This is the third in the At Home at Trinity series. When I requested it, I was assured that it could stand alone. It can. But. I feel like there is back story that would enhance this storyline and reveal nuances of character that I am missing. If you want to read the series, I suggest starting with the first book, because this book does mention some of what happened earlier in the other books.
When I read this book, I felt like I'd gone visiting. Nothing really exciting or dramatic happens outwardly. The dilemma, in fact there is more than one, occurs within the thoughts and emotions of midwife Martha Cade. The paragraphs of description above accurately explain what the book is all about. The turmoil is real, but it is primarily within. Some books are dramatic, or suspenseful, or romantic, this one was more an abiding, a resting, something like going to visit old friends and catch up on their lives. I enjoyed getting to know these characters, but I didn't feel compelled to read the next chapter. As a result, it took me longer to read the book. Because the pace was slow, it was easy for my thoughts to be interrupted. This is no doubt in part due to not having read the first two books. I think perhaps issues were being resolved that had significance that I didn't realize.
So, while this isn't a book that compelled me to read it, it was a nice place to go visit in my imagination. I do think, as one review stated, if you like Jan Karon's Mitford series of books, you will most likely enjoy this series as well.