A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785–1812
by Laurel Thatcher Ulrich

[1990, New York: Alfred A. Knopf; 444 pages, hardback.]

[Review first published in Midwifery Today Issue 82, Summer 2007, © 2007, Midwifery Today, Inc. Review by Amanda Bird.]

Painstaking research by historian Laurel Thatcher Ulrich has produced this Pulitzer Prize winner—a captivating investigation into the life of a Maine midwife. Martha Ballard’s diary records not only her midwifery activities, but such mundane undertakings as weaving, washing clothes, visiting neighbors and entertaining guests. With help from other historical documents of the period, Ulrich has gleaned revealing insights from what other historians termed “trivia.”

Thatcher opens each chapter with a passage from Ballard’s diary, consisting of twenty or so verbatim entries, complete with non-standardized period spelling. She then proceeds to flesh out Ballard’s sparing references to her daily activities with information gained elsewhere in the diary or from outside sources—tax records, diaries of Ballard’s contemporaries, town records and so forth. The result is an in-depth investigation of social, economic, medical and family practices in New England during that era.

The portions of greatest interest to 21st-century midwives will likely be the references to Ballard’s midwifery and other nursing pursuits. Although Ballard does not recount her methods and techniques in detail, with help from Ulrich’s commentary her careful records and accounting reveal a great deal about birth in that community. One noteworthy topic is her relationship with male medical practitioners, which Ulrich considers in light of the shifting status of medicine and physicians at the time. For example, Ballard appears to have been routinely invited to observe autopsies although a short time later women’s participation in such procedures was considered, at least by certain practitioners, to be too much for their delicate sensibilities.

Ulrich’s analysis of Ballard’s birth statistics (number of deliveries, complications, mortality rates and so forth) and comparison with those of her contemporaries practicing both in and out of medical facilities is also of interest. The author’s investigation into birth and medical practices common at the time enables her to make conjectures regarding Ballard’s methods. For example, bloodletting during pregnancy appears to have been a “progressive” but somewhat disputed therapy. The treatment seems, however, to have been regarded as the domain of male physicians and was not employed by Ballard.

Ulrich’s observations regarding other birth practices mentioned by Ballard—attendants, labor terminology, postpartum care and customs pertaining to unwed mothers (and fathers)—are also informative. In addition, Ulrich teases out such details as the house help Ballard employed; the relative roles of midwives, nurses and neighbors in treating illness; Ballard’s attitudes toward her own practice and those of the community physicians; the effect of families’ economic status on their payment of fees; and the complementary nature of the male and female economies that existed in parallel both within the community and within single families. Ulrich’s commentary is at times, by necessity, conjectural, but in most cases her conclusions are convincingly supported by her broad and informed research.

A Midwife’s Tale includes copious notes and an appendix of medicinal ingredients mentioned in the diary. A video based on the book, directed by Richard P. Rogers, has been produced by Blueberry Hill Productions.

Reviewer Amanda Bird is a freelance writer/editor and literary translator living in Eugene, Oregon, with her husband Brian and daughter Brianna, who was born January 29, 2007.

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