Take My Hand

Take My Hand (2022) is American author Dolen Perkins-Valdez’s third novel. Named a Most Anticipated Book of 2022 by many publications, it was awarded the 2023 NAACP Image Award for Outstanding Literary Work-Fiction and the 2023 BCALA Award for Fiction. It was a finalist for a Goodreads Choice Award and was named a Top 20 Book of the Year by the Editors at Amazon, and the audiobook version was named a Best of 2022 by Audible. The American Bar Association named Take My Hand a finalist for its prestigious Silver Gavel Award, which recognizes an “outstanding work that fosters the American public’s understanding of law and the legal system.”

Perkins-Valdez often grounds her themes in historical fact. Her first novel, Wench (2010), was based on an Ohio resort where white plantation owners vacationed with their enslaved mistresses, and her second novel, Balm (2015), tells the stories of a Black woman, a Black man, and a white woman as they attempt to rebuild their lives after the civil war. Take My Hand is inspired by the true story of two young Black girls who were surgically sterilized in 1973 in Montgomery, Alabama, without their consent, and the ensuing lawsuit that exposed the US government’s regular practice of sterilizing poor women and girls, especially women of color. The novel explores themes of "Othering" and the Savior Complex, Systemic Racism in the US Healthcare System, and Poverty, Racism, and Classism in the Post-Jim Crow South. It also touches on the themes of motherhood, family, the strength of community, and the effects of mental health struggles.

This guide uses the 2022 Kindle edition published by Berkley/Penguin Random House.

Content Warning: This novel contains depictions of racially motivated prejudice and forced sterilization.

Plot Summary

Dr. Civil Townsend, an OB-GYN who lives in Memphis, Tennessee, returns to Montgomery, Alabama, to make peace with people and events from more than four decades earlier. She tells her adult daughter, Anne, the story of what happened in 1973 when she was a nurse at a Montgomery family planning clinic. The narrative alternates between Civil’s second-person voice as she recounts the past to Anne and the first-person voice of Civil’s younger self, who has just graduated from nursing school. This summary below presents the two timelines separately, but the following chapter summaries follow the novel’s alternating timeline structure. Some chapters are subtitled with locations and dates while others are not.

2016

As Civil travels, she is plagued with regret for the 1973 forced sterilization of two young girls, India and Erica, that she was unable to prevent. Civil first visits her best friend from the clinic, Alicia Downs, in Jackson, Mississippi. Then, she travels to Birmingham, Alabama, where she visits Ty Ralsey, her ex-boyfriend who is now college president at Tuskegee University. In Montgomery, she visits Lou Feldman, the attorney who represented the girls in the lawsuit against the government. She also meets with the daughter of her old supervisor, Mrs. Seager, who is horrified by what happened, but still claims her mother was a good person; Civil does not validate the daughter’s desire to see her mother as nonracist.

Finally, Civil visits India and her sister, Erica. The women still live in the house the family moved to after leaving Montgomery. India has late-stage cancer, and Erica is her caretaker. Although Civil has not seen them since they left Montgomery, they welcome Civil in as family.

After visiting the sisters, Civil prepares to go back to Birmingham to see Ty to potentially rekindle their relationship. She closes by telling Anne that she hopes Anne will learn from the mistakes of the past.

1973

Civil is fresh out of nursing school and beginning work at a family planning clinic in Montgomery. Mrs. Seager, who is white, supervises the eight nurses, who are Black. The nurses’ primary job is giving their patients birth control injections of Depo-Provera. Civil sees her first patients—sisters India, 11, and Erica, 13—and wonders why they are on birth control when Erica has not begun menstruating and they are not sexually active.

The girls are extremely poor and live in a cabin on a white farmer’s land with their widowed father, Mace Williams, and their grandmother, Mrs. Williams. Civil, whose father is a doctor, befriends the girls, taking them home to bathe, taking them shopping, and finding them a better place to live.

Later, Civil goes to dinner at the Ralseys’ house. The Ralseys are long-time friends of her family, and their son, Ty, is her ex-boyfriend. Civil finds out from Ty that Depo-Provera is not FDA approved and has caused severe side effects in laboratory testing. Civil later learns from a librarian that the government forces sterilization on Black men and women. Afraid of the dangers of administering Depo-Provera, she and Alicia (her best friend and fellow nurse) stop giving the shots to their patients.

Meanwhile, Civil helps the Williams family move into government-subsidized housing. She gets the girls back in school and finds Mace a new job.

Civil learns Mrs. Seager took India and Erica to the hospital when she goes to visit them one day: Mrs. Williams and Mace were told the girls would be given shots, but the girls were surgically sterilized.

Civil rushes to the hospital and finds the girls in pain post-operation. She demands pain medication and calls Mace, who rushes to the hospital. Civil, upset, flees the hospital and gets in a car accident. When her father arrives, Civil tells him about the surgery, and they think of ways to help.

She and her father meet with Ty’s parents, who are attorneys, and discuss a lawsuit against the clinic. The Ralseys, busy with another important lawsuit, pass the case to a young white lawyer, Lou Feldman. Civil initially feels betrayed and has little confidence in Lou, but she eventually comes to trust him.

At work, Civil confronts Mrs. Seager, who blames Civil for the surgery because she quit giving the girls Depo-Provera. Mrs. Seager implies that the girls are sexually active and that their father might be sexually abusing them. Civil is furious and stands up to her. After losing her job, Civil becomes completely immersed in the lawsuit.

After the sterilization, Mace angrily accuses Civil of playing with his daughters’ lives. Undeterred, she continues to help the family. She takes them to visit relatives and works to enroll India, who is nonverbal, in a school for children with special needs.

Lou files the lawsuit, and it gains national attention. The family and Civil go to Washington, DC, where they meet Senator Ted Kennedy and testify before congress. A few days after the hearings, Lou drops the case against the clinic and files a suit against the federal government because the sterilizations are happening nationwide. Although they are hesitant at first, the nurses from the clinic join Civil in finding evidence for the lawsuit. Civil’s father and Alicia pressure her to go to medical school, but she completely focuses on the trial, regularly helping Lou and the family.

Lou’s case reveals that the government has sterilized more than 150,000 low-income women, most of them women of color, in over just a few years. The court rules in favor of the family, and everyone celebrates—until they realize Erica is missing. Mrs. Williams feels Civil has become too close to the family and asks her to stop visiting them. Three days later, they find Erica at the family’s old home.

After the trial, the Williams family leaves Montgomery. This is bittersweet for Civil, who has become attached to them; Mace stays behind temporarily until he can find work in the new city.

Civil goes to work for her father, and it is a positive experience. She visits Mace before he leaves, and he thanks her for her help. He tells her she is free, and that she should use her freedom to save as many people as she can.