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The Road to Nowhere #1

The Book of the Unnamed Midwife

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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.

300 pages, Kindle Edition

First published June 4, 2014

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About the author

Meg Elison

41 books987 followers
Meg Elison is a science fiction author and feminist essayist. Her series, The Road to Nowhere, won the 2014 Philip K. Dick award. She was a James A. Tiptree Award Honoree in 2018. In 2020, she is publishing her first collection, called “Big Girl” with PM Press and her first young adult novel, “Find Layla” with Skyscape. Meg has been published in McSweeney’s, Fantasy & Science Fiction, Fangoria, Uncanny, Lightspeed, Nightmare, and many other places. Elison is a high school dropout and a graduate of UC Berkeley. Find her online, where she writes like she’s running out of time.


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Displaying 1 - 30 of 2,706 reviews
Profile Image for Roxane.
Author 121 books157k followers
July 24, 2017
One of the most utterly absorbing books I've read in a long time. A post apocalyptic novel that doesn't forget that before the apocalypse people were LGBT and full of yearning and need. Grim but lots of pockets of warmth. Really interesting protagonist, an unnamed midwife, who begins to create a written history that will survive her for generations. Loved this novel.
Profile Image for Shelby *trains flying monkeys*.
1,573 reviews5,903 followers
January 16, 2017
A dark as night apocalyptic novel? That's actually good? All the stars going up.

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She wakes up in the hospital after being sick to realize that they are no people around. Just some dead bodies and the remembrances of a sickness that was rampant. Mostly all the women were dying and the babies and children were all gone.
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She ventures home shell shocked and is almost raped in her bed. She discovers that there are a few men still alive but the rules have changed.
She poses as a man because those are her best chances of making it anywhere without being made into a captive.

When the sirens quit, the rules gave out. Some people had been waiting their whole lives to live lawlessly, and they were the first to take to the streets. Some people knew what would happen; they knew better than to open their doors when they heard cries of help. Other's didn't. What disease cannot do, people accomplish with astonishing ease.

This book takes on this type of story differently than I've seen it done. It seems like by reading the blurb and a few of the reviews that you are getting a story that's been told before but not that I've read. The unnamed woman sets out on her journey and I became entranced by it. I usually gripe and whine about not knowing all the tidbits..like what the disease actually was and what caused it. But not this time. It is done PERFECTLY. The author does take the time to wrap up the stories of the characters she introduces. (Even when you wished she hadn't...dark stuff)
Then genders are blinded when the world is thrown to shit.
Women are basically trade items at times and then 'hive' masters the next.

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This is a whole new set of worms.
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Read this book.

(It looks like it might be a series but fear not my fellow series haters..this is a full meal on it's own.)

Booksource: Netgalley in exchange for review.
Profile Image for Melanie.
1,167 reviews98.2k followers
May 13, 2017
ARC provided by the publisher via Netgalley in exchange for an honest review.

“There are battles and accidents; there are collapses and plagues. There is silence only when one side wins or everyone has died.”

This book was perfection, and probably the easiest five stars I've given all year. This was so thought provoking, meaningful, eye-opening, and important. This was also, as a woman, the scariest dystopian I've ever read.

What made me initially request an ARC of this was that it had won an award in 2014, even though it is just being republished in 2016. Now that I've read this, it deserves every award - all the awards. If I could have people read one book this year, it would be this.

This book changed me.

I should preface this review by telling you there are many trigger warnings in this book: Rape, genital mutilation, physical abuse, sex trafficking/trades, stillbirths, and probably more things in the same vein. (You can ask me for a more specific trigger, and I will always reply back.)

Basically, 98% of Earth's population of men and 99% of Earth's population of women has died from an autoimmune disease. Even though most of the Earth's population has be wiped out, the ratio of men to women is immense. Women become a very sought after commodity. Most are raped, sold, and treated like dogs.

“What disease cannot do, people accomplish with astonishing ease.”

The unnamed midwife makes it her goal to travel to a safer place, while pretending to be a man, and giving women healthy options to not get pregnant. She also is willing to help with births, to try to save the lives of the pregnant woman, because all the children being born are stillborn.

Since the main character of this book is impersonating a man, we get to see all the gender roles, and characteristics they have in this "new" world. Spoiler alert, they aren't pretty. Many men take many steps back in progression, and have become more scary and animalistic, while trying to prove their alpha status.

This book heavily talks about gender roles and their impact on any society. They are obviously enhanced because of the ratio of men to women in this new post-apocalyptic society, but the parallels within our own society are so real and so scary.

The midwife is also very open about her sexuality. She identifies as bi, but I think she is most likely pan, too, and her take on being attracted to souls, and not bodies, hit really close to home for me. We also get to see juxtaposition with the Church of Latter-day Saints in this new post-apocalyptic world, and those chapters would be pretty eye opening, and very needed, for some people in today's world.

“Expiration date of body > expiration date of canned tuna.”

We also get to see the different stages of progressiveness around the world, and how others are dealing with this disease. I loved looking at all the different cultures, and their reactions. I also loved how the author let us see what happened to the characters our midwife meets along the way, even though she never gets to know their fate.

Two of the characters she meets along the way really hit home for me. One is from Michigan, where I was born and raised, and the other was from Vegas/Henderson, which is where I currently live. Seeing two people, in the same terrible situation, from the two places in the world that I consider home, really hurt and scared me. The impact of the situation felt so real and will haunt me from some time to come.

Again, this book is so important. This book honestly touched, and shook me to, my core. I don't use these words lightly, but I will carry this book inside me for the rest of my life. This book is so needed, and I hope it wins every award there is.

“Good old Planned Parenthood. Saved my life.”

Oh, and that quote made me decide that I loved Meg Elison, and I will read everything she creates. Honestly, the main and recurring theme of this book is how important it is to give girls options and keep them safe. Again, I'm repeating myself constantly, but everyone should read this book.

It's scary to be a woman in today's world, but it's downright terrifying to try to survive as a woman in this book's world. This main protagonist is one of the strongest and most empowering woman I've ever had the privilege to read about, and I don't even get to learn her name.

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Profile Image for Annet.
570 reviews723 followers
March 28, 2019
The Book of the Unnamed Midwife.... a really, really good apocalyptic book. If you can stand it. Dark, grim, bleak, scary but also hopeful... in the end. The world is in the grasp of a global flu. Many people get killed, mostly women. No more babies born. The Midwife survives the flu, wakes up in a deserted hospital, only to discover that the world is ruled by a lot of horrific, nasty men. Who rape, enslave women in a brutal way and terrorize the world. Only a handful of women seem to be left in the world.
'Jane', the unnamed midwife cuts her hair, covers her breasts with a tight vest and poses as a man, while travelling the devastated world, searching for food along the way in deserted houses and shops. Always on alert, gun in hand always... She chooses to be solitary, suspicious of everyone, but meets people, weird communities and 'hives' along the way. Weird, shocking and grim. But really good. Echoes of The Road.... Makes you wonder how the world can get really grim and the people in it. It is a hopeful book too. We witness it through the diary stories of the Midwife... and others. Wow....impressive though worried to turn the next page and wonder what you will find there..... More than 4 stars. I recommend this one. Read it, if you dare and can stand the darkness....
Profile Image for Kaceey.
1,067 reviews3,609 followers
January 6, 2017

Not my usual genre, but wow, so powerful and so very frightening. Even though this is a work of fiction, it's disturbing to think this could happen in our future.

