A Midwife's Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812

By Laurel Thatcher Ulrich, Laurel Thatcher Ulrich

6,656 ratings - 3.96* vote

Drawing on the diaries of a midwife and healer in eighteenth-century Maine, this intimate history illuminates the medical practices, household economies, religious rivalries, and sexual mores of the New England frontier.

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Book details

Paperback, 444 pages
December 22nd 1991 by Vintage Books

(first published 1990)

Original Title
A Midwife's Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812 (Vintage Books)
0679733760 (ISBN13: 9780679733768)
Edition Language

Community Reviews


This book won the Pulitzer Prize for History in 1991. The author does an excellent job of weaving the diary of Martha Ballard with the political and economic events of the late 18th Century in what is now Augusta, Maine. Without the diary of one courageous but ordinary woman, we would now know little about the obstetrical practices of midwives of that period.

Martha, known only as Mrs. Ballard, provided the needed care of women and children in that part of Maine. Her high rate of successful deliveries was evidence of her natural ability as a midwife.
Rising at any hour, traveling mostly by horse through snowstorms and below freezing temperatures, and crossing the Kennebec River when it was still partially frozen, all attest to her dedication and willingness to help her neighbors. Her meticulous record keeping of fees received for medical visits, vegetables grown, and cloth weaved, enable us to realize the economic contribution she made to her family.

It is amazing that this little schooled woman kept a diary and more amazing that it survived. Interestingly, it was passed down to her great-great-granddaughter, Mary Hobart, a graduate of the Woman's Medical College of the New York Infirmary in 1884. Only 5% of physicians were female at that time. In 1930 Mary gave the diary to the Maine State Library in Augusta.

Many women throughout history have shown courage in advancing the rights of their gender. Martha Ballard would be humbled if she knew her 'ordinary' life gave inspiration to women more than 200 years after her death.

"Well-behaved women seldom make history" is a phrase coined by Ulrich, a professor of history at Harvard.

Lisa Butterworth

I read this book 15 years ago shortly after it won the Pulitzer, and it was amazing then, and I was equally impressed this time. In fact I was surprised as I read how much of it I could remember reading even that many years ago, so it must have made a deep impression.

I'm just in awe if LTU, the depth and breadth of information that she gleans from Martha Ballard's spare diary entries is mind boggling, for instance, she'll throw out a comparison of the number of people, male and female that MB mentions visiting in her community, then compares it to two other contemporary men's journals, the sheer amount of data she collected, the spread sheets she must have made, and to keep it all straight, to find meaning in it, to organize it into such a readable fascinating picture of a life. It's FReakIN' AWESOME!


“A man works from sun to sun, but a woman’s work is never done.”

Martha Moore was born in 1735 in the town of Oxford, MA. She married Ephraim Ballard in 1754 and gave birth to nine children, lost three of them to diphtheria and eventually died in Maine, in 1812 at the age of 77.

Between 1785 and 1812, Martha Ballard kept a diary. Without it her life would’ve been just a succession of born and died dates in some town registry. We would know nothing about her. We would not know she was a midwife. That she delivered 816 babies during that time period with a higher living birth rate than some countries today. She kept an exhaustive record of her travels from house to house, helping not just the pregnant women but the sick and afflicted, her daily accounts of the weather, and her business dealings. We hear of her gardening, her cooking, the washing, and the spinning of wool to sell.

As she ages, we feel the effects of time as she complains of being tired and not well, but still she works, delivering babies, battling prejudice from male doctors, handling religious squabbles, dealing with armed settlers, and most especially loneliness when her husband is kept in debtor’s prison for over a year.

Such “trivia” would’ve been all but ignored but for Ulrich, who looked between the lines and found a heart-felt story within; a story that won a Pulitzer. By uncovering the subplots of Martha’s daily life, from someone’s hasty marriage, lingering labor, or sojourn to jail, she revealed a grander hidden picture of eighteenth-century social history.

I found this book to be fascinating, and I can’t believe I’ve never read it before. What women had to go through just amazes me. So many of their children died and yet these women persevered. And the medical practices, I just couldn’t believe what they used for remedies, and yet I found their return to a simpler time somehow comforting. Everything was much less complicated back then. Martha did really well for herself. She made her own money and took care of her and her own families needs, as well as countless of her neighbors. She did not sit idly back and let history write her off. She wrote her own. What would’ve been lost if she hadn’t? A treasure. For anybody that likes history, this is an excellent read.


I kept journals fairly religiously while I was in high school. They are so full of rampant sentimentality (i.e. boy craziness) that reading them now makes me want to fetch the lighter fluid and matches straightaway.

Martha Ballard avoided this problem neatly by keeping her entries brief, factual and largely devoid of emotion or interpretation. She kept careful track of her work as a midwife, her gardening and household chores, and the comings and goings of friends, family, and neighbors; basically, the daily happenings in her life. Consequently, her diary (of 1785-1812) was long dismissed as “not of general interest” and “trivial and unimportant” by historians. Ulrich, however, chose to take another look, and the result is A Midwife’s Tale, winner of the Pulitzer Prize.

