I am very late to reading the 2014 Philip K. Dick Award-winner The Book of the Unnamed Midwife by Meg Elison, despite it being highly recommended by a friend and having her copy sitting on my bookshelf for 18 months. I suspect that the timing wasn’t right–I was given the copy on New Years Eve 2019, read Station Eleven by Emily St. John Mandel in February 2020, right as the COVID-19 pandemic was developing, and I probably wasn’t ready for another post-pandemic, post-apocalyptic novel right then. After reading Elison’s novelette The Pill (the story I wish I’d written), I could wait no longer.
In Unnamed Midwife, there is a fever that affects everyone and kills most, but seems to be more virulent in women, especially pregnant women, who almost always die along with their babies. A nurse-midwife in the San Francisco Bay Area survives the fever, but when she wakes up, she realizes that society as she knew it has collapsed. After nearly being raped, she dresses and acts as a man for her safety and survival. She collects all of the medical supplies that she can, which she barters as she travels, offering birth control to every woman she meets as she heads east. All of the women she meets are enslaved, but she does what she can to help them survive. She forages, keeps to herself, tries to bulk up as best as she can, and practices passing as a man. She keeps a diary, and collects the stories of the people she meets.
As she travels, she finds a Mormon community, with a few women and many men who venture out as missionaries, but more often kill themselves instead of coming back. She doesn’t want to stay in the community, but stays a few miles away. After the fever finds the settlement, one of the few remaining women escapes and hides with her because she’s told the Bishop will find a husband for her since hers has been gone for six months on his mission. The Unnamed Midwife is bisexual, and this young Mormon woman living with her is exquisite torture. But her husband returns from his mission, so she is thrilled and the Midwife is relieved. He won’t talk about what he saw, but the Midwife finds his diary. After leaving them, she eventually finds a fair community where women are free to determine their own lives, but the path there is grueling.
As far as anti-fat bias, there was none. Elison describes characters’ bodies without resorting to negative descriptions of fatness. So I’d categorize it as weight-neutral because while there weren’t positive portrayals of fat folks, there weren’t any negative portrayals, either.
I can’t wait to read the sequels–The Book of Etta and The Book of Flora.