Ivy Rose and her husband are holding a yard sale outside their Victorian home when an old high school acquaintance stops by. Melinda White, who was an awkward, unpopular girl at school, acts as if she and Ivy were close friends, though Ivy barely remembers her. They now have only one thing in common: both are very pregnant. Melinda's peculiar and overbearing intimacy makes Ivy uncomfortable, so she's relieved when her husband distracts the woman by offering to show her around their house. Ivy thinks that's the end of it, but it's only the beginning. When a short time later the former schoolmate is reported missing, the police grow suspicious of Ivy's husband and after peculiar things start to happen, Ivy isn't sure who to believe.

Character development is not a hallmark of this novel; the reader never really gets to know Ivy's husband or gain a nuanced sense of their relationship. Instead, the focus is on steadily ratcheting up the tension, with a pace that's as inevitable as the approach of Ivy's delivery date. Ephron, an experienced novelist who published the Edgar-nominated book, Writing and Selling Your Mystery Novel, knows how to build suspense. The mood proceeds smoothly from disquiet, to distrust and doubt, to panic. It seems suitable, somehow, that much of the action takes place in an old house, full of history and secrets, where Ephron can blend the pulse-pounding creepiness of a Gothic horror story with the puzzle-pieces of a mystery.