Midwife Patience Murphy has a gift: a talent for escorting mothers through the challenges of bringing children into the world. Working in the hardscrabble conditions of Appalachia during the Depression, Patience takes the jobs that no one else wants, helping those most in need - and least likely to pay. She knows a successful midwifery practice must be built on a foundation of openness and trust - but the secrets Patience is keeping are far too intimate and fragile for her to ever let anyone in.

The Birth House is the story of Dora Rare, the first daughter to be born in five generations of Rares. As a child in an isolated village in Nova Scotia, she is drawn to Miss Babineau, an outspoken Acadian midwife with a gift for healing. Dora becomes Miss B.’s apprentice, and together they help the women of Scots Bay through infertility, difficult labours, breech births, unwanted pregnancies and even unfulfilling sex lives.

Reluctant midwife Emma Trimpany is just 17 when she assists at the harrowing birth of the Dionne quintuplets: five tiny miracles born to French farmers in hardscrabble Northern Ontario in 1934. Emma cares for them through their perilous first days, and when the government decides to remove the babies from their francophone parents, making them wards of the British king, Emma signs on as their nurse.

In 1950s Quebec, French and English tolerate each other with precarious civility - much like Maggie Hughes' parents. Maggie's English-speaking father has ambitions for his daughter that don't include marriage to the poor French boy on the next farm over. But Maggie's heart is captured by Gabriel Phénix. When she becomes pregnant at 15, her parents force her to give baby Elodie up for adoption and get her life "back on track".

At 97 years old, Winnifred Ellis knows she doesn’t have much time left, and it is almost a relief to realize that once she is gone, the truth about her shameful past will die with her. But when her great-grandson Jamie, the spitting image of her dear late husband, asks about his family tree, Winnifred can’t lie any longer, even if it means breaking a promise she made so long ago....