An experienced and respected midwife, Sibyl Danforth, attends a woman during a home birth. When she realizes that dangerous complications have set in, she tries to call for help in vain, as a severe ice storm has knocked out the phone lines. An attempt to drive the expectant mother to a hospital only results in the car being wedged into an icy snowbank, as travel conditions were impossible.

Trapped in this isolated home with a physically fragile, expectant mother in the throes of a labor that will not bear fruit, Sybil struggles to do the best that she can. Unfortunately, her best is just not good enough, given the complications that had set in, and the expectant mother appears to succumb to the ravages of a laborious childbirth.

Under the belief that the expectant mother had died, Sibyl performs an emergency caesarean section in an effort to save the unborn child. She successfully does so, presenting the stricken husband with an infant son. Yet, the next day, her assistant, Anne, who had been present throughout the ordeal, denounces Sibyl to the authorities, claiming that the expectant mother had, in fact, been alive, when Sibyl had commenced the caesarean. Consequently, Sibyl is charged with manslaughter, and the political winds blown by the traditional medical establishment, as well as that of the legal system, threaten to tear asunder all that she holds dear.

The story of this event, its aftermath, and the impact it had on many lives, is told through the eyes of Sibyl's daughter who had been a young teenager at the time of the incident, and through the pages of Sibyl's journal. The book takes the reader through a number of moral dilemmas for Sibyl, as well as for her daughter who is forced to come of age during this time of trial and tribulation for her family. Absorbing and often surprising, this sensitively wrought novel is a well nuanced literary gem from a gifted writer.