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“Children these days are very spoiled,” opines Ruth, the protagonist of Prevenge, as she stares at the ceiling of her hotel room. “‘Mummy, I want a PlayStation. Mummy, I want you to kill that man.’” In the context of a stand-up comedy routine, you’d just laugh at the gag and get ready for the next one. In the context of horror in general and Prevenge in the specific, you’ll still probably laugh, but only as an awkward acknowledgment of your discomfort. See, by the time an exhausted Ruth voices this complaint out loud, she’s already knocked off a few folks at knifepoint, hard work made harder by the fact that she’s seven months pregnant. Stabbing for two can’t be easy, after all, but Ruth turns out to be a natural at butchery.

Maybe getting close enough to gut a person when you’re blatantly with child is a cinch—no one likely expects an expecting mother to cut their throat—but all the positive encouragement Ruth’s unborn daughter gives her helps, too. The kid spends the film spurring her mother to slaughter seemingly innocent people from in utero, an invisible voice of incipient malevolence sporting a high-pitched giggle that’ll make your skin crawl. “Pregnant lady goes on a slashing spree at the behest of her gestating child” sounds like a perfectly daffy twist on one of the horror genre’s most enduring contemporary niches on paper. In practice it’s not quite so daffy, more somber than it is silly, but the bleak tone suits what writer, director, and star Alice Lowe wants to achieve with her filmmaking debut. Another storyteller might have designed Prevenge as a more comically-slanted effort, but Lowe has sculpted it to smash taboos and social norms.

The best evidence of her intentions is the film’s current of misanthropy. Prevenge hates human beings with a disturbing passion, even human beings who aren’t selfish, awful, creepy, or worse. Ruth’s midwife (Jo Hartley) provides routine well-meaning encouragement and counsel, but through Lowe’s eyes her advice chafes more than it soothes. Another character, a kindly young fellow in a relationship with one of Ruth’s victims-to-be, is genuinely empathetic toward her in one of the movie’s gentler moments, but even he isn’t spared her insatiable wrath when the time comes ‘round. No one here gets out unscathed, even the pure-hearted. They either fall to Ruth’s blade or Lowe’s merciless script.

She structures the movie with a simple pattern: Kill, reflect, visit the midwife, kill, rinse, lather, repeat. (The rinsing is especially important for not leaving behind evidence at crime scenes.) If you’re into slashers for the bloodletting, Prevenge won’t let you down much, but Lowe isn’t into creative brutality: Her violence has a point, and her film favors character study over explicit gorefest. Compared to her last screenwriting venture, Ben Wheatley’s Sightseers, Prevenge is downright tame, bereft of Wheatley’s love of fetishizing exploding heads and other gruesome forms of death. Lowe films huge swaths of Ruth’s rampage with impassioned minimalism, neglecting money shots of open wounds save in one very specific, very deserved instance in Prevenge’s first act. (Fair warning to male viewers: The instance in question involves testicles, so hang onto your groins.)

If you’re not the type to gaze at human viscera, the film will still leave you shaken. What it lacks in effects-driven carnage it makes up for with its disquieting atmosphere. Lowe means to rattle her audience with implication first and violence second, keeping us in a state of unnerved wonderment at Ruth’s mental stability. Is her daughter really speaking to her, or is she merely hearing what she wants to hear? Do we sympathize with Ruth’s motivation or not? She’s on a mission of vengeance, slaying each person either responsible or present for the death of her partner during a cliff-climbing excursion; now she’s left to raise a child without the father, alone and outraged. You’ll want to root for her in accordance with slasher custom, especially when she kills the piggish DJ Dan (Tom Davis) or the skeevy Mr. Zabek (Dan Skinner), but her other targets are as culpable as they are pitiable (Kate Dickie) or, well, normal (Gemma Whelan).

Lowe’s sense of morality here is murky, and that serves Prevenge well as a complex work about an intrinsically sensitive subject. Women’s rights being such a fixture in the zeitgeist, the very notion of making a movie with a pregnant murderess for a protagonist seems risky: It’s the kind of art with the potential to offend by its very premise. But Lowe isn’t overly concerned with ruffling feathers, in the sense that Prevenge both goes the distance with its black satire and holds a steady balance between gallows humor, graphic violence, and pathos. It would be easy to treat Ruth as a grotesque caricature, to fall back on easy pregnancy jokes and cliches, and to only aspire to be a slasher movie, so good on Lowe for refusing to follow the easy path. (In more ways than one, too. Not only does she layer Prevenge with substance and style, she also shot the damn thing in under two weeks while pregnant herself. That’s hardcore.)

Parenthood is a special experience, motherhood more so than fatherhood, but Prevenge imagines the bond between parent and child as something unnatural and even dreadful, without stepping clear over the line into poor taste. This is what pregnancy looks like when described by a woman through a genre lens, a fine addition to the subcategory of “pregnancy horror,” made up of titles like Grace, Proxy, and last year’s Antibirth. Prevenge turns out to be one of the best examples of its pedigree, moody and dreamlike with a blend of comic unpleasantry and homage that avoids navel-gazing. (Lowe doesn’t have Ruth watch Crime Without Passion in her hotel room just to show off her cinephilic tastes, but you have to wait until the very end for the reference to pay off.)

Child-rearing is a challenge, but very rarely is it actually murder. In Prevenge, it’s a form of real-life body horror that’s as smartly crafted and grimly funny as it is terrifying.

Director: Alice Lowe
Writer: Alice Lowe
Starring: Alice Lowe, Kayvan Novak, Gemma Whelan, Tom Davis, Kate Dickie, Dan Skinner, Jo Hartley, Mike Wozniak
Release Date: March 24, 2017

Boston-based critic Andy Crump has been writing about film and television online since 2009, and has been contributing to Paste Magazine since 2013. He writes additional words for Movie Mezzanine, The Playlist, and Birth. Movies. Death., and is a member of the Online Film Critics Society and the Boston Online Film Critics Association. You can follow him on Twitter and find his collected writing at his personal blog. He is composed of roughly 65% craft beer.