Arms Wide Open: A Midwife’s Journey by Patsy Harman — 324 pgs

Patsy Harman has led a very unusual life. In her twenties and thirties, she lived in the backwoods of Appalachia with her lover Stacy and their young son Mica. As self-proclaimed hippies, Patsy and her band of friends eat organically, protest environmental pollution and attend demonstrations against the Vietnam war. Living out in the deep woods of Minnesota, the small family lives simply, without electricity, indoor plumbing or running water. They grow and tend a subsidence garden and fill the chinks in their cabin by hand. But life out in the wilderness away from everyone eventually proves too hard for Patsy, so she leaves her son and lover on the homestead and begins to travel. When she finally ends up living in an intended community, Patsy finds that she’s far happier and falls in love with Tom, one of the community’s residents.

Life is hard out in the woods, but with many pairs of hands to help with the raising of children and the supporting of the commune, Patsy finds peace. That is, until one by one the commune’s residents begin moving away, either to their own farms or to the wider city. With the mass exodus of the commune’s residents, Patsy finds herself alone with Tom and their two boys and she’s not happy about it. Having been present as a birth aid for may of the rural women of the area, Patsy soon decides to take a chance and become a midwife. As she travels from residence to residence delivering babies, Patsy discovers she has a talent for the work and a love and respect for the women she meets. This leads her to discover that she would like to be a midwife in a more professional capacity so she begins to study nursing, alongside her husband Tom, who is studying to become a paramedic.

Fast forward about 30 years to 2009. After Tom and Patsy have opened up their own practice specializing in pelvic pain patients, things begin to become rocky, not only with their practice but with their marriage. The life they’re living is a far cry from their past, and soon Patsy must once again reinvent herself. She must also help her husband work through some crippling allegations that have been made against him. But above it all, she remains the same peace-seeking and caring woman, capable of helping women in many ways, leading others to brand her as “the wise woman.” This is Patsy’s story, from her humble days working the land and protesting the Vietnam War to the more comfortable yet sometimes difficult journey through the modern world. It’s a memoir that won’t soon be forgotten.

When the book opens, Patsy is describing life on the homestead with her lover Stacy and their infant son Mica. The winter is coming and they have only a short amount of time to chink their cabin against the frigid temperatures. Patsy is unhappy with the endless toil required to keep her family fed and safe, but Stacy doesn’t see the reason why Patsy is so unhappy. Her hours are filled with gardening and the boiling of cloth diapers, repairing the house and cooking meals for her family. Life is demanding in this environment, and Stacy isn’t one who is easy to communicate with. Patsy tries to explain that she would rather live in an intended community, but Stacy doesn’t see her point. He’s rooted to this cabin and refuses to leave. I could feel Patsy’s dissatisfaction and see that she wanted more than a rural life had to offer. The constant pressure of being all alone with her small family, miles away from civilization, was something that Patsy just couldn’t deal with. I can’t imagine what life must have been like for her. In a way, I idealized the life Patsy was living, for often I’ve thought what a joy it would be to be isolated in a cabin in the woods. But reading about the reality of backbreaking toil every day, with no one to call on for help, opened my eyes about the life of a rural woman far from civilization. Patsy longs to be part of the peaceful movement to stop the war and to live sustainably, and I think this is partly what drove her to leave her family and travel, along with her need for community. She didn’t stay away for long though, and eventually, finding herself among an intended community, she decides that this is the lifestyle for her. Eventually Stacy and their son join her, but her relationship with Stacy has ended and she’s now married to Tom. Living in a huge farmhouse with a handful of others is what Patsy had been hoping for, and she relishes the time spent with the others and the sharing of responsibility for the land and the homestead.

Soon Patsy is travelling all over Appalachia to help women give birth, and it’s clear that this is what she’s meant to be doing. Patsy delivers hundreds of babies naturally from the comfort of the mother’s homes, and as she lovingly describes the births she attends, she elucidates on the differences between each delivery, both the effortless and the difficult. I had thought that these would be my favorite sections of the book, but in reality, I found the entirety of Patsy’s journey to be fascinating. It’s so markedly different from the way I live, and reading her anecdotes of discovering a wild bear in her yard or being stricken with intestinal worms was just as interesting as hearing about the delicacies of an unusually difficult birth. I never tired of reading about Patsy’s life and found myself admiring her for not only her ideals, but for her tenacity and grace as well.

In the third section of the book, Patsy and Tom are leading an altogether different life. Living in a spacious and luxurious home, they are both deeply involved with the reproductive care of the women they treat. Patsy is no longer a midwife due to broader restrictions and unexpected changes in the field, but she’s still able to counsel women and help them at her husband’s practice. She now has three grown sons who have left the nest and started families of their own, and she has become careworn and anxious. In a way, I believe Patsy’s worries were influenced by her living a life where she now had so much more to lose. Having left the security of the land and her other companions long behind, she must again rely on herself in a world that’s more dangerous and corporate-minded than the one she lived in years ago. Though she is much changed, she reflects back on her time as a midwife in Appalachia and comes to accept that, though she is not birthing babies anymore, her work with women is just as important, if somewhat less satisfying to her. Unable to help Tom during his crisis, Patsy becomes afraid and despondent, eventually cornering Tom and trying to work things out. It’s with both a sense of joy for the new resolutions that she shares with Tom and an underlying sadness for all that has changed that Patsy begins to look forward again, into the face of the unknown.

I found this book to be remarkably compelling. Reading about Patsy’s life out in the wilderness was both interesting and enlightening in a way I didn’t expect. Much of what Patsy went through will be unfamiliar to readers who sit comfortably in their houses with every luxury at their fingertips, but sharing in the journey of a woman who has lived a very unconventional life should prove to be edifying in many ways. This is not a book that tells a heartwarming and easy story. Often the life we are invited to look into is full of hardship and heartache, but it’s a story told with an unusual sense of urgency about a lifestyle that is slowly becoming obsolete. It’s a book that I think will speak to the hearts of women everywhere, despite their very different circumstances. Highly recommended.

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This book was provided as a complimentary review copy.