Something has wiped out most of the world's population and only a small fraction of the survivors are women. It's a story of strength and survival in a post apocalyptic world. Very dark and violent at times, especially to women.
Between Ebola, Zika, super bugs or even biological warfare, are we that far off from something that would devastate our society? The thought is almost too scary to think about. Especially given the present state of our world today.

I was pulled into this book very quickly and sat wide-eyed late into the night not wanting to turn off the lights. This book will stay with me for a very long time.
Profile Image for Lyn.
1,867 reviews16.5k followers
June 23, 2017
A gritty post-apocalyptic tale told with stark realism and frank sexuality.

Unlike other post-apocalyptic books that wash over the disaster and cleanly describes later events down the road, author Meg Elison tells the good, the bad and the ugly of the immediate days afterwards. The reader follows the travels of a lone female survivor after a cataclysmic epidemic has targeted women and babies, leaving a very ugly and stinky male post-pandemic world.

In writing vaguely reminiscent of Fritz Lieber, the plague against women and reproduction also reminded me of Vonnegut’s brilliant Galápagos. The world that is left is predominantly male after a fast acting fever attacks pregnancies, killing the mother and child. Elison’s midwife protagonist displays some tough but mindful survival instincts to help humanity crawl back.

This is more Mad Max than Station Eleven, more post-apocalyptic than dystopian. Elison describes the lone female heroine, staying alive and taking care of business.

While we are still skittering along on the edge of the abyss, dystopian and post-apocalyptic stories will continue to mesmerize readers, this one is all the more real and terrifying as the Zika virus creeps onward. And while this sub-genre may be getting hackneyed and somewhat overdone, Elison’s voice is fresh and purposeful.

Not for the squeamish, but highly recommended.

*** A free copy of this book was provided in exchange for an honest review

April 9, 2019
I haven't the slightest idea why this is so lauded and hyped and all. In all seriousness, why?

A very plain, very disjointed tale of Apocalypse, the one that took mostly women and rendered the survivors infertile for the largest part of the novel. I get that we got a preview of the Doomsday and full view of feminism but... frankly, if something happens, both men and women will be in deep shit, together. So no need to antagonize the sexes.

Anyway, everything felt like the book was staged specifically to show men as some kind of beasts. It's basically misogyny in reversal.

Imagine that the Doomsday is here, underway, and the only thing you can think about is who you're gonna have sex with. Nice, huh? That's how most men in this book operate. I don't find it particularly believable, or even partially, or at all. Frankly, I sort of think that if it does ever strike, there will be other issues, like where are your families/relatives/friends, what to eat, how to deal with illnesses, where to live, what to wear (and this is not gonna be about any fashion statement choice) and where to put all the decaying bodies of the people that didn't survive?

Genital mutilation seems to be the upcoming trend in case of the Apocalypse. Yeah, right, is that an extinction event looming over there? Women are rare? Yeah, let's cut some or other stuff down there just to see if this one dies too?

The text organization. It's not impressive. Original but not functional. We got a bunch of Chapters across which go journals, the Books and plain text. The Books include 'The Book of Histories and Hives', 'the Book of the Dreamless Ones', you get it. Pretentious, that's what it is.

Too many equal signs. I am a fan of them myself, in personal notes. But then I use a lot of mathematical and logical signs to shorthand. In this text the '=' looked particularly out of place. I get it was supposed to be original and give the feel of authenticity but it didn't. The 'and's should have been replaced with '&' or reversed 'U's and the 'or's with '|' or 'U's, 'any's with upside down 'A's, 'more's with '>', 'less'es with '<' and so on... THEN the text would have looked as original scribblings (and incomprehensible for most people bar the most die-hard fans).

I don't believe there were only the handful of deadborn babies and people willing their life stories to get told that were mentioned in the above-listed Books. So, these looked scrimpy, out of proportion.

The text being framed in all the scribal version of boys working overtime to rewrite this drivel? Come on. They should have been taught something useful instead, since this material, they could have covered with a sane educator in, like, a couple of hours.

And I'm not gonna get started on the wooden belly that that gal puts on to symbolize what? Fertility? What for? Scare the poor boys? Respect is best gained when women demonstrate they have fully capable brains and, had I seen some gal put that gear, I would have been the first to suspect her mental faculties aren't quite top-notch.

Overall, 2 stars is plenty for this sorry tale.

Even without working plumbing, they all felt compelled to use the bathrooms for their intended purpose. (c) Awkward?
Lone wolf. Lone ranger. Cowboy. Work alone. Great savior. Magic man. Got your magic right here. Don’t need anybody. Fine by me. Fine. (c)
She gave herself the luxury of a few days of madness. (c)
Wish I had an almanac. Wish I had the SF public library. Wish I had the right batteries for this CD player, even if the only thing I have to listen to is this Destiny’s Child CD in it. Wish I had a prime rib and a chocolate cake. Wish I had Netflix. Wish I had a friend. Wish I had Jack. Wish into the fire burn it like a djinn. Wishes into the fire. Fire. (c)
Everyone you know is dead, but let’s focus on my language. (c) Well, 98% of male population's dead along with 99.99% of female but you're choosing to concentrate on sex.
The cities stopped burning. The stars filled the skies of places that hadn’t seen them since man started burning coal. Herd animals took the plains. Salmon swelled the rivers. The earth grew quiet and everything seemed to teem with life and hold its breath, waiting. (c)
I don’t like the term Hive. I don’t think of it like that. We’re more like a web. (c) Come on, give me a break with all the hive-y things, will you?
They lived together the rest of their lives and never again saw another human being. (c)
A harem of three women in the Ukraine chose that day to kill their captor. (c) I don't think it's a good portrayal. The author obviously has no idea just how spirited Ukrainian women are. The guy would have gone bonkers and/or dropped dead the very first day.
Men = dime a dozen.
They always were. (c) Okay, that's misandry. Imagine someone saying that about any gender/sexuality/race, except men? About women, asexuals, Latinos?
Profile Image for Adina.
827 reviews3,226 followers
October 18, 2016
The book of the Unnamed Midwife is tragic dystopian post-apocalyptic survivalist novel. I read a more or less corresponding to this type and I consider this to be one of the best (right after Blindness).

The story does not sound so new. A fever wipes out 98 % of the human population, the women and the unborn babies being the most affected. A terrible world to live in. The main character is a nurse who wakes up in the hospital bed where she was left to die with the disease. Thanks to her fighting instincts and skills she battles for survival in a world were there are no more rules and nothing to strive for. Disguised as a man, she travels from San Francisco to the north in search for safety. During her journey her path is crossed with people who react differently to the tragedy around them and who will mark her life, no matter how much she struggles to avoid any contact.

The first thing that I admire about this book is the beautiful writing and the harsh realism. One of my main problems with Station Eleven, although beautifully written, was the lack of realism of the post-apocalyptic world. In this novel, everything seems so real and I imagine that the end of the world could look exactly like the author wrote it. Rape and the hunting of women to become sex slaves or currency is one of the main themes here. It might be horrific but so plausible. Throughout the history women have been treated as a commodity and it is not hard imagine what would happen if only a few of them remained in the world. The lust for sex will probably be defining when there is nothing else left, no other entertainment, no rules, no civilization, no hope. It is a grim world out there but the author manages to describe the surviving efforts of the MC and of the other characters without being boring and repetitive, unlike what I read in the Road.

