It is about a home for women deemed "unfit to bear children", and is primarily concerned with eugenics in the United States.
A young woman named Mary Engle accepts a position as a secretary at the Nettleton State Village for Feebleminded Women of Child Bearing Age.
Engle knows from her past history with Faust that she is not feebleminded, and finds that many of the other women at the institution aren't either; many were institutionalized because they were sex workers, drank alcohol, or had interracial relationships.
[1][2] Kirkus Reviews wrote that the novel centers on Engle's "moral coming-of-age" as she reassesses her faith in Vogel's claims to do what is best for the women in her care.
[3] The Washington Post called the book a "beach read" with a serious topic, and also points out the parallels to the present day.