ARC provided by the publisher via Netgalley in exchange for an honest review.

“There are battles and accidents; there are collapses and plagues. There is silence only when one side wins or everyone has died.”

This book was perfection, and probably the easiest five stars I’ve given all year. This was so thought provoking, meaningful, eye-opening, and important. This was also, as a woman, the scariest dystopian I’ve ever read.

What made me initially request an ARC of this was that it had won an award in 2014, even though it is just being republished in 2016. Now that I’ve read this, it deserves every award – all the awards. If I could have people read one book this year, it would be this.

This book changed me.

I should preface this review by telling you there are many trigger warnings in this book: Rape, genital mutilation, physical abuse, sex trafficking/trades, stillbirths, and probably more things in the same vein. (You can ask me for a more specific trigger, and I will always reply back.)

Basically, 98% of Earth’s population of men and 99% of Earth’s population of women has died from an autoimmune disease. Even though most of the Earth’s population has be wiped out, the ratio of men to women is immense. Women become a very sought after commodity. Most are raped, sold, and treated like dogs.

“What disease cannot do, people accomplish with astonishing ease.”

The unnamed midwife makes it her goal to travel to a safer place, while pretending to be a man, and giving women healthy options to not get pregnant. She also is willing to help with births, to try to save the lives of the pregnant woman, because all the children being born are stillborn.

Since the main character of this book is impersonating a man, we get to see all the gender roles, and characteristics they have in this “new” world. Spoiler alert, they aren’t pretty. Many men take many steps back in progression, and have become more scary and animalistic, while trying to prove their alpha status.

This book heavily talks about gender roles and their impact on any society. They are obviously enhanced because of the ratio of men to women in this new post-apocalyptic society, but the parallels within our own society are so real and so scary.

The midwife is also very open about her sexuality. She identifies as bi, but I think she is most likely pan, too, and her take on being attracted to souls, and not bodies, hit really close to home for me. We also get to see juxtaposition with the Church of Latter-day Saints in this new post-apocalyptic world, and those chapters would be pretty eye opening, and very needed, for some people in today’s world.

“Expiration date of body > expiration date of canned tuna.”

We also get to see the different stages of progressiveness around the world, and how others are dealing with this disease. I loved looking at all the different cultures, and their reactions. I also loved how the author let us see what happened to the characters our midwife meets along the way, even though she never gets to know their fate.

Two of the characters she meets along the way really hit home for me. One is from Michigan, where I was born and raised, and the other was from Vegas/Henderson, which is where I currently live. Seeing two people, in the same terrible situation, from the two places in the world that I consider home, really hurt and scared me. The impact of the situation felt so real and will haunt me from some time to come.

Again, this book is so important. This book honestly touched, and shook me to, my core. I don’t use these words lightly, but I will carry this book inside me for the rest of my life. This book is so needed, and I hope it wins every award there is.

“Good old Planned Parenthood. Saved my life.”

Oh, and that quote made me decide that I loved Meg Elison, and I will read everything she creates. Honestly, the main and recurring theme of this book is how important it is to give girls options and keep them safe. Again, I’m repeating myself constantly, but everyone should read this book.

It’s scary to be a woman in today’s world, but it’s downright terrifying to try to survive as a woman in this book’s world. This main protagonist is one of the strongest and most empowering woman I’ve ever had the privilege to read about, and I don’t even get to learn her name.