This is a book about survival, hopelessness, death, lust, pain and in the end, a bit of hope. I admired the courage of the author to discuss subjects that I did not see in other similar books For example, she touches suicide and the inability to cope with the destruction and loss.

Finally, I thought the mix between third person narrative and 1st person journals to be of effect and made the read a lot more compelling and me feel deep about some of the characters.

I loved this book and I do not understand why it has so few ratings on Goodreads, having also won the Philip K. Dick Award. Highly recommended for dystopia fans and not only.

I received this copy from the publisher via NetGalley in exchange for an honest review.
Profile Image for John Elison.
2 reviews7 followers
June 11, 2014
Full-disclosure: I am married to the author. However, she did not ask me to review her book. But she did ask me to read it many times during its development and I must say it never became tedious or a chore.

I was immediately pulled in by the prologue and I found myself nodding, quietly yet triumphantly by proxy, at the end.

Obviously,I have a personal stake in this, but having read it and the newspaper lately, even if I weren't married to its amazing author, I would recommend this book.

We need books that look at injustice, misogyny, feminine strength, queer alternatives, and the value of life and we need others to read them, too.
Profile Image for Bradley.
Author 6 books3,964 followers
September 10, 2016
Thanks to Netgalley for this ARC.

Post-Apocalyptic survivalism, featuring perhaps the very last midwife upon the planet.

This wasn't a particularly easy novel to get through, mostly for the emotions and the horror of what would likely happen to the surviving women after 98% of all men die from a virus and only 1/100 of that counts as women.

The author makes a pretty convincing case that what would result would be massive maltreatment of the rare women, mirroring what still happens today, but much worse, with enormous ignorance, rape, and misogyny the likes that we haven't seen since that freaking rally last week or GamerGate. Only instead of words, it's pure hellish actions.

The novel has a large number of journalism-ish stories making up the early days all the way to through the first viable children after so many died with their mothers, even after the grand majority of the human race kicked it.

In these respects, the novel is like a cross between The Children of Men and The Handmaid's Tale and a large crop of The Walking Dead, Book One.

I really appreciated it. I've been missing some serious and deep look at what it would mean to be so necessary to life and be so disrespected. It was also horrible and fascinating at the same time, but I suppose that is to be expected. Wow.

Profile Image for Kelsey Cretcher.
157 reviews20 followers
February 1, 2018
So far this is the biggest contender for "Biggest Disappointment of 2016".

I was so excited for this book, and it's not even that I was too excited that it was a letdown. This book sounded like everything I'd love; an epidemic that wipes out 98% of humanity, and 99% of women. The book opens it up to be this interesting journalistic look into the fall of humanity, of society as we know it. Plus an image of what a world may be like when there are way more men than women, and what that could result in. "The Handmaids Tale" meets "Children of men or even grittier".

It sounded so interesting, great title, won the Philip K Dick award, I was sold. So when I received it from Netgalley in exchange for an honest review I was looking forward to it like crazy.

However, this book was just terribly written. The author says herself in her about me that she "writes like she's running out of time" and honestly, you can tell. This book feels like it wasn't planned at all, that she just wrote everything that came to her mind and shoved it in there with little concern about what it would do to the story. Or she wrote down all these interesting bits, and then shoved them together and said, "it's a book!". It felt like it was supposed to be important, it was supposed to make you see harsh truths and feel uncomfortable. The set up meant it'd explore rape and women as possessions, a chance at a truly powerful story. But it was so empty, nothing important or powerful whatsoever. How an editor approved the glaring issues in this book is beyond me. How it won the Philip K. Dick is even further beyond. I plan on seeing what then other nominations were, unless there were none.

This story opens up in the future when a group of children are given the task of scribing an important series of journals. These journals are known by everyone and have been read by all, they are a sacred window into the early fall of society. The author then goes straight into the expected journal (why have the framework of the kids scribing journals if she wasn't going to have her book be in journal form right?) following a woman who is unnamed (but goes by many throughout the book) who is a nurse and midwife describing the early stages of the epidemic. Society has begun to panic a little as there is a 100% mortality rate in pregnant women, and woman and men are coming down with the fever everywhere. Our story then abruptly changes from journal format (after maybe three paragraphs) and then goes into 3rd person (I'll... complain about this later) and switches back and forth between journal, 3rd person, and omnipresent throughout. Our nurse wakes up on a cot in her break room at the hospital. Supposedly weeks later, as all her food in her home is decaying and moldy. She wakes up with no life support or IV (ok at this point I'll look past this) and wonders into the completely wrecked world. The city is empty and partially burned, looted, bodies all over. She goes home, is immediately almost raped by some random man (cause men get super rapey within weeks, I'm sorry I'm sorry I'll wait till later). Then takes off on a journey to who knows where, encountering few on the way, dressing as a man, and administering birth control to the woman she can find (all slaves and controlled).

That's literally all I can say without spoilers. Also, I cannot contain my rant, sooo let us start with the major issue with this book. The frame the author created using the kids. She set it up to be an important story, she set it up to be a journal. But then she doesn't commit. She ditches the journal nearly immediately, writing in a style that has things the kids cannot know, so what is the point. What's worse is the majority of the stuff in the 3rd person view could have easily been rewritten to be in journal form. Having just finished "We" by Yevgeny Tarteskovy (sp?) which was completely done in a stream of conscience journal form, the whole story, and done well, this bothered me extremely. But giving the debut a chance I convinced myself to look past it. Then the unrealistic start to the story. She wakes up (while admittedly at a hospital) in the BREAK ROOM on a COT, no simple "she pulled the IV out" to make it remotely plausible she was unconscious for a long time. The body can only survive 3 days without water. So without any assistance, she couldn't have been out for longer than 3 days. However when she goes home, her food is rotten, and she talks about how it's been weeks. WEEKS. Okay, okay, I'll look past it, it's a debut, it won an award, it'll get better. Immediately things get rapey. I get it, not a lot of ladies, SOME men will get rapey, but the chance that the first man she meets is rapey after only a few weeks of pure societal collapse seems slim. It doesn't help that nearly every man she encounters is rapey. The character also thinks about men in a TERRIBLE way, a way that if it was being written about women would cause a lot of angry people. The portrayal of men, and thoughts regarding men, just seem like the author is projecting some Man-Hate. I tried to look past this too. In this world, all men are crazy sexual, or maybe the epidemic killed all but the over sexual, rapey, couldn't last a few weeks without sex before becoming a monster people. So now I'm at overlooking two major aspects of the book, and one arguably minor one.

The other HUGE problem with this book for me was the mid-wife herself. I hated her, I could not find any level to connect with her. She was mean, cynical, the kind of person that is judgemental and holier than thou. Rather than just saying she's pan-sexual (I get it, cause I consider myself pan-sexual it's about people, not genders) she thinks " I could educate them about gender fluidity but I doubt they could understand it", give me a break. She thought she was the last real person on earth, she was so full of herself it was sickening. Her actions and responses rarely made sense, and honestly, by the end of the book, she just seemed like a garbage person. She cursed like a sailor and not in a fun way, in a Jesus, you curse a lot way. Which feels weird coming from me (I curse a lot haha). She tried to be fiercely independent but instead came off as stubborn and ridiculous. But whatever, debut, I'll look past it.

