Title: Obstetrix
Author: Naomi Kritzer
Publisher: Tor
Publication date: June 9, 2026
Length: 208 pages
Genre: Thriller
Source: Review copy courtesy of the publisher via NetGalley
Rating:

Dr. Elizabeth Gwinn is a dedicated OB/GYN in desperate need of a fresh start. After facing a harrowing trial for performing an abortion, she’s narrowly managed to avoid prison — but legal fees have left her broke, the arrest and threat of conviction have destroyed her nerves, and she faces the sad truth that despite the critical need, there are now states with absolutely no obstetricians still in practice at all.

After a dismal job interview for yet another hospital job she’s doomed not to get once the hiring committee realizes just who she is, she agrees to meet with a representative of a home birth collective looking for an obstetrician to complement their team of midwives. Although the location of the interview seems unusual, Elizabeth really needs a job and sits down to learn more… only to find herself drugged, kidnapped, and transported in a van to some unknown destination.

Upon arrival, she finds herself held captive by a fundamentalist cult in a remote rural area. There are no phones, no internet, no books, no privacy. Watched every moment, Liz is informed that her role is to care for the cult’s seemingly endless parade of pregnant women. Although the compound has some modern medical supplies — drugs, ultrasound machine, surgical implements — it’s by no means an adequate medical facility, and Liz is disinclined to cooperate… until she hears what came of the last obstetrician who refused to play along. Liz decides to bide her time and look for a chance to escape, and meanwhile, she begins caring for the women, some really just girls, and provides more general medical care to the children and men of the compound as well.

The patriarchal, repressive society is headed by Pastor John, and rules are enforced through corporal punishment. Liz sees women and children with welts and other marks that would absolutely have her contacting the appropriate authorities if she were to see these type of injuries in a clinical setting. Here, in the middle of nowhere, at the mercy of her captors, all she can do is try to relieve pain and mitigate harm where she can.

Meanwhile, to self-soothe, Liz returns in her mind to the favorite fantasy book of her youth, recalling it page by page from memory and using it as a means of centering herself, holding out hope, and looking for any chance of contacting the outside world.

I’ve seen this book shelved as horror, dystopian, thriller, even sci-fi, and while there are bits of many of these (well, not sci-fi), none of these labels feel entirely spot-on. I’d described this book more as a near-future thriller, not to mention being a cautionary tale. Liz’s trial has concluded by the time the novel starts, and yet it’s not at all far-fetched to see this as a possibility not too far off in our own future. Learning that obstetrical care is no longer available in major areas of the country feels chillingly possible.

And in a world where choices are so controlled or outright denied, a religious cult that prizes pregnancy and birth above anything else a woman might represent seems like just one more likely outcome. Particularly painful is the revelation that a bright 13-year-old girl who’s eager to become Liz’s apprentice is scheduled to be married as soon as she turns 14, to an adult man who fully expects to start making babies right away. When Liz points out that the girl isn’t physically mature enough to safely carry a pregnancy, the woman behind her kidnapping who shadows her every move declares that “a woman’s body won’t grow a baby that’s too big for her to deliver”. The casual disregard of medical expertise and the casual expectation that a young girl is ready for childbearing are simply horrifying.

Obstetrix is a fascinating psychological study, a dystopian nightmare, and even an action tale, as Liz desperately struggles to find a way out, even while growing to care more and more for some of her patients, who clearly are victims themselves and just as much in need of rescue as she is. The tension mounts as the story progresses, and it’s a race to the finish to see how Liz will get out of this terrible situation.

Meanwhile, we can’t help but admire Liz’s dedication to her professional ethics and her devotion to patient care. Even without the blatant threats, she can’t refuse to treat those who need her. She may be distressed, she may feel that conditions are hazardous, but she still tends to those who need a physician, because she simply can’t do otherwise.

As Liz informs us:

The word obstetrics comes from the Latin words obstetrix, which means midwife. Literally it means “stands opposite to,” and references the person who stands opposite to the woman giving birth.

As Liz passes weeks at the compound, struggling not to lose hope, she uses her position of slight authority to oppose the system that might further harm the young women and girls in her care — an obstetrix indeed.

Obstetrix is a fast, compelling, chilling read. Highly recommended.

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