The following version of this book was used to create the guide: Donoghue, Emma. The Pull of the Stars. Harper Avenue, 2020.

Donoghue divides the novel into four sections: Red, Brown, Blue, and Black which depict three days in the life of narrator, Julia Power.

In “Red,” midwife Julia goes to work at a Dublin hospital on October 31st 1918. The city is ravaged by the war and the Spanish flu, referred to as grippe. She works in the small, makeshift Fever/Maternity ward for pregnant women with grippe.

She switches off the overnight nurse, who tells her she will by herself leading the ward today, as her supervisor is needed elsewhere. Julia sees that one patient, Eileen Devine, has died overnight. She checks on Ita Noonan and Delia Garrett, the two others.

A young woman named Bridie Sweeney enters the ward. She is an unexperienced volunteer sent by Sister Luke to aid Julia, since she is alone. Julia sets her to work, noting that she learns fast and has good bedside manner.

A new patient is brought in, Mary O’Rahilly, who is 17 years old and pregnant for the first time. She is in labor, but her contractions are still very far apart.

The orderly who brought in Mary, Groyne, tells Julia what he heard about Dr. Lynn, a private practice obstetrician who will help in the hospital due to their lack of doctors. Dr. Lynn is a suffragette, socialist, and anarchist who aided the Easter Rising in 1916.

Delia suddenly enters labor prematurely. Julia sends for a doctor but they are busy. Delia gives birth to a still-born girl, with Julia’s assistance. Delia then begins hemorrhaging due to her placenta being stuck. Since there is no physician, Julia manually removes it herself, saving her life. Dr. Lynn enters the ward.

In “Brown,” Dr. Lynn commends Julia on saving Delia, gives her authority to prescribe medications, and leaves.

Later, Ita has a seizure and dies suddenly.

A new patient, Honor White enters the ward. She is unmarried and on her second illegitimate pregnancy.

The day shift is over, and Julia and Bridie leave. They discuss movies on their way out. Julia learns that Bridie boards with nuns at the motherhouse as she is an orphan who was raised in an Irish Catholic residential school.

Dr. Lynn appears and asks Julia to aid with Ita’s autopsy before she leaves. Julia helps her, and they discuss politics in Ireland. Julia calls Dr. Lynn a terrorist for the Rising. Dr. Lynn says she once felt like Julia, before she was radicalized.

Julia leaves and returns to her apartment, where she lives with her younger brother Tim, who is mute due to his trauma from serving in the war. She speaks to Tim and then sleeps.

In “Blue,” Julia wakes November 30th, Julia turns 30. Tim gives Julia a birthday gift in the morning and she returns to the ward. Bridie returns, which makes Julia happy. The night nurse, Sister Luke, tells Julia that Honor have to return to the mother-and-baby home ran by nuns where unwed pregnant women are sent, to work for a year.

Mary begins Mary pushing to give birth, but makes no progress. Julia sends Bridie to tell Lynn the baby is obstructed. Bridie returns with Police men behind her, looking to arrest Lynn. Bridie lies and says she could not find her so they leave.

A male doctor enters, suggesting a pubiotomy to saw Mary’s pubic bone in half. A nurse appears with a message from Lynn to try Walcher’s position. Julia puts Mary in the position. Mary births a girl.

Julia goes to Dr. Lynn’s office to ask her to sign the birth certificate. Dr. Lynn reveals she is sleeping in the office, hiding from the police who have no real reason to arrest her. Julia asks her why she believes in violence, and Dr. Lynn says she is not violent, but that nations are not founded any other way.

Julia returns to the ward, and Honor begins labor. Her baby is an inverted position so she struggles. Dr. Lynn appears. Honor nearly faints, and Julia donates her blood to keep Honor conscious. Honor has a dangerous transfusion reaction, but gives birth to a boy with a cleft lip. Dr. Lynn tells Julia to sleep in the nurse dormitories since she must be weak from donating blood.

The day shift is over.

In “Black,” Julia asks Bridie if she too would like to sleep in the nurse’s dormitories. They go to the dormitory and find it has been converted to the ward. Julia suggests they go to the rooftop for some air. They talk about the stars, Julia’s profession, Tim, and Bridies childhood. Bridie reveals all the abuse she suffered at the hands of the nuns in the orphanage. Bridie calls Julia beautiful and kisses her. They stay on the roof all night, kissing and talking.

In the morning, they get return to the ward for the day shift. Delia leaves, Dr. Lynn having discharged her to rest at home.

Honor White dies, the grippe and labor having put too much stress on her body.

Julia baptizes her baby, naming him Barnabas.

Bridie looks flushed, and Julia realizes she has been showing the symptoms of grippe. Bridie turns from red to brown, and Julia makes her lie in a cot and cares for her.

Lynn appears, and realizes Bridie has fluid leaking into her tissues. She tells Julia to keep treating her, and that she will be back. Julia searches for her later when Bridie worsens, and finds her being taken away by the police.

Bridie turns form blue, to black and dies.

Sister Luke returns for the night shift. Julia tells her she has decided to adopt Barnabas in honor of Bridie, to prevent him being into the pipe.

Sister Luke tries to take him to the mother-and-baby house, but Julia says she will not let the baby suffer the way Bridie was abused by the nuns.