So back to the journal. Seriously, what is the point of setting up the book with a framing mechanism, the children transcribing her journals, if you aren't going to stick to your framing mechanism. It didn't help that when she did write in her journal she wrote in a style= terrible= weird weird weird style. No joke, I've never seen so many "=" and she had a habit of repeating words three times. I started to think it was a tick. A sentence would seriously go " Lake house= cool vacation home= raid potential= people, want to avoid people, avoid people, avoid people" it was... obnoxious. I think the author was going for a stream of consciousness kind of writing, but there are much better ways of doing that.

I found myself highlighting multiple passages, not for great quotes but to add a note: "what" "this doesn't make sense" "but that's not what the person is saying at all". One passage literally had a character admit they know that their companions will never come back, only to have her think two sentences later "he refuses to admit they aren't coming back", but... he did admit it, two sentences ago... The book was horribly disjointed. It gets worse when she gets to the Mormon town when she's constantly belittling them for trying to have a semblance of normalcy, it's not that they don't admit to what happened. They call themselves survivors and call travelers refugees and are absolutely aware of what happened, they just are trying to create a town and live again. She seriously spends the whole time going "they're so blind, pretending nothing happened, pretending the world isn't over" literally giving them crap for wanting to find some kind of happiness. I wanted her to move on from this part of the book only to realize I was nearly 80% so this was the main part. I also began to realize that I spent 80% going " I'll overlook this issue and see if it gets better" but I'm overlooking essentially the whole book by this time. It's that broken, I had to overlook everything. I may as well have been given a piece of paper with bullet points of the story.

Shortly after the Mormon town, the book takes a complete and utter dive off a cliff. It has random passages telling what happened to characters she has no way of knowing what happened to, these are done in a god perspective, taking us all over the world, once again rendering the children and that framing mechanism completely useless. Not only this but it got... awkward and explicit. I thought when reviews warned it got explicit that it would be in a "you need to read this and be uncomfortable because this is the reality of rape and sexual abuse" kind of way. But it wasn't. It was in a "she is just a sex-crazed as the men and starts talking explicitly with someone's husband" way. Describing sex and lady bits graphically, and thinking about sex and lady bits, and using unnecessary terms to do it. I'm not an "oooh nooo sex" gal. I read raunchy books, but I am a girl who hates unneeded explicit sex or reference to sex that detracts and doesn't add to the story at all. This literally takes up the majority of the remaining book. If you're going to add explicit sexual descriptions, make it worth it, don't make it random and out of place. This book could have used that to make a point of sexual abuse. But rather chose to play that card for some weird self gratification and obviously just for the, well, sex. It added nothing.

So by the end, nothing important happened. Nothing important enough that every future person would read this book and act like it was important. She didn't encounter enough people to be a good story of the end of the world as we knew it. She didn't learn anything, she was a pretty nasty person till the end. The majority of the book is spent not on what the world is like, but her describing sex to a Mormon guy in detail. Why would that be important to the future? I spent the majority of the book trying to make excuses for the book, and the rest being angry and annoyed. This book was a waste. A wasted chance on a good concept, a wasted chance traded for absolute worthless drivel and characters and interactions that are shallow and unrealistic. The author was all over the place. She had no idea how to put her thoughts together. She wrote the same story as multiple types of books than just shoved them all together. She didn't have a plan for her character. She had a cool title and couple of passages and just tried to make it work. It didn't.

I literally can't think of another book that made me this angry. "The Last One" got close (another amazing concept wasted, but far better written), and was #1 for worst of 2016 for me before this, and everything I've read by Fritz Lieber I've hated. But honestly, this book made him look like a fine author.

This needs to go to an editor and be re-written and 75% of the plot needs to change. Then maybe this won't be a waste of a concept.

I'm done for now with this rant. I've got to move on from this book.

Worst of 2016 for sure.

I'm sure many will go, Oh you're being too harsh, it's great for a debut. Or, It's better than how you write this review is littered with grammatical errors.

But honestly, when do we stop lowering our expectations and ignoring glaring problems for debuts. I've read amazing debuts and bad ones where the author improved later. That doesn't mean we need to pretend the bad one is better than it is because it's first. Also just because I can't write for anything doesn't mean I can't tell bad writing.

If you like this style of book, I swear to you there are better ones out there.
Profile Image for Emma.
2,433 reviews828 followers
February 23, 2017
4.5 stars.
This was a bit different from other post apocalyptic books because the outbreak that causes it wipes out almost all the women. This means that the women become prized commodities. Now this is a recurring theme in post apocalyptic stories, but it has more of a focus here: how the sexual dynamics of a community (where they survive or have organised themselves) pan out- where women are enslaved or sex is traded for booze or cigarettes or guns; where birth control is even more important when not all sex is consensual; hives where women are the queen bees, men are the drones....

At one point our unnamed midwife is taken into a Mormon community which has 3 women and the Mormons had their own way of dealing with the shortage of women.
Throughout the 20 or so years that the book spans not a single infant survives the birthing process and almost no mothers either.

'Enjoy' is not the word for reading most if not all post apocalyptic literature and this is no exception. However if you're a fan of the genre I strongly recommend this one.
Profile Image for Beverly.
805 reviews291 followers
September 17, 2018
This was a bit of a trudge for me, even though I love post-apocalyptic fiction. I was into it for about three-quarters of the way, the main character is a kickass nurse, who starts living as a man as the population of women and girls plummets. She is awesome and strong and deadly, even though she would rather birth babies, then kill rapists and murderers. She travels by herself through most of the book looking for safety and a reason to live.
So far so good.
When she takes up with the Mormons and then a young Mormon couple I started to find this side story a tad tedious, also the "hive" groups I found preposterous, which was one woman who takes up with a bevy of men. I felt like the ending made up a bit for this, so it was a solid 3 overall.
This entire review has been hidden because of spoilers.
Profile Image for Althea Ann.
2,232 reviews1,016 followers
December 19, 2016
Upon reading this, I was immediately reminded of PD James' 'Children of Men' - after all, how many stories are there which feature a near-future in which universal sterility has afflicted humanity, with the exception of one solitary pregnant woman, who is escorted through a dangerous journey by a former professional midwife? Well, there are at least two!

However, by happenstance, my post-apocalyptic book club was reading 'Children of Men' this month, so I re-read it after about two decades. (Which was interesting, thoughts here: https://www.goodreads.com/review/show...) The two stories are far more different than I'd immediately realized, treating their themes in very different ways.

While James used the sterility as a jumping off point for a musing on faith and the corrupting nature of power, Elison is far more concerned with gender issues. 'The Book of the Unnamed Midwife' lets us know right off that the post-apocalyptic future is matriarchal, with women in charge, and pregnancy revered - perhaps even worshiped. This future society, still struggling, looks to an 'ancient' text as history and guide. This text is the diary of the title's 'midwife.' And from there, we jump into said diary...

The midwife wakes after illness to a changed world. A plague (which she'd been researching) has wiped out nearly all of humanity. Survivors are few and far between - but only 1 out of 100 survivors are women. On top of that, no new babies are being born. The illness is particularly fatal to babies, and it seems that even if a woman has survived, she will definitely die if she becomes pregnant and attempts to give birth. Soon, it's a world of lawless thugs and dangerous gangs where the few women are viewed as commodities to be bought, sold and of course, gang-raped. To protect herself, our narrator disguises herself as a man, and wanders the post-apocalyptic landscape, trying to find other women and to help them with knowledge - and birth control - when she can.

