The Book of the Unnamed Midwife

Reviewed by Dave Truesdale

Somewhere around the middle of March I posted at a website forum asking for hard SF novels from the past couple of years written by women. For several days there was nothing but the sound of crickets. I then received eight suggestions in an email, and though they were not exclusively hard SF, they were still definitely SF, and of several varieties. Eight SF novels written by women and coming from seven different publishers. So I purchased three and was fortunate to receive review copies of the others.

As it turned out, three of the novels were finalists for the 2015 Philip K. Dick (PKD) Award, for best original SF paperback published in English in 2014. There were six works on the final ballot: one was an original anthology, one was male authored, and four were novels penned by women. Three of the four SF novels written by the women (I haven’t read Cherie Priest’s Maplecroft) were first novels (don’t know about the one written by the guy), so I was prepped and intrigued with what I hoped to find. I will be reviewing the three I acquired in the order I happened to read them, two of which I had finished and had written down notes for before the PKD results were announced on April 4th.

Sybaritic Press published debut novelist Meg Elison’s The Book of the Unnamed Midwife in June of 2014. A rather short book by today’s standards, it clocked in at a welcome 184 pages.

I looked at the rear cover blurb and cringed, seeing that it was yet another post-apocalypse novel. Not only have there been a multitude of them over the past hundred years, but a resurgence of them in one iteration or another for at least the past decade. The first two sentences of the blurb proclaim: “The apocalypse will be asymmetrical. In the aftermath of a plague that has decimated the world population, the unnamed midwife confronts a new reality in which there may be no place for her.” Well, I thought, if this made the short list for the PKD award it probably goes beyond the usual storyline of practically all other post-apocalypse novels (societal breakdown, roaming gangs, protag going it alone or meeting up with others for a short time, varying methods of survival tactics, etc.) and adds to the well-worked trope in some unusual or fresh manner, whether in depth of character, some deep insight into the state of mankind, or something else entirely unforeseen or imagined, so I will keep an open mind and see what the author’s take on the theme might be this time around.

The set up here is a plague that has decimated mankind, but for some unknown reason it kills women more than men—at a 10:1 ratio. Babies are stillborn, sometimes including the death of the mother as well. Women are, as one might imagine, highly prized commodities—not so very different from other post-apocalypse or post-collapse or post-disaster stories involving the entire planet where much technology and infrastructure is decaying or lost and the repopulation of the Earth is dependent on biological reproduction, but here this situation is emphasized tenfold and brought into stark relief.

The story begins and ends—is framed—by one Mother Ina who, in the Prologue, is conveying detailed instructions to a very special class of six boys, all just entering puberty. Their makeshift classroom is housed in the ruins of a building many years following the collapse. These specially selected pupils, chosen anew each year and called scribes, are honored as they are to hand-copy the carefully preserved, handed-down volumes of the original diaries and journals—all nineteen of them—known as The Book of the Unnamed Midwife. As the young scribes begin their painstaking task, we slide into the story itself, which opens with an attempted rape scene. An intruder has stealthily invaded the apartment of the female protagonist, to whom I will refer henceforth as Karen, as this is the first of several aliases she adopts. She fights off her attacker, killing him in a bloody struggle, then vacates her apartment still wearing her blood-covered clothes. Her journey through the new plague world has now begun and the reader follows her search for safety and possible news of what has caused the plague.

There are stories within stories here, and ofttimes Elison uses a third person omniscient narrator to stand above the first person limited pov accounts of the various characters as written in their diaries. This approach works very well for the most part, save for two glaring lines of first person viewpoint (in separate parts of the book) that are inexplicably buried in the midst of the third person omniscient narrator’s description of events. These prove to be extremely jarring missteps, throwing the reader out of the specific scenes being described. A technical, copy-editing oversight most likely, though fortunately not nearly the magnitude of flaw to ruin the primary story. These things happen.

Karen is one of the few female plague survivors, having recently recovered from a nasty bout of the fever herself. She begins her wanderings from San Francisco (which coincidentally is the setting for Jack London’s 1912 post-apocalypse novel The Scarlet Plague), and sets her sights in a generally eastward direction. As one has come to expect from countless previous scenarios of this kind, the first order of business for Karen is to secure safe shelter, food, and somewhere along the line weapons. This is not only reasonable but eminently practical. On one of her scavenging forays she stocks up on an item overlooked in other post-collapse or post-apocalypse stories that I can recall—and that is a large supply of birth control pills and contraceptives. This is something not only a woman might consider but one with medical training might think of as necessary (Karen has worked in a hospital in San Francisco). Given that the usual sexual abuse of women (i.e. rape) in such a situation is even more prevalent when there are ten men for every living woman, and in a time when civilization has regrettably regressed to lawlessness and roaming bands of survivors, birth control serves a dual purpose. Not only does it prevent unwanted pregnancies when medical facilities and care are rare, but it will save the life of the mother as well, for most women are not surviving their pregnancies and die along with their stillborn babies. Two lives are thus saved, one potential, one real. I found this to be a smart insight on the author’s part.

