It is Dublin in late autumn 1918, the waning days of World War I, and nurse-midwife Julia Power is suddenly thrust into the task of managing a small ward of heavily pregnant women who have contracted the deadly influenza. Having survived influenza herself, she does not fear infection, but she worries about her lack of experience. She also worries about her shell-shocked brother with whom she shares a home. 

Two people appear to help: the intelligent but uneducated young volunteer Bridie Sweeney raised in an institution; and the legendary woman doctor Kathleen Lynn –who quietly reveals her competence and skill, even as authorities are lurking to arrest her.  

Over the course of just a few days, they encounter recalcitrant mothers, complicated deliveries, battered wives, stillbirths, and deaths. Influenza adds special dangers to the natural event, but some patients survive their ordeal. 

Although Bridie was to help for just one day, she learns quickly and returns. Julia is impressed by her diligence and drawn ever closer to her kindness and earthy wisdom. They pass a night together sharing confidences, and Julia begins to understand the physical and emotional mistreatment that Bridie suffered in the care of nuns. Their embrace awakens in Julia a yearning she had never imagined. But only hours later Bridie falls ill and succumbs rapidly to the deadly infection.

When an unwed mother suddenly dies after giving birth to a deformed child, Julia is horrified that the baby must be placed in an institution. Instead, she takes the baby home to an uncertain future but sparing the child the same horrors that Bridie once suffered. 


The title “pull (or influence) of the stars” is a reference to the origin of the word influenza –from an epidemic in fifteenth-century Italy. Its clinical stages are marked by colour changes – red, brown, blue, black. The author uses the colours as subtitles to mark the few days of her story. 

In the beautifully written prose, users of this database will find evocative portrayals of the impacts of social determinants on the health of women and children—impacts that are exaggerated in times of crisis. Men are almost incidental to the novel as it features women caring for women with female problems. 

Obstetrical scenes are accurate and detailed, as are the tenets of early twentieth-century scientific hygiene to which Julia is devoted. Religion plays a prominent but conflicted role: the Catholic nursing nuns are by times cruel; the kindly priest invested with an authority that he seems reluctant to wield.  

Like so many of Donoghue’s works, this novel is inspired by real events and informed by documents that testify to the horrors of Irish institutions. While most characters are fictional, Dr. Kathleen Lynn (1874-1955) was the real, politically engaged activist, who supported Irish independence and woman suffrage. Later she founded free clinics and a children’s hospital.  She was arrested during the 1918 epidemic and soon released to tend the sick. 



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