Midwives

The novel uses the lens of home births and midwifery to explore real-world tension between alternative and institutionalized medicine. As in the real world, the conversation around home births in the novel is polarized, with alternative medicine practitioners viewing clinical settings as unnatural and oppressive and mainstream doctors viewing home births as inherently dangerous. These polarized views are reflected in the loaded imagery and vocabulary each side uses to justify its claims. For instance, an obstetrician in the novel compares a problematic labor to hitting “that patch of black ice and skid[ding] off the road” (19), while a midwife describes a hospital as a sterile, cold environment. The novel unpacks the nuances of each argument to show that the truth is far more complex.

Indeed, Sibyl herself has a nuanced take on home births, despite her dislike of institutionalized medicine. Sibyl always refers pregnancies she deems high-risk to a physician, B. P., even rushing mothers in need to the hospital when necessary—something only the snowstorm prevents her from doing in Charlotte’s case. For his part, B. P. does not deem all midwife-assisted births dangerous, noting that he trusts the judgment of a midwife as competent as Sibyl, with whom he has worked for over a decade.