The Midwife of Hope River – Author Interview and Book Giveaway

The Midwife of Hope River: A Novel of an American Midwife by Patricia Harman, CNM, is the first piece of midwife fiction I have ever read. On the day I blew through the pages at rapid speed, my parter looked over at me through my laughter and my tears and asked if I was okay. I responded: “It’s fantastic midwife fiction! Does it get any better!?!” Enough said.


This account of midwife Patience Murphy’s life in West Virginia during the Depression details the tough world of birth and life in Appalachia. This is Patricia Harman’s third book: she is also the author of two memoirs, Arms Wide Open: A Midwife’s Journey and The Blue Cotton Gown: A Midwife’s Memoir. What a wonderful addition to her publication list!

Patience Murphy is timid and assertive, unsure yet intuitive, and has a heart of hearts. Her dogs are named for a radical anarchist and her lover. Her tenacity at births in the mining communities had me fired up while reading. She has wild sex in a barn lit by moonlight. Cauls, cords, and malpresentations are handled with ease. She has gets her sanitized gloves from the pharmacy wrapped in newspapers. And she is a midwife.

A few favorite quotes:

“What makes me think I can be a midwife with only a few years’ apprenticeship…?”

“This child will be stronger than any of us.”

“Push with all your heart!”

“I’m trying to have a baby here!”

I had been waiting for the perfect review language to come to me, to let you all know how amazing I found this book. Instead, I realized that was foolish and I should open this giveaway ASAP. Check out the brief interview with Patricia Harman below, and read to the bottom to find out how to enter to win one of three signed copies of The Midwife of Hope River that she is graciously giving away!

How does Patience’s story parallel a new midwife’s integration into the provision of women’s healthcare?

In the early days in this country and even in the 1920s and 1930s there were no educational programs for midwives, no certification.  Women became midwives because they had seen a few babies born or had a few and were chosen by their community.

Now there are different pathways, you can become an RN and then get your masters in midwifery and be a CNM, Certified Nurse Midwife.  You can become a doula and after awhile become a midwife.  You can seek an apprenticeship and then take your certification exam and become a CPM or Certified Professional Midwife.

The trouble is the laws are different in all states.

What barriers do midwives continue to face in their work toward providing healthcare? How are those the same or different from the ups and downs of Patience’s story? 

The AMA, American Medical Association, was not powerful in 1930s and there were few physicians in rural areas and the slums of cities, so midwives like Patience were really needed.  Even the local family doc in Union County, Dr. Blum, was ok with Patience and Mrs. Kelly doing deliveries so long as they took care of the poor and the blacks, people he didn’t really care to serve. It is easier to get training and education as a midwife now, but there are still many barriers in many states.

What do Patience’s experiences with loneliness in her midwifery work teach midwives currently struggling with those feelings? 

Oh, I hate to think of midwives being lonely.  (Is it true?)  Email me,  I guess what I would say to those people is….find community…as Patience did in the end.

What similarities with race, class, finances, and support discussed in Midwife of Hope River do women still experience today in their access to healthcare?

Impoverished patients, the working poor without health insurance, immigrants and people of color are at the fringe of the health care system in one of the richest countries in the world.  People still make choices not to go to the doctor, the midwife, or hospital when they really need to, because they don’t have the money.  This is really wrong and needs to change, but politics, big business and misunderstanding stand in the way of a universal health care system where everyone has a right to be healthy.

What problems do midwives continue to have with compensation and accreditation in their work?

Even though midwifery is better accepted and established than in the 1970s and 80s, there are still places in the USA where midwives are not welcomed.  The established physicians see them as competitors and make it difficult for nurse midwives to get privileges in hospitals.  Many, if not most, insurance companies don’t compensate for home births.  On the other hand, there are communities, like Morgantown WV, where I live, where nurse midwives are part of the healthcare system and where most women know someone, a friend or relative, that was assisted in birth by a midwife.

What lessons of midwifery and care of women are at the core of Patience’s story?   

You don’t get to choose your labor, just like you don’t get to choose your life. You just do the best you can.

Think of all the things that happened to Patience…  She was orphaned at twelve, lost a baby at sixteen, was widowed twice, lost her mentor and surrogate mother, Mrs. Kelly, yet still she went on, trying to help others. Sometimes she felt like giving up, but she didn’t, and labor is like that.  You just take one contraction at a time and pretty soon, you have a baby.  It doesn’t help to tense up in labor or in life.  It just makes the contractions more painful.

What words of support would you share with recent graduates or new midwives? 

Keep the faith.  You know why you chose to do this.  If you haven’t written it down, do it now, so that when you feel discouraged you can get your journal out and remember.

Who is your favorite character in the book, besides midwife Patience?  

Bitsy!  I love her spunk!

What keeps sustains you in your midwifery work?

