The Doctor's Luck by Nancy Glenn Powell

Doctor Tom expects a good life until he cannot pay his bills because his patients are paying with vegetables instead of money, and a man abandons Betty, a fourteen-year-old pregnant girl in the doctor's yard; the girl has the mind of a three-year-old. Except for Rita, the doctor's housekeeper, and her two pre-teen boys, everyone walks away. Rita helps with Betty, but the girl tries everyone's patience. After Betty rips her doll into small pieces, the doctor and Rita worry about how they will keep her unborn twins safe from the girl's tantrums. Luke, Rita's husband previously deserted his family but returns to cause problems including stealing and attempts to kill Rita. This historical fiction novel contains mystery, suspense, and romance.