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The Blue Cotton Gown: A Midwife's Memoir Hardcover – October 1, 2008

125 customer reviews

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Editorial Reviews

From Publishers Weekly

A nurse midwife struggling to keep solvent the women's health clinic in Torrington, W.Va., that she ran with her surgeon husband shares poignant stories about her patients over the course of a year. A self-described former hippie who lived on a commune with her three sons, Harman later went to nursing school and became a midwife while her husband, Tom, attended medical school. Although their practice took off, they were strapped with debt, back taxes, growing bills for malpractice insurance, constant threats of lawsuits and the discovery, over the year, of Harman's freak ailments—a gangrenous gallbladder and uterine cancer requiring an immediate hysterectomy. Harman conveys the hope inspired by her patients' stories, such as the seven-time mother who never tried birth control and couldn't decide which husband to stay with, and the lesbian horticulture professor who wanted to become a man. Wearying of the financial pressures and tensions with Tom, Harman tells in this heartfelt memoir that she dreamed of leaving the practice, though a genuine love for helping women, and her great faith both in God and her spouse, sustained her. (Sept.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.


The many moving stories of the women that Patricia Harman cares for as a nurse-midwife add up to a remarkable account of a life spent listening, helping, and taking care. Inviting us into her clinic in rural West Virginia, she shows us the joys and sorrows of listening to women's stories and attending to their bodies, and she leads us through the complicated life of a healer who is profoundly shaped by her patients and their journeys. —Perri Klass, author of The Mercy Rule and Treatment Kind and Fair

"Nobody writes with more candor and compassion about women's woes and women's triumphs than nurse-midwife Patricia Harman. Her behind-the-exam-room-door memoir is a bittersweet valentine to every woman-young and old-who has ever donned that thin blue cotton gown, to every dedicated healthcare provider, and to every husband-wife medical team. I couldn't put The Blue Cotton Gown down."—Sara Pritchard, author of Crackpots and Lately

"This luminescent, ruthlessly authentic, humane, and brilliantly written account of a midwife in rough-hewn Appalachia-a passionate healer plying her art and struggling to live a life of spirit-stands as a model for all of us, doctors and patients alike, of how to offer good care."—Samuel Shem, M.D., author of The House of God, Mount Misery, and The Spirit of the Place

"Patricia Harman has opened for us a window, a glimpse into her life as a midwife and the lives of those women who have entered her exam room. And as the touch of her careful and caring hands learned the story of their bodies, into her heart they poured their life stories-stories of joy, of sorrow, those bright with promise, those dimmed with grief and pain."—Sheila Kay Adams, author of My Old True Love

"As the mother of seven children and veteran of eight pregnancy losses, I knew when I ran my bath that I would be unable to resist Patricia Harman's memoir of midwifery. What I didn't realize was that it would cause me, a sensible person, to get into the bath with one sock still on and rise from it when the candle was gone and the water cold. Utterly true and lyrical as any novel, Harman's book should be a little classic."—Jacquelyn Mitchard, author of The Deep End of the Ocean and Cage of Stars

"Patsy has the ability to put a knife in your gut, to make you long for things you have experienced and things you have not." —Penny Armstrong, co-author of A Midwife's Story

"In The Blue Cotton Gown, Patsy Harman, midwife and women's health care specialist, reveals herself as a real person-a wife and mother who has trouble sleeping, who has financial worries, who has suffered betrayal and loss, and who always runs late-someone with whom we can identify. But her faults and troubles seem inconsequential when we witness her compassion, wisdom, and good judgment in this gripping and heartwarming 'love song to women.' Through her clients' compelling stories of misfortune, survival, and triumph, Patsy Harman has composed an unromantic, down-to-earth idealization of women as told through their stories of loss and triumph." —Penny Simkin, childbirth educator, doula, and author of The Birth Partner: Everything You Need to Know to Help a Woman Through Labor

"Patricia Harman, Certified Nurse-Midwife, writes a book that tells the story of the reality of life as a midwife in private practice with her obstetrician/gynecologist husband. She also tells the stories of the women for whom she provides health care. Patsy Harman tracks her life, the lives of the women, and her periodic interaction with them through the seasons of the year. With compassion, forthright honesty, an eye for detail, and talented writing, the author draws the reader into all of their lives-the memories of whom last long after the book is finished." —Helen Varney Burst, CNM, original author of Varney's Midwifery

"The Blue Cotton Gown is a seductive read! Read it to understand the fragile thinness between the care-giver and the cared-for. Patsy Harman does not shy away from her narrative. She does not shy away from controversial topics. She grabs the reader by the literary throat." —Judy Schaefer, editor of The Poetry of Nursing

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Product Details

  • Hardcover: 296 pages
  • Publisher: Beacon Press (October 1, 2008)
  • Language: English
  • ISBN-10: 0807072893
  • ISBN-13: 978-0807072899
  • Product Dimensions: 5.8 x 1.2 x 8.8 inches
  • Shipping Weight: 1.1 pounds
  • Average Customer Review: 4.3 out of 5 stars  See all reviews (125 customer reviews)
  • Amazon Best Sellers Rank: #1,087,014 in Books (See Top 100 in Books)

More About the Author

Patricia Harman has spent over thirty years caring for women as a midwife, first as a lay-midwife, delivering babies in cabins and on communal farms in West Virginia, and later as a nurse-midwife in teaching hospitals and in a community hospital birthing center.

