The title is very fitting. 

Young Eliza believes herself to be on the righteous path when she marries the manor lord's son. It's only when she finds herself with child that she discovers her husband has never considered himself truly wed to her. He scoffs at their "marriage" and insists it was never legal. Her mother, who had overseen the wedding herself, goes off to have words with the boy's family. When she returns, she informs Eliza that the marriage was a scam and Eliza is being sent to live with a London apothecary who will oversee the termination of the pregnancy. 

The story really starts when Eliza arrives at her destination. Installed as a housemaid, she works for the reclusive apothecary, his live-in apprentice, and his not-so-nice wife. The only other help in the household is a young woman with what I assume to be Down's Syndrome based on her physical description and personality. 

Eliza and Mary, the other young woman, find themselves at the mercy of their employers. This extends beyond being expected to cook and clean. The apothecary has his own demons, most of which center around his perception of women and how he believes their bodies work. Determined to prove his thesis, he felt no compunction using Eliza and Mary in his studies. 

Years ago, I read a very disturbing book called The Trotula. It was written during the Middle Ages by men who believed they also understood human anatomy and biology. As I read this novel, I wondered if the author had also stumbled across the Trotula because the depth and breadth of misunderstanding about how women's bodies work in this fictional world was reminiscent of the very real medical treatise I had read so long ago. 

Back to the novel. Eliza is a difficult character to love. She's rather crass and often lacks compassion for others. However, she does grow throughout the book, and by the end, she is a much more mature and likable character.