Not all of the births are intrinsic to the plot, but they add reality and truth about this fundamental and often dangerous aspect of women’s lives in the past, and it is rare to find such sympathetic and accurate descriptions elsewhere in historical fiction.
Patience observes that “Birth is a messy, primitive event, and… it’s not for everyone”, and the numerous scenes of life struggling its way into the world – some animal as well as human – are certainly graphic. And her growing relationship with the local vet, Daniel Hester, further complicates matters.
When Bitsy, a colored girl, becomes her assistant and moves in to share her home as an equal, Patience inevitably invites more controversy. She’s even prepared to infringe state guidelines or try innovative methods if necessary. Her darkest secrets are revealed gradually through flashbacks, and although she lives in constant fear of discovery, that doesn’t stop her from displaying liberal notions and taking risks. Still, the stories of the births that Patience handles in this difficult era are fascinating.Patience Murphy is a “thirty-six year old widow, wanted by the law in two states,” so when she takes up the duties of midwife in rural West Virginia in 1929, it’s clear she’s going to face challenges far beyond ensuring the health of the women in her care. Patience's story is slow, and the characters that surround her are insufficiently drawn, creating more inertia than intrigue. While Harman (Arms Wide Open: A Midwife's Journey, a memoir), a certified nurse-midwife who has practiced in many rural communities, clearly has a comprehensive understanding of midwifery, her narrative pacing leaves much to be desired.
As times grow harder than they already are, these three unlikely friends have to pull together, even if it means revealing secrets that could bring trouble to them all. But a secret, violent past keeps her from letting anyone get too close, at least until she acquires a black housemate named Bitsy as well as Hester, a handsome neighbor and veterinarian whose exposure to dying horses in WWI fueled his decision to take up his father's vocation. Set in gritty Depression-era West Virginia, Harman's debut novel tells the story of rural midwife Patience Murphy, a woman who loves helping new mothers bring children into the world.
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