Chapter One
“Worth a Long Walk to See”

September 23, 1873. Jean Rio delivers the Ayer baby girl at five-fifteen p.m., after a relatively easy labor, and the mother sleeps quietly for the next several hours. “Had a good night,” Jean Rio records in her midwife’s notebook. (“The baby grows nicely [and] all seemed to enjoy themselves,” she notes nearly a month later, after the mother brings the newborn and the rest of her children to pay a visit.)

It is not always as easy as it might seem. Even the uncomplicated births like Mrs. Ayer’s are trials, the mother usually moaning and screaming in desperation through a long, painful labor to the final agony and then the sudden release of delivery. Often there are tests and horrors Jean Rio must face and somehow cope with, using only her hands and her self-taught skills, experience, and inherent fortitude—hemorrhaging or mortally ill mothers; distressed, deformed, or stillborn babies—a bloody life-and-death struggle no less of a test than any battle faced by a man.

When she cleans up afterward, changing one plain dress—now stained—for another, washing the blood and afterbirth from her hands and arms, she removes her rings, a fine gold band and an exquisite small sapphire set in platinum. They are hardly the rings of a hardworking midwife on the raw California frontier of the late nineteenth century. She might seem a plain, even ordinary, woman of her time and place. But the unexpected grace and beauty of the rings match her own dignity and gentility. The rings signal that she is something other than an ordinary woman.

In her diary entry for October 23, she all...