1. The Midwife’s Confession is also a story about deep and abiding friendships between women. What would you say is the ultimate take-away message about friendship?

2. How was Sam attracted to two women as different as Tara and Noelle?

3. Tara and Emerson are very different personalities but they are best friends. What keeps them together?

4. Imagine yourself in Noelle’s place when she learns that Emerson is her sister. Would you be able to keep that to yourself for 2 decades?

5. Why did Noelle choose to become a gestational surrogate.　 Why did she choose this particular path to atonement? Why didn’t she have children of her own?

6. Noelle lived not just one lie, but man. What must it be like to keep your most significant parts of your life a secret?

7. What Ian learns about her surrogacy, he says "It must have been so lonely, being Noelle." Do you think Noelle was lonely and if so, were there ways that she compensated for that loneliness?

8. Tara learns that her missing daughter is ot her biological daughter and at the same time realizes that her biological daughter is dead. What does she learn about herself as a mother in those moments?

9. Noelle is a powerful woman even from the grave. Every character has been hurt by her in some way. Why do you think Tara and Emerson make peace with Noelle’s actions?

* Some questions from Great Thoughts.