Hagar hustles Miriam and Fern into Hagar’s house and orders Holly taken to a cramped back bedroom. Hagar strips away her mother’s quilt and sheets, leaving Holly on the bare mattress. While Hagar boils water in a galvanized pot, Miriam and Fern undress Holly and prepare for the delivery.

Hagar refuses Fern’s suggestion to shave Holly and instead has Miriam teach Fern and Zinnia a meticulous hand-washing routine that feels like a ritual. Back in the bedroom, Holly is positioned sitting and braced for labor, and Hagar assigns Fern and Zinnia to support Holly at her shoulders and back while Hagar and Miriam work between Holly’s legs. Holly is terrified and in pain, especially in her back, so Hagar forces Fern and Zinnia to press hard at Holly’s tailbone as Holly begins pushing through contractions.

Hours pass in exhausting waves: Hagar coaches Holly to breathe and bear down in counted pushes; Fern fetches water and steaming rags from the kitchen to clean Holly and keep her hydrated. Holly repeatedly begs to stop and fears she is dying, while Fern feels helpless and increasingly panicked at how long and brutal the labor has become. Eventually the baby descends; Hagar and Miriam tighten their focus and demand Holly push “low,” but Holly’s strength falters.

The baby’s head crowns and comes out, but then the progress stops; the baby’s face darkens from red to purple to black as Holly cannot push and her body locks up. Miriam identifies a “shoulder” problem, and Hagar orders Fern to get down to the foot of the bed and help reposition Holly. Realizing the baby will die if they do nothing, Hagar insists they turn Holly onto hands and knees despite Holly’s frantic protests.

To get Holly to move, Zinnia pushes a fierce “wolf” image that helps Holly find aggression and breath. Working together, Hagar, Zinnia, Fern, and Miriam flip Holly onto all fours; Miriam and Fern assist at the baby’s head while Hagar and Zinnia keep Holly howling and pushing. With a final shift, the baby slides free—apparently limp and dead—still connected by a long streamer of tissue.

Miriam immediately resuscitates the baby by clearing an obstruction and giving breaths. The baby’s body jerks, turns pink, and begins to cry, and Miriam places the newborn girl on Holly’s chest. Holly holds her wailing baby, while Fern, overwhelmed by the raw reality and miracle of birth, collapses against the wall as the cries fill the room.