The Book of the Unnamed Midwife is a post-apocalyptic feminist novel written by American author Meg Elison, published in 2014 by Sybaritic Press.

The prologue lays out a radically changed world where the buildings have sustained major damage and the glass in windows have been replaced with plastic sheets.

Readers are introduced to a school and a teacher called Mother Ina who wears a hollow wooden apparatus designed to look like a pregnant belly.

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 wanders the Tenderloin district dazed until she smells someone cooking and discovers a gay man named Joe using an abandoned restaurant to make food.

This introduces what the Midwife learns is the new world order – men seeing women not as fellow human beings, but as a rare natural resource to be used both for pleasure (most women the Midwife meets post-pandemic complain of anal and oral rape) and in what she describes as “the fury to impregnate” despite the danger to the lives of the birth-givers.

Cis gendered, heterosexual men in the new world are revealed to be utterly callous toward the danger that rape and impregnation poses to birth-givers.

The attempted rape, the chase, and the rejection of the only two people who didn’t want to hurt her shows the Midwife that whatever else may be true in this new world, her gender is now a target for violence, trafficking, and likely death.

Angel of birth control?” Eventually, the Midwife, now disguised as a man, encounters two men and one woman traveling together.

Eventually, she finds a car where the radio still works, and hears a repeating message encouraging everyone to “bring their women” south to Costa Rica or Panama.

She realizes that there is no way for a radio station to have enough power to broadcast from those countries, she strongly suspects it is a trap of some kind, so she decides to head north.

She spends the time working out to make her arms look more manly, eating to put on weight, and practicing firing her two guns.

They eventually find out that someone is occupying another house on the lake, and when they figure out the occupant is a woman, they try raiding the home to trap her into being their sex slave.

In the spring she heads east, and in a small town in Nevada she encounters a group of five men who have two women on chain-and-padlock leashes.

Roxanne is a mid-forties casino cocktail waitress from Las Vegas who found love later in life with a younger woman.

Throughout the book, the Midwife finds her own strong urge to have sex surprising given the dire circumstances that might result from doing so.

Later, the reader learns from the third person narrator that while Duke was big and scary looking, he instantly gave up himself and Roxanne to a gang of men with superior firepower, just as the Midwife had predicted.

The gang kills Duke and locks Roxanne in a military garrison with one other girl who could neither hear nor speak and who only knew sign language.

Dusty, having been without a companion for nearly a year, remembers Roxanne fondly and hopes that Jodi will be a similarly good friend.

She learns that Honus and his mission partner found one woman who kept a large group of men to serve her and pays them with sexual favors and drugs.

Although Jodi survives the birth, she falls into a deep depression, and just sits and watches a solar-powered TV that Honus gave her for Christmas.

One night, Jodi and Honus take a rifle into his house and free Patty, who the elder has been raping despite promising not to until the girl reaches 16.

Colleen stays at Fort Nowhere, and eventually gives birth to Rhea, the first human child that lived in the 25 years since the pandemic.

The narrative also reveals that her daughter, Etta, has chosen to hunt slavers instead of trying to give birth and teach the boys who copy down the journals like her mother.

Some examples of this narrative are Vox (2018) by Christina Dalcher; Bina Shak's Before She Sleeps (2018); The Water Cure (2018) by Sophie Mackintosh; Larissa Lai's The Tiger Flu (2018); and also Diane Cook's The New Wilderness (2020).

[2] The novel explores themes of women's subjugation through sexual violence in a post-apocalyptic United States, often assuming roles of submission or as caretakers.

[3]The Book of the Unnamed Midwife received a starred review from Publishers Weekly for its "gripping and grim" story that's "beautifully written in a stripped down, understated way, though frequently gruesome in its depiction of rapes, murders, and stillbirths."

The reviewers assess that it "should particularly appeal to readers of earlier feminist dystopias such as The Handmaid's Tale, Suzy McKee Charnas's Walk to the Edge of the World series, and P. D. James's The Children of Men.

Elaborating, the reviewers said "Similarly to The Handmaid's Tale and The Power, the book has a framing device set generations later in that same settlement, where the midwife’s journals are kept and she is venerated as a sacred figure.

But confusingly, the story is not solely drawn from her journals; with no explanation, an omniscient narrator occasionally jumps in to reveal information that neither the midwife nor the future residents of the town could possibly know.