“How To Care for a Human Girl” is the Novel for the Post-Roe Era 

Ashley Wurzbacher’s debut novel How To Care for a Human Girl jumps with both feet into the debate over reproductive rights. When two sisters find themselves pregnant not long after their mother’s death, Jada choses an abortion, while Maddie drifts into the sticky embrace of a crisis pregnancy center. Their parallel journey explores the attitudes and judgments surrounding pregnancy in the U.S. However, Wurzbacher’s emotionally rich approach quickly moves past a post-Roe v. Wade hot take. 

While Jada, married to a doctor and at work on a PhD in psychology, doesn’t regret her decision, she wrestles with what it means for her marriage. And Maddy, whose teenage affair with a married politician led to getting knocked up, struggles to assert her own agency over a situation that has spiraled out of control. For both women, their pregnancies are just part of the complex tangle of expectation and constraint that comes with being a woman in America—and their reactions are wrapped up in their grief and confusion over their mother’s recent death.

I spoke with Ashley Wurzbacher, a National Book Foundation 5-under-35 honoree, over Zoom and email about how abortion presented itself as a powerful lens with which to examine the emotional complexity of how humans make decisions.

Emily Wortman-Wunder: This book is coming out at a time of crisis for reproductive rights (and health/gender rights generally)—however, I think you were working on this book years ago, long before the supermajority on the Supreme Court or the repealing of Roe v. Wade. What was the origin of the book? What drew you to explore abortion this way? And why sisters?

Ashley Wurzbacher: I started planning and writing How To Care for a Human Girl in graduate school in Houston in 2015. At the same time that I was getting my PhD in Creative Writing and Literature I was also doing a certificate program in women and gender studies. So I was thinking a lot about gender as something that shapes our experiences, and doing so against the backdrop of a lot of attacks on our reproductive rights—the whole Wendy Davis thing and her 13-hour filibuster in pink tennis shoes was going on when I was living in Texas, so I felt very close to all of that. I knew that I wanted to write about it. And sisters are a thing that I return to again and again in my work, both because I do have a sister—I love her and she’s fascinating—but also there is something about sisters that invites us to imagine different versions of our lives. They come from the same origin point but they take their own path. That has always been really interesting to me, especially as one of the psychological principles that the book explores is this idea of counterfactual thought. What if I had done this, or what if this had happened to me instead of that? And there is something about sisters that makes their relationship really ripe for exploring this psychological concept.

EWW. What did it feel like to be completing this book as the right to abortion crumbled about our ears (especially living in Alabama)?

AW: At the time of the repeal of Roe, the book was in the copy-editing stage, so virtually finished. I did have conversations with my editor at Atria about what this means for the book—Do we need to change certain parts of it, or even just read it again with an eye for things that are going to feel different now? But we didn’t end up changing anything. The book is set in 2016 and 2018. It’s set in a state where legal abortion is still available. It didn’t seem right to alter anything about the book.

I live in Alabama, where abortion is now illegal, it seems almost quaint to me that a character of mine who wants an abortion simply goes and gets one. She’s harassed and has to face protestors and jump through some hoops, but her ease of access is in stark contrast to what women currently face throughout much of the nation.

However, I’ve lived in red states or rural areas for most of my life, so I have always been aware of the repeal of Roe as a possibility. A lot of people have mentioned how timely the book is, which it is—but it is also unfortunately timeless. It’s not as if it’s only now that abortion access has become difficult. I prefer to think of the book as timeless in a painful way. None of this is really new.

EWW: How To Care for a Human Girl definitely has the topic of an “Issue Novel”—but it never felt didactic or like it was trying to teach a lesson. Even New Dawn, the crisis pregnancy center, and Pat, the slightly manipulative staffer, are treated with compassion. Did you find that fiction allowed you to better explore the moral gray zone?

AW: I’ve found that readers often express frustration when they can’t find a clear “moral” in the book they’re reading. My students sometimes tease me about how exasperated I get when they try to determine a book’s “message,” or when I challenge their negative reactions to difficult characters. I think a lot of readers want literature to confirm their biases or reaffirm the correctness of whatever political or moral position they hold, because it feels good to be able to pinpoint who is right and who is wrong, but I don’t think that’s what literature is for. Morally obvious fiction is usually boring.

I don’t think there’s really any way you could say that How To Care for a Human Girl is utterly apolitical, or that it isn’t a pro-choice novel. Choice is its central thematic concern. But my characters are complicated, their dilemmas are complicated, and they should be no less complicated, even difficult, for the readers looking in on them from outside.

It would have been easy to make Jada and Maddy these perfect, virtuous heroines, to make them victims suffering at the hands of villains, whether those villains are individuals or social systems. But imperfection and complexity are essential parts of humanity. Pat can be manipulative but still genuinely believe that she’s helping Maddy. And Jada and Maddy’s own imperfections and complexities are key elements of their realness. People don’t have to be perfect in order to deserve the right to decide how they will live their lives. I’m glad you mentioned compassion, because the search for compassion for oneself and others—regardless of the choices you make, or they make—is really what lies at the emotional core of the novel for me. In the end, if the book does take a “stance,” I suppose it’s in favor of compassion and empathy.

