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How to Care for a Human Girl

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From “a writer at the top of her game” ( The New York Times ) comes a bighearted and sharply funny debut novel about two estranged sisters and the crossroads they face after becoming unexpectedly pregnant at the same time.

Two years after the death of their mother, Jada and Maddy Battle both navigate unplanned pregnancies. Jada, a thirty-one-year-old psychology PhD student living in Pittsburgh, quietly obtains an abortion without telling her husband, but the secret causes turmoil in her already shaky marriage. Back home in rural Pennsylvania, nineteen-year-old Maddy, who spends her time caring for birds at a wildlife rehabilitation center, is paid off by the man who got her pregnant to get an abortion. But an unsettling visit to a crisis pregnancy center adds to her doubts about whether to go through with it.

Although Maddy still hasn’t forgiven Jada for a terrible betrayal, she goes to her for support, only to discover the cracks in the façade of her sister’s seemingly perfect life. As their past resentments boil over, the sisters must navigate the consequences of their choices and determine how best to care for themselves and each other.

With luminous prose and laser-sharp psychological insight, How to Care for a Human Girl is a compassionate and unforgettable examination of the complexities of choice, the special intimacy of sisterhood, and the bizarre ways our heated political moment manifests in daily life.

352 pages, Hardcover

First published August 8, 2023

53 people are currently reading
12645 people want to read

About the author

Ashley Wurzbacher

2 books87 followers
Ashley Wurzbacher is the author of the novel HOW TO CARE FOR A HUMAN GIRL and the short story collection HAPPY LIKE THIS, which won the 2019 Iowa Short Fiction Award and was named a National Book Foundation 5 Under 35 honoree and a New York Times Editors' Choice. Born and raised in Western Pennsylvania, she currently lives in Birmingham, Alabama. Learn more at ashleywurzbacher.com.

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5 stars
82 (16%)
4 stars
139 (27%)
3 stars
187 (37%)
2 stars
76 (15%)
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18 (3%)
Displaying 1 - 30 of 115 reviews
Profile Image for emma.
2,585 reviews93.2k followers
March 31, 2025
i could use instructions.

this book takes on a lot, and then is just kind of like "okay! that's enough of that."

we follow two sisters, both alike in insufferability, who are each going through a life-changing borderline traumatic life change 18 months after the death of their mother.

they react to these very different moments in very different ways — one strikes her high school relationship back up, the other is radicalized into christianity (?) — but if you're confused, it's okay. neither are at all relevant to the suddenly idyllic ending.

bottom line: i kind of respect being like, whoops! i bit off more i can chew! let's stop here.

(2.5 / thanks to the publisher for the copy)
Profile Image for Shelley's Book Nook.
516 reviews2,022 followers
July 16, 2023
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2.5 Stars

This story is told from two points of view. We have Jada and Maddy they are sisters who each find themselves unexpectedly pregnant. The book is about how each sister makes a different choice regarding their situation. There are also two timelines in the story...the present 2018 and the past 2016, just before their mother's death from cancer and Jada recently engaged to her now husband Blake.

The whole time I was reading this I kept asking "Why can't we say the word abortion?" Why the need to use terms like "TAKE CARE OF IT"? It boggles my mind that there is still so much stigma in this day and age. Is it because it means we had sex? And why doesn't the man get embarrassed if his sexual partner has one?

The research data parts were so boring, it was just too clinical for my liking. I wanted emotions, anger, sadness, grief, terror. I wanted to feel something for the characters but they were just blah, and the story is very character driven...which surprised me given the plot and subject matter. The characters were just horrible people who lacked any real depth and I hated them both. I know the book is supposed to be about choices but it just dragged so much, I felt very little while reading it and it did not take sides (I guess that was the author's goal).

The sister's different points of view come across well and I liked when the sisters are having a discussion and one says to the other "You didn't even have an excuse!" That is typical in today's society, so much judgment. By the way, YOU DO NOT NEED AN EXCUSE TO WANT AN ABORTION EXCEPT THAT YOU DON'T WANT TO BE PREGNANT. I am not pro-abortion, I am pro-choice as in a woman's right to choose what is right for her. I am all for the other sister's right to choose to have and keep her baby (like I did at 17) but we women are ultimately alone in this decision as it is we who have to live with the repercussions. One thing I really liked and appreciated the most was that the book is not told in a judgy way and I respect that.

Thank you to NetGalley and the publisher for the Advance Readers Copy.
Profile Image for Colleen Earle.
922 reviews64 followers
March 24, 2023
Thanks to Atria Books and Netgalley for allowing me to read this book ahead of its release in return for an honest review.

