Rena Basch is an administrative assistant at a San Francisco law firm. She is a single parent with a sick child. Her six-year-old daughter needs open-heart surgery and home nursing care. In order to raise money for the nurse, Rena takes on a second job as a gestational carrier. Rena signs a contract to become implanted with a fertilized egg and to deliver the baby to its genetic parents. She finds herself in trouble when she discovers she is pregnant with twins and under threat to keep the paternity of the second fetus a secret. In the process of solving the problem of what to do with an extra baby, Rena makes new friends, finds love, discovers her calling as a baker, and mends her relationship with her father. As her babies grow she develops into a stronger woman, one who knows her own mind and can stand up for what she believes. Covering in-vitro-fertilization, surrogacy, body image, questions of abortion versus choice, rape, pornography, multi-generational families, single parenting, and LGBT families, By Heat And Hand spans many contemporary topics without taking a stance. This is the story about our shifting, multiple identities and how a woman finds her strength through contemplating her body and the development of life inside it.