EWW. Science is so often held up as the source of capital-t Truth, but Jada, although she tries to puzzle out her situation using scientific principles, doesn’t find many answers there. Nor does Maddy really seem helped by her foray into religion. So what ARE the roles of religion and science in our lives, in your experience? 

AW: I was raised Catholic. It wasn’t all bad, it gave me a sense of purpose and community when I was growing up, but it also led to a lifelong preoccupation with guilt, and it taught me a lot of damaging things that it took a long time to unlearn, especially regarding reproductive choice. I was taught that it was gravely wrong not only to get an abortion, but even to use birth control.

I remain interested in the aesthetics of Catholicism, if not in its teachings. I eventually came to understand that the moments in my life that felt like profound religious experiences were in fact profound aesthetic experiences; I would be overwhelmed by the poeticism of Biblical language or the cadences of chants or prayers, by the grandeur of cathedrals, the haunting sounds of organ music, or the intoxicating scent of incense. I chose to place aesthetics at the center of my life and to locate my spirituality in language and art and the sense of connectedness to all things that they create in me. I think the experience Maddy has at church is similar; she’s overcome by the color and music and energy around her, it feels like God.

When I began writing this book, I initially thought of Jada and Maddy as representing these fundamentally different things: science and religion, logic and feeling. The more I got to know them and explored their experiences, though, the more they—and the things they supposedly represented—began to converge. Jada is a scientist through and through, but she’s also concerned with the meaning of her actions, she’s discovering that she can be a mystery even to herself, she’s coming to terms with the fact that she can feel and act in ways that might not make sense from an outside perspective or that cause pain to herself or others. Science gives her a way to contextualize her actions and thoughts—she thinks of herself as a rat in an experiment and takes comfort in the fact that her behavior accords with most other rats’—but there are mysteries in her heart and in her life that it can’t solve. A big part of her journey is coming to terms with the presence of uncertainty in her life—something religion often helps people contend with.

On the other hand, Maddy has this religious awakening, she’s all feeling with not a lot of logic, she’s much more at ease with uncertainty than her sister is, but she still has a scientific streak of her own. In trying to decide what to do about her pregnancy, she turns to a version of the scientific method. She tries things out, and she sees how they feel. She gathers and analyzes emotional data in order to make a decision.

EWW. One of your enduring themes is the easy trap of social roles (maybe especially for women?): Wife. Mother. Daughter. Floozy. Both Maddy and Jada adopt various roles, but none of them fit, and the book seems to suggest that humans are too messy and surprising for any role to ever fit. Can you talk about what you’ve learned about how people use or abuse labels and roles?

AW: I’m interested in the tension between public and private. Abortion is a great example: something that should be an incredibly personal and private decision has become this public thing. Jada feels almost like she has a responsibility, whether she wants to or not, to “come out” as a person who’s had an abortion and join this united front in proudly claiming this label for herself. She doesn’t want to, but she feels like she’s supposed to. Other characters in the book also struggle with their awareness of public perceptions of their roles or actions or labels and their private uncertainties about whether they fit, or whether those perceptions match what they’re feeling or match their private experiences. A label or a role is a public thing. It’s a performance, almost. But if people are honest with themselves, their private feelings about those roles are often much more complicated.

We should respect the mess and the surprise and fight the common tendency I mentioned earlier to read people—both in real life and in novels—from a place of judgement. There’s a lot of talk lately about “likeable” and “unlikeable” characters, and I fundamentally object to those labels. What does it mean for someone to be “unlikeable”? To me it implies that they’re unworthy of empathy, it lets us off the hook for considering their humanity or acknowledging potentially uncomfortable ways we might be like them. It’s a label that creates a false sense of order.

EWW. You did a ton of research for this book. What did you learn that surprised you? Can you offer any hope to those of us who are struggling with the direction the country is going vis a vis abortion?

AW: I’ve gained a new appreciation of the pressure that both people seeking abortions and healthcare professionals working to provide them are under. I also learned a lot about crisis pregnancy centers that startled me. Perusing scores of their websites brought me face to face with some of the misinformation they spread (see the pamphlets Maddy is given at New Dawn) and the tactics they use to coerce women, especially when it comes to things like “abortion pill reversal,” which uses doses of progesterone to disrupt an underway medication abortion, and which is not supported by science.

At one point, I impersonated Maddy in an online chat with a crisis pregnancy center worker. One thing that struck me was the way they talked about miscarriage as, basically, divine abortion—they sort of implied that “I,” “Maddy,” should just hold out and stay pregnant because miscarriages are common enough that I might not have to have the baby anyway. Like, you never know, you might get lucky after all! I found that really dark.

To keep apprised of important abortion-related developments and stories that aren’t being covered in the news, I recommend subscribing to Jessica Valenti’s brilliant and thorough “Abortion Daily” newsletter.

I guess my hope is that we can choose to care about women. That is really the project of this book: asking people to care about some imperfect but intelligent human women who deserve to decide their own lives.

Finally, there are a lot of people out there eager to help. I don’t think that any pro-choice person has really accepted defeat. We will find creative ways to get through this. I just wish we didn’t have to.