Alice Lowe is up the duff and on the hunt in the enjoyably provocative, blackly comic Prevenge, a film which gets considerable mileage out of its creator's own pregnancy. It balances a bad taste, exploitation movie plot (think Death Wish meets Rosemary's Baby and add a dash of 'Son of Sam') with a society-savaging agenda, mocking the tendency to pigeonhole and mollycoddle expectant mothers.

Lowe turns in a performance of eerie passivity and predictably brilliant comic timing playing Ruth, a woman in her third trimester who's told by her well-meaning but patronising midwife (the excellent Jo Hartley), 'You have absolutely no control over your mind or your body anymore.' Little does she know how true that statement is, because Ruth has become a conduit for her unborn child's murderous desires, as she seeks vengeance on those she blames for her daddy's demise.

Considering that this is Lowe's directorial debut (it's her second feature as screenwriter after the superb and not dissimilar Sightseers), Prevenge is remarkably well-realised. This is very much Lowe's baby but she's assembled an impressive cast who pop up only to be struck down; Kate Dickie and Game of Thrones' Gemma Whelan are two of Ruth's victims, while there is marginally more screen-time for the versatile Kayvan Novak.

Despite the extreme nature of the narrative, Prevenge plays on common pregnancy frustrations and fears and there's an element of demented wish-fulfilment here – we witness Ruth mouthing off at her midwife and laying waste to a hypnobirthing CD. There's a neat appropriation of advice to breathe through the agony, while her bloody rampage is mirrored in the birth sequence, with its crime scene level of claret. It's a film that wants to make you squirm, the discomfort enhanced by the intimacy and explicitness of the execution, the spiralling events reflected in woozy camerawork and a seesawing score.

By utilising her pregnant form and feeding off the associated anxieties what Lowe has achieved here is remarkable, not because being heavily pregnant is necessarily immobilising but because a parallel like this between reality and fiction is rare (and because she wrote it in a couple of weeks and shot it over 11 days). The conceit reaches its logical conclusion when the result of Lowe's own gestation, her lovely daughter Della Moon, cameos in a sequence where the actress is able to show us genuine maternal pride; it's a disarming moment of nice in amongst the large dollops of nasty.

Screening on Thu 13 and Sun 16 Oct as part of the London Film Festival 2016. General release TBC.