Inspired by the true story of Martina Greywind and follows the details of her story fairly closely. Ms. Greywind was a 28 year-old homeless North Dakota woman addicted to drugs who was unaware she was pregnant, after having had six children taken by the state, until being arrested for publicly inhaling spray-paint fumes (this was changed to patio sealant, a fictional product, for the film) and was charged with endangering her unborn child. She was bailed out by the Lambs of Christ, who offered her $10,000 if she gave birth to the child, even if it were given up for adoption. Ultimately, she had the abortion, with the fee donated by a pro-choice organization and was driven over 100 miles to the nearest clinic.
This movie marks the reunion of Laura Dern and Burt Reynolds in a theatrical movie. The 1970s Reynolds movie White Lightning (1973) had been Dern's uncredited film debut. Dern was just six years old when she appeared in a brief non-speaking walk on bit part. In White Lightning (1973), Dern played the daughter of her real life mother Diane Ladd who played Maggie. This time around in Citizen Ruth (1996), it is Dern who has the main part with Reynolds playing a supporting role.