While pregnant with Sam, Blythe is at a flea market and purchases a painting of a mother and her young son. Although she loves the painting from the start, it takes on new meaning after Sam’s death. With no opportunity to grow older, Sam is eternally young like the boy in the painting. Similarly, Blythe’s love of Sam is equally preserved within a tragically brief timeframe, and the painting represents how she views their miraculous time together. The imagined relationship between the mother and son in the painting is as free of heartbreak, abandonment, and recriminations as Blythe’s relationship was with Sam. This is the vision of motherhood Blythe clings to as she grieves for the child she lost—and seethes at the child she believes is responsible for his death.

In the most literal sense, the novel’s title refers to Violet’s real or imagined push of Sam’s stroller, which sends him into the street to his death. The tension in the novel’s last half revolves around the question of whether the push occurred. If it did, then Violet is a murderer, Fox is a passive-aggressive gaslighter, and