Reviewed by L. Bailey McDaniel

The prologue to Gretchen Moran Laskas’s novel, The Midwife’s Tale, begins with her narrator protagonist, Elizabeth, telling readers, “Mama always said that most of being a good midwife was in knowing the family history. Not just the birthing story of any given woman--although that was a good thing to keep in mind--but the whole history.” Assuming the “whole history” is a thing possible to know in the first place, a dubious aim in itself, Moran Laskas’s novel ends up reading as a sort of family history: at times exultant, heartbreaking, occasionally comic, and more than once bone-chillingly grim.

Beginning at the turn of the century and ending roughly forty years later as the Depression enters its last stages, Laskas’s novel follows the passions, failures, and triumphs of sometimes-midwife Elizabeth and the small group of mountain folk and family she shares her life with along the banks of Kettle Creek. Feeding her readers a painfully, if beautifully, detailed fare of the arduous lives endured by turn-of-the-century Appalachians, Moran Laskas serves up a novel that journeys between sorrow and triumph without ever indulging in sentimentality as her characters try to survive poverty, mountain life, a world war, an influenza epidemic, and the Depression. With image-rich descriptions of Appalachia’s natural landscape, Moran Laskas shares the stirring, at times comic, rural language of Elizabeth and the novel’s other midwives, Elizabeth’s mother and maternal grandmother, to construct a believable, if sometimes haunting world that periodically resembles a feminized utopia as much as it does an historical account of life in the mountains.

Although Moran Laskas’s primary characters are either midwives or involved with the practice of midwifery, the act of storytelling is also a constant focus of the novel. Whether articulated through intentionally shared stories and words, the ubiquitous mountain gossip, family mythology handed down like verbal heirlooms from generations past, or even the narratives involuntarily conveyed by the human form as it grows, degenerates, heals or conceives life, the sharing of stories is never far from the novel’s subject matter or its implied themes. Furthermore, this complicated significance ascribed to storytelling underscores another important facet of the novel--the power of and solidarity among its women characters. From the novel’s point of view, storytelling, in its barest form, can save a woman’s life. We quickly learn that, not unlike a hospital chart filled with family history and personal medical data, the “stories” of a woman’s female ancestors and their birthing experiences, not to mention what biological particularities are known about the woman in labor, are the most important tools a midwife can possess when “catching a baby.” But in addition to the fact that these stories are listened to and conveyed by a world of women, the sole responsibility of documenting these “histories of the body” also falls to the female half of the population. Indeed, Elizabeth’s mother, a sort of Appalachian uber midwife-cum-therapist, teaches her daughter that to get a “body [to] talk,” a little privacy, a lot of listening, and the occasional mountain herb usually does the trick. This reliance on herbal, nonwesternized medicinal practices also typifies the underlying gynocentric atmosphere of a world in which midwives who provide herbal remedies, mutual respect, and generations of experience are trusted more than the male and institutionally educated doctors found in the city.

But when, during one of their many informal midwife training sessions, Elizabeth’s mother instructs her daughter to always “Write it down...Everything,” she hints at a less obvious, if more powerful, facet of the midwives’/women’s storytelling practices. For it is not merely the possessor of knowledge who holds the power, but the subject(s) responsible for documenting and dispensing that knowledge who really hold the key to agency and empowerment. As the agents solely responsible for documenting the story, their own histories, and those of their peers, the women of The Midwife’s Tale possess an authority that can sometimes materially affect lives, for better or worse. Making the choice to withhold stories and their refrain in the documentation can also contribute to life-changing events. In addition to keeping her lifelong and invariably unrequited love for Alvin a secret (although this narrative is no secret given the nonverbal signs Elizabeth unwittingly shares in his presence), the novel’s protagonist also withholds the truth regarding the existence of her pseudo-step daughter and the latter’s supernatural healing abilities from her husband David (a marriage which occurs, somewhat implausibly and tangentially, at the end of the novel after the two share only a few hours of conversation; indeed, this hasty marriage emerges as the novel’s only weak point, even given the culturally shaped short courtship timetables within the story). The identity of Elizabeth’s father is also a story whose telling is intentionally precluded, her mother being the sole, if silent, holder of that information. But the biggest secret kept in the novel, and certainly the darkest, is the practice of infanticide or “midwife’s mercy,” whereby babies who are born but not wanted, whether because of poverty, suspicious paternity, incest, or physical deformities, are immediately killed and disposed of by the midwives and mothers. Intent to carry on in her mother’s, grandmother’s, and great-grandmother’s vocational footsteps, mid-training Elizabeth gives up the profession upon learning of this practice (tellingly, she makes her discovery accidentally when she finds the separate book her mother and grandmother keep for meticulously documenting each birth and death of these unwanted babies). Undeniably ghastly and deeply troubling, Moran Laskas deals with this practice, contested by some as factual for that particular culture and time, without engaging in romantic sentiment; instead she proceeds with frank description and an ethical detachment that effectually leaves any judgment to the reader.

Infanticide is not the only sensitive subject matter Moran Laskas interrogates. Stricken by indescribable poverty, some midwife clients seek out Elizabeth’s family for herbal remedies that will result in abortion of their unborn babies. Further underscoring the binary between a male-institutionalized medical culture and the female-headed world of alternative and natural medicine, Elizabeth’s maternal grandmother is known far and wide as an herbal healer and in addition to curing communicable and genetic disease, provides pregnancy termination to her women clients in need. Again, Moran Laskas refrains from indulging in any romantic and sensationalized language that might lead readers to a moral conclusion on her part, and instead presents the stark, often severe, realities of the characters and their decisions with honesty and neutrality.

Very early in the novel Elizabeth’s mother advises her, “Sometimes the truth isn’t found in the story itself, but in the telling--telling what you know, not just what is real.” In other words, revelation and knowledge come not only from sharing an existent story/truth, but the truth emerges in the very act of telling. And furthermore, the truth that is being told may very well be something other than what appears to be real, consequently implying a possible difference between reality and truth. While Moran Laskas is probably not hinting at a postmodern spin on the unreality of knowingness or the ultimate absence of a universal “truth,” her novel does, nevertheless, suggest a kind of nebulous and unstable relationship between the reality we are initially dealt, the choices we make, and the arguable degree of control we have over our destiny. Using Appalachian folklore, consistently rich language, and a heroine who defies sympathy or sentimentality, The Midwife’s Tale generates for its readers a story of women who face and overcome physical and emotional hurdles that would otherwise cripple the strongest among many.