Set in Switzerland, Austria, and Amsterdam, this 20th novel in the Saint-Germain series takes place approximately three-quarters of a century after the first (Hotel Transylvania), beginning during the hard winter of 1817. For those coming new to the series, Saint-Germain is a 4,000-year-old vampire, but his nature is only incidental to the story. Far more important are the interactions between the characters; the focus is more on the women in this novel than the vampire.

Hero von Scharffensee, a widow whose children are being raised by their grandfather, is Saint-Germain's current lover. To Hero's great sorrow, Graf von Scharffensee does his best to keep her and the children separated; he feels he is doing his duty to his dead son by raising them and Hero would only interfere.

In addition to feelings of inadequacy as a mother, Hero struggles with jealousy of Madelaine de Montalia, whom she believes to have a larger share of Saint-Germain's heart, despite his assurances to the contrary. Madelaine was the heroine of Hotel Transylvania and is now a vampire herself. Madelaine, however, appears only through her letters to Saint-Germain; she is at Varna, trying to organize an expedition into Egypt.

Saint-Germain owns a publishing house in Amsterdam that is planning to publish a book by Graf von Ravensberg, who has been studying the properties of blood, a subject dear to any vampire's heart. Von Ravensberg has a niece, Hyacinthie, who was raised in his house and is now of marriageable age. Despite Saint-Germain's obvious attachment to Hero, and Hyacinthie's own engagement to another man, Hyacinthie sets her sights on the count with unfortunate results.

Borne in Blood moves at a leisurely pace that reflects the long, slow life of the vampire. Presented almost as a series of lengthy vignettes, it is punctuated by correspondence; some of the characters (like Madelaine) appear in no other way.

Despite the pace, Borne in Blood is compelling reading. The setting is well-researched and meticulously presented, and the characters keep the reader coming back for more.

Since the series leaps about in time (the previous book, Roman Dusk, was set approximately 1,500 years earlier), continuity is not really a problem, nor is jumping into the series at any point.