Maggie O’Farrell is best known for her novel Hamnet, which explores the historical experience of motherhood through the lens of Shakespeare’s wife. The sense of The Universality of Motherhood is a recurring theme in O’Farrell’s work, including The Hand That First Held Mine. In an interview following the publication of her memoir I Am I Am I Am, O’Farrell describes motherhood as an “ancient undertow of biology”—a remark that depicts the astonishment, worry, trauma, and transformative quality of motherhood as innate and involuntary (“Motherhood with Giovanna Fetcher and Maggie O’Farrell.” The Waterstones Podcast, 26 Feb. 2020). In The Hand That First Held Mine Elina finds her identity and mooring in reality challenged by becoming a mother. A half century earlier, Lexie likewise discovers a key aspect of her identity in motherhood, which she describes as, “our hearts begin[ning] to live outside our bodies” (241)—a phrase O’Farrell uses again in the 2020 Waterstones podcast on Hamnet. There are eight distinct mothers in The Hand That First Held Mine, representing both variations and connections between women in different times and different locations. Even Margot, who is not Ted’s biological mother, experiences the sense of primal connection that Lexis articulates, and the novel’s title is itself an homage to the connection and love between a mother and child.