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The Last Midwife: What if childbirth was controlled by the state? London living a nightmare worse than Gilead - a dystopian thriller you won't be able to put down.
‘I’m going to snuff out the old witches – every last one of them!’
Childbirth in England is a state-controlled procedure. Midwives have been outlawed for decades. Only a handful remain, risking everything to help mothers give birth in secret, but now their very existence is under threat.
When young nurse Chiara arrives from Sicily, her dreams are quickly shattered by the horrifying truth behind the pristine walls of the Genesis Centre. Meanwhile Rava, the privileged wife of a government official, finds her perfect life unravelling when her pregnancy fails to meet her husband’s requirements.
Their worlds collide in a desperate fight for life, choice, and humanity against a system determined to control the future, one baby at a time.
Childbirth in England is a state-controlled procedure. Midwives have been outlawed for decades. Only a handful remain, risking everything to help mothers give birth in secret, but now their very existence is under threat.
When young nurse Chiara arrives from Sicily, her dreams are quickly shattered by the horrifying truth behind the pristine walls of the Genesis Centre. Meanwhile Rava, the privileged wife of a government official, finds her perfect life unravelling when her pregnancy fails to meet her husband’s requirements.
Their worlds collide in a desperate fight for life, choice, and humanity against a system determined to control the future, one baby at a time.
- GenresDystopia
472 pages, Kindle Edition
Published November 25, 2025
175 people are currently reading
332 people want to read
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Displaying 1 - 30 of 34 reviews
January 14, 2026
There were a lottt of typos in this book (kindle edition) which were hard to look past at times but I loved the story SO much (as twisted as it is)
November 6, 2025
Storyline: In this story, babies, referred to as Neonates, are only allowed to be born via a C-section. Midwifery is banned. Despite the ban, there are some who continue to practise the "dark art" of midwifery in this highly medicalised world. The storyline is compelling, with some unexpected twists to keep it interesting. The narrative arc builds up well, with a well-written rising action for the main characters. I found myself reading faster and faster as it progressed towards the climax. I could not put it down at the end- just as gripping as a Robert Harris novel!
World: A dystopian world with chilling parallels in current events. When is a baby a baby, and can it be disposed off before its status changes? In this world, the babies are only called babies when they are healthy and allowed to be taken home from the Genesis Centre. The sanitised, ultra-efficient city of London stands in stark contrast to the higgledy-piggledy unregistered slums on the outskirts of the city and the lush, natural surroundings of the last midwife's boat. I loved the descriptions of food in the book - Persian food, Italian food, herbs, cake recipes, tea. These details add richness and depth to what remains of humanity. I also love the description of women giving birth. The author writes these events from a deep, lived-through knowledge being a midwife herself!
Characters: A book is a great book with likeable protagonists! The novel features strong, likeable female leads with excellent character developmental arcs in Chiara and Rava. Chiara evolves from am innocent migrant nurse-in-training to someone who finds her true purpose in life. I also liked Rava; she transforms from a compliant wife to a fighter when she gets pregnant with a baby girl that her husband does not wish to keep. Both characters embody resilience, moral conviction, and the enduring strength of women in the face of systemic oppression.
Overall a very enjoyable, thought-provoking novel.
World: A dystopian world with chilling parallels in current events. When is a baby a baby, and can it be disposed off before its status changes? In this world, the babies are only called babies when they are healthy and allowed to be taken home from the Genesis Centre. The sanitised, ultra-efficient city of London stands in stark contrast to the higgledy-piggledy unregistered slums on the outskirts of the city and the lush, natural surroundings of the last midwife's boat. I loved the descriptions of food in the book - Persian food, Italian food, herbs, cake recipes, tea. These details add richness and depth to what remains of humanity. I also love the description of women giving birth. The author writes these events from a deep, lived-through knowledge being a midwife herself!
Characters: A book is a great book with likeable protagonists! The novel features strong, likeable female leads with excellent character developmental arcs in Chiara and Rava. Chiara evolves from am innocent migrant nurse-in-training to someone who finds her true purpose in life. I also liked Rava; she transforms from a compliant wife to a fighter when she gets pregnant with a baby girl that her husband does not wish to keep. Both characters embody resilience, moral conviction, and the enduring strength of women in the face of systemic oppression.
