Edwards’s assured but schematic debut novel (after her collection, The Secrets of a Fire King) hinges on the birth of fraternal twins, a healthy boy and a girl with Down syndrome, resulting in the father’s disavowal of his newborn daughter. A snowstorm immobilizes Lexington, Ky., in 1964, and when young Norah Henry goes into labor, her husband, orthopedic surgeon Dr. David Henry, must deliver their babies himself, aided only by a nurse. Seeing his daughter’s handicap, he instructs the nurse, Caroline Gill, to take her to a home and later tells Norah, who was drugged during labor, that their son Paul’s twin died at birth. Instead of institutionalizing Phoebe, Caroline absconds with her to Pittsburgh. David’s deception becomes the defining moment of the main characters’ lives, and Phoebe’s absence corrodes her birth family’s core over the course of the next 25 years. David’s undetected lie warps his marriage; he grapples with guilt; Norah mourns her lost child; and Paul not only deals with his parents’ icy relationship but with his own yearnings for his sister as well. Though the impact of Phoebe’s loss makes sense, Edwards’s redundant handling of the trope robs it of credibility. This neatly structured story is a little too moist with compassion.

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