Everyone knows everyone in the hills of Appalachia before WWI --- their foibles, their secret crushes, and their lineage. Most of them can climb a branch of their family tree all the way up to old man Denniker, the first white man to settle the mountain. Elizabeth Whitely, the protagonist in THE MIDWIFE'S TALE, is an exception, since she doesn't know who her father is. But at an early age, she already knows her destiny --- as a third-generation midwife.

In her youth Elizabeth follows her mother from house to house, watching and listening. She learns how important the whole family's birth history is and respects the ledgers her mother keeps --- ledgers Elizabeth herself expects to inherit. However, at the age of 17, Elizabeth learns an aspect of the midwife's job that results in her living with her grandmother, vowing never to follow the midwife's way. Before she dies, her grandmother teaches Elizabeth the arts of herbs, and after a year, Elizabeth returns to her mother's house.

Still, where love is concerned, Elizabeth is as headstrong as her mother was before her. She has fallen for Alvin Denniker, and even helping his new wife Ivy deliver a child (Lauren) doesn't sway her heart. The birth is a difficult one, though, and Elizabeth becomes Lauren's godmother and Ivy's good friend.

Influenza claims Ivy, and Elizabeth moves in to take care of grief-stricken Alvin and the motherless little girl, Lauren. She wins Lauren's devotion and the warmth of Alvin's body in bed, but she knows he'll never love her. Life settles into a routine of hard work and simple pleasures --- until young Lauren displays an uncanny power to heal. This gift unravels the family, which leads Elizabeth on a path that intersects with a truer, more mature love.

In the acknowledgements, Ms. Laskas credits the storytelling tradition of her two grandmothers. Wherever she got the talent, she's a natural. Presenting Elizabeth's story in the first person, the author quickly gains our sympathy for these unfamiliar characters. The chapters are expertly paced, with little hints of what's in store. I appreciated the mixed motives of the characters --- their stubbornness and their faults, as well as their strengths. For me, this brings them to life and makes their progress through the book more interesting and unpredictable.

Ms. Laskas salts her narrative with the vernacular of the time and place. To be pregnant becomes "getting a baby." To have diabetes is "having sugar." But like any good cook she doesn't overuse the spice, and we never doubt Elizabeth's intelligence despite the down-home expressions.

The only thing in this fine first novel that might stretch the reader's credulity is Lauren's ability to heal. However, each reader will have to decide how to deal with that. For, as Elizabeth's Mama tells her in the prologue, "Sometimes the truth isn't found in the story itself, but in the telling --- telling what you know, not just what is real." In THE MIDWIFE'S TALE, Ms. Laskas has admirably achieved this end.