Overall a very enjoyable, thought-provoking novel.
January 27, 2026
From a healthcare professional view point, the physiological birth stories were sympathetic and heart warming and the characters themselves completely loveable, admirable, and women I see myself in. Whilst I have inside knowledge of the way in which the world is going in terms of the changing attitudes to, and the medicalisation of, childbirth, I just feel some of the content went too far and I feel it would be very upsetting for some vulnerable readers. With that said, I would recommend this book, especially to my colleagues who face a daily barrage of criticism from the media all whilst trying to do their absolute best to accommodate families needs and wishes, but with a little caution for the more vulnerable readers.
February 7, 2026
oh my fucking god ?????? best book i’ve read this year so far and i think this book as a film would be 😘🤌
literally loved it so much & couldn’t put it down, the twists & turns and characters and how in depth all the births were (from authors previous job as a midwife) i just LOVED
10/10
literally loved it so much & couldn’t put it down, the twists & turns and characters and how in depth all the births were (from authors previous job as a midwife) i just LOVED
10/10
January 25, 2026
Fantastic read. Best book I've read so far this year.
Thought provoking and scarey because it's horribly believable!
Well written and fast paced.
Love the main characters and the growth throughout the book.
Thought provoking and scarey because it's horribly believable!
Well written and fast paced.
Love the main characters and the growth throughout the book.
March 3, 2026
A harrowingly conceivable story that as a midwife was frightenly close to current maternity affairs.
The role of a midwife is illegal and in this dystopian story follows nurse Chiara and wife Reva in their journey.
I scored the book 4 stars as there are a few typos that distracted my flow when reading but overall this was a gripping enjoyable read that could infact be the future of maternity services in the UK
The midwife’s skills and advice were on point and not exaggerated to make for dramatic reading, the experiences of Chiara were at some point harrowing and would encourage the reader to check the triggers as #baby death/ loss does feature in the earlier chapters and was for myself difficult to read. Push through the dark times and the ending of the story is actually kind of bitter sweet but there is hope that the midwives will once again rise
The role of a midwife is illegal and in this dystopian story follows nurse Chiara and wife Reva in their journey.
I scored the book 4 stars as there are a few typos that distracted my flow when reading but overall this was a gripping enjoyable read that could infact be the future of maternity services in the UK
The midwife’s skills and advice were on point and not exaggerated to make for dramatic reading, the experiences of Chiara were at some point harrowing and would encourage the reader to check the triggers as #baby death/ loss does feature in the earlier chapters and was for myself difficult to read. Push through the dark times and the ending of the story is actually kind of bitter sweet but there is hope that the midwives will once again rise
February 21, 2026
I love dystopian fiction and the premise for this one appealed to me when I saw an advert on instagram .i bought a copy and it went straight to the top of my reading list
The novel is setting in a dystopian England where the population has been confined to cities and and certain people are allowed to have children. This story follows a young girl who moves to England to work in a Birthing Centre. It quickly becomes clear that things are not right all babies are born by Caesarean section their mothers have no choice and babies showing any signs of Disability are euthanised at birth and women can only take their children home as a father signs for them. Our new nurse becomes quickly disillusioned and discovers an underground midwifery system with women who want to give birth naturally having to contact these black market midwives in order to do so.
The novel sets up well you’re quickly aware of what the dystopian world consists of. I quickly enthralled in the novel and didn’t want to put it down.
The author has a clear flowing writing style. This is an easy. Enjoyable Read.
The characterisation is detailed and the characters including some of the minor ones seemed really real
I’ve read a lot of dystopian novels and this is amongst the best if you like The Handmaid’s Tale you’ll love this novel or the the books of Christina Dalcher Viox and Q then I’m sure you’re going to really enjoy this book
I haven’t seen anyone writing about this on social media however I did see an advert which is the main reason I bought the book
It would make a great TV series
This review will appear on Goodreads, StoryGraph, and my book blog bionicSarahS books.wordpress.com. I will also publish it on Amazon UK.
