Given that this falls into a subgenre of literary women's fiction that I flippantly call the "gynecological novel", I enjoyed it far more than I expected to. A large part of that is due to the historical setting, around WW I, which gave both urgency and context to the fairly straightforward narrative of a young woman's apprenticeship in, and practice of, midwifery, chiefly in opposition to the men around her. This is largely a story of female friendship and mutual support, though I hasten to add that there are a few sympathetic male characters, notably Dora's brothers and her eventual lover. They have, however, a relatively small part to play in comparison with the three overwhelmingly negative males who create the tension in the story: the abusive Mr. Ketch, murderer of women and of Dora's reputation; Dora's feckless and increasingly controlling husband, Archer; and, of course, the obstetrical villain of the piece, Dr. Thomas.
As a woman who, if she had ever given birth, would have undoubtedly chosen to take advantage of medical science, pain relief, and the security of an institutional setting, I find myself in an odd position when asked to sympathize unstintingly with the older, less professional, in many cases highly unscientific practices and ideology of home birth and midwifery as presented here. To navigate this problem, I fall back on my knowledge of my own profound ignorance of the realities of childbearing, but also on the reassuring notion, which I devoutly hope is true, that the stark opposition of male and female, science and superstition, pharmaceuticals and plant remedies, is moderated in our own time by some mutual understanding, in a way that it was not in 1914-1918.
I said at the beginning that I'm not a fan of the gynecological novel in general. This one, fortunately for me, was character-driven rather than obsessed (as some are) with pain, blood and the fragility of life. I enjoyed Dora's gradual coming of age as a proto-feminist; near the end of the novel she travels far from her small Nova Scotia community to a foreign but friendly women's enclave in foreign but friendly Boston, where she associates with suffragists and lesbians (and her brother Charles) before returning to home base Scots Bay and her final defeat of the interloping Doctor Thomas.
The style is transparent and unexceptionable. I wouldn't characterize the novel as having a particularly vivid sense of place in comparison with some of the other east-coast Canadian novels I've read, nor is it particularly poetic in its description, but it was enough to carry the story and the characters. In enjoyed the introduction of the expected historical milestones - the Halifax explosion, the Armistice, the Spanish flu. All in all, a quick and painless read, without benefit of chloroform.