A review by burritapal_1
The Book of the Unnamed Midwife by Meg Elison

adventurous challenging dark emotional hopeful informative inspiring reflective sad tense fast-paced

• Plot- or character-driven? Plot
• Strong character development? Yes
• Loveable characters? It's complicated
• Diverse cast of characters? Yes
• Flaws of characters a main focus? No

4.0

The whole review is a spoiler.

From Wikipedia:
"The beginning of the book is recorded as January 15th. The Midwife is a labor and delivery nurse who is in a relationship with a handsome research doctor named Jack and she works at the University of California San Francisco medical hospital. She has heard of a serious disease, that she calls “the fever thing”, which seems to pop up all at once, everywhere. She notices that it seems to be especially deadly to women, parents that are actively giving birth, and their neonates.

This new pandemic is highly lethal, killing about 95% of the men, 99% of the women, and, as far as the Midwife knows 100% of the children that contract it.

The Midwife herself gets the disease but becomes one of the very few who survived it. In the shock of waking up alone in a hospital full of dead people, she heads home."

4 aliases she used:

Karen

Alex

Dusty

Jane

"Books in, books out, read novels, write a diary. Paper in your hands and silence in your mouth." The Midwife says this to herself when she's so lonely.

The Midwife wakes up in the hospital after being sick with the plague. She runs into a gay couple, and when they go raiding in a mall, they almost get caught by a gang of men. That's when the first friends she's met dumped her:

" 'what in the hell was that all about,' she bellowed toward them, raising both hands and looking bewildered. 

Chicken's head swiveled around to face her, ugly with rage. 'that was about you. They wanted you. They saw you a girl, and they decided they want to take you with them, so they run you down. We heard the noise and came running out, and they decided we're defending you, so they going to kill us. We don't need this shit.'

'what? What are you talking about?'

Joe started to speak, but Chicken cut him off. 'fucking gas explodes, whatever, that ain't your fault. And it ain't your fault you a female. But you are going to make trouble for us, and we don't need you. I seen this shit coming when I seen no women. We ain't going to die defending you. You got to go.'

'look, I can defend myself. You don't have to -'

'those guys would have acted tough, maybe made us leave the mall. They would have had no fight if they didn't see you. You too rare. We can't do this. I'm sorry. You got to go. We got to go. This ain't going to work.' "

"No way it was 98% of men. that would mean it was more than 99% of women. That's insane."

The Midwife makes it into utah, where she finds a nice house to stay. But she sees there are people around, so she makes her way into the nearest village. Here she finds a group of about 54 Mormons. It's almost all men, with only about four women. She finds out that men are disappearing.

"She waited, but he did not elaborate.

'Did you send out search parties?'

Comstock looked deeply uncomfortable. 'we did. Of course we did.'

She was mystified, watching him for signs. 'a lot of your people are locals, they must know the area. Where could these people be going? Do they just want to find another community?'

He looked at her quickly, appraising her. He looked at his shoes again. 'we found... some of them.'

She struggled for a minute, not sure what to say. 'oh. Suicides.'

she waited for him to confirm it or deny it. He did neither. 

Shit, he can't even say it.

....

'it's not important. It's going to stop the minute we find just one more woman or girl out there. That will be enough to bring hope. She will come. She was promised to us.'

She wanted to get as far away from him as she could."

The Midwife has been dressing as a man. SHe realizes that when they figure out she's a woman, she'll be imprisoned there.

The Midwife has found a companion, roxanne. But one day, they run into a biker man, Duke. Roxanne is definitely interested in the biker man. When he's going his own way, Roxanne wants to go with him, and she tries to convince the Midwife to go with them. She tells her no. Duke seems nice, but there's something wrong. 

the omniscient narrator, lets us know what happens to Duke and roxanne, when they make it to a gas station on the outskirts of LA.

"A young-looking guy was almost upon her. She decided there was time for both. She took a shot at the pump farthest from her. She hid it dead on, but it had been too long since it had been in service. It flamed, but it didn't explode. The action-movie boom never came. She stared at failure a beat too long, and the kid tackled her. They both slammed into the bike, and they went down on top of it. He pinned her, and another guy walked up and calmly kicked her in the side of the head. She blacked out. Duke separated his shoulders struggling against the man who held him. It was the last thing she saw.

Roxanne woke up in the Garrison two days later. Her vision was doubled, and the only other person there was a girl. The kid was young and developmentally disabled. She couldn't speak, so Roxanne never learned her name. The kids signed constantly, frantically, but the only sign language Roxanne had ever learned was please and thank you and a few obscenities. The deaf girl was dead in a year. Roxanne lived a long time, but she never saw Duke again. The Garrison's radio broadcast kept people coming down I-5, but it didn't always work. When she died, she was still the only woman there."

Skipping a lot...

The Midwife makes it to a settlement that's actually a good place. It's known as Fort Nowhere. One day two men and a Woman in Chains walk up, and offer to trade her for goods. They separate the men and the Midwife examines the girl. SHe's been genetically mutilated. She tells the girl she'll be safe, and goes to question the men. She asked one of them:

" 'did you fuck her today?'

'well, yeah.'

'did she say yes?'

'You don't understand.'

'stand or kneel?'

'Please don't shoot. Please. I'll make it up to her. I'll never touch her again, or anyone else. I didn't mean to hurt her.'

his eyes were green in his Haggard face. They darted as he begged. 

'I can't fix you. I don't have the time to teach you why you're wrong if you don't already know. So this is it. Stand or kneel?'

He lunged toward her. She took the shot, and he pitched forward, laid out on the ground.

The burial detail arrived as Jane was walking away. 

'check him. He might have a good knife for one of you.'

Jane got out of her scrubs and into bed. She slept with her door unlocked. She dreamed of nothing at all."

This book was disturbing. We're all here in our comfort zones, but Society is fragile, and with these volatile men in charge of all the nukes and biowarfare, any day we could all be put in a situation like this. The women.