The novel is setting in a dystopian England where the population has been confined to cities and and certain people are allowed to have children. This story follows a young girl who moves to England to work in a Birthing Centre. It quickly becomes clear that things are not right all babies are born by Caesarean section their mothers have no choice and babies showing any signs of Disability are euthanised at birth and women can only take their children home as a father signs for them. Our new nurse becomes quickly disillusioned and discovers an underground midwifery system with women who want to give birth naturally having to contact these black market midwives in order to do so.
The novel sets up well you’re quickly aware of what the dystopian world consists of. I quickly enthralled in the novel and didn’t want to put it down.
The author has a clear flowing writing style. This is an easy. Enjoyable Read.
The characterisation is detailed and the characters including some of the minor ones seemed really real
I’ve read a lot of dystopian novels and this is amongst the best if you like The Handmaid’s Tale you’ll love this novel or the the books of Christina Dalcher Viox and Q then I’m sure you’re going to really enjoy this book
I haven’t seen anyone writing about this on social media however I did see an advert which is the main reason I bought the book
It would make a great TV series
This review will appear on Goodreads, StoryGraph, and my book blog bionicSarahS books.wordpress.com. I will also publish it on Amazon UK.
December 29, 2025
Brilliant! I couldn’t put it down, reading late in to the night.
A clever story of love & survival with plenty of twists, turns & heart in the mouth moments.
A clever story of love & survival with plenty of twists, turns & heart in the mouth moments.
January 10, 2026
Very interesting
Very well written. Flows and good character development. Makes you think of what is happening in the world today. Thank you for a good read.
Very well written. Flows and good character development. Makes you think of what is happening in the world today. Thank you for a good read.
February 5, 2026
Very much enjoyed this book. Great originality. Scary peek into the future if men are allowed to rule women’s healthcare again
February 2, 2026
wow what a book!!!
this booked had me hooked
this booked had me hooked
February 28, 2026
Chilling - I hated it but couldn't put it down
February 8, 2026
Karen Lawrence’s The Last Midwife is one of those dystopian thrillers that feels less like speculative fiction and more like a warning flare. Set in an England where childbirth has been fully absorbed into state control, the novel imagines a world in which midwives have been outlawed and reproductive autonomy has been reduced to a bureaucratic process. It’s chilling precisely because it feels so plausible.
The story follows two women whose lives sit on opposite sides of the regime. Chiara, a young nurse newly arrived from Sicily, enters the Genesis Centre with idealism and ambition, only to discover the violence and coercion hidden beneath its immaculate surfaces. Rava, the privileged wife of a government official, believes she is protected by her status—until her pregnancy fails to meet the state’s strict requirements. Their narratives converge in a way that exposes the system’s totalising reach and the fragility of any illusion of safety.
Lawrence’s world‑building is sharp and economical. She doesn’t rely on grand dystopian spectacle; instead, she shows how oppression embeds itself in paperwork, medical protocols, and the quiet erasure of traditional knowledge. The tension builds steadily, driven by the knowledge that every choice these women make carries enormous risk.
What makes the novel so compelling is its focus on humanity: the whispered solidarities, the courage required simply to help someone give birth, the stubborn persistence of care in a world determined to control it. The Last Midwife is both a gripping thriller and a thoughtful exploration of power, autonomy, and resistance.
A timely, unsettling, and deeply resonant read.
The story follows two women whose lives sit on opposite sides of the regime. Chiara, a young nurse newly arrived from Sicily, enters the Genesis Centre with idealism and ambition, only to discover the violence and coercion hidden beneath its immaculate surfaces. Rava, the privileged wife of a government official, believes she is protected by her status—until her pregnancy fails to meet the state’s strict requirements. Their narratives converge in a way that exposes the system’s totalising reach and the fragility of any illusion of safety.
Lawrence’s world‑building is sharp and economical. She doesn’t rely on grand dystopian spectacle; instead, she shows how oppression embeds itself in paperwork, medical protocols, and the quiet erasure of traditional knowledge. The tension builds steadily, driven by the knowledge that every choice these women make carries enormous risk.
What makes the novel so compelling is its focus on humanity: the whispered solidarities, the courage required simply to help someone give birth, the stubborn persistence of care in a world determined to control it. The Last Midwife is both a gripping thriller and a thoughtful exploration of power, autonomy, and resistance.
