Necessary Lies by Diane Chamberlain

From 1933 until 1973, the Eugenics Board of North Carolina, sterilized, with or without permission, over 7000 individuals. Maybe many were like the Ivy of the story. She lives with her increasingly ill grandmother and beautiful but mentally challenged 16 year old sister who does not know that she was sterilized after she gave birth to her son two years ago.  They live in a ramshackle home provided by the owner of the tobacco farm where they live and work.  They rely on the benefits coordinated by Jane, a brand new social worker.  When Jane learns that Ivy is also scheduled for a secret sterilization, a practice she questions, she sets in motion events that quickly spin out of control.  It is a story of class, race and above all choice.  All sides of the issues come to play providing great fodder for discussion.