This book hit so many marks for me and I really enjoyed it. I loved the pacing and how it flips back and forth from the present and the past.

This book follows two sisters, Jada and Maddy, through their unexpected pregnancies and what they do about it. They are both in vastly different places in their life. Jada is married to a man who was the safe choice and is attempting to figure out whether marriage was the right decision for her; and Maddy is in her early twenties and recently dumped. The book looks at their difficult shared past, the death of their mother, and whether their new circumstances can bring the two together again.

Although there is a lot in this book that is highly stressful, Wurzbacher presents it in such a kind and meandering way that it’s almost understated. I think this style really helps the book. There is also just the right amount of interpersonal drama.

I really like how we get to see things from both sisters perspectives. This really helps to move the plot along and gives you a better understanding of what’s going on.

Overall this is a really lovely book. There’s a lot in it that really does it for me, but I would say that this isn’t a book for everyone.
Profile Image for Kathryn.
473 reviews10 followers
July 3, 2023
Not every author can pull off writing "unlikable" protagonists, and this book just doesn't have enough emotional depth for me to be able to sympathize with how terrible the protagonist is. And, my goodness, where was the editor? These characters' thoughts go on and on and on, but not in an interesting way nor did it help me understand the sisters any better. Just an overall bad reading experience. 1.5 stars.
Profile Image for Shannon.
8,421 reviews430 followers
August 10, 2023
I loved this debut SOOOOO so much! Layered and so intelligent, this story follows two sisters, one who gets accidentally pregnant and the other who is decidedly child-free by choice. Told in alternating POVs, the book explores their complicated relationship, what it means to want to be a mother, questions of abortion and adoption, women's rights and so much more. My review truly can't do this book justice but it will be a standout for me this year and I loved it on audio too! Highly recommended!!

CW: abortion, sexual abuse of a minor, infidelity
Profile Image for Crystal Palmisano-Dillard.
820 reviews15 followers
August 6, 2023
Maddy was an unexpected addition to her family. A late in life pregnancy for her mom and not all together welcomed by her big sister Jada. When their mother is diagnosed with cancer and later dies, each is set off in their own tailspin.

To Maddy’s eye, Jada has it all. Degrees, a husband, a nice home, money. Everything Maddy thinks she wants.

But Jada is hiding from her husband in literal closets and still drawn to her past.

Maddy is searching for belonging in men, religion, wherever she thinks she might find it and making not so great decisions along the way.

What they really need is each other, as they eventually discover.

Lots of real life messiness, grief, and love.

Thanks to NetGalley for the arc!
Profile Image for Kelsey (keliterate).
164 reviews182 followers
March 20, 2024
Oh my god, this was gorgeous and sensitive and empathetic and everything I needed. I need everyone to talk about this.

Long review to follow 💫
Profile Image for Jessica Stilling.
Author 8 books15 followers
December 3, 2023
This book is VERY, very, very anti-choice and pro-forced birth and the scary thing is, it pretends not to be, and maybe it even thinks it isn't, but anytime a pregnancy resource center successfully convinces a young girl to have a baby when she's seeking an abortion, says everything about this book (and about its author) we need to hear. In the year Roe V. Wade was overturned, this book stands with those who overturned it, not with women...like at all.
This novel follows sisters, Jada and Maddy as they navigate their lives after unplanned pregnancies. The biggest issue I have with this book is that the author thinks that she can justify ending her novel with a very young girl who gets pregnant by a man who she is not in love with, completely upending (and ending) her young life, after she visits a pregnancy resource center, because her older sister has an off screen and barely mentioned again abortion early in the book. Sorry Ashley, this book is anti-woman and anti-choice and it was published in a year when women need a voice, not to be told that they should surrender their lives to a pregnancy resource center.
Jada, a married women in a PHD program and a stable marriage, has an abortion. It happens off screen and is rarely dealt with other than as a tool for high drama later on. So it really feels more like a headline than as something substantial to be explored in the book. Nineteen year old Maddy, who got pregnant by a rising political star, decides to keep her baby and much of the story is about Maddy coming to this decision. We also see Jada leave her husband and explore that world. While I like the idea of a woman leaving a perfect guy after he's done nothing wrong because, hey, that's a complicated thing people do, the author did not make me understand WHY she was leaving and so she just seemed entitled and spoiled in her decision most of the time. Then of course, there’s a guy from her past, a Townie (who is of course super, super hot and totally into her for like no reason other than that she's a character in a novel), who she very quickly begins a relationship with. It felt forced and contrived and not like a genuine romantic relationship. The scenes with Jada and Maddy’s mother as she’s dying of cancer, are compelling and do spell out a nice relationship, but they are not enough.
Choices are a big theme, not only because of the abortion issues, but also because Jada is studying choices in her PHD program. I honestly felt like with Jada’s studies and abortion being such an important theme, that the theme of choices would be more pronounced or better integrated. But it’s not really integrated well or interestingly. The theme of abortion is strong in this book as well. As for that, I don’t think this book does nearly enough, or anything, to come down on a side, nor does it make any case for NOT taking a side. And honestly, the fact that this book refused to take a side, it really felt like the issue of abortion was used more for points than used to actually explore these complicated issues. In the world we live in today, to not take a side is taking a side.
This book was not brave.
Profile Image for Stacy40pages.
2,228 reviews170 followers
February 8, 2023
How to Care for a Human Girl by Ashley Wurzbacher. Thanks to @atriabooks for the gifted Arc ⭐️⭐️⭐️⭐️

