A midwife working in the tenements of turn-of-the-last-century New York, Sarah Brandt is summoned by the wealthy Lintons to confirm their worst fear: their teenaged daughter is with child. It's a mystery, however, since the young woman-mentally still a child herself-is never left alone.

With the help of her friend Detective Sergeant Malloy, Sarah vows to crack this delicate case, especially since suspicion is on those close to the Lintons. Then, when one of the suspects is poisoned, Sarah knows she must uncover the truth before more lives are ruined.