**As a warning, this chapter contains descriptions of childbirth.**

The ebb and flow of screaming gave way to the slap of sandaled feet against marble, to a servant's cry at her chambers.

"Is it Sasha?" Yalira asked, drawing the curtain back. Only the cries of childbirth thundered in desperation, echoed in longing. Like divine healing, motherhood mirrored that sacred trade of blood and pain for life.

The frantic woman, Sasha's handmaiden, nodded, wisps of hair escaping her tight braid. "She did not want you to come, priestess! But now I fear it is too late!"

The sharp, fearful truth of her aura stung at Yalira's senses.

"Lead the way," Yalira answered, retrieving the small kit of herbs she had prepared.

It had been an absentminded habit to arrange the neat bundles of healing herbs and over preparedness to return to the high city with them in her lap. As Sasha's cries burned holes into Yalira's empathy, the priestess thanked Antala for the security of habit and precaution.

Countless births, countless babes, and yet Yalira's spirit shuddered with fear at the sight of Sasha's chambers. Thick tapestries blotted out the night sky and helped the roaring fire smother the summer breeze. Heavy incense clouded the air. Servants cowered, helpless.

Beneath a pair of bushy eyebrows, a white-bearded surgeon glowered at the sweat-soaked queen.

"Don't waste your breath!" he snapped. As he moved to cut again, the silver bite of his surgeon's instruments flashed red in the fire's glow. He paused. The furrowed expression grew darker as the room's attention fell to Yalira, as a breath of hope rose in the stifling room.

"We don't need a priestess!" he shouted gruffly. Soaked in blood, drenched in sweat, he muttered vicious curses as Yalira cast aside her silver trimmed veil. With an air of ingrained self-importance, lined with his last thread of control, he added, "You cannot pray to turn the course of a breech child. I will cut it out."

Sasha howled again. Ignoring the man, and the tortured moans, Yalira turned to the nearest servant.

"I need you to fetch boiled water and fresh linen, can you do that for me?" She spoke clearly, calmly. At the woman's hesitant nod, Yalira added, firm, "Tell me, yes or no."

"Yes, High Priestess," she answered, her voice strong. Resolve replaced the worried shadow of her eyes.

Slowly, steadily, Yalira moved toward the sobbing queen. To control the energy of the room, she kept her face smooth, her pace unaffected. In this world, she was the healer, and this was another woman who needed her help. Yalira kneeled to place her hand on Sasha's arm.

"I know you did not want me here, Sasha," she said, meeting the woman's terrified blue eyes. The queen screamed again, agony and exhaustion twisting her features. It was not fair to ask Sasha to consent when she was in pain and scared, but time would not pause for a better moment. As the contraction died, Yalira pleaded, "Let me help you."

The queen whimpered, tears leaking from her eyes. "Please. Please. Please."

At the tiny voice, the ancient surgeon stood tall, in fury. He bellowed, "Get out! I will not have a priestess chanting spells over my patient! This is no place for a woman!"

For all his sincere, indignant pride, she scoffed at the ridiculous statement. Standing to meet his eye, drawing her chin up, Yalira cast him with the deep, haughty stare of a high priestess.

"This is the place for women," she intoned, gesturing toward Sasha, toward the trembling crowd behind her. "If you do not wish to see spells, then I suggest you leave."

As if he could see the finality of Yalira's determination, her immovable will, the surgeon wiped his bloody hands and grunted, "Their deaths are on your hands."

The room echoed with the crackle of the hearth, Sasha's panting. It stood in feared silence until the surgeon's assistant swallowed and asked, "May I stay? I have no problem with chanting or spells."

The man's brown eyes glowed with sincerity, a hunger to learn. Yalira nodded.

"Put out the incense," she ordered, pulling down a tapestry to let a gust of clean air drive away the heady smoke and the stench of blood.

Yalira untied her bundles of herbs and handed the eager assistant, this wide-eyed surgeon's apprentice, a shriveled pod of poppy seeds.

"Soak these in hot water. Let Sasha drink as much as she can."

"For pain?" he asked, answering his own question. His eyes flashed with sharp interest. "Why not opium?"

It felt odd to recognize a question she had once asked, odder still to realize that she was now teaching the answers. A thread of pride glowed gold near her heart—she could bring the wisdom of Antala far beyond the slopes of her temple.

"The seeds are less potent," she murmured, moving to the basin to clean her hands, fingertip to elbow. Her new shadow watched with interest, eyes following each movement. She paused the education to recite a prayer of purification. "Opium can too easily still the breath of mother and babe."

Another contraction broke Sasha into new moans, spurring Yalira to move between the queen's legs to examine her. She placed her hands on the woman's belly, searching for the lines of the babe's body through the contracted muscles. The surgeon had been correct, the child was breech.

