Ask any doting mother or seasoned midwife, and they’ll tell you: “baby knows best.” But in the case of Prevenge and the very pregnant Ruth (Alice Lowe), traditional advice need not apply. Because Ruth, rather than, say, frequenting lamaze classes and quelling highly specific food cravings, spends her prenatal days tracking down and callously killing people, then marking them down in a crude and creepy marker-filled notebook.

The hook? Ruth isn't committing the murders through any apparent black-heartedness of her own. She's simply taking orders from the tiny being inside her, a squeaky-voiced malevolent force inside of Ruth's unmissable swollen belly, referred to only as Baby, who serves as a kind of bizarro life guru for her host. Deeply cynical and thirsty for blood, Baby easily manipulates Ruth by nastily verbalizing her greatest fears surrounding motherhood, all the while coaching her along to the bloody end of her violent acts. "People say babies are sweet, but I'm bitter," snarls Baby as Ruth prepares to slay a new victim.

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Image via Shudder

At first, Ruth's victims are, if still morally objectionable, at least understandable: a cloying pet-shop owner who regales Ruth with nauseating insinuations to his "big snake" and an oafish DJ who pauses to unceremoniously puke before sticking his tongue down her throat. But Ruth's slayings quickly stray from a simpler conception of misandry to something much more complex as the film reveals a much darker rationale behind Ruth's choice of targets.

Slipping into each of her victims' lives with a simple change of wardrobe and hair, Ruth approaches each of her kills with the eerie combination of quirk and detachment, interacting with each of her victims honestly at first before retreating back into herself for her strikingly violent episodes. And in those, perhaps most disturbingly, Ruth isn't helpless so much as numb, participating in a ride-along with Baby the sole driver.

In one of the funniest scenes in the film, Alice lies in bed after a particularly brutal kill, bickering with Baby like two parts of an old friendship that's long gone sour. "Kids are so spoiled these days. 'Mummy, I want a Playstation, mummy I want you to kill that man,'" moans Ruth. But for all its warped comedy, Prevenge forgoes the traditional pitch of horror-comedies and never mines its kills for laughs. The violence in the film is graphic but never showy, with Lowe instead preferring to revel in the awkward muck of bloodletting, the physical reality of taking a life.

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Image via Shudder

For some time, horror films have had quite the fascination with pregnancy – Rosemary's Baby and Inside are two of the most elegant and notable options – but unlike its predecessors, Prevenge isn't interested in exploring looming threats to motherhood as it is the terror of motherhood itself. In fact, the presence of any looming exterior forces is notably absent, as Ruth is able to commit her series of increasingly messy crimes without so much as a brush with police. There is no grand conspiracy or singularly committed stalker to insight Ruth's mania; the simple fact of trauma and change are reason enough for dread.

It's worth noting that Lowe, who also wrote and directed the film, shot Prevenge just six months before she was due with a child of her own – apparently compelled to make the project as a response to her anxieties over the dueling forces of motherhood and career. But there also seems in Prevenge a desire to stake some claim on the subgenre itself. In Lowe's hands, morning sickness becomes a nauseating negotiating tactic, the chiding advice of doctors cruel reminders of the lack of autonomy women are often afforded, and while the violence is monstrous, Lowe ensures that Ruth never quite is. A near-perfect debut, delivering scathing commentary and one-of-a-kind acerbic wit with a surprisingly affecting emotional center, Prevenge is fearlessly singular from its off-kilter opening scene until its devastatingly perfect final frame.

Rating: A-

Prevenge is currently playing in limited release; it's also currently available on Shudder.