In THT, extremist Christian groups in the US stage a paramilitary take over of the government, by attacking Congress, the SCOTUS, and presidency all at once. Once that’s complete, they instill their own leaders and turn the US into a Christian state. This began with an unexplained severe drop in birth rates globally, and growing unrest around it in the beginning stages.

Once the take over is complete ‘fertile women’ are rounded up and assigned to families of power, wearing these red outfits and being named ‘Handmaids’. They’re raped once a month during peak fertility in the hopes of getting pregnant. Once they give birth the children are given to the family that was raping them, and the handmaid is moved to another powerful family to assist them in having more children, too.

They have no rights, anyone not part of the Christian in group is hunted and slaughtered. ‘Fertile women’ are raped monthly, and if they speak out their eyes are plucked out, their hands and limbs are cut off, etc. A brood mare* doesn’t need limbs or eyes to give birth…

Edit: additionally, women are stripped of all rights and are assigned to home keeping roles. Can’t vote, can’t work, can’t own property or have their own money. This is a sticking point for a woman who is married to a primary staff leader of the new regime, who actively participated in the creation of the movement and then is stripped of her voice within the group.