The Cider House Rules
This movie surrounds an orphanage managed by a doctor and some nurses. they manage to get by on meager means. It is very sad, but plays true to life in many of the scenes. It even brought me to tears. If you have not seen it you are missing out.
Here is a review:
https://www.haro-online.com/movies/cider_house_rules.html
According to the book, Rose Rose was being sexually molested by her father, and became pregnent by him. He taught her how to use the knife as skillfully as he did, and to prevent him from sexually molesting the daughter she had by him, she killed him using the knife that he taught her so well.