The diary of Martha Ballard is an extremely important document that brings us insight into a time period of transition within the practices of birth. Laurel Thatcher Ulrich did a fantastic job pairing the excerpts from Martha’s diary with relevant local and national history of the time period. This work can truly help us understand the larger political and social aspects of the practices of childbirth in America.
What is really striking to me is that Martha Ballard lived before formal training, certifications, and licensure existed among midwifery. It was unregulated; however, this does not once appear to be a problem during the course of her practice. Martha was not simply a self-proclaimed midwife with no skills; she was a person who had gained practical knowledge in the art of midwifery. It is unclear whether she started putting herself out there as a midwife or if the members of her community started calling on her because she seemed like the most obvious person to attend their births. Regardless of which it was the trust she and her patients had in the process is remarkable.
Martha rode on horseback with no equipment, except for perhaps some herbs, to attend the births of family and friends in homes that had no electricity or running water and had birth success rates that would shame the most technologically advanced hospital in modern America. She saw her patients usually once; during labor and delivery. Her success, according to her records, has little to do with any special instrument, technique, or tool but more with her emotional and practical support. What’s more notable is that this is during a time period when prenatal care did not exist and women were directly responsible for their own health and wellbeing. What a long way the birth practices have come.
For many of the people whose births that Martha attended she was not merely their midwife but also their neighbor, caregiver, nurse, mortician, and invaluable community member. In the small tight-knit communities of colonial America each member played a vital role within the community and many wore multiple hats and filled voids when needed. According to Martha’s diary it appears to be a perfect system of providing care for birthing mothers with near perfect results.
At the beginning of her diary medical doctors do not appear to be very much involved with medicine at that time and even less involved in birth. Occasionally they would cross paths but the relationship was civil. As pressures increased politically for doctors to gain credibility in the profession and gain market share, tension increased. It is clear that Martha was skeptical of the practice of doctors after observing some of their questionable techniques. Unforeseen by Martha’s diary; however, the medical establishment did eventually replace traditional midwives and village healers.
A Midwife’s Tale: The Life of Martha Ballard Based on Her Diary 1785-1812 is a historical example of how midwives and village healers can and did provide effective, affordable care within their communities without expensive formal training processes, government regulation, licensure, laws and even fancy equipment. Martha’s healing and midwifery practice was a natural extension of her skills into her community that worked with fantastic success. In light of such history it’s a shame that something closer to Martha’s model of care is not what is promoted in a national Affordable Care Act.