Two estranged sisters make different decisions when they both become pregnant. When they find themselves living together, they must navigate their choices and care for each other.

I love books about sisters, especially when there’s some dysfunction and history. I liked how this on led the reader on a bit to find out more. It was a slow read at times and character driven. I liked when the two sisters came together and their experiences apart, and together.

“She was a tiny atom, she was a sprawling galaxy. She was made of stars.”

How to Care for a Human Girl comes out 8/8.
Profile Image for Christopher Pegg.
33 reviews
September 20, 2023
Incredible story! I wasn’t sure what to expect as the book came to a close, but was assured I was in good hands— Ashley Wurzbacher is crafty as hell and I swear she never wrote a cliché. The dialogue between Maddy & Jada and Jada & Blake and Maddy & Jason and again between Jada & Drew is flawless. The rhythm and flow is prize worthy. Way to go, AW.
Profile Image for Amy Madden.
147 reviews6 followers
April 25, 2023
Two sisters, similar circumstances, two totally different paths of life being lived. This book really struck a chord (in a good way) with me. The writing was really captivating. The author is so descriptive and beautifully captures the emotions of the two sisters. I really loved the way the author intertwined studies with feelings, as I tend to nerd out on those kinds of things. I also really resonated with growing up in a family whose beliefs you independently outgrow.

That being said, this book won’t be for everyone. It kind of bummed me out at how short it was, as I would have loved to see more character development. I also at times was unsure if the author was trying to push a political/social agenda of some sort. The end had me very confused because I thought for sure I’d figure out where they were going with that, but it definitely leaves you questioning.

Thanks to NetGalley/Atria Books for an ARC of this book!!
Profile Image for Daisy.
148 reviews6 followers
September 17, 2024
ARC Read:
This was one of those books where not a lot happens but it had beautiful writing and really touches you. It covers two sisters who are at very different parts of life, both pregnant, and how it affects their relationship with each other and the rest of their family, while they also deal with the death of their mother. There's a real, accurate feel to the sisterhood here. I feel like a lot of negative reviews are coming from people who just want to talk about abortion rights and their political views, and there is definitely some talk about rights and wrongs and moral obligations in this, but not in a pro-life or anti-abortion way. The reactions these characters have are realistic for their characters and a character feeling coerced (or not) into abortion does not a bad story make. Overall I fully enjoyed this and would recommend it to others. I also really love the cover art and title.
921 reviews31 followers
June 18, 2024
3 1/2 stars

This book is a character study of two sisters, one significantly older than the other. I had high hopes for this book, but it let me down. I found it to be a plodding and ponderous tale, and all I wanted was for everyone to get out of their heads, to stop telling me what they were thinking. Instead, I wanted them to show me some genuine interactions. This eventually happened in the last few chapters of the book, but by then, it was too little, too late.

I also found the religious aspect of this book annoying. It revolves around abortion and the Christian charlatanism found in some abortion clinics and churches. The book looks at the different approaches to abortion the two sisters take, one to proceed with the procedure, and one to carry the child. At the end of the book, it’s still not clear if the child will be kept or put up for adoption.

How to Care for a Human Girl also touches on other sensitive topics such as: divorce, sexual predators, cancer and the toll it takes on both the sufferer and their family. There’s parental death and grief, marital discord, environmental pollution and the effects of chemicals left behind on human health. It’s a lot packed into the book, and the various subjects don’t always fit what’s happening.