The writing is very good - I found the book riveting, even though the plot was rather meandering. However, once I took a step back from the direct experience of reading it, I did have some criticism. My main one does have to do with the rather aimless meandering. In the introduction, we're given a "Point B." Then, we flash back to "Point A." However, the book never takes us from Point A to Point B. How did a world of women as abused commodities transform into the matriarchal society of respected women that we first glimpse? Yes, the 'midwife' sees in passing, the emergence of 'hives' - groups of men who cluster around one "Queen Bee" in hopes of her favor, but that phenomenon isn't really deeply explored by the text. The main character finds this mildly interesting, but not something she's interested in pursuing for herself. While I did find the wanderings interesting, I feel like the book set the reader up to expect something that it never delivered.

My other quibbles probably just have to do with my reading so much post-apocalyptic fiction, and seeing the same themes crop up over and over: the aimless journey, the pockets of religious groups who may hold it together longer, but who might get weirdly cultlike, & the future characterized by violent gangs and violence toward women. In some stories, this treatment can often feel somewhat misogynist, but in this book swung toward the misandrist. Actually, with few exceptions, humans in this book are really portrayed as falling into negative stereotypes. Men are either violent oppressors, or weak and ineffectual. But other women are also portrayed as self-interested backstabbers. I don't think of myself as having a particularly sunny view of human nature, but this book exceeded even my cynicism. Again, I wish that it had taken the reader a bit further, through the days of disaster and into the days of rebuilding and cooperation.

Still, regardless of its flaws, this is still a book that I would recommend - and have recommended - to other fans of post-apocalyptic fiction.

Many thanks to 47North and NetGalley for the opportunity to read. As always, my opinions are solely my own.
Profile Image for Char.
1,634 reviews1,487 followers
February 1, 2018
4.5/5 stars!

Just like in the novel REBECCA, we never learn the main character's name in this book. Hence the title!

I discovered Meg Elison through a few short stories she's written for horror anthologies and magazines and I decided that I wanted to try one of her novels. This one was recently on sale and to add the audio to the Kindle version didn't break the bank, and here we are.

THE BOOK of the UNNAMED MIDWIFE was a bleak post-apocalyptic tale wherein a disease wipes out nearly every woman on the planet. The scarcity of women soon becomes a problem for those that did survive the disease. Will they also be able to survive the wandering groups of men, many of whom haven't seen a woman in over a year? You'll have to read this to find out.

I loved the main character in this novel. Yeah, she swore a lot, was bisexual and independent. (These are a few aspects other reviews have pointed out as being negative; I actually enjoyed them.) I liked how her previous work as a nurse and midwife helped her to try to save other women she came across in her travels. I also respected her intelligence-dressing as a man to disguise her gender and doing whatever else needed to be done.

I enjoyed the way the story was presented with one exception. This tale was introduced as being the main character's diary, and a woman is having some young boys transcribe it decades later. As such, this is mostly a first person narrative; except that in a few spots the tale slipped into a third person narrative and that did not quite make sense to me, as there was no way our heroine could know these things. (Though I was happy to learn the facts related during those portions, to be sure.) That is the only gripe I had with the book.

Post apocalyptic fiction doesn't capture my attention as much as it once did, but this book rose above the normal PA tale. I was engrossed and invested and I wanted our unnamed hero to win, though "winning" was hard to classify-other than just surviving.

I should also mention that the narrator was most excellent and managed to believably deliver a number of different characters and accents. Kudos to Angela Dawe!

To wrap up here, I highly recommend this book and/or the audiobook if that's your thing, most especially to fans of post apocalyptic fiction and strong female characters!

*I bought this book & the audiobook with my hard earned money and this is my honest opinion.*
Profile Image for Choko.
1,198 reviews2,583 followers
May 11, 2017
*** 3.75 ***

A buddy read with the MacHalos, because we wanted something out of our comfort zone!!!

"...“Find some people, wish you were alone. Live alone, wish for people.”..."

Well this was very different than what I was expecting... Different means just that, different. Not better or worse... I almost never read anything that has to do with plagues, because I just can't handle it usually. This was not exactly the case here. Once I started and got over the shock of the first several pages after the MC wakes up from her ordeal with the fever, alive among thousands of those who did not make it, with 98% of the population of the world dead and only a very small percentage of those who made it women, I knew I was in it to the end. This was not an easy read. It was written in the form of the journal of this young woman, a maternity nurse, who tries to make it in a world gone mad. As many authors before her, she tackles the question of what will happen if the world's female population was minute compared to the males. And to make it even more interesting, the women survivors, having had the illness or not, are unable to give birth to alive babies - either they both die during childbirth, or the child does and hope for humanity dwindles... Suicides are plentiful, which is understandable seeing the horrors of existing in this doomed anarchy...

"...“I would be happy to defend you ladies,” Duke said with a shine in his eyes. Every man on earth thinks his dick is magic. Alex could hear Roxanne saying it in her head the day they had met.”..."

What made me so angry, probably because I can see it happening, is the way the majority of men became treating women as possessions, without a voice or personality, just an object used for trade, work, slave, a wet hole, and a way for the diminished "men" to take out their frustration and make themselves feel better and in control... I have to say, there were many times I was tempted to put the book down and leave it, because it was too much at times... Humanity really gets challenged in moments of adversity and unfortunately, the most basic, monstrous insists prevail... However, the story was like a car-crash - you just can't stop staring, or reading in this case. I liked the MC and the way her character developed as time went by. She was very imperfect and there were things, were it under normal circumstances, I would have hated on principle (like cheating). But seeing how low the level of morality had gotten, to mostly non-existent, I would say this was a very small indiscretion... However, the not complete 4 stars comes from the constant repetition of the word "EQUALS"... As in "this plus this equals this"! I was ready to kill her myself for afflicting this on the reader!!!! It bugged the heck out of me!!!

Overall, it was much better than I expect form this Post-Apocalyptic genre. However, I would not recommend it to the faint of heart, to those who have issues with implied rapes, and to those who have low tolerance for violence. I would not like to think that children or those under 18 would read this - I rather they wait until more mature, and no, I am not a prude.

"...“Books in, books out. Read novels, write a diary. Paper in your hands and silence in your mouth.”..."

Now I wish you all Happy Reading and may you all find what you Need in the Pages of a good Book!!!!
45 reviews100 followers
October 19, 2016
I'm a big fan of the post-apocalyptic genre, and this book was the best I've read in a while. Elison manages to create a fictitious futuristic world plagued by disease, death, and desperation without going overboard and forcing it down the reader's throat. The story flows and makes sense. Just the right amount of Mad Max-esque situations allow Elison to paint a detailed picture of the world post-plague. Gritty but not gratuitous, The Book of the Unnamed Midwife presents a realistic depiction of a world that is haunted but still hopeful.
Profile Image for Trish.
1,921 reviews3,402 followers
October 14, 2016
I received an ARC of this book from netgalley in exchange for an honest review (honestly, that phrase is so stupid, my opinion is always honest).

I've read my fair share of apocalyptic and post-apocalyptic books and seen an almost equal number of movies/TV shows of the same genre, but this novel is exceptional! And to think that it's a debut novel too!

