3 of 5 stars
I really wavered about how many stars to give this. I liked it, but it has its issues, and there is a great deal of handwavium inherent in the premise. This is also one of the grimmest books I have ever read, on a par with Margaret Atwood's The Handmaid's Tale (if nowhere near that book's quality).
Needless to say, All The Triggers applies. Rape, child rape, abuse, violence and extreme misogyny are found here.
This is a near-extinction-of-humanity and death-of-civilization tale, with a virus so virulent it kills 98% of men and more than 99% of women, including all pregnant women. Which is the first of my objections to the worldbuilding--the world's most lethal viruses, such as Ebola, simply do not work that way. Ebola kills something like 90% of its victims, but this occurs over a time frame of weeks and months. The virus here seems to strike the entire world population simultaneously, which is ridiculous. (Unless it was a genetically engineered organism, tailored specifically to humans, introduced years beforehand, and programmed to turn lethal in response to a specific trigger. Something like David R. Palmer's Emergence, which handles this scenario a helluva lot better.) Also, the Unnamed Midwife who is the book's protagonist--she never gives her true name, but goes by various aliases, mostly male, throughout the book--wakes up after who knows how long in a comalike state (somehow without starving to death or dying of thirst, which also bugged me) to find everyone else gone and San Francisco deserted. (And where, pray tell, are all the rotting bodies and feral dogs?)
But put all that aside, if you can, because that was just the pseudo-science to jumpstart the plot. The author's concerns are what happens to humanity after it all but dies out, and what she and the Unnamed Midwife sees isn't pretty. Specifically, men revert to brutish animals and make all remaining women their slaves.
I said "extreme misogyny" in reference to triggers, but it seems to me there is a lot of hatred of men in this story's subtext, thinking that nearly all men would act like this. Or, hell, hatred of humanity in general, that we would automatically revert to knuckle-dragging barbarians in such an event. To be sure, some of us would. But I'm sure that many more men AND women would band together in the hard work of changing to a non-technological, agrarian society (which is what would have to happen) while preserving as much old world technology as is feasible. (For instance, rounding up herd animals, building greenhouses, scavenging as many medical supplies/canned goods as possible, and also constructing windmills/gathering solar panels for power/etc etc etc. Jeezus. I just threw that out in fifteen seconds, and already I've got a much more hopeful scenario than this book.)
I think the reason the author goes with such a grimdark storyline is that the society she envisions coming after, which is established in the prologue and epilogue as a framing device, is so different from our own. For instance, instead of a two-person marriage as the basic unit of society, there are polyamorous "hives" (specifically, one women with two or more men), and women are separating into two different castes, Mothers and Midwives. (Hopefully this is expanded upon more in the sequel, The Book of Etta.)
In the meantime, this storyline is somewhat equivalent to a drive-by car wreck--it's horrific, but you can't take your eyes off it. Meg Elison is a good writer, with sharp pacing, nice characterization, and a good ear for dialogue. I just wish she'd given more thought to her worldbuilding, because that leaves a lot to be desired.