There is no purpose served by recounting and detailing each scene where Karen meets someone new. Rather, a mention of the more important encounters in support of the theme, or over-arcing thread weaving through the novel, might prove more valuable.

Which encounters define this novel, and what is their subject? Sex. Sexual preference. Homosexuality. Women dominated and/or abused by men for sexual gratification, or women dominated by men but not sexually abused, per religious belief in one instance. Women in control and dominating men for sexual gratification. These elements are what rise to the surface and provide a picture of what author Elison seems to want us to take note of in her otherwise routinely plotted post-apocalypse story, and with which she layers the surface of its usual structure.

In Unnamed Midwife there is straight sex, rape, gang rape, female masturbation, an orgy, and homosexual sex, yet there is nothing explicitly described, so don’t read the book for the “good parts.” In this sense there are none.

Examples of the above are in order, beginning with:

Sex. The simple physical act itself is nothing new in fiction or in science fiction or in any sub-genre of SF or Fantasy, including the post-collapse or post-apocalypse story. Wilson Tucker’s 1952 post-apocalypse novel The Long Loud Silence included straight sex and a loving triad; two men and one woman, though there was no threesome. Daryl Gregory’s engaging and thankfully different 2011 post-apocalypse zombie novel Raising Stony Mayhall includes two pubescent boys (one Chinese, the other a zombie) practicing masturbation (it didn’t work so well for Stony Mayhall, the zombie). The Wilson and Gregory are both post-apocalyptic works and are separated by just shy of sixty years. And I’m guessing sex in a post-apocalyptic story didn’t begin with Tucker’s superb novel. Point being that just in the post-catastrophe sub-genre sex has been part and parcel of it for a long time. And it abounds these days—and has for many decades now—in science fiction and fantasy works of all manner and description. There is one brief scene in Unnamed Midwife showing straight sex. Karen, who is bisexual, is comforting Honus after his young wife has lost her baby. They are both lonely (horny) so Karen has sex with Honus (a member of the Church of Latter Day Saints [LDS], about which more in a bit). There is no description of the sex act itself.

Rape and gang rape. These horrible occurrences could be expected to happen in any post-apocalypse/post-collapse scenario when everything has broken down and the worst elements of human nature are too readily exposed. Here they are particularly heinous, for women in several instances are dragged around in chains and used sexually by one or more men over and over and over. They are also “rented” for periods of time in exchange for whatever the seller wants from the buyer in trade. One scene has Karen (now “Rob” disguised as a man) trading some of the goods she has acquired (booze) for a bedraggled young woman, who she then provides with a two-year birth control shot and some IUDs. The young woman, aged 19, has already been pregnant twice and fortunately survived one stillbirth, the other pregnancy being a miscarriage.

Homosexual sex and orgies. Karen reads the diary of Honus, a nice young man from a community composed of members of the Church of Latter Day Saints (LDS). Honus and his young bride have broken away from their sheltered community and live with Karen in an abandoned house. It is the practice of the LDS community to send out pairs of missionaries to search for others to bring back to their community. Many of the men do not return. Honus’s diary relates his exploits on such a trip. His companion is killed when they are captured by a group of men belonging to a Hive. A hive is a group of men drawn to and under the power of a single female—the queen bee. In these bizarre arrangements, the queen bee has sex with whomever she chooses at her whim, and the men await their turns. In one grand orgy scene where Honus is expected to participate (anathema given his religion), the queen is engaged in sex and Honus, while waiting his turn, is grabbed in preparation for being raped by the men. Amidst the sexual frenzy and excitement he escapes, but his partner does not. Honus returns to the LDS community, which is where Karen first met him and his childlike, naïve young bride.

Female masturbation. One brief scene where Karen succumbs to her loneliness and masturbates in her bed. Nothing explicit is rendered.

The above are snapshots of the kinds and varieties of sex included in the book. Though sex per se—in and of itself—is present in many another post-collapse story as an element one would expect to find in such a world to one degree or another, it is here featured as a recurring theme and not just as a standard background trope in passing.

So, what do we have here with debut novelist Meg Elison’s 2015 Philip K. Dick Award winner The Book of the Unnamed Midwife? Her prose is certainly and unremittingly professional, though it is nothing above the commonplace literary standard required of novelists today that elevates it in any particular aspect above the pack. There are many professionally written novels in the marketplace today. The prose here is perfectly acceptable, but nothing so out of the ordinary, so exceptional that would recommend it as a special check on the Plus side of the equation when being considered for an award.

Is the treatment of sex or gender different or novel enough to warrant a raised eyebrow? Not really (except perhaps the Hive concept, which I found highly unlikely for any number of reasons). We read about characters who are gay or bisexual fairly regularly in both short fiction and novels these days (I just happened to have finished a very fine SF novel recently by Sarah A. Hoyt, for example, titled A Few Good Men, whose protagonist is gay. The novel wasn’t about his gayness, but it nevertheless provided more insight into his sexuality than is found anywhere in Unnamed Midwife with any of its mentions or depictions of sex or gender.).

