Amishwoman Sara Lapp, all but shunned for studying with the local doctor to become a midwife, is shocked that, after months of waiting, her first call comes from "Mad" Adam Zuckerman, a self-appointed outcast. Adam doesn''t want her to attend at a birth, but to tend to his children because his wife has died in childbed. Adam wants to love his children, but he is afraid he will hurt them in the way his father hurt him. Without his late wife, Abby, to protect them, Adam must find someone else to care for the girls. He can think of only one woman brave enough, Spinster Sara Lapp, the little midwife whose passion for things beyond her control is greater than is good for her. Though Sara knows the four little girls belong with their father, how can she leave them with a man who seems not to care for them? As much as she loves and wants the girls, she will only take them long enough to teach Adam to love them. Then Adam falls from the barn loft and Sara moves in to look after him. But in the Amish community a man and woman living together must marry or be shunned. The Bishop takes a stand and Sara and Adam are forced to face the greatest challenge of their lives.