The book tells the story of how a dead infant found on an Amish farm shakes the entire community. As the police investigate the death, they discover that the baby was not stillborn, but died shortly after birth. Police find cloth fibers in the infant's mouth and throat, including bruises on the mouth, which leads them to conclude that he was suffocated.
An eighteen-year-old, unmarried Amish girl, Katie Fisher, is charged with murder of her newborn son, but denies ever being pregnant. Ellie Hathaway, a top defense lawyer and a distant relative of Katie, reluctantly accepts the case after a confrontation with her aunt (the relative who connects her with Katie by marriage).
As part of the bail conditions of the pre-trial hearing, Ellie has to remain on the farm with Katie prior to the trial—a period that lasts several months. A doctor determines that the infant was born prematurely and could have died from natural causes due to listeriosis, a bacterial infection which Katie contracted from constantly drinking unpasteurized milk from their Amish farm. During that time, Ellie begins arelationship with her former lover Coop (a legal psychologist whom she trusts with Katie's interviews), whom she had previously left years before.
On the first day of Katie's trial, Ellie finds out she is pregnant with Coop's baby. Coop asks Ellie to marry him immediately, but she defers. After the jury deliberates for several days, Katie cops a plea and is sentenced to one year of electronic monitoring, allowing her to stay at the farm while wearing an electronic bracelet.
Katie's mother, Sarah Fisher, gives Ellie the scissors which have been used to cut the umbilical cord, revealing that she knew Katie was pregnant and had gone to her the night she gave birth, though Katie didn't know it. Ellie has an ethical obligation as an attorney to provide this evidence to the police, but opts not to, based on Sarah's plea to her—mother to mother. The novel ends with Coop picking up Ellie at the farm to begin their life together.