Labor

Joy grows impatient with the progress of her labor. While Lovie watches over Joy like a mother hen, Kenny invites the narrator to gather eggs from his chickens. Lovie shares her view of the midwife's role at a home birth and explains why Joy's labor is taking some time. As in the previous chapter, this chapter includes first-person accounts by Lovie: in this case, reflections on how labor tends to proceed for a woman who has several small children, and how Lovie supports a woman though labor. Joy tries to explain to the narrator what a contraction feels like. Joy confides her fear that the baby could be breech, and Lovie asks her if she’s ever had an episiotomy.

The Call

A middle-of-the-night call finally summons Lovie and the narrator to the birth of Joy and Kenny’s fourth child. The narrator drives Lovie to Joy and Kenny's house in Pantego, where it becomes clear that Lovie is not only completely in control of the situation, but that she is also doing some things for the narrator’s benefit and the benefit of posterity. A sleepless night passes. Interspersed throughout the chapter are first-person accounts by Lovie as she reflects on past deliveries, her practice and habits, and her philosophy of birth and midwifery.

You Run into All Sorts of Things

Lovie talks about prenatal screening and how she only ever took on a woman expected to have a low-risk delivery. She also discusses trying to avoid first-time mothers, as they weren’t “nature-measured.” Lovie describes how she handled problem situations on the job, including a woman outside of Washington who developed convulsions due to extremely high blood pressure with the onset of labor. She also tells the story of transferring one woman from Aurora to the hospital due to an antepartum hemorrhage. The chapter concludes with her discussing the variety of ways a baby can been born breech, and how she handled a number of breech births, including one particularly memorable one in Campbells Creek. She also discusses how her training with Margaret Myles would come back to her in problem situations.

Receiving

Lovie’s health declines as Joy’s due date approaches. Members of the visitation committee at Lovie’s church stop by to cheer her, and Lovie must struggle with her antipathy towards being on the receiving end of good deeds. Yarger reflects on the challenges of doing documentary fieldwork with an evangelical Christian who sees her as a mentee, someone to be witnessed to. Lovie explains “dropping,” when a baby sinks lower in the uterus prior to the onset of labor. Yarger tries to figure out just when to join Lovie so as not to miss the birth and finally drives out 13 days before Joy's due date to be on the safe side.

Up to My Neck in Deliveries

Lovie’s marriage takes her to the North Carolina town of Washington, where she takes a job with the Beaufort County Health Department and starts attending home births on the side. Lovie describes working under the granny law, given that North Carolina had no law at the time to regulate the practice of nurse-midwifery. At her job, she faces opposition from nursing colleagues prejudiced against midwifery who claim she is taking their profession “back to the dark ages.” Her prejudices against hospital births deepen after she has two babies at home and two in the hospital. This chapter also discusses Lovie’s departure from the health department in 1957 to embark on a solo home birth practice and chronicles the death of her husband, Marshall Shelton.

I’m Doing This for Joy

Lovie and narrator Lisa Yarger visit Joy and Kenny Mitchell in their Pantego (Beaufort County) home. Lovie gives Joy a prenatal exam (seemingly for Yarger’s benefit) and explains some of her requirements for a home birth. The Mitchells invite Yarger to accompany Lovie to the birth of their fourth child two months later.

Prologue

At Christmas time, the narrator visits the Alte Pinakothek in Munich and stands before a triptych by Jan Joest van Kalkar, contemplating why this particular Nativity brings midwife Lovie Shelton to mind.

Epilogue

The narrator reflects on her initial attraction to Lovie and her desire to fix Lovie in time, as an unchanging character. The narrator also contemplates the role Lovie played at a particularly challenging period of the narrator’s life. The epilogue chronicles the contact between Lovie and the narrator after the latter’s move to Munich up until Lovie’s death in 2013. The narrator explores the advantages and disadvantages of the book having taken so long to complete, with a particular focus on Lovie’s tendency to perform her role as midwife and Yarger’s frequent inability to recognize the significance of Lovie’s performances. The epilogue also explores possible conflicts between Lovie and the narrator’s agendas and discusses Michael Frisch’s concept of a shared authority. The epilogue also provides more context for Lovie and Yarger’s earlier disagreement about biracial babies; the narrator concludes that she is not the non-racist white person she thought herself previously, that she, too, carries racist patterns. She concludes that she and Lovie are both good white women who have clean-up work to do when it comes to racism.

Revelations

Lovie’s spirits plummet when forced to cancel her remaining scheduled deliveries after having hip replacement surgery. She and the narrator continue to try to make sense of their spiritual differences. After the narrator marries a non-practicing Jew, Lovie temporarily ramps up her evangelizing but eventually seems to accept the narrator’s resistance to being pinned down. Lovie leaves the door open for more deliveries, then experiences a devastating house fire that forces her to move in with her daughter. She continues to revisit her past through storytelling, but it is not clear where this process will ultimately lead her. Struggling with health issues and depression, she hints at her readiness for the narrator to wrap up her research. The narrator ponders her responsibility to Lovie and how she has possibly contributed to Lovie’s exhaustion by stretching out the documentary fieldwork phase of the book project.

Walking a Chalk Line

This chapter describes how midwife-attended home births declined dramatically as poor and minority women gain access to hospital birth with the Civil Rights Act of 1964 and the advent of Medicaid in 1965. With her clientele dwindling, Lovie returns to work at the Beaufort County Health Department, where she butts heads with a new generation of health officials not as supportive of her nurse-midwifery work as the previous generation had been and who expect her to adhere strictly to the letter of the granny law. Although Lovie employed a dual bag strategy to skirt the law, she maintains that she always strictly followed proper bag technique. She discusses problems she encountered with the health officer of Pitt County, problems that led her to deliver a handful of Pitt County women in her Beaufort County home.