Author Picoult tackles the controversial topic of gay rights in her latest powerful tale. When music therapist Zoe Baxter's latest pregnancy ends in a stillbirth, her husband Max decides he can't handle any more heartbreak and leaves her.

As she picks up the pieces of her life, Zoe is surprised to find herself falling for a school counsellor who happens to be a woman. While Zoe is finding happiness with Vanessa, Max falls off the waggon and is helped by a pastor from his brother's evangelical church. Vanessa and Zoe wed in Massachusetts, and Vanessa offers to carry one of the fertilised embryos Zoe and Max stored. Excited by the prospect of being a mother, Zoe goes to Max to get him to release the embryos to her and is shocked when he instead sues her for custody of them, backed by his church.