I had trouble relating to the characters. They didn’t seem believable or realistic, rather flat, as if they were acting in a play and not doing a good job of it. I can deal with the two sisters being so different, but neither was likable. Jada was both too academic, always mentally quoting research studies, and too flighty, willingly walking away from her marriage without even talking with her very good and caring, if entitled, husband. She also walked away from her mother, so she wouldn’t need to deal with her mother’s illness. Maddy was very much a self-involved teenager who suffered from her mother’s illness and death, but was constantly willing to ignore the advice of those who loved her and felt like she knew everything better than anyone. Yet, she also felt like she could break all the rules and walk away unscathed.

I really disliked the religious aspect of the book. There was no indication in the synopsis of it being so religiously focused. I could have dealt with a small amount of religion, but the middle of the book is heavily concentrated on both good and bad aspects of Christianity.

I enjoyed the wildlife aspects of the book. I didn’t really buy into Maddy being giving so much responsibility at the wildlife rescue center, but I still found that part of the book more believable than many of the others.

I received an advanced reader copy of this book in a Goodreads giveaway. I thank all involved for their generosity, but it had no effect on this review. All opinions in this review reflect my true and honest reactions to reading this book.
Profile Image for megan.
239 reviews6 followers
August 27, 2023
“You are all these things at once, not shedding your skins but wearing them in layers. You are all the people you’ve ever been, always.”

gah T_T

i don’t have a sister but i really loved reading this. what it means to be a mother, what it means to be a good person, what it means to be someone’s spouse, what it means to just live your life for yourself and not feel as if your actions are directed by people in your life/society/whatever. that’s what this book tackles. and i appreciated it. i appreciated that the author acknowledges that there’s no right answer. it’s okay to turn to religion or academic validation or other people or whatever to help guide you as long as it’s YOUR choice. sure, there’s an abortion debate ongoing in this book, but the author is very good at critiquing BOTH sides and inviting the reader to evaluate their best interests in approaching that topic and others.
Profile Image for Ainslie Vitale.
14 reviews
July 8, 2023
I won this book on Goodreads. I really struggled with this one. When I think about the storyline of the two sisters and handling unexpected pregnancies in different ways, I feel like I would like it.

The writing was very descriptive but I feel like it didn’t add value to the story- sometimes I would try to figure out what was the point of writing that.

With how much descriptive details I would think there would be more character development. There are many times I don’t agree with choices characters make, but still form an attachment and are able to empathize. These character I did not feel any type of connection.

Overall the idea of the storyline was fine, but the execution was lacking.
Profile Image for Kamryn.
374 reviews44 followers
September 6, 2023
I really enjoyed this one. I found myself highlighting a ton, lots of phrases and ideas truly resonating with me. While I’ve (thankfully) never had to face an unwanted/unplanned pregnancy, I loved this reflection on woman/mother/sisterhood and all the layers of choice within it.

The description and setting was vivid. Some other reviewers have complained about Jada, the one narrator, being too far in her own head. It didn’t bother me. Jada and Maddy both felt real to me and I was surprised by how “relatable” they felt even with stark differences between their situations and mine. Jada especially—but what can I say, I’m a big sister/eldest daughter.

Trigger warnings:
Profile Image for Kelli Hewitt.
251 reviews
April 1, 2024
This is a story told, in alternating chapters, by two sisters, 10 years apart in age still reeling from their mother’s lengthy cancer battle and heartbreaking death. Both in completely different stages of life and both dealing with pregnancies and all the choices, emotions, decisions, and outcomes that are part of it. Jada and Maddy are both self aware, extremely analytical, and reflective on their past, their present, and their future in such a way that you can honestly feel how they’re feeling. This is a story about pregnancy, abortion, choices; right wrong and in between, marriage, risks, love and family. It’s also about 2 sisters healing and starting their relationship over after such a devastating loss. Really liked this. 4⭐️
Profile Image for Jordan Prescott .
2 reviews3 followers
January 12, 2024
I do not agree with the politics that I feel like are insisted in this book as I am very pro life...and though at times difficult to read for me...I thought it was a 5 star novel. I like the different perspectives and the deep mind travel of the characters. This is a very raw tribute to womanhood, motherhood and sisterhood. With my own childhood being everything but vanilla and having to deal with shares of grief, I felt like I understood these characters and how grief and suffering can work in different ways inside of different people. I am an Omnist, but I loved the suggestions on the Virgin Mary and open-mind writing pertaining to religion in this book.
15 reviews
May 16, 2023
Excited to read this!
Profile Image for Jade.
548 reviews50 followers
January 19, 2025
4.5
A really beautifully written tale of grief, sisterhood and bodily autonomy. I love Wurzbacher’s language. Its poetry and rhythm immediately hooked me. Additionally, each perspective felt lived in and fleshed out. I understood Maddy and Jada’s voices and their feats and desires and imaginations. Many lines throughout also surprised me with their fresh language and wisdom. It is not often I find a scene written in a way I feel no one else could, but there were quite a few here.
I also felt the urgency of the story. Maddy and Jada’s problems were real and palpable and terrifying. The book burnt a hole in my pocket, and I always wanted to know where it would go next.
I do think it verges towards the preachy on occasion. It is always hard to deal with such topical ideas, and I (personally) have a low threshold for mentions of Trump—relevant and necessary as they may be. But this is Wurzbacher’s first novel and if this is her initial attempt, I can’t wait to see what else she produces.
Great first read of the year!
162 reviews12 followers
November 4, 2025
Finally finished it. Honestly it was rough getting through this because it just didn't hold my attention. Loved that some took place in Pittsburgh, PA.

