Liz is an obstetrician in North Dakota, a state where she’s possibly just performed the last abortion. She did this with the consent of her patient, a young woman with failing kidneys, but the state chose to make an example of Liz’ actions, and took her to court. She is acquitted, but is now struggling to find work with the reputational damage that came with a very public trial. Bitter about her home state’s stance on women’s health, and with dwindling funds and no job prospect in sight, Liz is getting desperate for a job in maternal care. She gets a call from a woman who claims to be from a group of midwives looking for an obstetrician. When Liz shows up for the interview, she is drugged and kidnapped. It turns out the Prairie Spring Home Birth Collective is actually just one midwife at a religious cult, a woman called Sarah who has been tasked with bringing home an obstetrician. Liz finds herself trapped in the compound, and forced to attend to the cult’s population, particularly of course, the many pregnant and soon-to-be pregnant women.
With Obstetrix, Hugo award winner Naomi Kritzer dips into what the near future (or current reality, in some parts of the world) could look like for the United States, with more and more legislation and governance policing women’s bodies fast becoming the norm. We are told women who need pregnancy and maternal care are forced to leave North Dakota to find it, and that there are no longer any obstetricians around either, assumedly since they are no longer allowed to practice properly. The cult that kidnaps Liz seems to be a fairly run-of-the-mill type Christian fundamentalist one, with a pastor running the show, and the men having a say over pretty much everything the women do. The women are mostly there to keep house and bear children, as is to be expected in this sort of situation. They don’t have any agency (not even a say in naming the babies they’ve just birthed), and are quite accepting of this. They all speak in a gentle, high, feminine voice, they all lean towards their husbands or fathers’ decisions for their future, and they definitely don’t have any bodily autonomy.
It’s clear from the start that the cult does not have any single-minded goal (no rapture leanings, here). Rather, it is a community that awaits more like-minded people to eschew the modern world’s immoralities, and join them in living a life by the word of the Bible (as kept under lock and key, read out loud and interpreted only by a man, of course). What’s disturbing about the cult is not merely its religious extremism, but that echoes of the patriarchal systems it employs are present in the way the state government is increasing control over women’s bodies. Many readers may wish there was something a little more frightening about the cult, but it is a homely sort of horror at play here, which unfortunately does not make for a high stakes thriller.
Liz is treated with respect and politeness in the cult’s compound, but she is watched constantly. There is an underlying threat always present, especially once she finds out what happened to the cult’s last obstetrician who had failed to comply. As much as she’d like to attempt a getaway, Liz finds herself fast realising how much she misses her work, especially once she attends a birth. She’s good at her job; empathetic and smart and reasonable even when faced with systems that shock and anger her. She has many women to care for, pregnant or otherwise, babies to look over and a little community clinic to run, and so she slips easily into her role. She is both angry at her circumstances and yet feels “sparkling joy of having this job back, a wave of anger that it had been taken from [her].”
Buy the Book
Obstetrix
It may be under that threat that Liz does her job, but soon she starts to gain affection and sympathy for the women and girls, and realises that she can not let them suffer anymore. A 14-year-old who wants very much to be Liz’ apprentice is set to be married off soon, and Liz simply cannot abide being told that “a woman’s body won’t grow a baby that’s too big for her to deliver” about a literal child. It is clear that no matter what, Liz is a person who will always do the right thing. It’s why she was arrested for the abortion, after all. But while we wait with her as she bides her time, we start to realise that this cult really is quite mundane. There are some lashings, some arranged marriages, some making women “lay with” their husband’s brothers to get them pregnant faster, but somehow none of this feels terribly horrifying, given the state of the actual world right now. And then there is the main issue with Obstetrix: the way Liz finally escapes the cult. Not much can be said of this without major spoilers, but it does not serve the feminist or anti-authoritarian themes well at all.
While Obstetrix is a very readable novella, not enough time is spent developing the cult or its backstory, or for that matter, the status of women overall in this (near future?) almost-but-not-quite-there dystopia. The speculative element of women’s bodies being controlled is a little vague, and much is left to the imagination. Obstetrix feels like it is scratching the surface of something important, exposing us a little to what lies below without really getting into the true depths of the matter. It promises much more than it delivers simply because it does not fully commit either to the patriarchal dystopia angle, or the creepy extremist religious cult angle. It certainly doesn’t venture into any pregnancy body horror either. Still, there will be plenty of readers who find this arresting and relevant, and many more who will enjoy the novella’s high readability factor and good-natured protagonist.
Obstetrix is published by Tordotcom Publishing.
