Jurgis sprints to the nearest midwife, a Dutchwoman named Madame Haupt. He walks in on her drinking and preparing dinner. After prolonged haggling, the midwife finally agrees to reduce her initial price of $25 to the $1.25 that Jurgis can offer, though she expects to be paid her full price later.
The midwife is too preoccupied with her own relatively indulgent lifestyle to help a family in its most profound moment of need. Jurgis needs her help. She cares about the money.
The midwife is enormously fat, and takes a long time to walk to the tenement. After much complaining, and a laborious climb up to the garrote of the tenement, the midwife tends to Ona.
The midwife's obesity and begrudging assistance further highlight her selfish greed.
Having done all he can to help, Jurgis is pushed out of the house. He goes to a saloon, where the owner takes pity upon him and gives him a glass of whiskey and a meal. Jurgis eats and warms himself by the stove.
Jurgis's powerlessness becomes clear to him yet again, and the only solace he can find, once again, is in alcohol.
After some time, the owner asks Jurgis to leave, fearing the man's stench will drive customers away. However, the owner recognizes that Jurgis is a decent, perseverant man, and lets him spend the night in the saloon's basement. Jurgis is unable to sleep, and he returns to the tenement at four in the morning.
Jurgis is lucky to benefit from a rare showing of human kindness, but his anguish proves too overpowering for him to enjoy the saloon owner's favor.
At the tenement, Jurgis finds the women huddled silently downstairs, as before. The midwife descends from the attic, covered in blood, and announces that she has done all she can do: the baby was positioned improperly, and it and Ona will soon die. The midwife callously demands food and drink along with her full $25 pay, and is indignant that she had to work in such squalid conditions.
The midwife's shameless greed in the face of the family's catastrophe showcases the selfish and inconsiderate mindset that capitalism ingrains in people.
Jurgis storms up to see Ona, who is at death's door. He holds her skeletal frame in his arms, and there is an instant of recognition between the couple just before she dies. Jurgis is overcome with grief and loneliness and cries until the following morning. Kotrina comes in from selling papers, and Jurgis demands the money she has made. She gives him close to three dollars, and he takes the money to the saloon to get drunk.