I love being around women.  I love my patients.  Everyday I have the opportunity to make someone’s life better in a little or big way.  I don’t deliver babies anymore; I do early OB and lots and lots of Gyn, but I still do what every midwife does…I empower women, teach women, give hope and give love.  Then I get to write about it…How great is that?

Patricia Harman is giving away three signed copies of her latest novel, The Midwife of Hope River! To enter into the drawing, leave a comment here or on Facebook, answering the question, “What have you learned about life through being a midwife, doula, women’s health provider, or women’s advocate?” Ms. Harman will select the winners from her favorite comments. Entry closes next Wednesday, April 24th at 5:00pm CST-USA. 

We look forward to reading your responses! And many thanks to Patricia Harman for this generous giveaway!


  1. hannah says

    As a brand new midwife I am very much aware of how much I have yet to learn and I am continually amazed by the way that the women, the community and especially my fellow midwives help me grow as a woman and a midwife. We all carry stories within us and when you listen closely, when you offer kindness and support, when you turn towards compassion and patience you can get a glimpse into the ways we are all unique…and the ways we are all the same. We come from different backgrounds and we may hold different views on things, we all have different challenges, and yet ultimately we all try to do the best we can with the resources we have. When I’m struck by the struggles of a particular woman or a particular family more often than not I find that the simple tools I can share during these times – a kind word, a gentle touch, an open heart, a safe space – are often more effective than all the book knowledge and technology we can offer.

  2. says

    I have worked in nutrition for the past 20 years. I really love the tenacity of our body human – given the right tools – whole healthy food, supplements, positive direction for our minds and hearts it can do amazing things!! woman example this each and every day!

  3. says

    I’m a doula. In 2009, just a year after I became certified, I supported my daughter during the birth of my granddaughter. As soon as she was born and was skin to skin on her mama’s breast, the midwife asked me if I would like to feel the pulsing of the umbilical cord which was still attached. I still have trouble describing how it felt for the three of us to be so completely physically, emotionally and spiritually connected for those few moments. In Celtic legends, there is a trio of maiden, mother and crone. In those brief moments, I felt the connection to my ancient ancestors and the sisterhood of the divine feminine. It was the most beautiful and enlightening experience of my life.
    Every birth I attend reminds me of that moment. It reminds me that we are all connected and every birth is sacred.

  4. colleen says

    I learned I matter. I am the only one who can make the choicesvfor myself and my body. I have a right to compassionate care.

  5. lbs says

    As, a doula, midwife, and nurse caring for women, I see following themes resonate: life can be hard, we are strong, and decisions aren’t always straightforward and clear. Women make tough decisions every day, and rarely in a vacuum; the system in which we live can be tough, and most of us act and navigate our way supported and motivated by our loved ones.

  6. M. says

    For several years, I’ve worked as a lactation consultant at our local health department. What I have found working with women on nearly a daily basis is that every woman is the same, but also different. Some women are happy to be pregnant. Others are not. Some women want to nurse their babies wholeheartedly. Others do not. I try to relate to each mother on an individual basis, hopefully, giving them a sense of support, even though we may have differing perspectives. A commonality that I do find amongst the mothers that I work with locally is a general lack of ownership over their experiences. They seem to be going through a system on small and large levels. Their health care is being handed to them as the only way. Most mothers have not thought about being proactive in their experiences instead of passive. They assume that the hospitals will take care of them with little to no effort from them. When I mention a birth plan, they are surprised. When I talk about the personality of their baby, they take a moment to process that their baby is a sentient being now. I suggest thinking about the kind of pregnancy, labor, and birth that they want to experience and writing that down to give to their birth team. So, what have I learned about life? In life, one cannot just accept things the way that they are just because that is the way it has always been or due to the fear of not being able to change a seemingly larger entity than oneself. One must ask questions. One must seek the answers to one’s questions. We must find our truths and realize them ourselves. Then, we will fully live and be able to love each other because we know and love ourselves.

  7. ecd says

    Working with female veterans, I’ve been floored at the stories of trauma, loss, grief, and struggle I’ve heard. But I’ve been astounded and am grateful to re-learn and be reminded all the time of these women’s resilience, ingenuity, and determination. All this, even in the face of a system that’s almost always stacked against them. And even in the most desperate of situations, even with the most horrifying of experiences, even while suffering tremendous pain, women are able to give me answers when I ask them “What are your strengths? In what ways are you strong? What’s helping you right now?” They can tell me. They acknowledge what they have and ask in different ways for the help they need. Breathtaking.

  8. Erin Kerr says

    I’ve learned as a doula that we as women and people (in the US?) have grown accustomed to a certain level of comfort rather than an ability to navigate difficult waters. Our culture has provided many “ways out” rather than “ways through” and it has quite an impact practically on maternal and neonatal outcomes, as well as broadly affecting our whole lives and all of the complicated things we navigate every day.

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