The beginning is a little bit like in "28 Days Later" (there is a reason I'm naming that movie, namely the rape theme) with the protagonist waking up in a hospital to find the world in ruins - only in this book she knows roughly what happened because it had already progressed quite a lot when she got sick and thought she'd die.
The woman walks first through San Francisco, then through other parts of what was formerly known as the USA. She meets a few people on the way and, naturally, some encounters are very dangerous. Humanity is not just dead and dying physically because of that ominous plague but also dead and dying emotionally.
We get to experience those travels and encounters partly through the MC's journal entries and partly through an all-knowing narrator.

In order to do this book justice, I'll have to get into detail about a few things.
First, right at the beginning the tone is set with . That aspect of events was to be expected of course since so many people died and only very few women survived the initial outbreak of the plague. Nevertheless, it is a very difficult topic and the author was very brave in how she portrayed the different viewpoints on it throughout the entire book!
Moreover, I liked that the MC was level-headed and capable but not too capable and not always level-headed. Someone not having trouble living through the end of the world would not have been realistic.
After having been back in familiar territory (her apartment), the MC's (and therefore the reader's) focus widens as the MC wanders through San Francisco. We get a feel for what type of person she is and I hope .
The focus steadily broadens with every mile the MC travels, at one point even addressing events in other parts of the planet that the MC cannot have known about (some disjointed, some about characters the MC had met previously).
Although this broadening is slow progress, it is never boring. The author instead takes her time to paint a thorough picture of the world in general and the human condition, portraying many different people from all kinds of backgrounds. It struck me at some point, I don't remember exactly when since it was a sneaking feeling, that Meg Elison shows her true mastery in those characterisations because she reminded me of none other than the master of creepy and seemingly innocent hints that gut you once you recognize them for what they truly are: Stephen King.

Honestly, one example was !
Or the whole !

Oh but there were some characters I just wanted to see dying for their stupidity. Honestly, sorry to any Mormons out there who are decent people or if the representation was inaccurate (which I cannot imagine from this author and considering that she was awarded for the story), but ! FUCK THAT!!!

As you can see, this book made me very emotional. *lol* Which made the whole reading experience so real. As much as I hated certain characters or aspects of them, they were all extremely realistic (which probably is exactly why their behaviour got my blood boiling). It's amazing how affected I often was, even by things happening to people I didn't even really get to know much.

What is also noteworthy is that the rapes are never portrayed in an obvious tear-inducing sort of way. No pity party, just the facts. Clinical. Which, in my opinion, made it all the more impactful. Stated like facts of a case. Real.

The journal entries, by the way, were quite unique. No "clean" prose but a mess of thoughts and emotions, raw and unedited (written in a way that made them look like an actual journal by an actual person). Real. Just like the rest of the book (there actually is no better word to describe this story).

This book is dark, make no mistake. But it's so rich in detail and realistic exactly because of it. I mean not many authors address unsexy hair growth in armpits, a woman's period during the end of the world, or they cut to the good times after a baby is being born without addressing the messy after-birth. Not this author. Everything was written like true account. The "clinical" descriptions might also have been a deliberate style because the MC was a nurse/midwife - in any case, they had the (probably desired) effect of making me shudder.

No moments of pure action like in an action movie but plenty is happening, some things shocking the reader to the core, all of it taking its toll. A fantastic if devastating world in which to immerse oneself for a few hours.
Profile Image for Jenny (Reading Envy).
3,876 reviews3,049 followers
October 20, 2016
Everyone knows I'm a sucker for apocalypse, but I almost didn't read this one. I was not sure I could take yet another breeder-apocalypse novel, one that focuses on women not being able to reproduce (a la The Handmaid's Tale or forces the women to become breeding machines to save the human race (every apocalypse novel, it feels like.) And this is present here, in fact the central character is an unnamed midwife who is one of the few survivors after some kind of virus has wiped out 98% of humanity, and the majority of the survivors are male. Somehow, she survives. Her name changes as she encounters different people in different situations (and even still, I hadn't really realized I didn't know her actual name; I just went back and checked for one!)

One interesting element of the novel for me was the issue of sexuality. The unnamed character is bisexual, although most of this comes up in her memories. To survive in a male-dominated society, she tries to be as gender-neutral as possible, trying to rewire her brain to move her body in a different way, to lower her voice, etc.

But that's not the only way. What happens where there are almost no women? Does male sexuality change? For some in the novel, it does. And in another story, some women form hives of a sort, with a queen bee, a bunch of men, and a lot of sex and drugs. In other situations, women are sexually assaulted, traded, and kept as slaves. The commodification of women in post-apocalyptic situations is not new. But in this novel, the unnamed midwife helps to fight it when she encounters it. Because of her unique background, she helps people through quick thinking but also birth control. Women are still dying from childbirth, almost every time.

There is a framing story where a small group of boys is tasked as scribes, making a copy of the nineteen journals making up The Book of the Unnamed Midwife. It is the society's history, it's start, and they have built in ways to preserve it. The journal entries permeate the novel and help break up the sections. At first it is just the midwife's journal, but it is joined by others.

Other parts I liked - the Mormons attempting to live exactly as they had before, and of course they are the most prepared with all their canned food and supplies. But there is more going on under the surface, and the elders continue to send out missionaries, but the reason may not be what you expect. The descriptions of the silence in a world without people also really stood out to me.

This book won the Philip K. Dick Award in 2014. I recently received a review copy of it from the publisher, so I can only guess that it is being re-released. And it looks like there will be a sequel early next year, which I will definitely be reading. (The Book of Etta.)
Profile Image for Emily.
296 reviews1,534 followers
April 27, 2018
A new favorite!!!!!

Are you looking for The Handmaid's Tale with a wider world and none of Margaret Attwood's problematic feminism? WELL HOLD ON TO YOUR HATS, BECAUSE I HAVE THE BOOK FOR YOU.

I loved this book. ADORED it. And I'm particularly happy about that because I once met Meg Elison at a book event and she was just lovely. It's always wonderful when a person you liked writes a fucking phenomenal book.

So, what did I like? Beyond a generic EVERYTHING? Let's discuss.

The world: I love that this book feels simultaneously very wide and very intimate. It's a bit of a road novel (our protagonist, the titular unnamed midwife, travels from SF to Utah), but the moments of quiet domesticity counter the vast bleakness of the world. I love that we get glimpses of the world outside of the midwife's point of view--it makes sense that different cultures would react differently to a plague that kills off most people, but especially women and children. Those little snippets make the world seem wider, make the apocalypse seem more realistic.

The character of the midwife was just SO BRILLIANT. First of all, I loved that the diary sections truly read like someone is journaling--it's full of fragments, shorthand, swearing, random ALL CAPS (truly relatable, for me). Layer on the fact that Elison chose to use these diary portions sparingly, and you have perfection. I don't know that I would have enjoyed an entire story in that format. Because it's switched up between journaling and traditional narrative prose, it never feels like a gimmick. The diary entries are also a brilliant lesson in empathy. They fee raw, and I DARE you to not connect to them deeply. I also loved the fact that she is unnamed. Elison toes the line perfectly between using the unnamed midwife as a stand-in archetype and crafting a genuine, authentic character. It's brilliant.

