The author Megan Abbott was inspired to write the novel by a conversation that she had with a man she was dating who told her that her reproductive history could affect his opinion of her.
[1] Abbott was inspired by Gavin de Becker, who was famous for his book The Gift of Fear, which told women to trust their instincts.
[4] The novel was inspired by Gothic literature, drawing particular comparisons to Daphne du Maurier's Rebecca, Bram Stoker's Dracula and Emily Brontë's Wuthering Heights.
[9] Abbott has often written about female bodies, focusing on teenage athletes in Dare Me and You Will Know Me and medical conditions in The Fever and Give Me Your Hand.
[2] Abbott consciously used the Gothic trope of an overbearing mother-in-law, subverting it with the character of Dr. Ash, who hides his darkness behind charm.
[23] Kirkus Reviews commented that Jed did not feel like a fully-fleshed character but wondered whether this was a deliberate choice, to contrast him against Jacy's full personality.
[14][24] The Irish Times described it as "a slow-burning novel of almost unbearable tension, with a compelling, poetic narrative voice, an unsettling, delirious atmosphere, an abundance of darkly funny one-liners and a plot that dramatises incisively issues around patriarchy and female bodily autonomy; the violent, shocking, pulpy climax is splendidly lurid".
[25] Lawrence De Maria for the Washington Independent Review of Books similarly praised the prose, although he criticized the pacing and described the ending as "implausible".