12 February 2012

Thoughts on A Midwife's Tale

One of the books I am reading in the course of researching my fourth book is A Midwife's Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812 by Laurel Thatcher Ulrich. While not completely analogous to a surgeon's daughter living in 1816 England, the work does help to provide some flavor to what life would be like for a female caregiver from the late 18th to nearly the mid 19th centuries.

Ulrich's work is fascinating. Martha Ballard attended 816 births in the 27 years of the diary. Her statistics are quite remarkable: out of these births, 46 or 5.6% were listed as "difficult" with 14 stillbirths with a ratio of 1.8 out of every 100. These are births for which Ballard did not rely on forceps or the "hook and the knife", but were natural. What is also interesting is that Ulrich writes that "In fact, many historians believe that the routine employment of physicians in the nineteenth century probably increased rather than decreased mortality."

Ballard's method of curing and midwifery were considered gentle, using herbs and influenced by humoral therapy. By contrast, the male physicians tended toward more dramatic therapies, including bloodletting, sedatives and calomel, a mercurial compound.

For Ballard, the birth was an event at which more than one women attended; for male physicians, women attendants at births were a distraction with their unwelcome chatter. For Ballard, women have a useful role as they help tend to mothers who are expecting or who have just given birth, giving care or helping with tasks that need to be done to keep the household running smoothly. For male physicians of the time, there seems to be a feeling of superiority and exclusion at the birth.

The number of babies born out of wedlock are also noted in the diary; as a midwife, Ballard had to determine the parentage of the child as "sexual intercourse between unmarried persons" was considered a crime. One of the births of these unmarried mothers Ballard attended was that of a woman who claimed Ballard's own son as the father--he married the woman just before he was charged with the crime.

Rape was also reported in the diary. The most dramatic was that of the wife of an evangelical minister who charged a number of men, among them one of the community's most influential residents, Judge North, was the perpetrator. Rebecca Foster, the victim, told Ballard that "was not the worst shee had met with since Mr Foster's absence, but shee hoped they would not quite kill her, that they Could do nothing worst than what they had unless they killed her." Ballard testified for Mrs Foster at court--a court that did not find in favor of the victim. The Fosters left the community where Ballard lived; Mrs Foster may may have suffered a mental breakdown while her husband turned to drink and never preached again. Ballard's protest was to stop attending the church to which Judge North was connected except on rare occasions.

Each chapter begins with pages from Ballard's diary, which allow the reader to see large swaths of this unpublished in toto diary. The full two volumes of Ballard's diary can be found at the Maine State Library, across from the state capital in Augusta, Maine.

I am only about halfway through this book which is a must-read for anyone who wishes to know more about women in medicine and history.


In just a few more pages, I found more about the importance of the women at the births. Martha Ballard called upon them at the moment of birth (or as near as she could judge) as they would literally support the mother while she labored. As Thatcher wryly noted, carrying about a birthing stool would be a little difficult as Ballard rode horses, walked through woods, walked over the frozen ice of Kennebec River, rode in canoes, etc to reach her patients. The women also served at witness for Ballard should there be a difficult birth--they can witness the fact that Ballard did her job properly, no matter the outcome. The women could also give support to the new mother, speaking with her about her new baby, or helping to lay out the funeral clothes should the baby be stillborn or die soon after the death. And, when the mother needed support after a difficult birth, the women could help to nurse her and the child when Ballard was called away.