Joanna Kavenna’s ambitious second novel comprises four separate narratives. The first centres on Ignaz Semmelweis, the real-life physician who, having failed to persuade his colleagues that the incidence of childbed fever would be drastically reduced if they disinfected their hands after autopsies, was committed to an asylum in 1865, raving about a ‘massacre of mothers’. The two central narratives are set in present-day London: one follows Brigid Hayes, an exhausted and embattled woman in her early forties, going into labour with her second child; the other introduces Michael Stone, the author of a novel about Semmelweis, whose publication-day nerves are exacerbated by the news that his estranged mother is to be moved to a nursing home. The final narrative takes us a hundred years into the future, when climate change has necessitated measures to curb population growth: women are ‘harvested’ for eggs, then rendered infertile, their ‘progeny’ birthed and reared collectively on ‘breeding farms’. We follow the interrogation of Prisoner 730004, who has assisted at an illegal birth.