyokuyou’s pregnancy, however, was not a good sign. There was only something like two months until the child would be born.

“What do you think we should do?” asked Consort Gyokuyou, who had finished changing. Hongniang was beside her, looking worried.

“I’m told that exercise and moxibustion can help remedy the condition. Information on the exact exercises you should do might best be obtained outside the rear palace, but as for the moxa, I know how to administer it.”

“I see. I’ll try asking around to see if there might not be any other ways to help while I’m at it,” Gyokuyou said. She requested Maomao, however, to handle the moxibustion; then she stroked her belly and, as if she had just thought of it, said, “What will we do if it doesn’t change positions?”

“In a worst-case scenario, we may have to cut your belly open.”

Maomao didn’t want to think about it. Even with a proper midwife present, the danger would be great. Cutting Gyokuyou open would be a last resort, and if it came to that, the consort’s life would be on the line. The fact that there would be no qualified physician to turn to if something went wrong only added to Maomao’s discomfort.

If only the quack had half an idea what he was doing, she thought, but she knew he had always been a quack and always would be. A sweet-hearted man but absolutely not a competent doctor. Nonetheless, it would be a tall order to bring a different physician into the rear palace. Officially, he would have to be a eunuch, and he wouldn’t be able to enter until after he had been castrated. Could that be done in time—or otherwise, could the system possibly be changed quickly enough to help them?

Wait! Maomao put a hand to her chin. She could think of one person who fit their needs perfectly. But... Shit. She groaned and scratched her head, and then, after much internal debate, looked at Gyokuyou, knowing that nothing ventured meant nothing gained.

“I can think of one person who might be able to help us, ma’am. Someone with medical skills beyond reproach, who’s delivered children by surgery several times before.”

“Goodness, you can?”

“Really?” Hongniang said, sounding much less convinced than Gyokuyou. “You’re not thinking of Master Jinshi’s lady-in-waiting, are you?” (What had Suiren gotten up to in this pavilion?)

“I’m not thinking of a lady-in-waiting. I’m thinking of a doctor.” There was only one problem; namely... “He’s a criminal who was banished from the rear palace.”

She was thinking of her adoptive father, Luomen.

Consort Gyokuyou didn’t bat an eyelash, but Hongniang was incandescent. “We could never let such a man near the consort,” she said forcefully. She didn’t yell as she often did when scolding one of the palace women; instead she quietly, coldly eviscerated Maomao’s idea. “This person might hold Consort Gyokuyou’s life in their hands. It must be someone we can trust.”

That much was certainly true. And under other circumstances, Maomao might have seen fit to back down at that point. But not this time. Luomen was, in fact, their best choice to ensure Gyokuyou’s safety—and more than anything else, Maomao had a deep and abiding respect for her old man. He might be softhearted, luckless, and grandmotherly, but she was also convinced he was the best doctor their nation had.

“We can trust him,” she said. “He’s as good as any ten doctors you might find.”

“It’s not like you to push a matter like this,” Hongniang observed, though Maomao had only said what was true. Nonetheless, the chief lady-in-waiting wasn’t going to cave either. “But you said he’s a criminal. I don’t know what his crime was, but that’s a fact we can’t ignore.”

Hongniang remained calm, but Maomao’s gaze took on a dangerous edge. As the two women faced each other, their ordinary positions reversed, it was Consort Gyokuyou who interceded. “Perhaps you could tell us what he did? Hongniang, we should listen to what Maomao has to say instead of dismissing her out of hand—and Maomao, you need to stay calm and explain.”

At that, Maomao felt the rush of blood to her head subside. She let out a small sigh and composed herself, then turned to Gyokuyou and Hongniang. “This person was a eunuch and medical officer. He was responsible for delivering the current ruler and the current heir apparent, as well as Lady Ah-Duo’s child. As for why he was banished from the rear palace, I’ve heard only that the reason was somehow connected to Consort Ah-Duo.”

The fact was, Maomao didn’t have a strong understanding of the reason. It would be untrue to say she couldn’t guess what might have happened, but she wasn’t at all sure, and she wasn’t about to offer wild speculation.

“I see... So that’s it,” Gyokuyou said. Oddly, she seemed to have already known about this. She was an upper consort, living in the rear palace because she had the Emperor’s favor. She would surely have heard stories. “And, if I may ask, how is this person related to you, Maomao?” She sounded less concerned with his status as a criminal than with what kind of person he actually was.

“He’s my adoptive father, as well as my teacher in matters of medicine.”

Gyokuyou closed her eyes for a second, thinking, then opened them again. “All right. I’ll suggest it to Sir Jinshi.”

“Lady Gyokuyou!” Hongniang exclaimed, but the consort only smiled.

“Hongniang, I want to surround myself with capable people and make the best use of them that I can. If they’re trustworthy as well, all the better. He can’t be a bad person if this stray cat of ours has taken such a shine to him.”

Stray cat, huh? Nice.

“But he’s a criminal.”

“Yes, so they say, but you must have heard at least a few tales of how the rear palace was in those days. How many were purged in the time of the great empress regnant? Are you telling me you’re going to take such calumny at face value?” Her words were gentle, but insistent.

The empress regnant, Maomao thought. Quite a presence to invoke.

“If you still aren’t comfortable, we can have him kept under watch. Would that be a fair compromise?” Gyokuyou said, and then she took paper and brush from the table and started writing a letter to Jinshi.

Two days after bringing up the matter with Hongniang, a grandmotherly individual appeared at the rear palace. Maomao was surprised; they’d moved quicker than she’d expected.

Gaoshun accompanied Maomao’s old man as he paid his respects at the Jade Pavilion, after which they headed to the medical office. He was going to be with the quack doctor for a while. Maomao’s father had a soft spot for cats, so she expected to see the kitten’s fur grow even more lustrous now.

She’d initially worried about what would happen if the quack found himself out of a job after her father showed up, but it seemed there was no need to fret about that, at least for the time being. Her old man’s admission to the rear palace had, after all, been an emergency measure, a compromise.

I’m glad about that, at least. Without him, there would be no physician worthy of the name in the pleasure district. Maybe it wasn’t her place to be concerned about that, considering she had suggested the idea to begin with, but she worried that if he wasn’t back home by the turn of the year, the old madam might come storming into the rear palace to drag him back herself.

Such were the thoughts occupying her mind as she worked at cleaning the Jade Pavilion. Perhaps in part because of her old man’s visit, all the chores had been packed into today, and they all had to work diligently. Yinghua came up hauling a fresh bucket of water.

“So that guy—he’s your dad, right, Maomao?” she asked.

“Mm... Yeah.”

Yinghua looked puzzled. Strictly speaking, Luomen was Maomao’s granduncle, but the two of them looked nothing alike—probably the source of Yinghua’s confusion. Anyway, Maomao was content to let the subject lie. Trying to explain further would only be a pain in the neck.

“He’s just...” Yinghua searched for the words. “...not how I pictured him at all. I guess you could say he’s almost...normal. I’m like, is this really the guy who raised Maomao?”

“And what exactly were you imagining?”

“Ahem. Well, you know. He seems downright...”

Guiyuan and Seki-u, who were working alongside them, nodded along with Yinghua. Haku-u, who didn’t know Maomao very well yet, was simply listening to the conversation with a grin on her face.

“...sensible?” Yinghua concluded.

“For sure!” Guiyuan and Seki-u agreed in unison.

I’ll never understand these people, Maomao thought. For the life of her, she couldn’t imagine what they had been expecting.