In an alternate world, not too dissimilar in appearance to our own, every day life is pretty much the same apart from the adulation and cult that surrounds the ruling elite class: the Midwives. The Midwives have amassed great power and wealth and also long life for their knowledge of the physiological process of childbearing and their ability to grant parents 5 wishes. Each wish forms the attribute of the first 15 years of a person's life. But with such power comes great sacrifice, and Saffie, has three years to decide whether becoming a Midwife, is worth signing her own soul away to never love or bear a child herself.