In A Midwife's Tale, Laurel Thatcher Ulrich transforms the humble account book of an eighteenth century midwife into a magnificant commentary upon American life during the early Republic. Indeed, Martha Ballard's writings provide a wide-ranging glimpse of New England society at a time when the American people were striving for a separate identity, distinctive from the mother country. In her earlier book Good Wives: Image and Reality in the Lives of Women in Northern New England, Ulrich used probate records and wills to reconstruct the lives of women. In contrast, The Midwife's Tale benefits from the 9,965 daily entries that Martha Ballard recorded in her diary over a period of twenty-seven years. The three decades covered by the account were years of transition for American society on several levels including medicine, religion, and family life. Chief among these issues examined by Ulrich was the "professionalization" of medicine especially in the area of childbirth.

For centuries, midwifery was an expertise practiced almost exclusively by women. However, because of the the mid-eighteenth century advent of university training, medicine became a respectable, learned field in which scientific knowledge superseded "folk medicine." This transition occured during the years of Martha Ballard's midwife practice and is duly recorded within her account book. In her commentary upon this displacement, Ulrich betrays a popular feminist bias against the transformation of a "natural process" into a "medical event." She relays Martha's horror at the mutiliations caused by the experimental Doctor Page's "heroic" interference in the natural rhythms of childbirth. Ulrich also carefully compares the mortality rates suffered by Martha's patients with those of several doctors both in the eighteenth and nineteenth century. If Martha Ballard's accounts are correct, her patients certainly had an unusually high survival rate. However, this attests more to her skill as a midwife than to any conclusions upon the detrimental effects of the intrusion of medicine into childbirth.

Ulrich's comparison of mother and child mortality rates in births attended by midwives and physician is weakened by the fact that doctors tended to be called in during difficult cases. Often the painful disasters recounted in the diary were not overzealous experiments with a new technology, but a desperate attempt to save the mother's life. Furthermore, Ulrich's mortality statistics from London and Dublin hospitals have little bearing upon home births in New England. During the eighteenth century, these maternity hospitals were increadibly unsanitary birth locations of last resort for prostitutes and the urban poor. The high mortality rate could only be expected. Thus Ulrich's rosy vision of pre-medical birth is somewhat unbalanced.

Because she practiced midwifery, Martha Ballard had access to every level of her society. Even with the widespread acceptance of male doctors attending births, women from all classes often still chose a midwife for their accouchement. Her diary records almost indifferently her movements from well appointed houses to shacks within her community. Martha Ballard was also well aware of sexual scandal and its consequences. The law accorded to a midwife the responsibility of taking testimony during the birth of illigitimate children for the purpose of determining paternity. Thus upon these and other occasions, she was privy to information which sometimes never made the public record. She also recorded some of Hallowell's more extraordinary events. On one occasion, Martha Ballard was the sole confident of and key witness for Rebecca Frost, the wife of the unpopular village minister, in her unsuccessful charge of rape against the prominent Judge North. In 1806, towards the end of her diary, Martha first encountered and prepared for burial the family members of Captain James Purrington who were the victims of his murderous rampage. Although the public documents duly record this event, Martha Ballard's diary expresses the horror and fear felt by the community. In both instances, the social and religious balance of Hallowell was threatened or even endangered. After such events, she was grateful to return to her routine.

Ironically, for decades the "dailiness" of Martha Ballard's record, arguably the strongest reason for its study, was either ignored or given short shrift. Earlier treatments of the diary gleaned references to Hallowell's public figures or to medical practices and disregarded its subtle testimony to everyday existance at the turn of that century. Here lies the beauty of Martha's writing. From gardens planted to children delivered, the reader follows the diary's rich account of the rhythm of life for over a generation. As an Early-Republic farmwife, Martha Ballard's life revolved around the seasons. Ulrich aptly reflects this in the book's organization for each chapter focuses upon either an aspect of Martha Ballard's life or that of the community at large. Marriage, religious tensions, debt, rape, and family violence are each treated in conjunction with entries from the diary.

This book is accessible to both the casual reader and the professional historian because Ulrich deftly weaves the rather terse entries into flowing prose enriched by careful documentation. Her painstaking efforts to correlate Ballard's remarks with both public records and the diaries of contemporaries provide a sound, believable foundation for Ulrich's theories about life in Hallowell, Maine. In fact, the transformation between primary source and polished prose only attests to Ulrich's skill an interpreter of historical documents and her imaginative insight into Martha Ballard's world. In Ulrich's hands, Martha Ballard comes to life as an honest, hardworking, and human individual who served her family and community not only as a midwife but as a neighbor, helpmeet, and friend. Indeed, she conveys both an admiration for and sympathy with this woman whose life and surroundings Ulrich immersed herself. A Midwife's Tale only reminds the reader how much information about the past is both waiting to be discovered and has been lost forever. Indeed, in her introduction, Ulrich makes plain that had Ballard's diary not survived, "we would know nothing about her life after her children were born, nothing of the 816 deliveries she performed between 1785 and 1812. We would not even be certain she had been a midwife." (5)
 

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