Ruth Stoops is a woman engulfed in desperation in Nebraska, desperately seeking substances to dull her inner pain. As an addict, she's willing to sacrifice everything—including her four children, who have been taken from her due to her inability to provide a stable environment. One fateful morning, after a night of reckless partying with her boyfriend, Ruth finds herself unceremoniously thrown out of their flophouse apartment, leaving her feeling vulnerable and exposed.
In search of comfort, she turns to her brother's house, hoping to catch a glimpse of two of her children and plead for financial help. However, instead of a warm welcome, Ruth finds herself waiting at the back door, reminiscent of a discarded animal, as feelings of shame and inadequacy wash over her.
As her addiction spirals further, Ruth gets arrested once more for her reckless behavior. An unexpected twist occurs when she discovers her pregnancy, which shakes her to her core. The weight of her situation deepens when she learns she's facing felony charges for endangering her unborn child's life—a stark difference from her past misdemeanors.
At her arraignment, a judge, informed about her troubled past with her other children, presents her with a daunting choice: terminate the pregnancy or face even harsher penalties. Just when despair seems to be her only companion, she is bailed out by the Stoneys, Norm and Gail—a radical Evangelical couple who have taken an unusual interest in her story after hearing it through local news reports.
Moving into their home, Ruth grapples with their well-intentioned guidance. On her first night under their roof, she sneaks out with their teenage daughter, Cheryl, engaging in her vices—huffing paint and smoking marijuana without a care for her future. The looming question haunts Ruth: can she break free from her chaotic life, or will her demons dictate her existence?
As pressure mounts from the Stoneys, Ruth reluctantly visits a crisis pregnancy center, where bombastic rhetoric solidifies her resolve to carry her child to term amidst her struggles. However, her determination doesn't last long when she's caught huffing glue at an anti-abortion protest alongside Gail and Norm, leading to her eviction from their home. Within this turmoil, Ruth encounters Diane, a friend of Gail's who also serves as a lesbian abortion-rights activist, determined to help women like Ruth who feel exploited by zealous advocates.
Finding refuge in Diane's farmhouse, Ruth is embraced by Diane, her partner Rachel, and Harlan, a gruff yet gentle disabled veteran who provides security for their cause. Tensions between the Stoneys and Diane escalate as anti-abortion activists stake out the area, conducting fervent prayer sessions—often caught by news cameras.
The situation reaches a breaking point when Blaine Gibbons, a charismatic evangelical leader, arrives, offering Ruth $15,000 from his ministry to reconsider her abortion plans. Tensions escalate, and Harlan matches this offer if she opts for termination. The unfolding drama at Diane's home captivates the media, highlighting the intensity of the situation.
However, on the day of her scheduled abortion, Ruth suffers a heartbreaking miscarriage, prompting her to reassess her relationships and intentions. She soon realizes Diane is using her as a pawn in a larger agenda, much like the Stoneys had. Feeling a sense of betrayal, Ruth decides to keep her miscarriage a secret and longs for a new beginning.
Determined to pursue her own path, Ruth agrees to accompany Diane and Rachel to the abortion clinic, where they meet renowned activist Jessica Weiss. As they arrive by helicopter, Ruth's thoughts are consumed by the promise of the $15,000 from Harlan, which she eventually discovers hidden behind the front desk. With a newfound sense of purpose, Ruth seizes the moment and escapes through a back window, disappearing into the throngs of protesters amid the tension surrounding the clinic.
