The Midwife's Apprentice is narrated in third person ("she said," as opposed to "I said," which is first person), using a limited omniscient viewpoint (in which only the protagonist's thoughts and feelings are revealed). The novel is set in medieval England.
Brat, the protagonist, or main character of the novel, is a homeless, nameless young girl who might be twelve or thirteen years old (she doesn't know her exact age). Brat has no memory of her parents. For as long as she can remember, she has lived on her own, going from village to village, stealing food or working in exchange for food or a dry place to sleep. One morning, she is discovered sleeping in a warm pile of dung by the village midwife. Brat calls the midwife "Jane Sharp," because she has "a sharp nose and a sharp glance." The midwife calls her "Beetle" and takes her in to work as her servant. In return for her labor, Beetle receives scraps of food and a place to sleep. Even though the midwife is mean to Beetle (slapping Beetle and calling her names), Beetle considers her situation a step up from living on the streets and sleeping in dung. She now has work and a place to live.
Soon, Beetle befriends a stray cat that she rescues from the inhumane treatment of the village boys. Even though she doesn't know how to sing songs or speak gently to the cat, who is close to death, she feels compassion and is relieved when she realizes the cat will live. Beetle begins to give the cat scraps of food she saves from her meager meals and the cat begins to follow her wherever she goes. Later, she names the cat Purr.
Beetle continues to follow the midwife from cottage to cottage, preparing and carrying the midwife's supplies. But Beetle is never allowed to watch the midwife or to learn what the midwife is doing when she helps to deliver a baby. Because she is curious, Beetle watches covertly — looking through cracks in the windows or standing in the shadows of a room out of the midwife's sight. Beetle begins to gain some self-esteem. This becomes evident when she goes to the Saint Swithin's Day Fair for the midwife, to replenish the midwife's supplies. During the course of the day, Beetle is treated with respect. She is complimented, given a comb, and is mistaken for someone who can read. She renames herself "Alyce," and thinks that someone named Alyce could be loved.
