The Cider House Rules by John Irving

Raised from birth in the orphanage at St. Cloud's, Maine, Homer Wells has become the protege of Dr. Wilbur Larch, its physician and director. There Dr. Larch cares for the troubled mothers who seek his help, either by delivering and taking in their unwanted babies or by performing illegal abortions. Meticulously trained by Dr. Larch, Homer assists in the former, but draws the line at the latter. Then a young man brings his beautiful fiancee to Dr. Larch for an abortion, and everything about the couple beckons Homer to the wide world outside the orphanage ...