A timely, unsettling, and deeply resonant read.
February 21, 2026
If you like The Handmaid's Tale, you'll love this!!
October 21, 2025
Feminist dystopian thrillers have been hitting eerily close to reality lately, and The Last Midwife brings that discomfort home. Set in a chillingly plausible time, it echoes real-world horrors: from forced sterilizations to coerced abortions driven by state's policy. It's London living a nightmare worse than Gilead.
Surveillance, fear, and secrecy add to the novel’s claustrophobic tone. The epigraph and recurring themes of heavily monitored reproduction deepen the unease, but what stands out most is how the novel centers midwifery. It’s reimagined here through Liz’s magical and intuitive practice—adding warmth to the birthing experience in sharp contrast to the "safe", clinical horrors of "modern healthcare" in the story.
The narrative structure is gripping, with backstories placed perfectly to explain character motivations without slowing the pace. The attention to detail, especially in settings like Rosie Lee and Genesis Centre, pulls you further into the action.
It leaves me with a lasting thought: when medical science becomes a tool of authoritarian regimes, it spirals into unimaginable forms of violence. A gripping and chilling read. Perfect for fans of feminist dystopias and thrillers. Highly relatable for women around the world.
Surveillance, fear, and secrecy add to the novel’s claustrophobic tone. The epigraph and recurring themes of heavily monitored reproduction deepen the unease, but what stands out most is how the novel centers midwifery. It’s reimagined here through Liz’s magical and intuitive practice—adding warmth to the birthing experience in sharp contrast to the "safe", clinical horrors of "modern healthcare" in the story.
The narrative structure is gripping, with backstories placed perfectly to explain character motivations without slowing the pace. The attention to detail, especially in settings like Rosie Lee and Genesis Centre, pulls you further into the action.
It leaves me with a lasting thought: when medical science becomes a tool of authoritarian regimes, it spirals into unimaginable forms of violence. A gripping and chilling read. Perfect for fans of feminist dystopias and thrillers. Highly relatable for women around the world.
February 14, 2026
great read!
This book was pretty good! It’s something so dystopian but sadly something you could see happening possibly in years from now. It’s a story of grit, perseverance, and courage!
This book was pretty good! It’s something so dystopian but sadly something you could see happening possibly in years from now. It’s a story of grit, perseverance, and courage!
February 2, 2026
Beautifully written Story
The Last Midwife is a beautifully written, emotional, and gripping story that I truly enjoyed from start to finish.
Karen Lawrence does an amazing job bringing the world to life and creating characters you quickly become invested in. I found myself genuinely caring about what happened to them, and that connection made the story even more powerful. The main character’s strength, vulnerability, and determination felt real and deeply human.
The pacing kept me turning pages, and the mix of tension, heart, and hope made this more than just a compelling story—it was an experience. I especially loved how the relationships between the characters developed naturally and added depth to every challenge they faced.
This was an engaging, heartfelt read with memorable characters, and I would absolutely recommend it to anyone who enjoys character-driven stories with emotional impact.
The Last Midwife is a beautifully written, emotional, and gripping story that I truly enjoyed from start to finish.
Karen Lawrence does an amazing job bringing the world to life and creating characters you quickly become invested in. I found myself genuinely caring about what happened to them, and that connection made the story even more powerful. The main character’s strength, vulnerability, and determination felt real and deeply human.
The pacing kept me turning pages, and the mix of tension, heart, and hope made this more than just a compelling story—it was an experience. I especially loved how the relationships between the characters developed naturally and added depth to every challenge they faced.
This was an engaging, heartfelt read with memorable characters, and I would absolutely recommend it to anyone who enjoys character-driven stories with emotional impact.
January 11, 2026
A really great read.
Excellent thought provoking read about a dystopian future in the U.K. Great believable characters I struggled to put it down.
Excellent thought provoking read about a dystopian future in the U.K. Great believable characters I struggled to put it down.
