More character development would have been great, as would more information about the world, though it wouldn't have fit well with the format of the book. Ultimately, the book is stifling and crushing in the oppressive feeling of having no control over your future and being stripped of humanity. The treatment of women and the betrayal of some women by others is depressing and disheartening. The desperation to control natural processes even at great cost to life and without any real success mirrors how we would rather murder scores of people than admit that our actions are largely the cause of our harms. We cannot control the world without destroying ourselves and losing our humanity.