Content Warning: This section references abortion.

The motif of letters and letter writing reflects the importance and difficulty of honest communication. A letter first appears in the Prologue when Frances’s letter to Nancy is misdelivered and becomes lost for seven years. This letter launches one of the main plotlines, as Angela discovers the letter years later and searches out the people involved. Although the letter goes astray, the honest and emotional revelations within its pages motivate Angela to find Maggie (under the name Evelyn Taylor) and reunite her with her daughter, Nancy (born Jane).

In a novel that is deeply interested in the power of relationships, letters and letter writing represent the characters’ attempts to reach each other. Other prominent letters include the notes that Maggie and Evelyn write to their daughters, stowing them away in their blankets with the hope that someday their daughters will know that their birth mothers loved them. Angela sends Facebook messages—modern-day letters—in search of Nancy. The letters that Maggie and Evelyn write to their families from St. Agnes’s are monitored, censored, or even thrown out. The author uses these various instances of letters and letter writing to demonstrate the difficulty of clear, honest communication. Unlike a verbal conversation, written communications experience a delay as the words are transported from the writer to the addressee, creating more chance for interruption.