Patricia Harman has spent over thirty years caring for women as a midwife, first as a lay-midwife, delivering babies in cabins and on communal farms in West Virginia, and later as a nurse-midwife in teaching hospitals and on the faculty at Ohio State University, Case Western Reserve University and West Virginia University. She is the author of two acclaimed memoirs and now she is also the author of a brilliant debut novel, The Midwife of Hope River. The Midwife of Hope River centers on Patience Murphy, a lay midwife in Appalachia during the Great Depression. Patience has a gift: to escort mothers through the challenges of birth, bringing children into the world. Working in the hardscrabble conditions of Appalachia during the Depression, Patience takes the jobs that no one else wants, helping those most in need—and least likely to pay. She knows a successful midwife practice must be built on a foundation of openness and trust, but the secrets Patience is keeping are far too intimate and fragile for her to ever let anyone in. Honest, moving, and beautifully detailed, The Midwife of Hope River beats with authenticity as Patience faces nearly insurmountable difficulties. From the dangerous mines of West Virginia to the terrifying attentions of the Ku Klux Klan, Patience must strive to bring new life into the world. Partially inspired by her own experiences, Harman proves she is a remarkable new voice in American fiction.