The Book of the Unnamed Midwife: A Review

Meg Elison’s The Book of the Unnamed Midwife received the Philp K. Dick Award in 2015, and it’s not hard to see why. Philip K. Dick once said,

“Today we live in a society in which spurious realities are manufactured by the media, by governments, by big corporations, by religious groups, political groups… So I ask, in my writing, What is real? Because unceasingly we are bombarded with pseudo-realities manufactured by very sophisticated people using very sophisticated electronic mechanisms. I do not distrust their motives; I distrust their power. They have a lot of it. And it is an astonishing power: that of creating whole universes, universes of the mind. I ought to know. I do the same thing.”

midwifeGood science fiction allows us to imagine an alternate reality and, in many cases, to challenge those systems of power that structure our world. The Book of the Unnamed Midwife, examines and challenges social structures like gender, sexuality, injustice, morality, religion, and ultimately power. 

“There are no women left. Maybe a handful of us. Eventually we’ll get used up. I’ll get captured again. It’s all men out there now.”

The novel opens sometime in the future in a classroom led by an old woman named, Ina. She leads a group of young boys in archiving and transcribing a diary titled, “The Book of the Unnamed Midwife,” a diary that records the aftermath of a plague that wiped out most of the world’s population and that is written by a woman whose name we never learn.  The midwife’s story begins when she awakens in a hospital in San Francisco  to discover that she is alone and surrounded by corpses. They litter the hallways of the hospital and the deserted streets. Yet, she has somehow survived a plague that devastated the world and seemed to begin with women and the babies they carried. In this post-apocalyptic world, the majority of women are dead, the ratio of men to women is 10:1. Women are commodities and are thus sold and traded by men.They are used, raped, and valued for their reproductive abilities, their ability to insure the survival of the human race.  To survive this new world, the protagonist disguises herself as a man and learns her own strength, all the while seeking what is left of humanity in the people she encounters along the way.

“The Book of the Dying is very hard to read, and terrible things happen in it. Some of you might cry or feel sick. That’s ok. I felt sick, too, when I came to read it.”

The novel is brutal at times, and some scenes are indeed “very hard to read.”  So much so, that early on I considered bailing, but I’m glad I stuck with it. Meg Elison’s exploration of femininity and women’s inequality  is unflinchingly honest. She doesn’t hold back when considering the differences between men and women, those that naturally exist and those that are constructed. Particularly, I appreciated Elison’s ability to examine the ways in which women are treated when the laws that protect them are gone. In other words, Elison shows that it would’t take much for society to regress. That the progress we’ve made is an illusion unless people enforce it themselves.

“Did an ok job of changing my look. I’m tall. Apartment in the Mission, found a compression vest 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. Candlelit mirror tricky, tricky. Look like a young, effeminate man. A guy like Joe. Need to do more push-ups. Walk tall, keep hips straight. Don’t sway. Feet 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.”

The author challenges the stories created for women, namely those of mothers and wives, and the few opportunities for power they possess. I was a little disappointed, however, in the ambiguity of these roles because in the end, the women who successfully bear live children are perhaps portrayed as the most important. It is the entire reason that the young boys are transcribing the story of the unnamed midwife. They hope to record and to learn how to repeat the successful delivery of babies.

“Without birth, life is only that wait.”

I concede that it makes sense that children are necessary in this plague-devastated world, for the survival of humanity. And the author depicts various paths women can take in their new lives. Not all become mothers or wives. I just think this part of her message about equality and womanhood could have been handled a little better.

The novel’s narrative structure was hard to follow at first, though the author’s strengths shine in her dialogue and in the first-person journal entries. Interspersed between the midwife’s journals are third-person sections that chronicle the events outside of the midwife’s scope. The writing in these early sections were choppy as the protagonist travels from place place, encountering a diverse group of characters , but the writing becomes smoother after the midwife settles into a community. Because she is in one place, perhaps it was easier to identify and make sense of these sections. That said, in the end, the author uses third-person narration to explain what happens to some of the characters the midwife meets. These parts detracted from the story. One of Elison’s strengths is her honesty, the reality she brings to the apocalypse, and her focus on the midwife’s interiority. It would have been in keeping with the story to leave these secondary characters’ fates ambiguous. The midwife doesn’t know what happens to people outside of her world, and neither should we.

The Book of the Unnamed Midwife  is a successful and satisfying dystopian novel in the tradition of Margaret Atwood’s The Hand Maid’s Tale and Justin Cronin’s The Passage (but without the vampires).  Be prepared for an engaging, but brutally honest read.

I received this copy from the publisher via NetGalley in exchange for an honest review.
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