Aftercare Instructions

by Bonnie Pipkin

Questioning everything after deciding to terminate an unexpected pregnancy, 17-year-old Genesis works to establish her identity apart from her ex while confronting her most painful memories and rediscovering a long-forgotten dream.

• ISBN10: 1250114845
• ISBN13: 9781250114846
• Publish Date: 27 June 2017
• Publish Status: Out of Print
• Out of Print: 24 February 2022
• Imprint: Flatiron Books
• Format: Hardcover
• Pages: 368
• Language: English

Reviews

[Joséphine]

Actual rating: 3.5 stars

Initial thoughts: Dealing with a mother's mental illness as a child isn't easy, especially when she's not receiving the treatment and support that she needs. In that regard, I thought Aftercare Instructions examined that mother-daughter relationship really well. However, the prose didn't really do it for me. I found it awkward at times, which was underscored by the narration. As a result, the main plot of Genesis' abortion, her (ex-)boyfriend's abandonment and the aftermath don't grip me as much as such an ordeal should've. That being said, I loved that this book supported the agency of girls over their own body, and for that, I do think it's an important book for teenagers.

[girlinthepages]

Aftercare Instructions is the book we need in YA.

It's an honest, vulnerable, frank, and succinct story about family, relationships, and yes, abortion. But it's not an issue book about abortion. It's a book about the aftermath, or aftercare, about the thousands of decisions that happen in a family, in a friendship, in a relationship that lead to a single moment or pivotal point. It's about a person being made of so much more than one action that defines them. It's a true coming of age novel that's somehow extremely quick yet tells an extremely in depth story.

The story begins with Genesis, the protagonist, being abandoned by her boyfriend in an out of state Planned Parenthood after terminating an accidental pregnancy. From there the narrative shifts between the next week in Genesis' life, told through traditional chapters (each titled after an "aftercare instruction," such as "you may experience bleeding," "call if you develop a fever," etc. which I thought was really clever), and flashbacks that establish her and her boyfriend Peter's relationship, told in a play format. The entirety of the book is divided into a four act play structure. I'll admit I was dubious about the format as I haven't had a great experience with reading plays, but it was fantastic and provided such a great way to add depth and complexity to the story without making the flashbacks feel too long.

While the novel obviously dealt with reproductive health & issues, it was also so much more than that. Through Genesis' struggles, we see that though she has a troubled family, she has a strong support system that she's built outside of her immediate family, from cousins to friends to new acquaintances. We see her learn the importance of simply asking for help or allowing others to help us when we're overwhelmed or in need of support, which is such a simple message that so often gets overlooked. Genesis also has a complexity to her character that struck the right balance between being vulnerable while also being selfish, like any teenager can be. I loved how the characters were able to call each other out and put things into perspective despite what they had each been through, and that rather than argue when emotions ran high or horrible things happened, they often talked through their anger and agreed to do better and move on. It was refreshing to see characters, especially female characters, have healthy relationships that weren't without flaws, and that they proactively acknowledged them and learned from them.

Despite all of the other wonderful elements to Aftercare Instruction's plot, there's no denying that abortion is an important topic in the story, and it's the only YA book I have ever read before that openly discusses the topic, or has a prominent character go through with it. I cannot stress how important the portrayal of abortion is in this book. It doesn't sensationalize it, but it also doesn't skirt the gravity of the choice to terminate a pregnancy. While Genesis is confident that it was the right decision for her and Peter at the time, she does struggle with the emotions and physical side effects of the procedure. However, the book also does a good job at demystifying the procedure as well. The procedure is eventually described in a succinct way that gives readers an understanding of the medical procedure and recovery without diving into details that may be too graphic. It depicts the options patients have (such as sedatives vs. no sedatives), the proficient medical staff, and, of course, the after effects and post-procedure instructions. No matter your political views, unintended/unwanted pregnancies happen and it's satisfying to see the topic handled in a mature narrative that was obviously written with care and research. Shannon @ It Starts at Midnight has a wonderful review that explains how responsibly the topic was handled, so I encourage you to check out her review if you're interested in learning more about the book and the topics it handles!

Overall: Aftercare Instructions is a stunning debut that clips along at an incredibly fast pace while still building a story of meaningful relationships and that tackles emotionally charged topics. It responsibly handles the topic of abortion, and is really a stand out for featuring a controversial topic in a debut novel. While I almost wish the novel had been a little longer so I could have learned more about Genesis' family, it's one of the most important books I read in 2017 and I'm glad to have finished my year reading it. I can't wait to see what topics Pipkin chooses to tackle in her future projects, and hope she continues to push the boundaries of YA content.

