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 new-born son. 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). 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 drinking unpasteurized milk. During that time, Ellie begins a relationship with her former lover Coop (a legal psychologist whom she trusts with Katie's interviews), whom she had previously left years before. After a long period of debating, 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 is revealed to be pregnant as Coop asks her to marry him.