The novel was released on March 1, 2011, and follows the story of a bisexual woman fighting for the right to use the frozen embryos she created with her ex-husband with her new wife.

The novel features a companion soundtrack CD of ten original songs with lyrics written by Picoult, and music by her best friend, Ellen Wilber.

Zoe Baxter, a music therapist, and her husband, Max, have tried to have children for the past decade, but cannot due to fertility issues.

Zoe has experienced multiple miscarriages during five rounds of in vitro fertilization and eventually learns that she suffers from polycystic ovary syndrome.

Reid and Liddy are devout Christians who are also trying to have children, and have similarly experienced several miscarriages because of the Baxter men's infertility.

Max is shocked and disgusted, and admits to Pastor Clive that he fears Zoe "turned" to lesbianism because he was not enough of a man to satisfy her.

Pastor Clive urges Max to sue Zoe and Vanessa for the parental rights of the embryos so that Reid and Liddy can use them instead.

In turn, Max and Pastor Clive enlist legal help from Wade Preston, a Christian lawyer, and Ben Benjamin.

Max eventually realizes that he is in love with Liddy, and that he is incapable of acting as an uncle figure while she and Reid raise his genetic child.

Max Baxter: Zoe's ex-husband, a spiraling alcoholic who is eventually saved by the local Evangelical church and Pastor Clive.

Clive Lincoln: An overzealous and charismatic Evangelical Christian pastor, deeply opposed to gay marriage and LGBTQ rights.

Picoult often employs this writing technique, including in, Songs of the Humpback Whale, My Sister's Keeper, Change of Heart, and House Rules.