In this novel of a young girl's determination to discover a place, or niche, for herself in the world, Cushman has concentrated on two universal themes — the search for identity and a sense of belonging and perseverance in the midst of adversity.
Throughout The Midwife's Apprentice, Alyce is on a personal journey to discover who she is and where she belongs. At the start of the novel, Alyce is alone. She has nothing but the clothes on her back. She is mocked and tormented by the bullies in the village. Alyce has no place to go to get away from the bullies and no one to protect her. She is ostracized from "normal" day-to-day activities because she is different — she is homeless and nameless. As Alyce begins to work as the midwife's apprentice, she begins to talk to people and to listen. She realizes that she is not "stupid." She watches the midwife and learns about the uses of herbs. The people in the village begin to respect her opinion and to ask her advice. She learns how to speak in a comforting voice after listening to Will as he delivers calves. She realizes that she is worthy of love when a merchant at the fair tells her so. And, she learns what it feels like to smile and to sing.
Alyce learns what she likes and dislikes, what is important to her and what isn't. For example, she knows that she prefers Will's gentle voice to the midwife's screaming and yelling. Alyce realizes she is not stupid when she learns to read while working at the inn. Alyce really sees herself for the first time after she has taken a bath with soap. She becomes aware of all that she can be and she knows that she can be a good midwife's apprentice. When she returns to the midwife after running away and working at the inn, Alyce is self-confident. She has discovered her identity after much thinking and soul searching. Even though it has not been an easy journey, she now knows who she is, what she wants, and where she belongs.
Cushman's belief in perseverance despite obstacles or challenges that arise throughout life is another major theme. After Alyce is unable to deliver a baby, she gives up and runs away. She tells herself over and over again that she is a failure. Consequently, she truly believes she is a failure, incapable of being the midwife's apprentice. Will shows up at the inn and tells Alyce in a friendly way that she is not a failure, that she can't be expected to know everything. The midwife also visits the inn and comments that she needs an apprentice who doesn't give up.
After successfully delivering a baby at the inn, Alyce gains self-confidence and returns to the village, determined to work as the midwife's apprentice. Cushman reiterates the importance of perseverance as Alyce tells the midwife that, "I know how to try and risk and fail and try again and not give up."
Cushman exposes readers to the universality of an individual's search for his or her own place in the world, illustrating to her readers that they are not alone in their search. She writes about persevering when faced with life's challenges, showing that everyone falls down, but the people who get up, dust themselves off, and try again are the people who find their niche in the world.