The Book of the Unnamed Midwife (2016)
Written by: Meg Elison
Genre: Post-apocalyptic fiction
Pages: 291 (Paperback)
Series: The Road to Nowhere Book #1
Publisher: 47North
Why I Chose It: I read this book because its sequel, The Book of Etta, is nominated for the 2018 Philip K. Dick Award. I really did not want to read this book because I disliked both of the books I reviewed for last year’s Philip K. Dick Award. I had never heard of Meg Elison before, so I was wary of having to read two of her books. I hoped that the library wouldn’t have them so I’d have a good reason to say no, but my local library system is fantastic.
The premise:
When she fell asleep, the world was doomed. When she awoke, it was dead.
In the wake of a fever that decimated the earth’s population—killing women and children and making childbirth deadly for the mother and infant—the midwife must pick her way through the bones of the world she once knew to find her place in this dangerous new one. Gone are the pillars of civilization. All that remains is power—and the strong who possess it.A few women like her survived, though they are scarce. Even fewer are safe from the clans of men, who, driven by fear, seek to control those remaining. To preserve her freedom, she dons men’s clothing, goes by false names, and avoids as many people as possible. But as the world continues to grapple with its terrible circumstances, she’ll discover a role greater than chasing a pale imitation of independence.
After all, if humanity is to be reborn, someone must be its guide.
Spoilers: A few mild spoilers ahead.
Discussion: The book’s regrettable, clunky title is one of the reasons that I wasn’t enthusiastic about reading it. The Book of the Unnamed Midwife makes me think historical fiction set in the 1800’s. The book’s cover, a bleak scene of a snowy road in the Rocky Mountains, didn’t grab my attention, either. Neither the title nor the cover suggests a post-apocalyptic world to me. The titular midwife is actually a labor and delivery nurse in a modern-day hospital when the apocalypse hits, but I suppose The Book of the Unnamed Labor and Delivery Nurse would be too wordy.
It’s unfortunate that the title is off-putting because this is a page-turning, beautifully written book. I’ve read numerous post-apocalyptic books that imagined a future with limited commodities, but Elison has created a world where women are one of those scarce resources. The plague kills off most of humanity but it’s deadliest to pregnant women and fewer women survive overall. The world becomes a grim and disturbing place. By the tenth page of the book, the midwife has already stabbed a man to death because he was trying to rape her. She encounters a group of men who are keeping two naked women on leashes, “as dirty as rescue dogs. Same look in the eye” (p.61).
The midwife is forced to disguise herself as a man for her safety. Because pregnancy is so lethal, she becomes an angel of birth control, secretly dispensing shots and morning after pills to women being held captive. She is a resilient person with a strong sense of justice. The midwife kills several men, but rescues many women. At one point, the midwife “dreamed she was an auctioneer, selling every girl she had ever loved to men with long knives” (p.73).
We only get glimpses into what the midwife was like before the end of the world. The midwife is bisexual but she was in a relationship with a doctor named Jack who worked at the same hospital. She reminisces about her life with Jack — “She thought of dark absinthe bars and museums and galleries. She thought about restaurants in the city, and her stomach cramped on itself though she wasn’t hungry. She remembered the rarified tastes, the roasted bone marrow and local vegetables. The artisan cocktails and small-batch cheeses. It all came back in a rush of her former privileged, moneyed life.” (p. 195). I wish that Elison had included more flashbacks like this one because it is hard to get to know a character when she spends the whole book fighting for her life and you never even learn her real name.
The book also has many intriguing and compelling secondary characters. Roxanne is a former stripper that the midwife saves from her captors, who claims that she knows how to manipulate men, even in this dramatically altered world. Joni and Honus are a married Mormon couple who still cling to the proclamations of their religious leaders. Joni spent most of her time watching reality TV shows, making her a dull companion for the midwife and giving me something new to fear about the apocalypse. Even though The Book of the Unnamed Midwife is essentially a journal, I appreciated very much that Elison has the midwife copy parts of Roxanne’s and Honus’ diaries and breaks into an omniscient point of view to let you know what happens to the characters once they leave the midwife’s life. The ultimate fate of the midwife’s boyfriend, Jack, brought tears to my eyes.
In conclusion: I’m happy to say that I was completely wrong to want to avoid reading this book. I loved it. The Book of the Unnamed Midwife reminded me of Cormac McCarthy’s The Road, Margaret Atwood’s The Handmaid’s Tale, and P.D. James’ The Children of Men, but Elison has created her own unique take on what would happen in a world where women are rare and successful childbirth almost impossible. It is a gripping story but very grim, with a disturbing amount of sexual violence. The Book of the Unnamed Midwife won the Philip K. Dick Award in 2014 and it was richly deserved.
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