Necessary Lies by Diane Chamberlain

Working on a North Carolina tobacco farm in 1960, teenager Ivy Hart lives with her ailing, temperamental grandmother, mentally ill sister, and this sisters small child.  Jane Forrester, their social worker, is married to a doctor who would rather she did not work but Jane is determined to.  She becomes deeply involved with this impoverished family and her actions cause conflicts with her husband and her boss. Jane questions this states Eugenics Sterilization Program which eventually causes much drama in this story. I enjoyed this book and plan to read more books by this author!