Obstetrix by Naomi Kritzer is a chilling cult thriller that feels uncomfortably plausible

Some dystopian novels rely on elaborate worldbuilding to make their horrors believable. Obstetrix by Naomi Kritzer doesn’t need to. Its premise is terrifying precisely because it feels only a few steps removed from reality, taking current political and religious extremism to their logical, ugly conclusion. The result is a tense, claustrophobic thriller about bodily autonomy, fanaticism, and survival that never overstays its welcome.

I’m a sucker for a good cult novel, so this one was right up my alley. There’s something endlessly fascinating about the power dynamics inside insular religious communities, especially the relationships among women forced to survive within those systems. Kritzer taps into that fascination immediately. The novel is brief and concise, but it uses every page effectively, building constant tension as Doctor Liz navigates a nightmare situation with no safe options.

Liz is already carrying the weight of public scrutiny before the kidnapping even happens. She performed the last abortion in North Dakota to save a pregnant woman’s life, only to be charged with murder despite the procedure technically being legal under medical exceptions. Though she’s acquitted, the damage is done. Every other OB/GYN flees the state, and Liz follows, relocating to Minneapolis where her notoriety makes finding work nearly impossible. She’s isolated, broke, and vulnerable, which makes it painfully believable when she’s lured into a trap.

The cult itself is one of the novel’s strongest elements. The Harvest is a fundamentalist Christian sect led by Pastor John, a man who twists faith into a weapon of control. The group operates entirely according to his whims, enforced through intimidation and violence. Women and girls are treated as property, marriages are arranged without consent, and even something as harmless as secretly reading a romance novel can lead to brutal punishment.

Pastor John kidnaps Liz because his daughter Joy is experiencing a dangerous pregnancy that requires a C-section. Rather than seek legitimate medical care, he decides abducting an obstetrician is the better solution. It’s exactly the kind of warped logic that makes cults so horrifying: the complete certainty that their cruelty is righteousness.

Once inside the compound, the novel becomes increasingly tense. Liz is treated with a strange mixture of respect and imprisonment because she’s medically necessary, and that contradiction creates some of the book’s most unsettling moments. She cares for countless pregnant women and girls, many of them teenagers married off to much older men, while trying to calculate how to survive long enough to escape.

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The emotional core of the novel emerges through Liz’s growing concern for Bethany, her thirteen-year-old apprentice who is nearing her fourteenth birthday and an impending forced marriage to an older man with a violent past. The looming deadline gives the story momentum, transforming Liz’s escape plans into something larger than self-preservation. She knows leaving without trying to help the girls trapped there would haunt her forever.

One of the most effective aspects of Obstetrix is how grounded it feels. The book explores the consequences of criminalizing abortion without turning into a lecture. Instead, Kritzer examines the ripple effects through practical realities: doctors fleeing hostile states, pregnant patients losing access to care, extremists feeling empowered, and vulnerable women paying the price. The idea that outlawing abortion could eventually create conditions where obstetricians become targets for kidnapping sounds outrageous at first, but the novel makes the possibility disturbingly convincing. Writers are always asking “what if?” and Kritzer follows that question somewhere dark.

Despite the heavy themes, the novel’s shorter length works in its favor. There’s no filler here. The pacing remains tight throughout, and the focused narrative keeps the tension simmering from beginning to end. Some readers may wish for deeper exploration of certain side characters or the broader political landscape, but the streamlined approach gives the story urgency.

Obstetrix is unsettling, timely, and frighteningly plausible. It’s the kind of dystopian thriller that lingers because it never feels impossible. Fans of cult fiction, feminist dystopias, and tense survival narratives will likely devour this one.

What are your favorite cult novels or dystopian thrillers? Let me know in the comments. An advance reader copy of this book (ARC) was provided to me by the publisher via Netgalley in exchange for an honest review.

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Now that Jack has been forced to reflect on everything he has to lose, he resolves to do better. He’s determined to spend more time at home with his family and repair the relationships that have suffered over the years while he’s been so focused on work. But as Callie’s behavior becomes increasingly bizarre, Jack realizes he has a lot more room to improve than he realized – and it might be too late to save his daughter after all.

For fans of We Need to Talk About Kevin, The Push, and Baby Teeth.