January 10, 2026
Honestly just read it. It’s a brilliant book although it’s a tad uncomfortable at times due to the nature of it. Thank you to our NHS midwife’s and Nurses
December 10, 2025
As someone who is very passionate about birth this book ticked so many boxes for me. Set in a dystopian London where physiological birth and midwifery is now illegal and all mothers “incubators” are subjected to c-sections and all of these other regulations on women’s bodies. Following Chiara and her journey as a nurse turned traditional midwife leads to unexpected turns and a fight to the end for what is right.
It gives hand maids tale vibes and some of the storylines are truly harrowing. I think the concept of neonatal 2 will always make me shudder. But also the joy of all the births on the Rosie Lee, it makes me tear up and brings me back to my own birth experience. Liz is such a character and I genuinely feel like we all know a “Liz” in midwifery!
But honestly, it’s not that far fetched to imagine some of this ideas could be our reality with the current maternity system being what it is and with increasing c-section rates!
Loved it and will recommend to all my other birth enthusiasts.
It gives hand maids tale vibes and some of the storylines are truly harrowing. I think the concept of neonatal 2 will always make me shudder. But also the joy of all the births on the Rosie Lee, it makes me tear up and brings me back to my own birth experience. Liz is such a character and I genuinely feel like we all know a “Liz” in midwifery!
But honestly, it’s not that far fetched to imagine some of this ideas could be our reality with the current maternity system being what it is and with increasing c-section rates!
Loved it and will recommend to all my other birth enthusiasts.
January 18, 2026
Surprisingly excellent
Wasn't to sure if I'd get into this book as not usually my thing , dystopian futures, but totally enjoyed it and read it in no time...a different take on wot may lie ahead for us as a population but not an impossible reality, if u enjoy books on midwives fighting not to become a thing of the past from being hunted out of existence I'll enjoy this book
Wasn't to sure if I'd get into this book as not usually my thing , dystopian futures, but totally enjoyed it and read it in no time...a different take on wot may lie ahead for us as a population but not an impossible reality, if u enjoy books on midwives fighting not to become a thing of the past from being hunted out of existence I'll enjoy this book
January 18, 2026
A must read
So clever on many levels. Really got me thinking about so many real world issues.
But that's not to say it's a boring or dull book, far from it. I read it in 2 days.
If you're even in the slightest bit interested in this book then I recommend you buy it, just make sure you've got enough time to binge read it!
So clever on many levels. Really got me thinking about so many real world issues.
But that's not to say it's a boring or dull book, far from it. I read it in 2 days.
If you're even in the slightest bit interested in this book then I recommend you buy it, just make sure you've got enough time to binge read it!
February 23, 2026
Not quite unputdownable — but definitely memorable.
I enjoyed this book and didn't guess the twists regarding Liz until just before it was revealed - it's scary to think of a future like this but I suppose anything is possible.
A mix between Call the Midwife and The Handmaids Tale
I enjoyed this book and didn't guess the twists regarding Liz until just before it was revealed - it's scary to think of a future like this but I suppose anything is possible.
A mix between Call the Midwife and The Handmaids Tale
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December 31, 2025It was an interesting story, and a good book. However, I will not be reading any more books with cats in them unless I know for a fact that nothing happens to said cats. So I'm leaving this content warning here for everyone else: very gruesome description of the body of a tortured and murdered cat.
All other potentially triggering content (child death and abuse, eugenics, abuse, racism, misogyny, etc.) is as one would expected in a dystopian book, which is why I don't feel the need to go into detail.
The book was very moving and thoughtful, as well as interesting.
All other potentially triggering content (child death and abuse, eugenics, abuse, racism, misogyny, etc.) is as one would expected in a dystopian book, which is why I don't feel the need to go into detail.
The book was very moving and thoughtful, as well as interesting.
December 3, 2025
A chilling book that could come a brutal reality in this scary world we are living in.
Plenty of twists to keep the reader hooked.
Only problem is in the kindle edition there is a fair few typos, but this doesn’t take away from the authors brilliant style of writing.
Plenty of twists to keep the reader hooked.
Only problem is in the kindle edition there is a fair few typos, but this doesn’t take away from the authors brilliant style of writing.
December 30, 2025
Fantastic read
WoW....what a wonderful story and it makes you think this is the way the world is actually heading. I hope not and if it does, it won't be in my lifetime...........or will it. Read this brilliant book and decide what you think.
