The Midwife’s Apprentice was written by Karen Cushman and published in 1991 by Houghton Mifflin. A young adult historical fiction novel set in medieval England, the story follows a young unhoused girl with no ambitions or sense of belonging as she experiences kindness and learns to have confidence in herself and find her place in the world through midwifery. The book won the John Newbery Medal in 1996, an honor also given to Cushman’s 1995 novel Catherine, Called Birdy. Karen Cushman is the author of several books and anthologies for young readers, mostly in the historical fiction category.

This guide follows the 2019 Houghton Mifflin Harcourt Publishing Company hardcover edition of The Midwife’s Apprentice.

Content Warning: The source text depicts animal cruelty, difficult childbirth experiences, and pregnancy loss.

Plot Summary

The Midwife’s Apprentice follows Brat (who is also called Beetle and later Alyce), an unhoused girl who seeks a purpose in life and a place to belong. At the story’s outset, Brat—who is around 12 or 13, though she doesn’t know for sure—has lived alone for as long as she can remember, running from village to village and stealing what she needs to survive. When a severe-looking woman bids her to be on her way, Brat desperately offers to work for food. The woman—the village midwife—accepts, and after proving her worth as a chore girl, Brat becomes the midwife’s apprentice. For the next few months, Brat divides her time between running errands, assisting with births, and keeping the village boys away from a cat that Brat has taken a liking to. All the while, Brat keeps her head down and tries to remain unnoticed, typically acting by accident.

After Brat rescues one of the village boys from drowning, the villagers begin to accept her. When the midwife injures herself, Brat goes to a nearby festival in the midwife’s place, where she is fascinated by a beautiful hair comb. The merchant, noticing her interest, gives her the comb and tells her to use it on her beautiful hair, and this moment sparks a desire in Brat to be more than she is. When another festival-goer mistakes her for someone named Alyce, Brat flings away her old name and adopts the name Alyce because it feels like the name of someone worthwhile.

As Alyce, the girl finds her confidence growing, and the villagers begin to treat her less poorly. One night, Alyce and the midwife are called to a difficult birth. The midwife is sure the mother and baby will die, so she leaves Alyce while she goes to help a richer family. Using the kindness and compassion she’s learned from her new friends in the village, Alyce talks the mother down from her panic and helps deliver the baby, much to the midwife’s consternation. Sometime later, another family calls Alyce for a birth. After studying the midwife’s techniques, Alyce is sure she can handle it, but she is unable to do so without the midwife’s help.

Ashamed of her failure, Alyce leaves the village and becomes a chore girl at an inn in a nearby town. She remains there for several months as she tries and fails to overcome her feelings of inadequacy, all the while learning to read from a magister who’s staying at the inn to write a book. Through this and her successes at other tasks, Alyce begins to regrow her confidence, which is nearly shattered again when the midwife visits the inn. Alyce is sure the woman is there to berate her for failing, so she hides; instead, Alyce overhears the midwife tell the magister that Alyce ran at the first sign of difficulty, a bad quality for a midwife.

Unsure how to deal with being a failure, Alyce stays at the inn, not ready to return to the village. One night, a group of rich people arrives at the inn, one of the women in labor. Alyce is terrified, but she steps in to help with the delivery and saves the lives of both the mother and baby. Afterward, the grateful family offers her a position caring for their child, but Alyce turns it down. She knows now that being a midwife is a mix of successes and failures, and she returns to the village, willing and ready to do her best and accept her mistakes.