She spent over a decade in the sixties and seventies in her wild youth living in rural communes in Washington (Tolstoy Farm), Connecticut (The Committee for Non-Violent Action) and Minnesota (Free Folk). During the Vietnam years, she and her husband, Tom Harman, traveled the country, often hitch-hiking, as they looked for a place to settle. In 1974 they purchased a farm with a group of like-minded friends on top of a ridge in Roane County, West Virginia. Here on the commune, they built log houses, dug a pond, grew and preserved their own food and started the Growing Tree Natural Foods Cooperative.

It was during this time that Patsy attended her first home birth, more or less by accident. "Some people are destined," she has written. "I was staying at a woman friend's commune when she went into labor and I ended up delivering my first baby." Soon after, Harman traveled to Austin, Texas to train with a collective of home-birth midwives. When she returned, she became one of the founding members of The West Virginia Cooperative of Midwives. Her passion for caring for women and babies led her to become an RN as the first step in getting licensed as certified nurse midwife. In 1985, with her children, a yowling cat and her husband she traveled north, pulling a broken down trailer to begin her training at the University of Minnesota where she received her MSN in Nurse-Midwifery.

Patricia Harman still lives and works with her husband, Ob/Gyn Thomas Harman, in West Virginia.. Though she no longer attends births, she provides care for women in early pregnancy and through-out the life span. She brings to this work the same dedication and compassion she brought to obstetrics.

Customer Reviews

Most Helpful Customer Reviews

23 of 23 people found the following review helpful By Penny Armstrong on October 15, 2008
Format: Hardcover
The stories of Patsy Harmon's Blue Cotton Gown are the stories of everyone who has ever closed the door of an exam room. Yet Harmon imbues the stories with a humor, pathos and insight that make this telling unique in the writings about women's health. We end up caring what happens to Nila, Kasmar and Aran as they come in and out of Patsy's exam room and our compassion is aroused by Patsy's compassion.

Yet Patsy has the ability to put a knife in your gut, to make you long for things you have experienced and things you have not. She takes you to her green fields and lets you play among the stars, but she is also merciless when looking at her own complex relationships and her practice challenges. The only thing missing in the drama of her day to day life in Appalachia is the revenue agent charging out from behind the hills to discover that she and her husband, who is also her practice partner, have an illegal still in their office.

Practice is not easy, relationships are not easy, being a driven and compassionate mother and woman are not easy, and Patsy makes that painfully clear. You come to cheer on her thoughts of running away from it all and returning to a simpler time. If anyone who practices modern day healthcare does not share this fantasy, then they are not present to the challenges of today's practice. Patsy, more than any other writer in this time, has the skill to take us into a world where tragedy, joy and tedium mix every time the exam door closes behind another woman.
Penny Armstrong, CNM, MSN
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18 of 19 people found the following review helpful By Story Circle Book Reviews on October 10, 2008
Format: Hardcover
I think this is the bravest book I have ever read. It took me captive from the first paragraph:

I have insomnia...and I drink a little. I might as well tell you. In the middle of the night, I drink scotch when I can't sleep. Actually, I can't sleep most nights; actually, every night. Even before I stopped delivering babies, I wanted to write about the women.

And held me captive with this: the stillest part of the deep night, I sit down to write. I need to sleep...but I need to tell the stories. The stories need to be told because they are from the hearts of women; the tender, angry hearts; the broken, beautiful hearts of women.

The women. The women who bring their bodies and their souls into Harman's examining room. Who tell her their stories, which she captures for us with a rare compelling clarity and honesty. And not just their stories, but her own, as well--the story of a nurse-midwife, half of a wife-husband medical team, who is struggling to keep a small family practice afloat in the face of IRS threats, uterine cancer, a gangrenous gall bladder, and problems in her thirty-year marriage.

The Blue Cotton Gown is a compilation: a memoir of a year in the author's life, its passages interspersed with the stories of the women who visit her practice, as well as the story of the practice itself. Every part of this memoir is about women's bodies, since that is Harman's profession and her calling. There is Heather, an unmarried teenager pregnant with twins. Nila, who has already delivered seven babies and is cheerfully expecting her eighth. Holly, whose daughter is anorexic, and Trish, whose daughter kills herself with an accidental overdose.
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11 of 12 people found the following review helpful By Emily O on April 15, 2009
Format: Hardcover
Patricia Harman's memoir, The Blue Cotton Gown, was an easy read. Through the author's intimate depictions of the patients in her OB/GYN clinic, the reader is drawn into this midwife's life. At times, I felt like I was peaking through the window into someone else's life, and not just Patsy's, but the many women she describes in her story, women we not only relate to, but feel for and come to know as if they were our own friends and confidants. Patsy's account was like reading a diary, it was that personal. I did not love her writing style as much as other readers, however. I found it to be a bit choppy, and the story as a whole did not flow as well as some other memoirs I have read. Loss and Found, by Karen Flyer, for example, is a much more compelling story in terms of a plot, and the reader is propelled from chapter to chapter. With The Blue Cotton Gown, I felt at times like I was meandering from chapter to chapter. Overall, I would recommend it to anyone interested in memoirs, or the field of midwifery.
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8 of 8 people found the following review helpful By Doula Mama on February 28, 2009
Format: Hardcover
Patsy Harman's memoir starts out with a revelation about drinking in order to sleep and the restless nights spent worrying about the practice, patients, and her life. The book immediately drew me in with rich character development and the range of emotions, successes, failures, worries, and triumphs that make up all of our lives. I felt a strong connection to her - her love of her work, her connection to her clients, her relationship with her husband, and her joys and sadnesses.

Unlike other memoirs that focus on birthing and assisting laboring moms, this book delves into all of the other aspects of working with women - violence, disease, puberty, trans-identification, sexuality, pregnancy, care, drug use, birth loss, and more.

I highly recommend this book, not just to birth professionals, but to anyone who loves a good read!
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