Though Martha seldom mentions deep friendships in her diary, she relies heavily upon her connections to people in her community. One of the most significant elements in her diary is her chronicle of neighbors she visits with and those who visit her. The interaction itself, not the reason for the visit, is what matters to Martha, and sometimes she makes no mention of why the visit takes place. Her midwifery is the greatest example and facilitator of these connections, giving a wide variety of people a reason to reach out to Martha and ask her for help. Martha is a popular midwife, and her delivering and nursing take her to most of the community. When the Purrinton murders strike the community, Martha focuses on the neighbors’ actions instead of on the crime itself and describes how together they deal with the dead and help the survivor. When Martha becomes increasingly homebound, her isolation from the rest of the community bothers her a great deal, and she begins deliberately passing along the produce from her garden in an effort to reach out to the community once again.
Though contact with others is vital for Martha, she also needs to maintain authority over her own life. Midwifery gives Martha the chance to make her own decisions, spend considerable time away from home, and work with only the eyes of the community as supervision. Unlike most jobs available to women, midwifery provides a salary equal to her husband’s and the chance to manage it independently, both of which help Martha gain a greater autonomy in her marriage. Martha clashes with the local doctors only when they try to deny her ability to make intelligent, skilled decisions on her own, and though she acknowledges their skills, she does her best to avoid working with them. Martha’s need for autonomy also contributes to making the later years of her life difficult. Without the responsibility and constructive effort of midwifery, she feels she has lost the ability to control her own life.