Baltimore, 1986. Julia and Matt are newlyweds, in love and eager to begin graduate school. Julia longs to leave behind haunting memories of her mother's devastating decline in Maryland, but she unexpectedly learns the truth her father has hidden: Her mother died of a fatal genetic illness. Julia now faces a 50 percent chance of inheriting the same fate, and every child she longs to have will carry the same risk. When an unplanned pregnancy rocks their careful plans, Julia and Matt face agonizing uncertainty and impossible choices. Desires and convictions pull them toward starkly different paths, each possibly leading to misery. As the couple struggles to protect the fragile, fierce love that first bound them together, they face the cost of secrets and the ache of betrayal - but they also discover the hope of forgiveness.