By Victoria Dillon
I know the exact moment I decided to write my debut novel, Ava. It was June 25, 2022, the Saturday after the Dobbs v. Jackson Women’s Health Organization decision overturned Roe v. Wade. A Facebook Messenger notification pinged on my phone, and suddenly I was part of a thread filled with like-minded high school friends who were stunned and angry. We had grown up in a rural, deeply conservative town in North Carolina, and many of us still live in the South, often surrounded by people who don’t share our views. A lot of other classmates were posting about how excited they were over “the good news.”
It took some restraint not to fire off replies or start blocking old friends who were on the opposite side of the spectrum. Instead, the small virtual klatch of us vented over morning coffee. It felt comforting to sit there in our shared outrage, even if the conversation eventually waned and we all returned to the rest of the weekend. I felt what so many women felt that day: powerless, unsure how to fight back, and angry for our daughters who would inherit this new reality.
Later that afternoon, a random memory resurfaced from middle school. While my friends and I whispered about periods, pregnancy, and birth, I thought the whole process sounded bloody, painful and unpleasant. Chickens, I decided, had it much easier. They laid an egg, kept it warm, and a cute chick hatched itself, and it seemed like a better alternative in my twelve-year-old mind. For whatever reason, that memory collided with the Dobbs fallout, and I followed it down a rabbit hole (or deep into the chicken coop) imagining what society might look like if human reproduction had evolved differently.
By the end of the day, I realized it could be the premise for a book. Because I had spent several years studying chicken embryos as a research scientist before becoming a pediatrician, the idea felt strangely natural. I started outlining a story.
That Monday, I told a couple of my pediatric colleagues that I wanted to write a novel about women who could lay eggs. In my head, the concept was brilliant. Out loud, it earned polite smiles and awkward enthusiasm. I decided to keep the project quiet until I had a better pitch and a finished manuscript.
Living in Tennessee provided plenty of real-world legislative material. One chapter of Ava focuses on the state’s mandated abstinence-only curriculum, known as “sexual risk avoidance.” One of the groups that provides this instruction for a larger area has headquarters in my county. The American Academy of Pediatrics has repeatedly found these programs ineffective in delaying sexual activity. No surprise.
When my daughter was in eighth grade, she attended one of these classes at her public school. An early beta reader told me the chapter felt unrealistic, but the parts she questioned weren’t fiction.
My daughter and the other students were asked several anonymous questions including:
“Have you had sexual intercourse?”
“If you haven’t, do you plan to wait until you are married?”
The main character in Ava hands in a blank sheet. When I asked my daughter what she wrote, she told me she answered “no” to the first one. For the second, she wrote that she planned to wait until after high school but didn’t intend to marry until thirty, and she wasn’t waiting that long to have sex. That’s my girl.
Another piece of Tennessee policy woven into the book is the repeal of the state’s Mature Minor Doctrine. This mostly forgotten law was passed during the 1980s HIV crisis that allowed teenagers fourteen and older to make certain medical decisions without parental consent if their physician deemed them mature enough.
During the COVID-19 pandemic, the Tennessee Department of Health sent weekly updates to physicians. Dr. Michelle Fiscus, a fellow pediatrician, served as medical director and reminded us in one email about the Mature Minor Doctrine. From a medical standpoint, this was routine and helpful. From a political standpoint, it created a nonsensical firestorm. Lawmakers accused Dr. Fiscus of encouraging teens to get vaccinated behind their parents’ backs, something I have never once seen in my practice. She was fired, the controversy made national news, and she later sued the state and won. Good job, Shelley.
In 2024, the Tennessee legislature repealed the vaccine portion of the doctrine entirely. In Ava, I took it a step further and imagined the entire law being removed. Today, only a parent or guardian can consent to vaccines. Phone consent is allowed for some vaccines, but COVID and HPV still require written authorization. Both have been targets of conspiracy theories ranging from infertility myths to accusations of hidden 5G technology. The disinformation is staggering.
Of course, the biggest piece of legislation that influenced my writing was the Human Life Protection Act that passed in Tennessee a month after Roe was overturned, which effectively banned nearly all abortions. Women needing this care must now leave the state. In Ava, the option of leaving the state is gone as well.
I chatted with one young woman affected by this law who lives near me. Allie Phillips learned in the nineteenth week of her pregnancy that her baby had multiple lethal anomalies. She had to travel out of state for care, adding financial strain to unimaginable grief. Allie later ran for the Tennessee House of Representatives in 2024. She lost, as many Democratic candidates do here, but people like her give me hope for the state’s future.
In the summer of 2023, I realized how my state provides a unique setting for the stripping of reproductive rights as I watched journalist Anne Applebaum on a morning news segment discussing her article in The Atlantic titled “Is Tennessee a Democracy?” She referred to my county as “the reddest county in the reddest state.” It was not an exaggeration.
It is also the place I have called home for more than twenty-five years and still love despite its flaws. I love being a pediatrician, and I have been honored to be entrusted with the care of thousands of children. I don’t ask about parents’ political beliefs, and I respect their child-rearing choices as long as their children are safe, fed, supported and loved.
My hope is that people who don’t think like me will read Ava. The book is speculative, yes, but it is also grounded in the real policies shaping the lives of women and girls across Tennessee. Ava is my way to imagine what might happen if we continue down the path we are on, and sometimes imagining a different future is the first step toward building one.
Victoria Dillon is a former research scientist, current pediatrician and writer with a passion for exploring the intersections of politics and science. She has a unique ability to blend speculative fiction with thought-provoking social commentary, creating prose that speaks both to the heart and the mind. She has lived in the South throughout her childhood and career and she currently resides in Middle Tennessee. Learn more about her writing at: victoriadillonauthor.com.
ABOUT THE BOOK: For fans of “The Handmaid’s Tale,” “The Farm,” and “Red Clocks,” Victoria Dillon’s unique, provocative new novel “Ava” (She Writes Press, March 3, 2026) asks: What if the only way to reclaim reproductive freedom was to rewrite the very nature of birth itself?
Ten years after Roe v. Wade is overturned, twenty-two-year-old comparative biologist Larkin finds herself unexpectedly pregnant in a country where choice is no longer an option. Initially uncertain, she embraces motherhood—until a devastating diagnosis changes everything. Trapped by Tennessee’s strict abortion laws, she is forced to carry her baby, Maeve, to term, only to endure the heartbreak of losing her hours after birth. Years later, still haunted by her loss, Larkin joins a radical scientific movement that could change everything: a groundbreaking technology that replaces gestation with incubation, allowing women true control over their reproduction. When she uses it to bring her second daughter, Ava, into the world, she believes she has finally reclaimed her autonomy. But as Ava grows and begins to question the very choice that created her, Larkin is challenged in ways she never imagined.
