The Midwife by Tricia Cresswell

This is an historical novel which is steeped in mystery, as well as the hard realities of childbirth and women’s position in society in the 1840s. Set in two locations, Northumberland’s Alnwick with its small town society, and London in both its fashionable and desperate areas, it tells two stories. One is of a woman, discovered on a moor, without a single thing to identify her, even to herself. The other is of a young, increasingly fashionable physician who specialises in pregnancy and childbirth, when both could be dangerous for even the healthiest and wealthiest women. The woman has no memories, but can deliver a baby and care for the wounded and ill with a rare skill. Dr Borthwick is a man-midwife, an accoucheur, who adopts methods of safely delivering babies that are in conflict with the established physicians of the day. 

This is a brilliantly researched book on so many fronts. The medical details seem accurate to this non specialist, and from delivering babies in one room shacks with the dirt of ages through to the bedrooms of the rich, the descriptions are convincing. The settings are also vivid – desperately poor farmhouses, dubious “clinics” and the over-decorated rooms of the rich and aspiring are all visualised for the reader in such detail. The narrative is never interrupted for a description or factual statement; like other readers I have found that it flows so smoothly that this book is almost impossible to put down. Both characters are aware of their clothing as giving an impression, and in the case of the mysterious woman, it seems to give her a name as she becomes Joanna, named by the woman Mary who helps to save her life. Her dirty and inadequate clothing will be replaced as she helps a man and his wife who creates a dress for her that suggests that she can make a real difference in people’s lives as she treats them. 

This is a book that works on so many levels. It has so much to say about the different ways that people live, in absolute poverty, disease and without hope, alongside those who live in such fashionable areas and social circles that reputation is all that is needed to gain success. It looks at the lack of medical knowledge of the time which meant that women and babies’ lives were at such risk from basic factors, compared with today. Other illnesses could only be tackled with simple remedies and almost instinctive care. This is also a book of sensitively and brilliantly descriptive characters who react in such understandable ways, from Mrs Bates, Dr Borthwick’s assistant who knows her work but can also show sympathy in surprising ways, to the strong minded women Dr Borthwick encounters who are determined to improve the lot of women throughout society. While there are mysteries at the heart of this book, there are also so many points of clearly described story that it is a fascinating novel to read. I greatly enjoyed this book, aware of the grim realities it presented, but also moved by the actions and reactions of the characters it features. It is a beautifully written novel of place, of people and so much more; I thoroughly recommend it to all those who enjoy historical fiction.