On its most basic level, this book is a fascinating look at life in Maine in the decades following the American Revolution. Each chapter uses a passage from Martha’s diary to explore a specific topic: midwifery, the religious environment, the legal system, the role of women, marriage, and so on. History buffs will certainly enjoy this glimpse into day-to-day life in Martha’s time and place.

On another level, however, this book is a detective story. The format of the book – each chapter is an excerpt from the diary, followed by Ulrich’s commentary – allows us a glimpse into the brilliant detective work that Ulrich undertook to craft this book.

Take, for example, the sentence, “Was Calld in at Mrs Husseys.” To a casual reader, Martha simply visited her friend Mrs Hussey, nothing more. Ulrich knows better. Throughout the diary, Martha speaks of going to Mr Bullins or Capt Coxes or Mr Goodins. In Martha’s world, houses belong to men. So why refer to the house as belonging to Mrs Hussey? Ulrich can tell you why (and she does, in the Introduction, so you don’t have to read far), and she tells you how she came to her conclusion so that we can share in the feeling of discovery.

I enjoyed Ulrich’s writing style. It was scholarly (lots of footnotes, for you footnote lovers!), but readable and laced with humor. I did find it impossible to keep track of all the people in the book; Martha did know most of the people in town after all. Ulrich warns her readers in the Introduction that this can happen (and that it shouldn’t really matter), but it made my head spin nonetheless. In spite of this (very, very minor) annoyance, I quite enjoyed this book and would recommend it to all history lovers.

Emma Deplores Goodreads Censorship

This is an interesting history/biography that’s both accessible and scholarly. Ulrich uses the bare-bones journal of a midwife in early New England, kept from age about 50 through her late 70s, to illuminate the social history of early Maine, as well as Martha Ballard’s own life and family drama. Ulrich clearly digs deep, cross-referencing many sources including official documents and other diarists from the area.

The result is surprisingly rich, and includes some major events (a backwoods rebellion, a mass murder) as well as the details of Ballard’s life (visiting neighbors, gardening, delivering babies, marrying off her daughters and left in old age unhappily relying upon her son). Some of the information is surprising or illuminating: for instance, that 40% of first babies were conceived out of wedlock (overwhelmingly the parents soon married, however). Some of it seems fairly obvious now, though perhaps less so 30 years ago when this book was published: for instance, the fact that the women of Ballard’s small farming community had independent social and economic lives, typically visiting separately from their husbands and carrying on their own small-scale transactions with their neighbors.

Meanwhile, Ballard had an eventful career in midwifery, often rushing from one home to another when multiple women were in labor at once, walking across frozen rivers or canoeing across partially-frozen ones to reach her patients. Ulrich presents her as part of a complicated network of “social medicine,” which ranged from neighbor women who showed up to assist at births or sit with the sick, through midwives who also acted as doctors, nurses, apothecaries and morticians depending on the situation, up through physicians, who were only beginning to monopolize the practice of medicine. In Ballard's lifetime doctors and midwives seem to have worked together mostly harmoniously – she witnessed several autopsies at the doctors’ invitation – though they sometimes butted heads.

I would have liked to see a little more analysis of the medical techniques Ballard used. She was pretty clearly a practitioner of traditional rather than experimental medicine, but she also had a fantastic success rate for the time, losing only 5 mothers out of 1000 births. (Contrast with hospitals in London and Dublin, which had far higher maternal death rates, one as high as 1 in 5.) Ulrich mostly dismisses this with the notion that birth is a natural rather than a medical event, over-dramatized in fiction (though, 1 in 24 of the babies Ballard delivered were dead at birth or soon after). But what could those hospitals have been doing so badly wrong? Perhaps New England's colder climate and sparser population, making the spread of disease more difficult, was a major factor here? Overall Ulrich is more focused on the role of women in medicine than the effectiveness of the medicine, but I don’t think discussion of the latter would have undermined the impressiveness of the former at all. Yes, Ballard’s treatments included things like putting onions on people’s feet, but this was a time period when the most celebrated treatment promoted by the male medical establishment was bloodletting, which goes beyond just ineffective to be actually harmful.

Overall, I would definitely recommend this to those who are interested as a strong piece of original scholarship that’s also quite interesting and accessible to those who enjoy popular history. Ulrich’s ability to draw meaning out of what might first appear to be a dry and abbreviated record is nothing short of impressive.


An interesting account of one woman's day to life in the late 1700's to early 1800's in New England.


Though seemingly aimed at an audience who eat up popular history like its cake, Thatcher's book is well researched and obviously the child of a social historian. It may actually be in its favour to be so accessible by those that don't live in the same world as Thatcher in terms of gaining understanding of it and the implications Thatcher's work holds for both gender and medical history. While some parts are questionable in terms of putting thoughts on the person of Mrs. Martha Ballard, A Midwife's Tale helps stitch together gender history and medical history in her social history of late 18th and early 19th century New England. Ultimately, this is a book that should be read by anyone endeavouring to study medical history or gender history. The life surrounding Martha Ballard encapsulates the problems and tribulations as experienced by women helping settle at the time a frontier that seemed so foreign. As such tension between gender role and necessity, especially in light of changing medical opinion concerning the involvement of women are exemplified in Martha Ballard's life.


