Ultimately I found this a frustrating read. The prose is excellent, and it is full of good observations about family in-fighting, marital pressures, gender disputes & middle-class US values. However I found it one of those novels that promises so much more than it finally delivers.
Initially I thought it was going to be excellent as it confronts a number of tough issues: disability, marital burn-out, loss and miscarriage. But finally it tips into a sentimentalised redemption of each of the characters in such a way that these differences and the tensions between them are supposedly resolved by a deep-seated love that each of them finds. For me this was disappointing and unconvincing. The dirt the narrative kicked up was considerably greater (and more interesting) than the slightly saccharine resolution. Shame, because it has some strong elements.