One night, at three in the morning, Catherine goes into labor. Henry takes her to the hospital, as she talks in a jovial way about the pain of her contractions. Once they reach the hospital and she is given a room, she tells Henry to go out to get breakfast. The nurses tell Henry everything is going fine. He goes to get breakfast.
Catherine's stoicism while in labor is reminiscent of the casual language Henry and other soldiers used in the war to talk about their wounds.
When Henry returns from breakfast, Catherine has been brought to the delivery room and is strapped to an operating table and inhaling gas to help the pain. She has been in labor for nine hours. Henry goes to have lunch. When he comes back, she is drunk on the gas and her labor has not progressed.
The carefree tourist life that Henry and Catherine have been living, eating all their meals in cafés, contrasts sharply with the deadly predicament that Catherine is in now.
The doctors decide that a Caesarean section is the best option to save both Catherine and the baby. They wheel Catherine away. Soon, the doctor emerges with a baby boy. Henry feels nothing for the baby. He tells the nurse that he hadn't wanted a boy and rushes inside to see Catherine. She asks about the baby. He tells her it is fine. The nurse looks at him strangely, and takes him out of the room to inform him that the baby was stillborn.
To Henry, the importance of his son's life pales in comparison to Catherine's life. He looks at the baby and sees only something senseless that Catherine will die for in vain. He preferred having a girl to a boy because if he had to have a child, he wanted another Catherine.
Henry goes to dinner and reads in the paper about some success on the British front. When he returns, he learns that Catherine has had a hemorrhage. Henry begs God not to let her die, but when he gets to see Catherine, she stoically tells him she's dying and asks him never to say the things he said to her to anyone else. The doctor's ask him to leave, assuring him that Catherine will be fine. She dies while Henry is in the hall.
As Catherine approaches death, the war returns to Henry's consciousness. Even though Henry has professed his distrust of God throughout the novel, here he falls back on prayer. Love has become his religion, but his earlier cynicism is borne out: Catherine dies.
The doctor wants to take Henry back to his hotel, but he refuses. Instead he goes in to say goodbye to Catherine's lifeless body. But, "it was like saying goodbye to a statue." He leaves the hospital and walks back to his hotel in the rain.
In the end, there is a single inescapable reality: everyone dies. Henry and Catherine escaped the war and tried to live only within the confines of their love, but any success they had was an illusion. The realities of the war and mortality destroyed their fantasy. Now Henry can do nothing more than bear his loss with typical stoicism.