The central crime in Plain Truth reflects the real-world phenomenon of neonaticide. Neonaticide is defined as the deliberate killing of a newborn infant within the first 24 hours of life, a term first introduced in modern criminology to distinguish it from broader forms of infanticide. Forensic psychiatry research, such as that pioneered by Dr. Phillip Resnick in the late 1960s, identifies neonaticide as a distinct act tied to “unintended (i.e., unwanted or unplanned) pregnancy, stigma that may be associated with the births to unmarried women, shame, concealment or denial of pregnancy, nonhospital birthing, and limited available resources to care for the child” (Wilson, Rebecca F. et al. “Neonaticides in the United States—2008-2017.” National Library of Medicine, 2022). Although statistically rare, neonaticide is widely understood to be underreported due to the secrecy surrounding both concealed pregnancies and the disposal of infants, which can obscure detection and classification.

Factors associated with neonaticide are often more pronounced within insular communities—social groups that are culturally or geographically isolated and governed by strict norms. In such environments, conformity is highly valued, and deviations from accepted behavior, such as premarital pregnancy, can result in ostracism or severe social consequences. This can intensify the pressure to conceal pregnancy, reducing the likelihood that individuals will seek medical care or external support. Additionally, limited interaction with outside institutions such as healthcare systems, education, or legal resources can further restrict awareness of options and reinforce secrecy.

Within Amish communities, the social dynamics that contribute to concealed pregnancy and, in rare cases, neonaticide become particularly pronounced due to the community’s emphasis on Ordnung (a strict code of conduct), humility, and collective reputation. The Amish prioritize social harmony and moral conformity, especially regarding sexuality, where premarital relationships are strongly prohibited. As a result, an unwed pregnancy carries not only personal shame but also the potential to bring dishonor upon one’s family and church district. This intense pressure can encourage secrecy, as young women may fear confession, disciplinary action, or social exclusion, including shunning. At the same time, the insular nature of Amish life, marked by limited engagement with modern healthcare systems, minimal sex education, and restricted access to outside support networks, can leave individuals with few perceived options when facing unexpected pregnancy.

Katie Fisher’s desperate attempts to hide her condition and Sarah’s decision to smother the baby are better understood through this sociological lens. The novel grounds Katie’s experiences in the specific cultural pressures of the Old Order Amish community. Her world is governed by the Ordnung and upheld by the threat of Meidung, or shunning. This formal ostracism is a devastating punishment in a collectivist society where belonging is paramount. For an unwed mother, the fear of being shunned by family and friends, as Katie’s aunt Leda was for marrying an outsider, creates an unbearable pressure. Leda explains that under the bann, she cannot eat at the same table with her family or accept a ride in their buggy, illustrating the social death that Katie fears more than anything. Ultimately, Plain Truth frames neonaticide as the tragic outcome of overwhelming psychological strain shaped by cultural expectations, secrecy, and fear. By situating Katie’s experience within this broader social context, the novel challenges readers to consider how systems of silence and judgement can contribute to desperate and devastating choices.