A girl of twelve or thirteen years begins The Midwife's Apprentice without mother, name, or home. She is a stranger to soft words who has known only curses, kicks, and blows. One would need to read widely to find a heroine on the verge of womanhood with a less promising future, yet by the end of the novel she has moved far beyond the desperate struggle just to survive and become a person who knows ". . how to try and risk and fail and try again and not give up." She has put herself in position to learn everything about being a midwife—physical techniques, herbs, potions, superstitions, spells and charms—and, even more importantly, has unlocked her capacity for compassionate intelligence which will add the grace of tenderness to her future ministrations.
It was as cold and dark inside her as out in the frosty night. . . .She knew only that hunger and cold cursed her life and kept her waking and walking and working for no other reason than to stop the pain.
This is the dire poverty of circumstance facing the girl known in the beginning only as Brat. She digs herself into a village dung heap to keep warm on a gelid night and is woken in the morning by hunger pangs and the most downtrodden of the local boys who torment her with cries of '"Dung beetle! Dung beetle! Smelly old dung beetle sleeping in the dung.'" A woman comes by, scatters the taunting boys, awards Brat the new name Beetle, and meagerly feeds the starving girl in exchange for work.
This woman—"neither young nor old, neither fat nor thin with a sharp nose and sharp glance and a wimple starched into sharp pleats"—is Jane the Midwife. Jane is competent at her profession, unlike many of her peers, but she has only strong hands, clean fingernails, and the bitter memories of giving birth to six children who later died as qualifications for being a midwife. She now lacks compassion for the physical agony and mental distress of women in labor and feels little joyfulness at bringing new life into the world. This harsh woman, the only midwife in the village, is also greedy for money and goods exchanged for her services, as well as being jealous of her position in the community. She constantly haggles over her fees and twice refuses to attend laboring mothers who are unable to pay. She treats Beetle like a lackwit drudge, giving her heavy work, scant food, no encouragement, and much dispiriting abuse.
Beetle soon finds herself doing much of the tedious "collecting and stewing and brewing" that are necessary to prepare the midwife's potions and ointments. The villagers begin to call Beetle the midwife's apprentice, though this does not stop them from taking out their frustrations at Jane's greed on her helpless helper. Beetle has one companion to confide in, a loyal listener who cannot give advice. This comforting companion is an abused cat the girl rescued from a pond where it was thrown by cruel village boys in a sack with an eel; upon recovering, the cat bonded with Beetle. Whenever she is faced with an especially trying situation, Beetle seeks solace from the affectionate Purr.
By this early point in the novel, Cushman has established the essential traits of her two chief characters, and it is apparent that there are critical differences between them. Jane the Midwife is too hardened by past rigors and crippled by a cheerless heart to grow as an individual. Beetle, though stunted by an unloved and rootless life, has youthful energy,...
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a resilient spirit, a latent capacity to learn, and buried reserves of compassion for living creatures—as proven by her first friend the cat. She has for the first time a ground of precarious stability on which she can fight to become the person it is in her nature to be. Beetle's struggling growth towards realized potential now begins as she meets new people and faces various testing situations. These encounters—even those that result in feelings of hurt, failure, and futility—each contribute a little bit to her personal growth.
Even though Jane for a long time excludes Beetle from being present at actual deliveries, the girl can't help but witness her first birth when the weaver's daughter goes into labor in a field and has her baby there on clean straw. Beetle learns from this that being a midwife is "as much about hard work and good sense and comfrey tonic as spells and magic." The first indoor birth she sees is a sobering experience. Beetle is brought to attend to the miller's wife only because Jane is having an amorous tryst with the married baker. Beetle has discovered their secret and been bullied into silence. Since Jane is temporarily unavailable the girl will have to do. Unfortunately, the miller's wife gets so upset at Beetle's innocent ignorance of birthing technique that she throws all within reach at the terrified girl. The overheated midwife finally shows up and delivers the baby, but not before Beetle has hidden in the shadows to escape the agitated pair. This incident makes Beetle work twice as hard, both out of fear of the midwife and a dawning awareness of how little she really knows about childbirth and adult life.
