Nearly every person in the United States is affected by adoption. In the wake of the U.S. Supreme Court's overturning of Roe v. Wade, the renewed debate over women's reproductive rights places an even greater emphasis on adoption. Wellington's timely–and deeply researched–account amplifies previously marginalized voices and exposes the social and racial biases embedded in the United States' adoption industry.

The history of adoption is rarely told from an adoptee's perspective. Wellington remedies this gap by framing the chronicle of adoption in America using her own life story. As she reckons with the pain and unanswered questions of her own experience, she explores broader issues surrounding adoption in the United States, including changing legal policies, sterilization and compulsory relinquishment programs, forced assimilation of babies of color and Indigenous babies adopted into white families, and other liabilities.

According to Wellington, US adoption practices in America are shrouded in secrecy, for they frequently cast shame on unmarried women, women struggling with fertility, and "illegitimate" babies and children. As the United States once again finds itself embroiled in heated disputes over women's bodily autonomy Wellington's book offers a unique and much-needed frame of reference.