Wikipedia suggests that this is the cover to the Italian translation of Sheri Tepper's 1988 novel The Gate to Women's Country. The title, in English, means 'Postwar Chronicles', which applies to Tepper's powerful book only in the most oblique manner; and the artwork (by Oscar Chichoni) is not of any scene in the novel. There is a moment, late in the narrative, when the main character has a contraceptive implant cut out, but from her arm, not her back, and with a regular knife, not a weird swastika-shaped scalpel torture device. It is, all in all, really not a pleasant image: a queasy blend of sexual lubriciousness and petty male-on-female sadism-domination. I was prepared to chalk this up to a Wikipedia mistake; but a quick trip to the Urania.it website disabuses me -- this is indeed the Italian translation of the novel. Ugh.