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This book took me several attempts to get into it, it’s not riveting, especially not off the bat. The summary is fairly accurate about Jeff being terrified he'll lose his wife, Caro, when they learn they are unable to conceive and Jeff becomes obsessed and desperate to get a baby for her. The reason Jeff is scared of losing his wife is because it is known between them that Caro's life goal is to be a mother and marrying Jeff, who is well-off and I think 7-9 years older than her, was a catalyst and means to an end for this to happen. They're both still young, the only age indicator was that Jeff was described at one point as a man of about 35, so it was kind of extreme to me that Caro thought her dream of being a mother was over.
Jeff's personality becomes increasingly strange as he fears losing Caro, but more development of his mental state would've helped the story to be more believable. However, the author might not have done this to emphasize how disturbed Jeff was - by making his abnormal thoughts seem regular. As obvious or subtle his poor mental state was, it would've been more impactful if this was more definitive and developed - a few good twists and turns could've been incorporated. For example, if he had secretly not been taking some medication he needed this whole time, or a psychological disorder he never told his wife about and some friend or relative coming forward about his past and reason of mental state. There were a few other side stories that eventually become relevant, but they could've been better or more interesting.
The best part of the book is the eerie foreshadowing that the author is able to create and maintain. I wouldn't push this book on anyone, but I also wouldn't recommend against it.