How to Care For a Human Girl is a novel about two sisters that end up pregnant but have two very different experiences. One chooses to have an abortion and the other keeps the baby but looks into other options such as adoption. It also goes back and forth in time from when the two sisters mom is still alive but struggling with cancer and dying and present time.

The novel goes into choice and the consequences of those choices, politics, and sisterhood.

Although the book dragged for me I did enjoy the ending. I also enjoyed reading about the parts about Pittsburgh. I just thought the book went into a lot of statistics, studies and so forth. I did like the sisters interactions with each other and thought the book could have used more support of each other.
102 reviews1 follower
April 30, 2024
I am very consfused by the reviews of this book claiming it shows a pro-life perspective overall, claiming that Jada's nice guy husband is "perfect" etc. Just because these characters make complex choices and the book is not overly moralizing does not imply any of that. The book clearly shows why Maddy feels the way she does, clearly illustrates the hypocrisy of the pro life movement, etc. Real life is nuanced and complicated so so are the experiences of these characters.

There is a tiny smidge of essentialism that I get the vibes of from this book but overall I really felt for these characters and I think the author did a beautiful job of interweaving the various motifs and themes.
Profile Image for Devin.
17 reviews1 follower
May 6, 2024
I received this book as part of a Goodreads giveaway in exchange for my honest review. I’m very surprised this novel doesn’t have a higher rating because I found it to be a really touching story and easily relatable. It deals with the complex feelings that surround the death of a parent, pregnancy, divorce and sibling relationships. The different perspectives of how each sibling viewed their mother and the different versions they each received of her, was eye opening. Thank you for the opportunity to read and review such a beautifully written book!
Profile Image for Amanda.
454 reviews5 followers
November 28, 2024
This one covers some heavy topics and is about two sisters dealing with unplanned pregnancies and the aftermath of their decisions. Both sister's are also dealing with their grief after losing their mother and trying to figure out how they deal with each other. The heart of the story is the relationship between two sisters, one that had to act more like a mom and one that had her hope crushed. This is a dual point of view novel that alternates between present and the time leading up to the loss of their mother.



*I received a gifted copy from the publisher*
Profile Image for Colleen Pegher.
55 reviews
March 24, 2024
1. A small thing, but I loved the spot on Pittsburgh references throughout
2. Really explored some in-depth emotions and experiences, complicated family dynamics, and societal pressures on women to marry, stay married and have children
3. I thought the characters were complex in that neither were really likable, nor were they unlikeable. They were just… complicated.
4. It lost one star because it did start somewhat slowly for me.
Profile Image for Summer.
110 reviews
July 28, 2024
“she may not have chosen Maddy, but she can choose to love her. Each day, with agency, she can make this choice”
Ugh this was so good? Like there are so many choices in our lives - especially a woman’s life - that I hadn’t even thought about at first. An interest look into sisterhood, womanhood, and choices. I also love that it takes place in PA 🫶🏻
Profile Image for Dieuwke.
Author 1 book13 followers
September 1, 2024
Solidly good book, plotwise, details, theme
It also feels like I understand the USA a little bit better maybe? (the right to abortion not being debated here where I live)
I was in a book selling spree and I’m glad I still decided (after having it on my wish list for as long as I known it would be published) to order a copy at the local bookstore.
3 reviews
July 25, 2023
Beautifully written tale of sisters, motherhood, and impossible decisions. Told in dual narrative (I love that format!), the story begins with two women's news of unexpected pregnancies. Don't be fooled by the relationship and sisterhood themes- this is NOT a romance. The author's exquisite prose, along with references to modern politics and scientific studies, keep this novel strictly in the Literary Fiction category. A compelling narrative on sisterhood and humanity, I look forward to more from this author! Thanks to Atria Books and Goodreads for the ARC.
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