WoW....what a wonderful story and it makes you think this is the way the world is actually heading. I hope not and if it does, it won't be in my lifetime...........or will it. Read this brilliant book and decide what you think.
March 5, 2026
This novel is a chilling and powerful dystopian story that feels both terrifying and painfully plausible. Set in a future England where childbirth is completely controlled by the state and midwives have been outlawed, the story immediately pulls you into a world where autonomy, compassion, and basic human rights are being systematically stripped away.
The author does an incredible job of building tension from the very first page. The Genesis Centre, with its pristine walls and strict rules, becomes a haunting symbol of a society that values control over humanity. What appears orderly and safe on the surface slowly reveals something much darker beneath.
Chiara’s journey is particularly compelling. Arriving from Sicily with hope and ambition, she quickly discovers that the system she believed in is deeply flawed and disturbingly cruel. Watching her confront the reality of what is happening behind closed doors is both heartbreaking and gripping. At the same time, Rava’s storyline adds another powerful dimension. As the privileged wife of a government official, she initially seems protected by her status yet her pregnancy exposes just how ruthless and unforgiving the system truly is.
The dual perspectives work beautifully, gradually weaving together into a tense and emotional narrative. Both women are forced to question the world around them and ultimately fight for something far bigger than themselves: the right to choice, dignity, and compassion.
What makes this book truly stand out is how it blends suspense with deeply human storytelling. The themes of bodily autonomy, power, and resistance are handled with sensitivity and urgency. It’s a story that lingers long after the final page, leaving readers reflecting on how fragile freedom can be when systems of control go unchallenged.
Disturbing, thought-provoking, and impossible to put down, this is a brilliant dystopian novel that will stay with you. Highly recommended.
The author does an incredible job of building tension from the very first page. The Genesis Centre, with its pristine walls and strict rules, becomes a haunting symbol of a society that values control over humanity. What appears orderly and safe on the surface slowly reveals something much darker beneath.
Chiara’s journey is particularly compelling. Arriving from Sicily with hope and ambition, she quickly discovers that the system she believed in is deeply flawed and disturbingly cruel. Watching her confront the reality of what is happening behind closed doors is both heartbreaking and gripping. At the same time, Rava’s storyline adds another powerful dimension. As the privileged wife of a government official, she initially seems protected by her status yet her pregnancy exposes just how ruthless and unforgiving the system truly is.
The dual perspectives work beautifully, gradually weaving together into a tense and emotional narrative. Both women are forced to question the world around them and ultimately fight for something far bigger than themselves: the right to choice, dignity, and compassion.
What makes this book truly stand out is how it blends suspense with deeply human storytelling. The themes of bodily autonomy, power, and resistance are handled with sensitivity and urgency. It’s a story that lingers long after the final page, leaving readers reflecting on how fragile freedom can be when systems of control go unchallenged.
Disturbing, thought-provoking, and impossible to put down, this is a brilliant dystopian novel that will stay with you. Highly recommended.
November 21, 2025
A compelling read from the opening paragraph to the very last sentence and one I found very hard to put down. There was a chilling feeling of reality and an authenticity in the detailed accounts of the lives of women who, for the benefit of society and to maintain population control, are only permitted, with strict conditions including paternal permission and support, to have one child. All babies, being born by C section and if not perfect being eutanased at birth. The mothers, referred to as incubators, are then sterilised, or sealed to prevent them from incubating again, are drugged following delivery and are forbidden to breastfeed. Meanwhile, outside of the sterile birthing unit, the Genesis centre, and hidden in an underground world, midwives are delivering babies to women who don't have a licence including those having multiple births. One such midwife is one of the last not to have been hunted down by the authorities.
The characters in the book, whose lives intertwine in an unexpected way, are so vividly portrayed. The attention to detail, particularly medical and cultural make this book stand out as one that has a chilling ring of reality that is haunting.
At the end of the book, the pieces of this cleverly woven tale fit together and you will feel the compulsion to read it again with the hindsight of knowing how it ends.
As a woman, mother and a nurse, his book was strikingingly impressive.