Other learning experiences follow which result in a new name and a changed outlook for the midwife's apprentice. Jane breaks her ankle just before she is to go to the Saint Swithin's Day Fair to lay in midwifery supplies, and Beetle must go in her stead. She finds the fair a delightful medley of pennants, gaudy booths, exotic goods from distant lands, puppets, and soothsayers. The merchant from whom she must purchase the goods has a wooden comb with a cat carved on it amidst his wares. Beetle falls in love with the comb, and the merchant, sensing this, gives her both the comb and the first compliment on her looks she has ever received. Stimulated by the gift and the praise, she is surprised when a fairgoer hails her as Alyce, a girl he knows who can read; she immediately transfers the name to herself. "Alyce" begins to attain a measure of self-esteem, as she now knows her personality and appearance can please others. She is also aware for the first time that the ability to read confers value on its possessor. This nascent sense of self-worth is increased when she saves Will Russet, one of the village boys who used to plague her so, from drowning in the river. He turns from foe to friend, and the bond is made stronger when Alyce helps his cow deliver twin calves. She realizes after this that all creatures in labor gentled to calmness stand a far greater chance of easy delivery.
This understanding helps her deliver a baby for the first time. The bailiff's wife is having a very difficult labor, and Jane is convinced that the baby will die before it is born; she goes off to the Manor to collect a fee for delivering of Lady Agnes, leaving Alyce to deal with the desperate woman as best she can. Alyce, with the gentleness drawn out by recent experiences, so soothes and eases the pain wracked woman that she is able to have her child. This success encourages Alyce to steal into the shadows of each room the midwife is called into so she can learn the art of midwifery. Just after this she saves a little boy from the cold and then rescues him from bullying boys. She names him Edward after the current king of England before sending him to the Manor House to seek lodging and work. This confirms that her compassionate nature is now a vital force in her apprehension of the world and the decisions she makes from what she sees.
Alyce then suffers a humiliating crisis of confidence when she is unable to deliver a woman's child, which is finally brought forth by Jane. Alyce feels such a failure that she knows "only to run away." Purr follows the only kind person he knows. The next morning she reaches the inn at the crossroads where the innkeeper's wife, " the round and rosy Jennet," takes her in to board and work. Alyce is completely despondent over her failure till she meets Magister Reese, a scholar compiling an encyclopedia of knowledge. He senses that the girl who sweeps the floor near where he nightly dines is shy, lonely, and despairing, though not without intelligence. Magister Reese knows that he will not be able to talk to Alyce directly, so he starts to "teach" Purr the the alphabet. Alyce listens carefully as he explains the letters, and she is fascinated by the shapes they make.
She goes over at night what she has heard by day; between her daily chores she practices the letters by scratching them in morning frost and scraping them into the chimney soot. Magister Reese moves on to words, often reading arcana from his compendium. Alyce is not only learning to read, she is expanding her base of knowledge. The day comes when the scholar asks, '"And what, inn girl, do you want?'" Alyce spends the whole afternoon pondering this question before she responds: "I know what I want. A full belly, a contented heart, and a place in the world.'" The girl still feels a failure, but her confidence is slowly returning, spurred on by the unexpected acquisition of a new discipline and skill.
The midwife shows up at the inn unexpectedly, encounters Magister Reese, and tells him much esoteric midwife lore which he carefully notes in his encyclopedia. Alyce is disturbed by Jane's presence but is overcome with curiosity. She approaches the table where the two are conversing and hears the midwife ask the scholar if he has seen her strayed apprentice, who gave up because she failed once. The seed of reclaiming her former position is planted in Alyce's mind. Her lingering trepidation is swept away after she delivers the baby of a woman who is forced to stop at the inn. Alyce now realizes that she has a calling and purpose in life if she will only sieze it; being a midwife's apprentice is her place in the world and nothing else can give her what she wants and needs. She returns to the village where Jane first refuses to take her back. Alyce falters but then regains resolve to master her fear of failure. She insists Jane take her back because she now knows how to live with failure. "The door opened. Alyce went in. And the cat went with her."