Winner of the 2014 Philip K Dick Award for Distinguished Science Fiction, Meg Elison’s The Book of the Unnamed Midwife is an incredible science fiction read that is confronting, chilling, and wonderfully constructed. If you are one for adult dystopian, end-of-the-world science fiction that leans a little dark and heavy, then this is the book for you – and I have great news for you, because this is just the start to the series.

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.

Let me reinforce the fact that this is an intense, heavy, and sometimes dark read. The themes are mature and very much so adult-leaning, with the setting and circumstances pointing towards some archaic and animalistic behaviours. This is not a book for the faint of heart or teen readers. There is also a bit of religious structure as part of the story, something that may upset some readers, so please take caution with yourself and this book is any of that bothers you.

The idea of women either dying off or losing their ability to procreate is not new to science fiction. As I was reading The Book of the Unnamed Midwife, I had the sense that fans of The Handmaid’s Tale may like this. The characters and angle are different, but the themes and ideas are similar. I also saw myself thinking about Her Body and Other Parties seeing as a few of the short stories share the same themes and ideas. The Book of the Unnamed Midwife does something interesting though, something unique – the story is a record, a tome used to teach future generations, as shown in the first chapter. It is a blend of present day teachings, past notes in a journal, and past perspective where we follow this midwife as she wakes and finds herself in a strange, new world. The mixed storytelling is fun, keeps the story intriguing and snappy, while also giving emotion to someone we follow in the third-person.

It won’t be a book for everyone, but The Book of the Unnamed Midwife is not to be forgotten about. For those who do read it, you are in for a story and a half with this novel. Either way, I encourage you all to read up on it and see if it is something you are comfortable giving a go.