READERS GUIDE

Introduction

Kettle Valley, West Virginia, may appear to be a quiet and simple place—women sit on front porches and quilt, men work in the coal mines, children wade in the creek—but it is also a world of secrets and mystery. As the mountains themselves protect the world within them, so does fourth-generation midwife Elizabeth Whitely keep hidden the darker side of the world she has helped to bring into being.

In The Midwife’s Tale, Gretchen Moran Laskas offers us a glimpse into the not-so-distant past of Appalachia between the World Wars. A time of grassroots change and dramatic scientific advances, this was an era where many people felt caught in the middle, struggling to understand modern medicine, automobiles, telephones, and airplanes, while still remembering their traditional ways and wisdom handed down from one generation to the next. Drawn from stories collected from her own family and others, The Midwife’s Tale is a story of “complicated romance, hard wisdom, enduring loyalties and the miracles one person can bring to another” (Robert Morgan, author of Gap Creek).

Alive with characters confronting their own pasts, presents, and futures, The Midwife’s Tale is a poignant and original literary debut, asking questions about where we came from, and where we are going next.

Questions and Topics for Discussion

1. When Elizabeth first learns from her mother about the little red book, did she respond appropriately? How might we respond differently, many decades later? How would we respond in ways similar to Elizabeth’s mother and grandmother—that this was simply part of what it meant to be a midwife?

2. Elizabeth often seems to be caught in the middle of the people she loves—between her mother and grandmother, between Alvin and Ivy, and later Alvin and Lauren. How does this role of “in between” develop her as a character? Did she seem to have more choices or less, by seeing both sides?

3. Elizabeth comes from a long line of midwives. What role did the multigenerational aspect of the novel play? Was the knowledge and understanding of history a beneficial aspect of Elizabeth’s life, or something that caused her more burdens?

4. The friendship between Elizabeth and Ivy would seem a very strange one. Did you feel that it was genuine on both sides? Given her mother’s disapproval at the beginning, do you think this friendship was something she shared with her mother, or something she kept to herself?

5. Although Elizabeth has many chances to leave Kettle Valley in the novel, she never travels more than a short distance from her home. How does this affect her life and the choices that she makes? What emotions do you think kept her from making the decision to leave?

6. Many family secrets are told in this novel. What is the significance of these stories? Did you see them as gossip or oral history? Is there a difference between the two? Why do you think Elizabeth is telling us her own story?

7. When Elizabeth learns that she is unable to have children, she is naturally devastated. How else did it change the way she saw herself and her relationship to those around her? Was it important that this knowledge came in the middle of the book?

8. What, if anything, do the men in Elizabeth’s life have in common with each other? What was it that attracted her to them, and why did each relationship seem to end so sadly? Do you think that Elizabeth would have learned to love David Newland without Lauren?

9. Different forms of healing play a large role in this novel. Given that more women than ever are having babies with midwives or seeking alternative forms of healing, what do you think that medicine today has learned from the past? Did you find the notion of miracles a viable form of healing? What impact does one’s spirituality have on one’s health?

10. This novel does not have an epigraph at the beginning—a bit of poetic verse or a quotation from a book or speech. If you could give the book an epigraph, which one would you choose and why?

11. What kind of life do you imagine Elizabeth having after the book has ended? Do you believe she continues to practice some midwifery? What sort of mother is she likely to be to her children?