"Stephanie Daley" deals with several hot-button topics—teenage pregnancy and infanticide not the least of them—that are prime material for a predictably preachy or exploitative television movie. Produced with the assistance of the Sundance Film Institute under the helm of indie filmmaker Hilary Brougher (1997's "The Sticky Fingers of Time"), the picture mostly avoids these trappings, taking a non-sensationalistic and gritty look at the way guilt and regret can eat away at a person's psyche. Although the story elements ultimately don't seem to add up to much by the end, the ride to the finish line is riveting, affecting, and well worth the effort.

Lydia Crane (Tilda Swinton) is a forensic psychologist in her seventh month of pregnancy who is hired to uncover the truth in a case gearing up to go to trial. Her subject is Stephanie Daley (Amber Tamblyn), a meek, withdrawn 16-year-old who secretly gave birth to a premature baby while on a class ski trip and is accused of killing it. Stephanie claims that she had no idea she was even pregnant before she went into labor—her friends and devoutly Christian parents just assumed she was putting on a little weight—but Lydia is not so sure of her validity. As the teenage girl little by little opens up and tells her story (seen in flashbacks), Lydia is plagued by fears about her own unborn child and haunted by memories of the tragic stillborn birth she experienced the year before. With Lydia's marriage to Paul (Timothy Hutton) becoming more distant by the day, she and Stephanie concurrently move closer to a shared self-actualization and acceptance of the choices they have made in their lives.

Written and directed by Hilary Brougher with a keen eye for setting (filmed in Upstate New York) and unpretentious visual panache, "Stephanie Daley" doesn't quite rise above being a common "issues" movie, but it at least handles said issues with intelligence and tough realism. Crisscrossing back and forth between the present and past, the narrative nonetheless retains a low-key, minimalist approach that allows the viewer to concentrate their attentions on the two fascinating lead female characters. Lydia and Stephanie are strangers to each other before they meet and seemingly share little in common, but as the onion layers are torn off of both of their tortured pasts, Lydia discovers she is more like Stephanie than she'd care to admit. In essence, they have both made selfish decisions out of fear and shame, one in response—or is it derision?—to what she believes God would want, and the other out of an inability to accept what cannot be changed.

The performances from Tilda Swinton (2005's "Broken Flowers") and Amber Tamblyn (2006's "The Grudge 2") are nothing short of stupendous. Swinton, taking a break from her frequently typecast villainess roles in 2005's "Constantine" and 2005's "The Chronicles of Narnia: The Lion, the Witch and the Wardrobe," plays Lydia as a woman levelheaded and self-assured on the outside but bristling with underlying insecurities. As she struggles to come to terms with her current pregnancy and the failed one that constantly eats away at her, doubts about the strength of her marriage arise when she finds an earring—not her own, since her ears aren't pierced—in the cat's litter box. Swinton is a force of naked emotions made even more impressive because she is portraying a woman whose voice decibel rarely goes above a loud whisper.

As Stephanie, Tamblyn is exceptional, bravely essaying the role a teenage girl whose naiveté is either the effect of a religious upbringing, a desire to fit in with her peers, lack of experience, or all of the above. When Stephanie attempts to comfort tearful school outcast Satin (Caitlin Van Zandt), an old friend of hers whom she has drifted away from, in the bathroom, and Satin angrily tells her she's a sheep like the rest of them, Stephanie recognizes the truth in what she says but is powerless to stop it from happening. As for the centerpiece of the film, an uncomfortable sequence of great power as Stephanie goes into labor in a public bathroom, all the while trying to keep quiet as oblivious girls shuffle in and out, Tamblyn's amazingly astute acting is accomplished solely through facial expressions saying far more than words possibly could. Supporting work from Timothy Hutton (2007's "The Last Mimzy") as Lydia's husband Paul, and Melissa Leo (2005's "Hide and Seek") and Jim Gaffigan (2004's "13 Going on 30") as Stephanie's squabbling parents, is also strong.

There are times when the low budget of "Stephanie Daley" shines through—the editing of certain scenes has a disconnected quality that can be confusing, perhaps due to too little filming coverage. Additionally, the final scene's effect does not seem to equal writer-director Hilary Brougher's intentions, and feels anticlimactic in comparison to what has come before. Nevertheless, "Stephanie Daley" provocatively carries itself through the rough spots with exquisitely realized protagonists and first-rate performances to match. The film wisely delivers no easy answers and draws no pat conclusions in Stephanie's and Lydia's actions. They must live with the choices they have made as they strive to move forward, and they will.