Philip José Farmer shook the field to the core with his breaking of sexual taboos in SF with 1952’s “The Lovers.” Theodore Sturgeon was writing deeply insightful examinations of homosexuality as far back as the 1950s and 60s (“The World Well Lost,” “Affair with a Green Monkey,” “If All Men Were Brothers, Would You Let One Marry Your Sister?,” and others), the 1960s and 70s were replete with stories and novels examining issues of gender and sex; think Joanna Russ, Ursula K. LeGuin, James Tiptree, Jr., Samuel R. Delany (Dhalgren anyone?), and we would be remiss if we failed to mention Margaret Atwood’s 1985 novel concerning the subjugation of women, The Handmaid’s Tale. We could go on but the point has been made. It is unfortunate that nothing new or fresh awaits us in Unnamed Midwife. We get but a passing look, as if the author were a bus driver on a guided tour without stops, allowing only brief glimpses of the scenery. We are left to surmise that nothing new has been added (save for perhaps an elbow to the ribs in the side of the Church of the LDS, whose stance on homosexuality gives Honus’s frightful capture by members of a Hive and close scrape from being man-raped a not-so-subtly veiled, Take that).

So—if it isn’t the prose that sticks out, and the sex just lies there, what might make this novel potential award material? What specifically does it bring to the table that is fresh and different?

At this point I must bring attention to another unfortunate faux pas to go with the pair of first person pov sentences buried in the middle of third person narration mentioned at the top: near the beginning, “Karen” has found herself an abandoned lake front house around which said lake more houses are arranged. A party of men have discovered and now live in a house on the opposite side of the lake. Following several unsuccessful instances when they attempt to break into her house, Karen takes matters into her own hands and decides to pick them off from her well-barricaded abode. She selects the one of her two guns which is “slightly more accurate at a distance. The shot was a hundred feet, easy.” A hundred feet? The distance from home plate to first or third base in major league baseball is ninety feet (less than thirty yards), and the bad guys are partying in a house on the opposite side of the lake. Such an obvious error is more than embarrassing. I can’t believe that out of all the people who must have read this novel—including proofreaders, copy editors, and the editor, no one picked up on this glaring error. Talk about being thrown out of the reading experience.

To put all the preceding in a nutshell, there is nothing radical or new in this novel. A female author is nothing new these days. A female protagonist is nothing new these days. The depictions of gender and sex in the novel are nothing radical or new these days. The vast majority of readers don’t care, or have read it all before—decades ago and in one variation or another. Nothing in this book has the edge, radical or otherwise, it might have possibly had if it were published in the 1970s (except perhaps the concept of the Hive and the queen bee, which, if anything, is naught but a simple role reversal of the traditional male dominated harem if you want to go there), but the concept isn’t examined beyond a cursory description from Honus’s diary (what the men get out of it aside from the obvious and just what explicit power the queen bee has over them, etc.), but is just presented then abandoned. In today’s more accepting world in the areas of sex and gender roles, when a lot of the ground has been explored and worked over decades ago, merely tossing in any or all of the elements in this novel isn’t enough; the author must do something with them and do it differently or in more depth or from a different perspective (I give another nod to Daryl Gregory’s Raising Stony Mayhall in this regard).

Please remember that the points of criticism leveled here are from the perspective of this otherwise decent first novel—an “okay” debut but nothing special—being nominated for an award, and actually winning—as the best SF/F novel published for the first time in English in the U.S. and with its first edition being as an original paperback. Standards should be high. It is clear that Meg Elison has talent and is an author to watch, and her first novel is worth a look. But of award-winning caliber I entertain serious reservations. The final pages of the book, including the bookend Epilogue which closes the novel are well done, by the way. This aspect was well handled, giving closure and a satisfying last impression with which to leave the reader, as a faint glimmer of hope is intimated.

The Book of the Unnamed Midwife is what it is, and the reader will simply come away from the experience with a positive or negative feeling, as is the case with any work of fiction. Readers coming new to the post-apocalypse novel, or who may have only sampled a few will no doubt enjoy this novel much more than those of us blessed (or cursed) with decades of exposure to this popular sub-genre, who have read more than our fair share of post-apocalypse novels over the years and yearn for something truly fresh and exciting. They are becoming increasingly difficult to find.

♣  ♣  ♣ 

Next: Another 2015 PKD nominee, Finnish author Emmi Itäranta’s debut novel Memory of Water.

Dave Truesdale has edited Tangent and now Tangent Online since 1993. It has been nominated for the Hugo Award five times, and the World Fantasy Award once. A former editor of the Bulletin of the Science Fiction & Fantasy Writers of America, he also served as a World Fantasy Award judge in 1998, and for several years wrote an original online column for The Magazine of Fantasy & Science Fiction. Now retired, he keeps close company with his SF/F library, the coffeepot, and old movie channels on TV. He lives in Kansas City, MO.