Common themes in the book include the untimely death of children, the effect of the two World Wars on the family, the ultimate fate of characters who "disappeared" from their family's lives never to be heard of again, and how the women of the family feel compelled to enter into unhappy marriages.
The fate of Ruby's family is revealed gradually. A number of revelations, such as the fact that Ruby's sister Gillian dies in a road accident aged 11, are revealed to the reader long before they occur. However, other revelations relating to the fate of various characters are withheld and revealed gradually throughout the novel, including:
- The fact that Ruby had a twin sister, Pearl, who drowned shortly before their fourth birthday, for which Ruby was falsely blamed (Gillian lied to shift the blame from herself). Ruby has lost all memory of Pearl, and it is not until she is given hypnotherapy at the age of 18 that she remembers Pearl at all. We are given subtle hints of Pearl's existence earlier in the novel (e.g. the doctor looking surprised when Ruby was born as if he wasn't expecting it, the midwife inexplicably saying "Snap," Ruby's mother seeming to possess twice as many pictures of Ruby as of her other children), but because everything is told from Ruby's point of view, their significance is not made narratively explicit.
- That Ruby's great-grandmother Alice, who was believed to have died giving birth to Ruby's grandmother Nell, actually ran away with a travelling French photographer in an effort to escape her unhappy life. She spent her final years back in York, vainly searching for her children.
- The whereabouts of characters who "disappeared" from family life is not explained until nearer the end of the book: these include Nell's brother Lawrence, her sister Lillian, and Ruby's sister Patricia.
- The interconnections between Ruby's family, and Doreen O'Doherty, the Irish nurse. When Doreen is first mentioned, she is introduced as the person with whom Ruby's father George is having an affair. In a later flashback, we discover that Doreen had become pregnant by Edmund, Bunty's Canadian cousin (son of Nell's sister Lillian), who was in the UK on a tour of duty with the Royal Air Force during the Second World War In the final chapter, clues allow us to surmise that the nurse who is present at Bunty's 1992 death is the daughter of Doreen and Edmund, whom Doreen gave up for adoption.
- The father of Edmund, whom the unmarried Lillian had steadfastly refused to name, is revealed on the final page of the footnote ahead of Chapter 11.