The topic of the book is Martha Ballard and how she represented women in late 18th century America. It focuses on the role of midwives, women in the home, in a market economy, sexual relations of the time period, family hierarchy and structure, a women’s place in society as a whole. The book is an analysis of her life and her work. It is represented as a true eulogy to early American women and their often unrecorded lives.

The story takes place in the town of Hallowell along the Kennebec River in Massachusetts, what is now Augusta, Maine. It covers the time period from 1785-1812 with an epilogue detailing Martha’s descendants’ actions pertaining to her diary. This time period was from when Martha Ballard moved to Hallowell from Oxford, MA until her death in 1812.

The central argument is that women in late 18th century America, while often over looked, played a major role in all aspects of society. In fact each chapter of the book focuses on a different aspect of Martha Ballard’s impact on her surroundings. These individual themes include women’s impact on the local economy, the definition of women’s work, women’s influence on local politics, the nature of sexual relations at the time, the nature of childbirth, the nature of marriage and family interdependence, how women coped with local and often intimate scandals, and how the role of women was changing during the time period. The author concludes that women had significant influence in several areas of local life including the market economy, medicine, and childbirth. These different aspects of the diary combine to tell the tale of the American women at the turn of the 19th century.

The primary source for the analysis was the diary of Martha Ballard. However, the author, Laurel Thatcher Ulrich, cross-references the diary with documents from the time period. These documents include court transcripts, prison logs, land records, wills and testimonies, newspapers, sermons, census records, town records, maps, and other diaries. This detailed work of scholarship let Ulrich piece together much more of the story about the surrounding area than the diary alone would have allowed her.

The thesis is very well constructed. I believe that Ulrich’s argument is foolproof. Women most certainly had a crucial, if often unrecorded effect on society and daily life. The close look at the experiences of Martha Ballard was extremely enlightening. I especially found the nature of the market economy of the time to be captivating. Women often had an entire economic structure all their own. The author’s separation of topics and themes by chapter also was useful as it allowed a segmented and detailed study of the different topics. Her cross referencing of the diary with other sources paints a broader picture of the time period and allows certain of Martha’s sometimes mundane or unnoticed comments to stand out. The book was informative as to the nature of family and sexual relationships and also neighbor and town associations. As a whole it explained the role of women during the time period extremely well.

The book itself is rather boring but for anyone interested in the topic it is an excellent piece of scholarship.


I am so thankful to live in the age of modern medicine!
Martha Ballard was a caring, talented midwife who helped to deliver hundreds of babies. She also nursed neighbors through their illnesses and prepared the dead for burial. She had a strong faith in a sovereign God which gave her much comfort in the many trials she encountered.
Ulrich weaves a tapestry of the social, political, economic, familial, religious, & medical ways of Martha's day along with her journal of the every day work she faithfully performed.
I was fascinated.

2018 - A biography


History is endlessly fascinating to me. Learning about how real people lived decades, centuries, even millennia ago - so different in so many ways to our lives today, yet so similar in others - makes me feel connected to those who have gone before.

I'm also fascinated by the process historians go through to better understand the past. It seems obvious to me that whether in science or history or any other area of study, as new information is discovered, as new data is gathered, as new connections are made, as distance provides broader perspective, our understanding will change, sometimes radically. I've seen the phrase "revisionist history" thrown around as a condescending epithet to describe new interpretations of historical events that challenge the traditional interpretation, but shouldn't we constantly be revising our understanding of history? Shouldn't it be a goal to replace our mistaken assumptions or misunderstandings with a better picture of how it really was, or to try to fill in the gaps a little more, even if that challenges previous conclusions?

Early on in her introduction to the Pulitzer-Prize-winning A Midwife's Tale, historian Laurel Thatcher Ulrich mentions that several other historians have been aware of Martha Ballard's diary and even quoted parts of it in their histories of Augusta, Maine, but "those few historians who have known about the diary have not known quite what to do with it." The repetitive structure, the rhythm of domestic chores and seasonal planting, growing, and harvesting cycles of life on a farm, were dismissed as unimportant "trivia". "Yet," Ulrich claims, "it is in the vary dailiness, the exhaustive, repetitious dailiness, that the real power of Martha Ballard's book lies." She goes on to explain :
The problem is not that the diary is trivial but that it introduces more stories than can easily be recovered and absorbed...Taken alone, such stories tell us too much and not enough, teasing us with glimpses of intimate life, repelling us with a reticence we cannot decode. Yet, read in the broader context of the diary and in relation to larger themes in eighteenth-century history, they can be extraordinarily revealing.

Martha kept her diary for more than twenty-seven years, "9,965 days to be exact,"...

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