Laura Thatcher Ulrich begins each chapter of A Midwife’s Tale by transcribing a few entries from Martha Ballard’s diary, from the month and year listed in the chapter title. Ulrich follows these entries with an essay that further explains the entries’ details and relates the entries to what happened to Martha in the surrounding few years. Ulrich explains and builds on the entries with her own analysis, and she provides a wider historical context by drawing from documents such as town records and the diaries of Martha’s New England contemporaries.

Martha Moore was born in 1735 in the small town of Oxford, Massachusetts, to a well-educated family. She married Ephraim Ballard in 1754 and had her first child, Cyrus, two years later. She quickly had five more children—four daughters and one more son—but lost three of the girls to a diphtheria epidemic in 1769. That same year, she gave birth to her fifth daughter, and her sixth followed two years later. In 1773, Ephraim traveled to Maine to find a new home for the family, finally settling in Hallowell and taking management of the mill and property owned by a British sympathizer who had fled to Canada. Martha and the children joined Ephraim there in October of 1777, and Martha officially delivered her first child as a midwife in July of 1778. Martha’s oldest daughter, Lucy, married her cousin Ephraim Towne that same year, and in 1799, Martha gave birth to her youngest son. She begins writing in her diary on January 1, 1785.

In August of 1787, Martha describes several events that give an overview of the many medically related tasks she is called on to perform, including delivering babies, answering false alarms, preparing bodies for burial, making medical calls, dispensing pills, and harvesting and preparing healing herbs. Ulrich then gives an overview of homeopathic remedies of the time and the relationship between local healers and physicians. In September of 1788, Martha talks about the goods she and her daughters trade with local women and the help her daughters give her with the housework, particularly the weaving. Ulrich then discusses the gender-based division of duties, the female economic subsystem of the time period, and the importance of household help in a midwife’s career. In October of the following year, Martha’s family is forced to relocate when the mill’s original owner returns, and she discusses the difficulties of living so much closer to her neighbors. She also talks about being questioned when one of these new neighbors accuses a public official of rape. Ulrich offers a fuller historical account of the case and its participants.

In November of 1792, Martha’s niece, Parthenia Barton, who had been living with the family for some time, marries Shubael Pitts. Martha’s daughter Hannah marries Moses Pollard, the son of an old friend, Merriam Pollard, who often worked as a town nurse. Ulrich then describes traditional marriage practices in those days, including simple, work-intensive weddings and the fact that couples lived apart until they were able to set up a household. Martha also talks about being summoned to Sally Pierce’s delivery. Sally identified Martha’s son Jonathan as the father of her illegitimate baby and sued him for support, which he fulfilled by marrying her. Ulrich then discusses the histories and results of other paternity suits from that time period. In November and December of 1793, Martha describes several complication-free deliveries she performs in the quiet period following the weddings. Ulrich expands upon this by explaining in more detail how these deliveries might have gone and comparing Martha’s success rate to other historical rates.

Martha’s youngest daughter, Dolly, marries Barnabas Lambard in May of 1795, and in Martha’s entries for January of the following year, the problem of housework has become dramatically larger now that she has no one at home to help her with it. In November of that year, Martha recounts that a band of armed men had attacked her husband while he attempted to complete a survey job. Ulrich adds further explanation, saying that poor settlers often saw surveyors as agents of richer men who were trying to take away the land that the settlers felt they had won for themselves. Even in these more difficult times, Martha’s medical involvement in the community still continues, and in February of 1801, Martha talks about tending to the death of her daughter-in-law’s nephew and being asked by the doctor to be an attendant at his dissection. Ulrich follows this with a more detailed look at the little boy’s history and offers a look at the changing relationship between doctors and midwives.

By March of 1804, Martha had grown weary, troubled by untrustworthy hired help, Jonathan’s often alcohol-induced temper, and Ephraim’s imprisonment for debt related to his job as a tax collector. Ulrich gives a more detailed picture of what Ephraim’s imprisonment would have been like, after which Martha describes the difficulties of being a woman on her own. Jonathan and his family move in with her, but due to her strained relationship with Jonathan, and Sally’s insistence on being mistress of the house, the move only adds to Martha’s troubles. In 1806, however, Martha’s neighborhood faces even greater obstacles when they discover that a neighbor, Captain Purrinton, had slaughtered almost his entire family before committing suicide. Ulrich describes the entirety of the case and gives a few theories offered at the time as to Captain Purrinton’s motives. Eight months later, another tragedy hits Martha’s family when the husband of her niece, Betsy Barton, commits suicide.

By May of 1809, Martha’s focus is mainly on her garden, the preparation that went into it, and what happened to the produce that came from it. Grandchildren are now old enough to help her with the housework, and the number of deliveries she attends has increased dramatically. Ulrich offers details on gardens of the time period but also describes the larger political turmoil of the area that is only offered in brief, family-related details in Martha’s diary. Martha attends several deliveries early in 1812, but the stress makes her ill, and her last entry describes the family and preacher gathering at her house on May 7. She dies a few weeks later.

Martha’s diary is passed down through Dolly’s descendents until it reaches Martha’s great-great-granddaughter, Mary Hobart, one of the country’s early female physicians. Mary treasures the diary but gives it to the Maine State Library in 1930 so that it might be more accessible to historians.

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