At the age of sixteen, Paulina leaves her small village in western Kenya to join her new husband, Martin, in the bustling city of Nairobi. It is 1956, and Kenya is in the final days of the "Emergency", as the British seek to suppress violent anti-colonial revolts.

But Paulina knows little about city life, or about marriage, and Martin's clumsy attempts to control her soon lead to a relationship filled with silences, misunderstandings, and unfulfilled expectations. Soon Paulina's inability to bear a child effectively banishes her from the confines of traditional women's roles. As her country at last moves toward independence, Paulina manages to achieve a kind of independence as well: She accepts a job that will require her to live separately from her husband, and she has an affair that leads to the birth of her first child. But Paulina's hard-won contentment will be shattered when Kenya's turbulent history intrudes into her private life, bringing with it tragedy -- and a new test of her quiet courage and determination.

Paulina's patient struggles for survival and identity are revealed through Marjorie Macgoye's keen and sensitive vision -- a vision which extends to embrace the whole of a nation and a people likewise struggling to find their way. As the Weekly Standard of Kenya notes, "Coming to Birth is a radical novel in firmly asserting our common humanity".