Adaptation of Chris Bohjalian's novel about Sibyl Danforth, a midwife from a small Vermont village who faces the nightmare of having to choose a baby's survival over that of a mother's and is then charged with involuntary manslaughter. The story is told through the eyes of Danforth's daughter.
Sybil Danforth is a respected midwife throughout Vermont. Overworked, and trying to appease her husband Rand, who accuses her of neglecting him and their 14-year-old daughter Connie, Sybil hires 22-year-old Anne Heston as an apprentice. In early spring, one of Sybil's patients, Charlotte Bedford, the wife of Reverend Asa Bedford, begins having her first contractions. As hours pass by, an icy March rain begins to fall. Twelve hours later, Charlotte finally reaches ten centimeters and begins to push, but no sooner does she begin than Sibyl stops her when she notices that Charlotte is bleeding. Sibyl suggests they go to the hospital, but when she attempts to call for an ambulance, she finds that the phone lines are dead. Supressing her panic, Sibyl offers to drive Charlotte and Asa, but everything is covered with a sheet of ice and the car skids into a ditch near the driveway.
After calming down an anxiety-ridden Anne, Sibyl carefully explains the situation to Charlotte and Asa. Again, Charlotte begins to push, but after five hours Charlotte has yet to make any further progress. Then, something goes terribly wrong; Charlotte's chin shoots up from her chest, her eyes roll back in her head, and she slumps in the bed. Sibyl leaps into action and begins CPR. Getting no response, Sibyl orders Asa to get her a knife. She meticulously performs an emergency cesarean section and saves the baby.
Days later, questions arise as to what really happened that night, Concerned that the press and whole town are talking murder, Rand convinces Sibyl to hire defense attorney Stephen Hastings. The Coroner reports that there was no sign of stroke or seizure, and that Charlotte was alive when Sibyl operated. Sibyl is arrested and put on trial for involutary manslaughter. When the prosecution calls Anne to the stand she becomes hysterical and accuses Sibyl of killing Charlotte. On the stand, Sibyl mentions her personal journal; the judge orders the notebooks to be brought to the courthouse. Connie volunteers to retrieve the journal; at her house, she takes down the notebook and opens it to the entry for March 14. Then, she makes a life-altering decision. After Stephen and the prosecutor make their closing arguments, the family awaits the jury's decision.