I could go on and on forever about how brilliant this book is, but I'm going to end by saying JUST READ IT ALREADY.
Profile Image for aPriL does feral sometimes .
1,889 reviews428 followers
July 11, 2020
Meg Elison's 'The Book of the Unnamed Midwife' describes the most intelligent science-fiction dystopia I have read this decade. I thought it brilliant. She has extrapolated from current reality an intense speculative book based on some current civilization trends and a deep understanding of human nature.

The eponymous Unnamed Midwife was a nurse in San Francisco when the killer pathogen struck. She was not concerned at first when sick people began to flood her hospital. Everyone believes it is a normal flu - until no one seems to survive it, especially pregnant women and children. When almost everyone has died in only a few weeks, leaving behind one woman alive per hundreds of men, when all electrical grids have stopped delivering electricity and water has stopped flowing, when cities of 700,000 people have only a few hundred people left alive, the midwife understands she cannot trust anyone, especially the packs of surviving men looking for food, water, guns and the few women, girls or female toddlers still alive.

Everyone is grieving. But not everyone feels being civilized has any value anymore...

If anyone feels like scoffing once the premises of the story become clear, simply Google search for college fraternity hazing deaths and party rapes, Russian military hazing and military college hazings. Look up Central American countries which have been overwhelmed by ex-American gangs, or read about how Afghanistan, Pakistan and other Islamic theocratic States support the enslavement of women by law or practices culturally disguised as 'customary religious practices'. Inform yourself by searching for the degenerate Mad Max military/police practices of warfare in Africa. Gentle reader, you will see stories about unleashed hierarchical male cruelty and dog-pack gang behavior in male-only institutions that are dated 2017, not 1817, or 1017.

I understand many men are not patriarchal or naturally hierarchical in their natures. I know most men do not have strong cravings to be in sexual control over women. However, it is obvious many men are. It is also clear not enough of the men who are not patriarchal by nature stand up to those who are, too.
Profile Image for Hannah.
591 reviews1,051 followers
November 5, 2016
This book was too dark for me. Yes, I'm a wuss, and yes I should have known before I started it. But it sounded intriguing, came highly recommended and won a prestigious award, so I read it anyway.

This is a more or less classic take on the dystopian genre. But while most books I have read concentrate on the "after" of a specific society-ending event, this book tells the story of that event and the early years after. Our heroine is a midwife and one of the very few women who survive a pandemic outbreak of some disease. The author very successfully imagines what would happen to a society where there are about 100 men per woman; and what she imagines isn't pretty. The book more or less starts with the attempted rape of the heroine and only gets bleaker from there. And while this might very well be realistic, for me it made the reading experience rather unpleasant in parts. Call me hopelessly optimistic, but I really hope this is not how our society would evolve.

In the beginning we follow our heroine closely and only learn as much as she learns, which was a very effective way of telling this story. I still very much enjoyed when the author started showing more of the rest of the world and how different people coped or didn't cope with the experiences.

The unnamed midwife (who stays in fact unnamed for the whole book) is a brilliant, kick-ass, but still flawed protagonist. I liked that she wasn't some damsel in distress, but that she was still allowed to be vulnerable and griefing and human.

Overall, it was a great book, just not the book for me. I am still intrigued by the following book - because Etta seems kinda bad-ass! So, I would definitely recommend this book; unless like me you prefer your fiction on the less brutal side of things.

I received a copy curtesy of Netgalley and 47North in exchange for an honest review. Thanks for that!
Profile Image for donna backshall.
642 reviews177 followers
April 23, 2021
The Book of the Unnamed Midwife is absolutely my favorite read thus far in 2019.

The diary format was fascinatingly effective for this novel: "This is supposed to be my personal scripture" said one character, when she was caught copying his diary into hers.

For such a stark and difficult world portrayed, I found an odd comfort in the Midwife's genuine and intimate journey. Her diary spoke to me in the same way The Road did, leaving me both hopeful and hopeless for mankind, should there ever be a near extinction level event.
Profile Image for Carolyn.
2,172 reviews615 followers
October 10, 2016
A particularly virulent plague has wiped out 98% of Earth's population, being particularly fatal to women and their unborn children. With ten men left for every woman, life is dangerous for those women who survived, either fought over or enslaved by groups of men. The unnamed midwife is one such woman who survived the plague and woke to a frightening new world. Determined to survive without becoming a sex slave, this is the story of her journey.

This was an interesting study of human behaviour following the breakdown of society with people adapting a range of lifestyles to survive from hives with a queen and many males to religious groups protecting their surviving women. With shades of Margaret Atwood's 'The Handmaid's Tale' where many women are infertile, this is scarier and more violent with lawlessness predominant and violence condoned if it means capturing a woman. The unnamed midwife is a gritty, determined woman who is not without survival skills, at the same time offering medical help to those who need it. As a post-apocalyptic novel it paints a realistic picture of a world without basic services, technology and simple laws and ethics.

With thanks to Netgalley and the publisher 47 North for a digital copy to read and review
Profile Image for Ian Mond.
502 reviews76 followers
January 27, 2015
What’s It About

A plague has wiped out most of the population. The bulk of those who have survived are men, which makes women a scare resource. Our protagonist was once a nurse. Now she survives by masquerading as a man and offering her services as nurse and midwife. But what hope is there in a world where pregnancy is a death sentence for both mother and child?

Should I Read It?

Yes. Of the six books nominated for the PKD, this one just pips Memory of Water as my favourite.

Compared to other end of the world narratives, The Book of the Unnamed Midwife is a brutal novel. Not unsurprising given in this post-plague world women have become a commodity. Except, for all the savagery displayed, Elison has done a masterful job in limiting the sexual violence. It helps that our protagonist, who adopts a number of false names throughout the novel, is smart and resourceful and driven by the need to save the lives of women, not just by freeing them from men but by giving them access to contraception.

But what really struck me about the novel is its eroticism. No, not rape fantasies, but consensual sex and intimacy. It’s a surprising and powerful aspect of the book.

Representative Paragraph

A strategy for survival where woman are a commodity.

"Apartment in the Mission, found a compression best to hide my tits. Thanks transman of yesteryear. Little too small, real tight. Shaved my head. Wasn’t easy. Got men’s cargo pants and combat boots, with a couple of loose shirts and my hoodie on top. Can’t do anything about a beard. Couldn’t find one in a costume shop or anywhere. Settled for rubbing dirt into my jaw every morning. Candelit mirror tricky tricky. Look like a young effeminate man… need to do more pushups. Walk tall, keep hips straight. Don’t sway. Feel flat. Hunch a little, arms straight down. Don’t gesture. Stare down. Make fists while talking. Sit with knees apart. Adjust. Don’t tilt your head. Don’t bite your lip. Interrupt. Laugh low."

Sex while the world ends.

"Tension = ridiculous. Pretty sure Honus feels it too, but Jodi doesn’t have a clue. Every time she’s out of earshot, we’re talking about sex. How to touch her, how to talk to her, how to turn her on. He says he’s not jacking off because it’s wrong but I doubt it. Think I’m ding a good job of hiding it, but I’m down. As down as I’ve ever been. Shit. Trauma, loss, assault, afraid for my life, and yet. Compulsion to fuck is so strong in our species. In all circumstances, always. Remember what it was like when I was with my first girlfriend in college. Was head-over-heels wanting to fuck her all the time. We barely went to class until we both flunked that anatomy test. Ironic. This feels like that. Stir-crazy inevitable comes-and-fuck-me crazies. Probably crazy for nothing."


