The story was inspired by the case of Martina Greywind, a homeless, unmarried mother from North Dakota who was offered $15,000 to carry what would have been her fifth child to term.

On the first night, Ruth, impervious to their convictions, sneaks out of the house with the couple's reckless teenage daughter, Cheryl, and again huffs paint and smokes marijuana.

The witless Ruth soon finds comfort in Diane and her partner, Rachel, as well as Harlan, a gruff disabled veteran and friend of the women who provides security detail for them.

The scene becomes a spectacle documented by news stations and is exacerbated when Blaine Gibbons, a charismatic and famous evangelist, arrives to participate.

On the morning Ruth is to have her abortion, she suffers a miscarriage and becomes disillusioned with Diane, whom she realizes is using her as a pawn to promote her message, similar to the Stoneys.

Upon arriving at the clinic, Ruth manages to locate the $15,000 Harlan had promised her, which he has stashed behind the front desk, and escapes out of a back window.

Though the clinic is surrounded by anti-abortion and abortion-rights picketers alike, they fail to notice Ruth as she walks through the crowd before running down the street with her backpack of money.

"[5] This point has been noted by critics, who reaffirm the common loss in sight made by extremists of the people and issues involved in such debates.

[7] Alexander Payne and Jim Taylor expressed that Miramax did not make good on a promise to support the film and to campaign Dern for an Academy Award nomination, instead focusing their promotional efforts on Sling Blade for that Oscars season.

The site's critical consensus reads, "Smart and sharply funny, Citizen Ruth is an entertaining look at a tough subject – and an impressive calling card for debuting director/co-writer Alexander Payne.

Proving herself a terrific physical comedian, the long and rangy Ms. Dern kicks and shrieks her way through the crisis that erupts over Ruth's plight.

"[18] Owen Gleiberman of Entertainment Weekly also gave the film a positive review calling the performances "pinpoint perfect", though also suggesting that the "movie is a little too aware of its own outrageousness.