“Most days I wake up and say a prayer. I want, I wish, I wait for something to happen to me. While I thank God for all good things, I don’t say this verse to Him, or to Jesus or even to Mary. They are far too busy to be worrying about the affairs and wishes of my heart. No, I say my prayer more to the air than anything else, hoping it might catch on the wind and find its way to anything, to something that’s mine.”

At the outset of the novel, Dora is waiting for her life to begin. In a sense, she is teetering on the edge of her own coming-of-age story. Given that she is female and does not come from a wealthy family, she also does not feel that she possesses anything of her own, even an identity in some ways. At the start of the novel, she seeks answers and meaning in romance, but she later finds it in motherhood and in acting as a midwife to a community of women.

“‘Some babies ain’t meant for this world. All you can do is keep him safe until his angel comes.’” 

As a midwife, Miss B. doesn’t try to challenge or master nature. She accepts the inevitable truth that sometimes there is nothing she can do to prevent death and pain. Her treatments and herbs are meant to help achieve the best possible outcome in each situation. In a way, all Miss B. ever does is keep women and babies safe until their angels come, as everyone dies. Later, Miss B. accepts her own death with grace, knowing that it is inevitable.

“It’s a disgusting mess we come through to be born, the sticky-wet of blood and afterbirth, mother wailing, child crying…the helpless soft spot at the top of its head pulsing, waiting to be kissed. Our parents and teachers say it’s a miracle, but it’s not. It’s going to happen no matter what, there’s no choice in the matter. To my mind, a miracle is something that could go one way or another. The fact that something happens, when by all rights it shouldn’t, is what makes us take notice, it’s what saints are made of, it takes the breath away. How a mother comes to love her child, her caring at all for this thing that’s made her heavy, lopsided and slow, this thing that made her wish she were dead…that’s the miracle.” 

Childbirth and motherhood are major subjects in the novel, and both are central to Dora’s life. She reflects on the fact that many people, usually men, call childbirth a miracle.