A Midwife's Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812

Like each of Ulrich’s chapters, Chapter 1 begins with a collection of Martha’s diary entries, this time from August 1787. These entries outline Martha’s various deliveries, visits to households ailing from scarlet fever, and her household activities, which included picking saffron, pulling flax, and knitting. 

Ulrich explains the difference in Martha’s medical accounts compared to those of male doctors, like Daniel Cony (which Martha sometimes spells “Coney”): “The most obvious difference […] is that it is a woman’s record. Equally important is the way it connects birth and death with ordinary life. Few medical histories, even today, do that” (52). Cony recorded the births and deaths from Martha’s minutes/records, not from his own, demonstrating the importance of her work and also the connection between her knowledge of birth and life. She attended the births of Hallowell, but oftentimes, also the deaths. In August 1787, Hallowell endured an outbreak of scarlet fever. The first to die was Henry and Tabitha Sewall’s son, six-month-old Billy. During the outbreak, Martha tended to dozens of sick people in her own family and the broader community. One mother, Mrs. McMaster, lost her son William while heavily pregnant. Ulrich notes, “‘Poor mother.’ That entry contains the one burst of emotion to appear in the diary all summer” (55). This burst of emotion is rare from Martha, and Ulrich postulates that Martha felt an empathetic connection to the mother due to the fact she lost three of her children while heavily pregnant during the Oxford diphtheria outbreak. The scarlet fever outbreak was difficult to contain, and it was difficult to understand why a young mother, Susanna Clayton, died after childbirth despite displaying no symptoms of scarlet fever, as no one yet understood that puerperal fever (fever that takes place 24 hours or less after childbirth) and scarlet fever were both caused by Group A hemolytic streptococci.

Ulrich transitions from her exploration of Martha’s diary entries to a broader interrogation of the daily work of a midwife in early America. Some thought of midwives with “reverence,” and some with “disdain.” They were polarizing figures; many women sought them for comfort and advice, and some men regarded them as gossipy and impious. Martha’s diary both challenges these stereotypes and elucidates the reality that they were based on. Ulrich writes, “Midwives and nurses mediated the mysteries of birth, procreation, illness, and death. They touched the untouchable […] swaddled the dead as well as the newborn […] and presided over neighborhood gatherings of women” (60). There was a mystery to Martha’s work that men struggled to understand, even the male doctors that Martha worked alongside and was “deferential” to. Women practitioners were also the ones who tended to women and children and also minor illnesses, which made up much of the necessary medical care in Hallowell. Martha also had a clear understanding of natural healing tools, such as herbs. She adhered to the concept of purging, which dates back to the ancient ideas of humors, which required “proper balance of the four bodily fluids—blood, phlegm, choler (or yellow bile), and melancholy (or black bile)” (68). Both doctors and midwives like Martha would encourage purging, lancing abscesses, or applying drawing salve to blisters. Bloodletting was occasionally used by doctors, but never Martha. Male physicians tended to use more “dramatic” remedies. They also attempted a solidistic approach, using “Newtonian physics in attempting to regulate the mechanical properties of ‘solids,’ usually defined as blood vessels and nerves” (70). Martha may have been aware of solidistic medicine, but she did not use many remedies that aligned with it. She rejected some of the methods of physicians, not out of distrust, but instead a more conservative approach to medicine.

Physicians and midwives often achieved the same results, and both worked part-time. Doctor Cony, for example, was a doctor but also a local politician and land proprietor. Many of the other doctors, like Dr. Samuel Colman and Dr. Benjamin Page, were also part-time doctors and part-time traders/merchants. They were respected, though, due to their social status as men and due to the deference shown to them by the female healers and midwives. Martha always referred to these men as “Doctor.” Physicians viewed themselves as separate from their communities by title, while “social” or female healers were integral pieces of the communities they served. In the August 1787 diary entries, Martha names five other people involved in healing, demonstrating that she was not an anomaly in the Kennebec Valley. Hannah Cool was a servant who assisted with caretaking, Sally Patten was a “watcher” who sat with the ill, Merriam Pollard was a nurse like Martha, and Captain and Mrs. Sewall also provided comfort to the ill at the Howards’. 

Ulrich ends the chapter with an explanation of the complicated nature of the Howard family, as the widowed James Howard remarried a young woman at the age of 79 and had another child with her that he named James, despite his son Colonel William Howard already having a son named James. The three Jameses lived at the old Western Fort in 1785, but by 1787, only the youngest James was still alive, and extremely ill. Between 1785 and 1787, dysentery or bilious fever struck the old fort, killing eight people. A canker rash also struck the fort, killing the Colonel’s wife, three of his children, and his father, the elderly James, before moving on to infect the young James, who survived. The Colonel paid Martha for her services in white rum and sugar, amounts of both worth the price of six visits from a doctor. During this period in the summer of 1787, Ephraim Ballard and their son Jonathan began work to rebuild the mills that had burned down early in August.