Nurse Becky Myers is a reluctant midwife. She's far more comfortable with tending the sick than helping women deliver their babies. For these mothers-to-be, she relies on an experienced midwife, her dear friend Patience Murphy. But the Great Depression has hit West Virginia hard. Men are out of work; women struggle to feed hungry children. And sometimes Becky is called upon to bring new life into the world.

Though she is happy to be back in Hope River, time and experience have tempered Becky's cheerfulness— as tragedy has destroyed the vibrant spirit of her former employer, Dr. Isaac Blum, who has accompanied her. Patience too has changed. Married and expecting a baby herself, she is relying on Becky to keep the mothers of Hope River safe.

Becoming a midwife and ushering new life into the world is not Becky's only challenge. Her skills and courage will be tested when a calamitous forest fire blazes through a Civilian Conservation Corps camp. And she must find a way to bring Isaac's spirit back to life and rediscover the hope they both need to go on.