This review was originally posted on Girl in the Pages

[Bianca]

— For its length, it was trying to do A LOT of things, and none was truly done well.

[Sam@WLABB]

Rating: 4.5 Stars

Aftercare Instructions had been one of my Can't Wait Wednesday picks, and I had some great expectations for it. I must say, this book more than met my expectations. It left me with so many feels. It's a story imbued in heartbreak and heartache, but it also attests to the power of friendship and inner strength.

I fully embraced Genesis, flaws and all. She had to deal with her father's death. She had to assume the role of responsible adult and take care of her mother, when her mother should have been taking care of her. She had to watch her little sister be taken from her home. She had to make a hard choice to abort her unborn child with no real support from her boyfriend. She had to emerge from the procedure to find herself abandoned, once again. This girl kept getting knocked down, and sometimes she made made some poor choices in the throes of her emotions, but she soldiered on. I just really admired her strength.

She had a wonderful support system in Rose and Delilah. Sometimes Gen did not utilize them, because she was keeping so many secrets, but when she opened up, things improved. She was very lucky that these two were quite persistent. Gen kept giving the "okay" line, but they were not buying it. They showed up and were there for her when she really needed them.

I loved the format. Each chapter began with post-procedure aftercare instructions, which related to the chapter, and I liked the way it set the stage. The story was told as a traditional narrative, which was interspersed with flashbacks written in a play format. I liked the differentiation between past and present, and thought it worked quite well. I also liked the way Pipkin led us through the rise and fall of Gen and Peter's relationship. These peeks into their past coupled with facts presented by Gen's friends, helped me better understand why this relationship was broken.

With respect to Peter and Gen's relationship, I actually liked where Pipkin brought it. It was realistic. If you really consider everything surrounding the rise and demise of this union, it made sense. I also love that she gave me closure. Pipkin beautifully wrapped up the storylines and answered those big questions.

I watched the laughter slide off his face. I wanted to dive for it. To pick it up off the floor and reattach it to him. To us.

I read a lot, and I don't normally comment on the writing, but when there is something stylistically that captures my attention, I am strongly compelled to say something. Pipkin's writing was something special. There were so many times in this book, where she evoked such strong physical reactions from me through her word usage and phrasing. UGH! It's so hard to explain, but there were instances when the writing matched my racing heart or my sinking feelings. I was fully drawn into the story and found myself lost in her words several times in this book, and I though it was quite a magnificent experience.

Yes, this book deals with a lot of heavy issues. Yes, this book is sad, but it is also permeated with hope, and in the end....

And he says, "Are you okay?"
I shouldn't be.
And it doesn't come with any guarantees.
But the answer is finally yes

**I would like to thank the publisher for the advanced copy of this book. Quotes are from an ARC and may change upon publication.


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[shannonmiz]

You can find the full review and all the fancy and/or randomness that accompanies it at It Starts at Midnight

4.5*

First, I must say, the topic of abortion is one that is woefully unspoken about in most books. I love that the author and publisher took such a heavy, important topic and channeled it into a really responsible, well-thought out novel. Lest we get into some kind of political/religious debate, no one enjoys talking about this sort of thing, but unintended pregnancies are a real part of people's lives. And I feel like young people especially have so few places to turn (in most cases, anyway) in the event that this happens to them. I can't imagine the havoc this kind of decision would wreak on a young woman's life, so I absolutely applaud this book for handling the subject so respectfully, and so honestly.

I loved that the author didn't make this exclusively about Genesis's decision, though. She portrayed Genesis as a well-rounded and thoughtful young woman with a lot of promise. But she also shows the difficulty of Gen's life, her family, her boyfriend (who you'll probably want to punch, just saying). And of course, the aftermath of her life changing decision to end her pregnancy. Genesis was confident of her choice, but that doesn't mean it didn't still have a huge impact, and I loved how honest that felt.

We get glimpses into how Genesis got to the point she is at, how her relationship evolved, how her home life was, as the story goes on. These are told as a play script, which was fun- and made it really easy to decipher what parts were flashback and which were present time, and I appreciated that.

Bottom Line: This is a lovely story, woven by both past and present situations, that not only shines a light on the effects of a young woman's decision, but how her life continues and how she grows after the decision.

*Copy provided for review