What's the Name of That Book??? discussion

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SOLVED: Children's/YA
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SOLVED. Dystopian YA book that takes place on the edge of "Unlake" Superior. [s]
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Rosie, please unprivate your account. Mods can't see the threads you've started with a private account.
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The book takes place in a not too distant Earth that has been absolutely bodied by climate change, so much so that Lake Superior of the Great Lakes is now called an ~unlake~ and is empty. I did wonder how anyone was surviving in a landscape so devoid of water that the entire Great Lakes went dry haha.
The main character is a midwife and lives as part of a second class community of outsiders that struggle to subsist outside the walls of a city of rich people.
She has a large burn on her face from when she was a child, which (spoilers incoming) turns out to be a result of her mother burning her intentionally to prevent the rich people in the walled city from taking her away. This is because they are desperate for genetic diversity and steal children from the outsiders to improve their gene pool.
I don't remember exactly how it went down, but there was possibly a sort of uncomfortable undertone of... incest apologism..(??) in this book. There was a scene where the mc goes inside the city and sees a public execution of two people who were first cousins but also discovered to be in a relationship. Hopefully I misinterpreted it or something, but I remember feeling weirdly like the message was supposed to be that the cousin-lovers should have been more accepted. (Not that I think they deserved to /die/ obviously, but idk I remember being a little suspicious of the author's intent lol. Ideally I was wrong and it was actually a nuanced take of "incest bad but execution not the answer" lmao