A young woman finds the most powerful love of her life when she gives birth at an institution for unwed mothers in 1883 Philadelphia. She is told she must give up her daughter to avoid a life of poverty and shame. But she chooses to keep her.

Pregnant, abandoned by her lover, and banished from her Quaker home and teaching position, Lilli de Jong enters a charity for wronged women to deliver her child. She is stunned at how much her infant needs her and at how quickly their bond overpowers her heart. Mothers in her position have no sensible alternative to giving up their children, but Lilli can't bear such an outcome. Determined to chart a path toward an independent life, Lilli braves moral condemnation and financial ruin in a quest to keep herself and her baby alive.

Confiding their story to her diary as it unfolds, Lilli takes readers from an impoverished charity to a wealthy family's home to the perilous streets of a burgeoning American city. Lilli de Jong is at once a historical saga, an intimate romance, and a lasting testament to the work of mothers. "So little is permissible for a woman," writes Lilli, yet on her back every human climbs to adulthood."