"Do you need me to cut, priestess?" the assistant asked, as if the thought of inflicting a wound would upset her.

"The tea first, please," Yalira answered, ignoring the implication that gore bothered a trained healer. "I will avoid the knife if I can."

The firmness of Yalira's voice, combined with the poppy-laced tea, soothed Sasha. Wracked sobs became unlabored breaths. Contractions still wracked through the queen's body, but it no longer fought Yalira's touch. The priestess placed her hands to find the stubborn infant once more. Through the layers of skin and muscle, she found its head, its spine. Cupping her hands around the tiny form, she prayed.

She pushed.

Sasha groaned with the force. "Please, I can't!"

"You can. You will," Yalira demanded through clenched teeth. Even with the current of night air now pouring into the chamber, sweat beaded at her brow.

In her fingertips, the distant heartbeat fluttered like a bird's, weaker and weaker.

As she pushed to turn the babe, Yalira's mind raced ahead through scenarios and treatments. Stubborn pride refused to look at the gleam of the silver knife, to acknowledge the hovering presence at her shoulder.

Help me, Antala! Help me, Temia, goddess of mothers! Give me strength, she begged, her arms aching from the effort.

There!

As if the goddesses themselves had pushed her hands, the baby shifted. Sasha groaned in relief, her body slumped. But the work was not yet done.

Yalira ordered two of the serving women to help pull Sasha upright, to wipe her brow.

Prayers to Temia on her lips, Yalira chanted through each contraction, her hands guiding the descent of the infant. The women holding their queen lent their strength, their encouragement. Her assisting shadow watched silently, the gleam of the knife forgotten.

"When the next wave comes, you push, Sasha. I know you're tired. But it's time."

As if the last hours had not been filled with pain and terror and misery, Sasha nodded with fierce determination. Golden hair a crown, she shouted in triumph through the wave of contractions and was rewarded with squalling cries of a tiny voice.

But the breath of victory died in Yalira's chest. Happy, grateful tears shifted to smothered gasps.

Not a boy. Not a girl. Not a child.

A monster.

Misshapen skull with a single eye, a flayed back, the tiny creature screamed weakly, howling as if its red skin burned. Andar of Tyr's son.

With shaking hands, trapped in the comfort of routine, the priestess tied off its connection to Sasha. Yalira watched the pulse fade between them as her own heartbeat thundered in abandon. Countless births, countless babes, and none had appeared like this creature.

"Is it a son? Show me my child!" Sasha begged weakly, struggling to sit forward.

Practiced hands severed the cord, swaddled the child. Empty of thoughts, of words—her horror mirrored in the servants behind the queen—Yalira handed the monstrous babe to his exhausted mother.

"Get it away!" the queen moaned, dissolving into shuddering sobs.

The surgeon's assistant quickly handed her a vial to drink from. With fumbling, greedy hands, Sasha drank until none remained. Her hiccups and soft cries faded.

"He'll kill me," Sasha whispered.

Yalira looked to the handmaidens, the servants. In color and dress, they matched Sasha's northern features. Their hands petted her bright hair, their eyes gleamed with unshed tears. Affection and pity would not be enough. She would give them more. 

"Are you loyal to your queen?" Yalira asked, burning them with her gaze. Wild hair curling around her face, arms stained with blood, the feeble infant held close, Yalira turned to the downcast surgeon's assistant. "No one will speak of this night."

For Yalira knew, heart pounding in her chest, only a lie would save the queen from Crosao.

Author's Note:

This scene was partially inspired by my experiences on my OB rotations and Euripedes' Medea, who says, she "would rather stand three times with a shield in battle than give birth once." But it also was influenced by some of the histories of childbirth and midwifery. Maternal health has suffered throughout history and continues to suffer today. 

I've taken a few liberties with the medical accuracy in this chapter, namely with the pharmacology of poppy seeds, the likelihood of Yalira's maneuvers being successful, and the timing of labor. I try to keep things as close to medically accurate as I can but some details are hard to fit into the narrative. 

Opioids (originally derived from the opium poppy) can be used during labor but their side effects make them less attractive than other options for analgesia. I use Dioscorides' De materia medical for inspiration of ancient medicinal plants. 

Yalira is able to successfully do an external version before delivery (this would not be attempted during active labor). My fiance frequently accuses me of getting too graphic with my medical descriptions, so I tried to keep it brief here. I hope I didn't scare anyone off! Most deliveries go much smoother than this one!

As for the outcome, I'll leave that mystery up to Yalira—but I'd love to hear your theories. For those of you that guessed anencephaly, you're on the right track!