Patience was at one time known as Elizabeth Snyder -- a showgirl, a social activist, a wife, and a mother-to-be. Now she is Patience Murphy, a midwife in Appalachia in the 1930's during the Depression in a little community called Hope River.

Patience attends the births of both rich and poor families but is rarely paid in cash for her services. Usually she's paid nothing at all or a bag of flour, a few potatoes, or some other form of food. Times are tough for everyone, but Patience gets by with a little help from her friends in the community. When she is alone, Patience worries constantly about the day her past will catch up with her and is always on guard wondering if the people coming up her driveway are in need of her services or if it's the Sheriff coming to arrest her for murder.

The novel opens with Patience attending one of the influential white residents' wife who is expected to have a stillbirth, but, to Patience's amazement, the baby is born alive. Patience has not yet had a lot of experience at being a midwife, having been just barely trained before her mentor passed away, but she is the only choice for a lot of folks since Dr. Blum, the county's white doctor refuses to birth any babies for people who cannot afford to pay him and Mrs. Potts, the negro midwife, is ill and able to attend her patients any longer.

Patience keeps a record book of all the births she attends, recording the name of the family, the baby's name and weight, who was in attendance and if there were any complications during the birth. The births she attends are as different from one another as night and day and drive this story from beginning to end. There are many obstacles that Patience must face, including opposition from certain members of the community for her services to the African Americans, but she overcomes these trials with grace and dignity.

Patricia Harman shows an adept talent for storytelling in this debut novel. Her characters are fascinating, the time- period and the social atmosphere in which the story is set is intriguing, and the tale she weaves is fast-moving, suspenseful and satisfying. THE MIDWIFE OF HOPE RIVER is a historical novel that will remain with readers long after the final page is turned.

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