In a recent post on his excellent blog The Mumpsimus, Matthew Cheney wrote passionately about the apocalypse as comfort fiction. In short he argues that novels which provide a hopeful outcome to an apocalypse, one where we do survive and thrive, are disingenuous and delusional. He says,

"It is highly unlikely that you, I, or anybody else would be a survivor of an actual apocalypse, and it is even more unlikely that, were we to survive, the post-apocalyptic world would be worth staying alive to see. To imagine yourself as a survivor is to evade the truth and to indulge in a ridiculous fantasy. To imagine yourself as a successful survivor — someone who doesn’t suffer terribly before finally, painfully dying — is even worse.


To tell a story of apocalypse in which people’s lives are not even as difficult or painful as the lives of millions and millions of people currently alive on Earth moves beyond escapist fantasy and into the realm of idiotic irresponsibility. (This, perhaps, is why some of the better apocalypse/dystopia stories are written by people who are not middle-class white Americans.)"

Now, while I love Station Eleven precisely because it does reject the nihilism of books like The Road, I can appreciate Matthew’s point. Apocalyptic and post-apocalyptic fiction that pretends that everything is going to be OK, that we’ll all become happy, chappy farmers free of the evils of the modern world, are, as Matthew points out, indulging in a “ridiculous fantasy”.

One of the key points Matthew makes, especially toward the end of his piece, is that if the aim of apocalyptic fiction is to provide the reader with a cautionary tale, then it’s irresponsible to make extinction seem bearable. While the protagonist of Meg Elison’s The Book of the Unnamed Midwife does ultimately find stability in her life, the novel goes to great pains to show us a world that’s anything but bearable or desirable. Elison chooses a plague to wipe out most of humanity because it gives her the ability to kill off more women than men and make pregnancy a near death sentence. In other words, create an apocalypse scenario that’s not only bad because billions have died, but also puts whatever power remains in the hands of men. Violent, angry, horny men.

This scenario makes for uncomfortable, upsetting reading, precisely the emotion that Cheney believes apocalyptic fiction should be aiming for. Having said that, The Book of the Unnamed Midwife is anything but an extended rape fantasy. Elison makes the smart move of having a protagonist who is competent and resourceful from the get go. Some might think that’s cheating. But by having someone who can fend for themselves, and is smart enough to realise that women have become a commodity, we avoid the woman captured, raped, escaped narrative. Rather we get a female protagonist who not only rescues other women but offers them birth control.

But beyond the conventions of the post-apocalyptic narrative, where The Book of the Unnamed Midwife excels is via its structure and its take on sexuality. In terms of structure I loved how we moved from abrupt diary entries written by the unnamed midwife to an omniscient third person perspective that provides more details about her journey and the people she meets along the way. This third person point of view also allows Elison to momentarily move the focus away from America. Yes, we have an apocalypse novel that isn’t American-centric, that actually recognises that other parts of the world exist.

And then there’s the sexuality. For one, we have a protagonist who identifies as bi-sexual dressed up as a man to avoid the possibility of entrapment, rape and death. Beyond the need to survive, Elison recognises the gender issues at play here. When our protagonist finds herself living with two Mormons (a husband and wife) gender and sexuality is explored further. And these discussions feed into the most startling aspect of the novel, its eroticism. This element comes to the forefront when she’s cohabiting with the Mormons, but it’s also there, softer and less insistent, earlier in the novel. It’s startling because you expect a novel of this type only to be about survival and death and barbarism, to be bereft of any sense of intimacy even if it’s just the need to fuck. And yet, given the novel’s focus on primal urges, such as giving birth and killing to survive, the idea that we would retain our horniness in the most miserable of situations makes perfect sense.

I loved this book. It may still be a little too hopeful for Matthew Cheney – the indication is that the human race will survive – but it’s an honest novel, both in the way it depicts a post apocalyptic world and how it recognises that human sexuality and the need to fuck and feel pleasure will stay with us even as the human race falls into darkness.
Profile Image for Ash.
123 reviews134 followers
April 1, 2020
I devoured this book in twenty-four hours. I couldn’t put it down. This is going to be a tough one to review, because I’m not sure how to put into words what I liked about it, but I’ll try.

I’ll start with our unnamed protagonist. What a well-written, well-developed, complex female protagonist. I was truly blown away by how relatable and lifelike she felt. I experienced the protagonist’s innermost thoughts and feelings as she experienced them. I wasn’t nearly as attached to any of the side characters, but I think that was intentional. There was always the sense that they were impermanent.

The Book of the Unnamed Midwife covers some rough subject matter. A list of trigger warnings for this book would go on forever. But I don’t read post-apocalyptic fiction because I’m looking for something lighthearted or hopeful. I’m not sure why I love reading books about the apocalypse, but whatever it is I enjoy about the genre, this book had it in spades. It was certainly an emotional experience.

For about the first half, it was a pretty standard plague narrative: lonely protagonist travels aimlessly, encounters a few friendly people but mostly people who want to attack her, occasionally hunkers down in a shelter for a time. The main difference was that the book specifically focused on the treatment of women in the apocalypse. I’ll never get tired of reading about women.

Once the protagonist arrived in Utah and encountered the Mormons, the narrative changed slightly, although it still wasn’t groundbreaking. I’m an ex-Mormon, so reading about Mormons from a non-Mormon perspective is always a bit uncanny valley. Meg Elison got the gist of things, but it wasn’t a completely accurate portrayal.

The one major complaint I have about this book was that I wasn’t a fan of the protagonist’s journal writing style. It was slightly stilted and unnatural. I preferred the sections of the book that were written in third person or that were excerpted from other character’s writings.
Profile Image for Kerry.
803 reviews93 followers
January 8, 2023
Saw this on a couple of Best science-fiction book lists and remembered that I tried it and DNFed at about 50% as it got redundant and just too predictable but the midwife in the future theme still intrigued me. In all my years of being an in hospital midwife I seldom saw any book, movie or play that put midwives in the future or even the present. Mostly in the media midwives are put on horses or bicycles and are as often witches or herbalists with a sideline as midwives. Too often it is as if the profession only existed in the past, rarely in the present and seen to have no future. So I decided to listen to the end and see how midwives faired in this one.

This is a dystopic novel that begins with a world devastated by a plague that kills primarily women and children and leaves a world with no future as all babies are stillborn and the mothers rarely survive to try again. The few women who manage to survive the plague are hunted, often held captive and used for sex. Lots of trigger warnings here for sexual abuse that is for sure. Men do not fair well. The ones who have a woman and try to protect her die doing so and the women are often held in chains. A few manage to learn to work the system to their advantage. It's depressing for sure but mankind has a way of surviving even when it seems unlikely.

I don't like books with agendas much. This novel often felt that way with the male bashing overdone yet there were rays of hope in this dim picture of society and the world with few women left. And as a dystopian scenario there were many parts that rang true.
The best part was the midwife. She became a real person to me and wanted only the best for the women who came under her care. I could have learned a few things from her approach and how she handled a few very difficult situations. I loved so much how she came across at the end and how she continued to be a champion of the women she helped. So for that a 3 star moved up to a 4 star (and almost a 5 star at times). She made this story and for that I will think of it for long time.

Audio was narrated by Angela Dawe. She did an excellent job. Good but dark story of a dystopian world. It is the first book in a trilogy. Not sure I need to read more soon but if it sticks in my mind I may be drawn back.
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