Grace Experience, left, Ellen McLaughlin, Monique Robinson, and Ryan George in ‘Midwives.’

“Midwives,” Chris Bohjalian’s adaptation of his 1997 novel to play form, is so intrinsically dramatic and so chocked with weighty matters it grips throughout — even though its first act is much stronger, more theatrical, and more powerfully intense than its second.

Wisely structured, “Midwives,” having its world premiere at New Brunswick’s George Street Playhouse through February 16, is neatly divided into two distinct parts.

The first depicts a complicated, tension-fraught birth in an isolated Vermont home further cut off from civilization and conveniences like a hospital by an ice storm experienced locals cannot negotiate.

The second is a more standard courtroom episode reviewing the events, nuances, and responsibilities associated with an emergency Cesarean delivery performed by a midwife without surgical credentials that night.

Just as the two acts have different settings and purposes, they have different tones and levels of involvement.

The first act, in which you see a woman struggling with a long, unproductive labor, her sympathetic husband nearby, and the midwife working to keep all calm and controlled despite signs the situation may be unusual, borders on edge-of-your-seat thrilling.

Director David Saint and his cast keep all at a harrowing level of emotion. Stakes are high, lives are on the line, and it’s difficult to expect a happy outcome when so much, medically, meteorologically, and technically, is going wrong.

Ellen McLaughlin as the midwife, Sibyl, is brilliantly authentic as the dedicated, assured professional confronted with a circumstance that challenges her experience and rattles her poise.

McLaughlin is remarkable in the way she registers so much so economically. Sibyl works to soothe, to keep everyone’s confidence and morale positive, but McLaughlin lets you see the worry in her eyes and the considerations troubling her mind. For once, Sibyl cannot command, or even ameliorate, a situation, and this unnerves her, whatever the front she puts up for the sake of the mother, father, and an apprentice midwife who accompanies her.

McLaughlin’s ability to balance competence with masked panic makes “Midwives” richer, as does the actress’ gorgeous and supplely expressive voice, which rings with tranquility and authority while betraying stoic doubt.

Monique Robinson, as the Alabama preacher’s wife, Charlotte, relocated to Vermont, and as a woman who insists, even when given advice to the contrary, on having her baby at home in her bed, could make the hardest of hearts melt from her suffering and determination as she enters her second day of labor with no indication one more push will propel the baby from her womb for Sibyl to “catch.”

The actors’ work adds to how much we care and how much we want the best to occur. This includes the performance of Ryan George, the archetypical good man who stands by his wife, shares her tribulations, and is willing to do anything he can to help, trusting Sibyl thoroughly.

Saint and company make all as effective as can be. The atmosphere in the Arthur Laurents Theater becomes feverish, as unbearable, in the best way, as Charlotte’s labor. They create top-notch theater, but in many ways the star of the evening is the unseen playwright, Chris Bohjalian.

One of the concerns about a novelist writing for the stage is whether he or she can suspend their prosaic, descriptive style for the more visual, more compact, and less explained needs of the theater.

Bohjalian showed he could navigate theatrical waters like an admiral. There were side trips to sequences involving Sibyl’s family and home life, but in general Bohjalian concentrated on the drama that was rampant in Charlotte’s bedroom as her fully gestated child would not make his way through the birth canal and all conspired towards disaster.

Bohjalian is not as successful with the second act. While the maternity scene is filled with possibility and carries its own tension, courtroom scenes are from Playwriting 101. They have a conventional structure and can suffice with just presenting testimony and its cross examination.

Interest remains high as Sibyl is on trial for the consequences of her decision to take a surgical step she was not trained or qualified to do, but unlike the first act, the second seems more narrative than theatrical, more in the voice and style of a novelist than that of a playwright.

“Midwives” raises a lot of issues, but he doesn’t go deeply into the pros and cons of midwifery or the attitude towards midwifery by the medical community. Those subjects may have been a reason for veering from a basic courtroom pattern. Instead, he interrupts scenes of testimony to show attorneys strategizing or participants being oddly aloof from all that might derive from a trial.

These sidebar scenes are like the rehearsal footage from “Dancing with the Stars.” They’re more than you want, need, or care to know. In Act One of “Midwives,” Bohjalian showed an instinct to depict what matters. In Act Two he wanders too far afield instead of holding firm on the words of the witnesses. The act becomes more like a novel, depending on narration to cover information that might be better shown.

“Midwives” holds up in its entirety. Overall, it is a fine achievement and a tribute to Bohjalian, Saint, and all involved. It could be better if the second act was as taut and spellbinding as the first.

Shoko Kambara’s bedroom set added to the tension in Act One, as did David Lander’s lighting.

Midwives, George Street Playhouse, New Brunswick Performing Arts Center, 11 Livingston Avenue, New Brunswick. Through Sunday, February 16. Tuesday, Wednesday, Friday, and Saturday, 8 p.m., Thursday, Saturday, and Sunday,2 p.m., and Sunday, 7 p.m. $25 to $70. 732-246-7717 or www.georgestreetplayhouse.org.

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