The characters in the book, whose lives intertwine in an unexpected way, are so vividly portrayed. The attention to detail, particularly medical and cultural make this book stand out as one that has a chilling ring of reality that is haunting.
At the end of the book, the pieces of this cleverly woven tale fit together and you will feel the compulsion to read it again with the hindsight of knowing how it ends.
As a woman, mother and a nurse, his book was strikingingly impressive.
February 9, 2026
The Last Midwife by Karen Lawrence is a gripping and unsettling dystopian thriller that imagines a near-future England where childbirth has been seized by the state and midwives have been outlawed. Both terrifying and heartbreakingly plausible, the novel explores what happens when reproductive autonomy is stripped away under the guise of order and progress.
At the heart of the story are two women from vastly different worlds. Chiara, a young nurse newly arrived from Sicily, enters the immaculate Genesis Centre full of hope only to uncover the brutal reality behind its polished façade. Rava, the privileged wife of a government official, begins to question the system when her pregnancy fails to meet rigid state expectations. As their lives intersect, the novel exposes the human cost of absolute control over women’s bodies.
Lawrence excels at building tension while grounding the narrative in deeply personal stakes. The outlawed midwives portrayed as brave, hunted, and indispensable embody resistance, compassion, and quiet heroism. The novel’s pacing is relentless, its atmosphere claustrophobic, and its moral questions urgent. Fans of The Handmaid’s Tale will find this story equally haunting, but The Last Midwife stands firmly on its own, offering a raw, emotionally charged exploration of choice, power, and survival.
At the heart of the story are two women from vastly different worlds. Chiara, a young nurse newly arrived from Sicily, enters the immaculate Genesis Centre full of hope only to uncover the brutal reality behind its polished façade. Rava, the privileged wife of a government official, begins to question the system when her pregnancy fails to meet rigid state expectations. As their lives intersect, the novel exposes the human cost of absolute control over women’s bodies.
Lawrence excels at building tension while grounding the narrative in deeply personal stakes. The outlawed midwives portrayed as brave, hunted, and indispensable embody resistance, compassion, and quiet heroism. The novel’s pacing is relentless, its atmosphere claustrophobic, and its moral questions urgent. Fans of The Handmaid’s Tale will find this story equally haunting, but The Last Midwife stands firmly on its own, offering a raw, emotionally charged exploration of choice, power, and survival.
February 9, 2026
This book really got under my skin. The Last Midwife is a dystopian story set in a future England where midwifery is banned and all babies are born by C-section under strict state control. It sounds extreme, but the scary thing is how believable it feels.
The story follows two women. Chiara is a young nurse who starts work at the Genesis Centre believing she’s part of something modern and safe, only to slowly realise how harmful the system really is. Rava, the wife of a government official, thinks she’s protected by her status - until she gets pregnant and everything changes. I loved watching both of them grow and push back in their own ways.
What stayed with me most was the contrast between the cold, clinical world of state-controlled birth and the warmth of the outlawed midwives working in secret. The birth scenes feel real, respectful and full of humanity, and you can really tell the author is a midwife herself. Even the small details like food, tea, shared moments make the world feel lived-in and human.
It’s fast-paced, unsettling and hard to put down, but it also makes you think long after you’ve finished. A really powerful read about control, care and what happens when women lose choice over their own bodies.
I really hope Karen considers writing a sequel!
The story follows two women. Chiara is a young nurse who starts work at the Genesis Centre believing she’s part of something modern and safe, only to slowly realise how harmful the system really is. Rava, the wife of a government official, thinks she’s protected by her status - until she gets pregnant and everything changes. I loved watching both of them grow and push back in their own ways.
What stayed with me most was the contrast between the cold, clinical world of state-controlled birth and the warmth of the outlawed midwives working in secret. The birth scenes feel real, respectful and full of humanity, and you can really tell the author is a midwife herself. Even the small details like food, tea, shared moments make the world feel lived-in and human.
It’s fast-paced, unsettling and hard to put down, but it also makes you think long after you’ve finished. A really powerful read about control, care and what happens when women lose choice over their own bodies.
I really hope Karen considers writing a sequel!
Displaying 1 - 30 of 34 reviews