Diane Chamberlain’s Necessary Lies offers a fictional account of families impacted by the eugenics movement in the mid-20th-century United States. It presents the alternating narratives of Jane Forrester, a budding social worker assigned to impoverished Grace County, North Carolina, and her client, 15-year-old Ivy Hart. Through Jane’s encounters with Grace County’s poverty and its citizens’ lack of control over their lives and futures, she becomes increasingly desperate to prevent Ivy from undergoing forced sterilization at the hands of the state. Through the novel, Chamberlain explores this little-known aspect of America’s past, delving into the aims of the eugenics movement and exploring the motivations of those in power.

The author of more than 25 novels, Chamberlain is known for narratives that explore family relationships and personal traumas with characters who overcome personal and societal obstacles. A former social worker, Chamberlain draws on her knowledge and experience in the field in Necessary Lies and other novels, many of which have been New York Times bestsellers (Chamberlain, Diane. “Bio.” Diane Chamberlain.)

This guide is based on the 2013 St. Martin’s Press paperback edition.

Content Warning: The source material and this guide contain references to forced sterilization, eugenics, racism, violence, suicide, and sexual trauma.

Plot Summary

In 1960, Jane Mackie interviews for a social work job just weeks before her wedding to Dr. Robert Forrester, a pediatrician. Though she has no experience in the field and her university degree is in sociology, Jane is offered the job. She will be serving impoverished communities in Grace County, near her home in Raleigh, North Carolina. Jane’s husband is dubious about his new wife taking on a career.

For the first two weeks, Jane shadows Charlotte Werkman, the senior social worker whose role she will be filling. The focus of Jane’s work becomes the families living and working on Davison Gardiner’s tobacco farm. Gardiner allows two tenant families—the Jordans and the Harts—to live rent-free in houses on his property, employing them to harvest and grow tobacco. Lita Jordan is a 30-something woman of color who has five children. Three of her sons work on the farm as well, while her oldest daughter has been relocated north to live with relatives. The Hart family, whose matriarch and patriarch grew up with Lita Jordan and Davison Gardiner, also are tenants. Percy Hart was killed in a machinery accident on the farm, and Violet Hart, his wife, has since been permanently committed to a psychiatric hospital due to mental illness. Their teenage children, Mary Ella and Ivy, are in the care of their grandmother, Winona “Nonnie” Hart. Mary Ella has a two-year-old son whose father is unknown.

Jane learns that unbeknownst to Mary Ella, Nonnie consented to sterilization surgery to prevent Mary Ella from becoming pregnant in the future. Mary Ella qualified for sterilization through the state’s eugenics program because she was assessed as having a low IQ. Jane also learns that Charlotte has begun the petition to sterilize 15-year-old Ivy, per Nonnie’s request. Jane is concerned that these surgeries are performed without the knowledge or consent of the teenage girls.

Ivy spends her days working in the tobacco barn and shoulders the responsibility for the family’s income and well-being. Nonnie cannot work, due to her age and diabetes. William, Mary Ella’s son, needs constant care and supervision. Mary Ella works alongside Ivy but disappears most nights. Ivy and Nonnie are unsure where she goes. Some nights, Ivy sneaks off to meet Henry Allen, Mr. Gardiner’s son. The two are sexually intimate and secretly dream about leaving the farm and moving to California.

Charlotte and Ann, the nurse assigned to the Hart family, become increasingly certain that Ivy should be sterilized immediately. Ann provides Ivy with contraception, but Ivy insists she does not need it, keeping her relationship with Henry Allen a secret. This secret persists until Henry Allen and Ivy are caught together in a barn after it catches fire. Later, William goes missing, leading Jane to worry that the Harts are not able to supervise him properly.

Meanwhile, Jane’s marriage is off to a rocky start as Robert grows increasingly disapproving of the time she devotes to her job. He is not only concerned that venturing to Grace County is unsafe but also fearful of his peers’ judgment of Jane’s work. The couple grows increasingly distant as Robert wants Jane to focus on charity and domestic work and to begin a family of their own while Jane remains dedicated to her work.

Jane is committed to protecting Ivy from sterilization surgery. She continually breaks professional protocol by taking a personal interest in the Hart family, especially Ivy. As she gets to know both girls, Jane decides Mary Ella has a right to know that she has been sterilized and, though it violates Nonnie’s wishes, reveals the secret to her. Mary Ella is devastated, even more so after William is placed in foster custody after he consumes Nonnie’s diabetes medication while unsupervised. The conflict reaches a climax when Ivy becomes pregnant. The state approves the petition to have her sterilized, and plans are made to complete the surgery soon after Ivy delivers the baby. Jane repeatedly argues against this plan, and her actions cause her to lose her job.

Around the same time, Mary Ella dies by suicide, overcome with grief at the loss of William and unable to cope with the truth of her inability to have more children. Ivy, meanwhile, is predicted to deliver early and ordered to begin bed rest. In a last attempt to save her from surgery, Jane convinces Nonnie to allow her to harbor Ivy at her home in secret while Robert is away at a conference. Ivy gives birth at Jane’s home with the assistance of Jane and Jane’s mother. Within days of the birth of Ivy’s daughter, Mary, Ivy’s whereabouts are discovered, and Mary is removed from her care. Ivy, however, flees, and not even Jane knows where she goes.

The final chapter of the novel is set decades later. Jane is about to testify at a reparations trial for survivors of the eugenics movement. Her stepdaughter surprises her by reuniting her with Ivy, who escaped to California with Henry Allen. The two married and had more children together.