A midwife working in the tenements of early 20th-century New York, Sarah Brandt is summoned by the wealthy Lintons to confirm their worst fear: their teenage daughter is with child. When one of the suspects is poisoned, Sarah knows she must uncover the truth before more lives are ruined.
When the affluent Lintons of Lenox Hill summon Sarah Brandt to examine their teenage daughter, their worst fear is confirmed: she is with child. The pregnancy is a mystery, however, as the young woman--mentally still a child herself--is never left on her own and denies that any man has ever hurt her. It's a delicate situation, casting suspicion on those close to the Lintons, including their beloved minister, the Reverend Oliver Upchurch.

But as Sarah and a reluctant Detective Sergeant Frank Malloy investigate, fate deals their inquiry a harsh blow. The reverend falls dead during a service--poisoned by cyanide-laced wine in his chalice. Now, they must not only uncover the truth behind the Linton girl's pregnancy, they must track down Upchurch's killer before this entire sordid affair wreaks havoc on more innocent lives...