With as much as I loved The Book of the Unnamed Midwife I had high expectations coming into this book - some of them were met and some of them weren't.
I quite enjoyed getting to see this world 100 years farther down the timeline, and getting to see the town the Midwife helped establish. Seeing how the ripples of the first book shaped this new world, at least in a small corner of it. It was also interesting seeing how different towns evolved to face the new paradigm in different ways. The world building in this book is top notch.
Much like the first book, this story focuses a lot of attention on sex and gender, which is one of the things I enjoy about the series. Our hero is Etta/Eddy, an individual struggling to more fully understand themselves and their own gender. I appreciated seeing a gender fluid character walk through this world - it brings up a lot of interesting questions. There are also some trans people represented in the narrative, which was also interesting.
My one issue is that it is implied Etta/Eddy's fluidity is a result of trauma, and at times it even reads a bit like Dissociative Disorder, which is not an accurate representation if Elison was attempting to describe the experience of being genderqueer (at least for most folks). Gender identity isn't something born out of a trauma response, and I found it troubling the book kept pointing in that direction. I'd like o give Elison the benefit of the doubt, but it did put my hackles up.
All in all this book was an interesting addition to the series, and I plan to read the third book when it hit shelves next month. I appreciate Elison's world building, and her focus on issues of sex and gender in the apocalypse. (Especially after reading another book *cough cough The Power cough* which handled the subject so poorly.)