This one is definitely a pageturner. In total, I think I read it in 8 hours across 3 days. Carey does a spectacular job moving the story along, plus she does all the other things you expect in a decent novel: characters written so you like and empathize with them, a plot with many moving parts that fit into a cohesive whole, a setting that could certainly make sense in that kind of virus-riddled future. Actually, one of the best things a sci-fi novel can do is make it ever so plausible to us that this kind of future is possible, and then fleshing that out accordingly. (A Handmaid's Tale, anyone?)
What she doesn't do well is give us a potty-mouth mother, as well as three potty-mouth fake priests and nuns (yea, weird, you'll see). It doesn't jive-- the first 40% of the book feels kind of odd because of it. There's no real reason these characters should swear so much. They do seem angry at their fate, but not that kind of angry. It's as if it's added to make the book hip. Perhaps Carey swears a lot, and it's natural for her. But then your characters need to have that piece of them better described. Because in the end it's not amusing, it's just uncomfortable.
Also, there's a lot of graphically described sex, and the relationship this revolves around doesn't feel very real because of it. The relationships between Loup, her trainer and her boxer friends feel far more real- there's a reason for this and it's excellently drawn out. While the boxing relationships are a focus of the tale, I wish they were the primary focus instead of in addition to what Carey and her editors know will simply titillate the reader.
All this gets better as you get closer to the end, and I do recommend reading it regardless. I'm looking forward to the sequel if just to find out what happens to Loup.