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Despite the tragic subject matter, Manning's (Whitegirl) narrative generates little emotional engagement. Except for her economic circumstances, Axie barely changes. Her nemesis, Comstock, receives even less character development. Based in part on the story of a real-life 19th-century midwife, the novel might find an audience in those curious about times when women had little knowledge about reproduction and few options to prevent multiple pregnancies. [See Prepub Alert, 4/1/13.]