Jane Forrester just wants to help people. It's as simple as that. So she takes a job as a social worker, and while her husband isn't exactly on board with that idea, he allows it. It's the 1960's and it's just not proper for the wife of a physician to work, but Jane is strong-willed, independent, and unsatisfied with simply playing the role of a subservient housewife. As a social worker, she'll get to help people. She'll bring them much-needed supplies, much-needed money, much-needed assistance. Or so she thinks. 
 Assigned to a few families in rural North Carolina, her job is nothing like what she imagined, and the Hart family quickly sucks her in. Ivy Hart is practically running the family at fifteen years old. Her parents are gone. Her grandmother, Nonnie, is sick. Her older sister, Mary Ella, has some intellectual problems. And Mary Ella's son, Baby William, while well-loved, isn't well-cared for. Ivy, Mary Ella, and occasionally Nonnie work on a tobacco farm, barely earning enough to keep themselves fed, even with the extra assistance from the state. Jane gradually becomes more and more involved with this family, bending the rules and paying them extra attention. 
 When she finds out that a large part of her job is ordering the sterilization of at-risk children, such as Ivy, her world comes crumbling down around her. It seems so wrong to her, to sterilize these girls without their consent, without their knowledge - yet to her coworkers, it's common practice. As Jane protests more and more vigorously against the sterilization, she puts her job - and her marriage - at risk. 
 I was pulled into this novel from the very first sentence, and I was absolutely done for by the time Jane got her job as a social worker. I couldn't believe what I was reading about the eugenics program - in all the history classes I've taken, all the college courses I sat through, all the books I've read, I never once heard about this awful program. I had to research it myself, see if it was true, and the horrifying part is that it was. North Carolina had a particularly aggressive eugenics program, approving nearly all proposals involving the "mentally defective," "feebleminded," or those with epilepsy. Knowing that this book is based on real events is chilling. 
 If I could give this book more than five stars, I would. Not only is it incredibly well-written, it's such an important topic. Highly, highly recommended.