The Book of the Unnamed Midwife

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The Book of the Unnamed Midwife

Terror. Destruction. Disease. Violence.*

Many post-apocalyptic novels paint their settings in various shades of death – I’ve yet to read a novel that believes the world ends in kindness and sing-a-longs – but this one… this one kept me up at night.

Author: Meg Elison • Publisher: 47 North • Released: 2014

Meg Elison’s The Book of the Unnamed Midwife is harrowing. Set in a world where a pandemic fever has killed 99% of men and 99.9% of women, the broken, violent husks of humanity wander a desolate, rotting wasteland. As my last novel of 2018, Elison’s story left me in a cold sweat wondering if the people who died from her pandemic fever were really the lucky ones.

I don’t want to survive the apocalypse if it looks like this.

They lit candles against the dark and waited. Without birth, life is only that wait.

-Meg Elison, The Book of the Unnamed Midwife

The Book of the Unnamed Midwife follows an unnamed protagonist during the immediate aftermath of the deadly fever. During the next two years, we witness a haunted world where gangs of men trade the few remaining women for cigarettes and bullets. These women are raped, tortured, and forced to give birth to stillborn babies. The unnamed protagonist – I will refer to her as her taken name “Jane”  – is a woman, a nurse, and a survivor of the pandemic. She’s introduced through her diary entries which begin before the fall of civilization and continue throughout the story. This mixture of third-person narration with intimate first-person diary entries drags me into the emotional trauma of Jane’s story before placing me in a front-row seat, high above the destruction and terror she encounters. It’s an effective storytelling choice that breaks up the action and allows for intimate moments of character growth and connection in a hostile world.

Elison begins her book with a prologue – and it works. While there are many good reasons to skip the prologue, especially in speculative fiction, The Book of the Unnamed Midwife creates immediate intrigue by giving us a disturbing look at the future of our world. It’s a mournful future, set in a crumbling school building with children transcribing Jane’s diary entries to preserve the nightmares of the past. The prologue pulls me in, making me hungry for answers. How did this happen? How did our infrastructure crumble? How are these haunted humans finding the strength to rebuild?

And, as I continue reading, this glimpse into the distant future comforts me: the world will heal.

Because The Book of the Unnamed Midwife is not a novel for a weak stomach. Elison never shies away from describing the brutality of men – yes the male sex – in their absolute animalistic and sadistic treatment of women. Graphic descriptions of rape, genital mutilation, torture, disease, death, and mental and emotional abuse color every page. They’re witnessed through Jane’s eyes, and the eyes of some of her temporary companions, accompanied by an underlying acidity of fear. We are running from a mob of men with guns and knives with Jane. We’re holding our breath in a dumpster with Jane. We’re hiding in a locked cabin with Jane. We’ve pushed the furniture against the doors with Jane. We’re praying they’ll leave with Jane.

We’re shooting to kill with Jane.

And we’re touching women with Jane. We’re passing our shaking hands over their ripped bodies, offering them kindness, hope, and relief – if for only a moment. We’re delivering their silent babies and holding their hands as they scream. We’re continuing to believe in the endurance of the human spirit as we nurture every breath of hope.

But even as I root for Jane, it’s impossible to ignore the thriving landscape unburdened by the boots of humanity. A guilty peace shakes the leaves of unshackled trees, their roots breaking through cracked asphalt to reclaim the land, and I see the parallels. Elison’s hollow-eyed women attached by chains to savage men, birthing suffocating babies until they die with their eyes wide open remind me that our fetish with the destruction of life – with creation itself – is behind every holocaust.

But it can be too much. I needed a break. Elison’s violent, post-apocalyptic world set me on edge, and I took a week off to grieve. I grieved for our sleeping daughters unaware of the violence capable by the hands that tuck them in at night, and I grieved for the women whose eyes are wide open right now. The Book of the Unnamed Midwife is a story, but the reality of Elison’s women – chained, beaten, raped, and sold – is not speculative fiction. Their trauma happening right now, right this second, in every single country around the world.

After sitting on this book for a week, I began to wonder: do plagues only kill the good or does evil lurk in us all? Faced with a pandemic that cripples the future and destroys every law and cultural comfort we’ve grown to rely on, is chaos the only answer? Is this descent into the ugliest of humanity the only option?

Or could a post-apocalyptic future reveal the best of us: our compassion, community, empathy, and endurance? What if, instead of picking up knives and guns, we picked up hammers and rakes and rebuilt? What if the people who survived the plague were more like Jane? What if they were the helpers?

I’d like to think I’d be a helper like Jane.

You should read this book if: you enjoy speculative fiction, post-apocalyptic novels, psychological horror, feminist fiction, or you are looking for a new book to give you nightmares and jump at every cough this flu season. It was quite the way to finish my 2018, but one of the best books I’ve ever read. As I look forward to 2019 with two speculative fiction WIPs, Elison has inspired me to never shy away from showing the ugliness of my characters. Pain and trauma change people, and they should change characters too. I’m glad I read an author who draws their characters with bruises and scars, sweating and screaming as they stumble through the worst of Hell…and keep going.

This book inspired me to donate to organizations that work to end gender-based violence against women and girls. Below are a few organization that accept donations in their campaigns to end gender-based violence:




*Readers Warning: this book includes graphic descriptions of rape, genital cutting, psychological horror, pedophilia, gender-based violence, birth trauma, stillborn birth, and violence. While it’s never exploitative, it describes these themes without censorship and may not be suitable for all readers.

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