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I first encountered A Midwife’s Tale by Laurel Thatcher Ulrich twenty years ago when I was a teaching assistant for a course called Medicine and Society in America. For Professor Allan Brandt, the book was of interest mainly for its content. Based on the diary of an eighteenth century midwife in rural Hallowell, Maine, Ulrich’s book gives a wonderful sense of the system of “social medicine” that thrived in that time and place, a system sustained by women, often co-existing alongside but sometimes in open conflict with the more elite practice of “scientific” medicine dominated by male physicians. I was fascinated by the types of remedies employed by the midwife, Martha Ballard, who acted as “nurse, physician, mortician, pharmacist, and attentive wife” (40). Martha was a stalwart member of her community, in addition to delivering its hundreds of infants.
One of Professor Brandt’s themes was the complex transition from lay healing to professionalized medicine. How did a profession of medicine constitute itself and assert its authority against rival and longstanding practices– an authority it claimed long before it had any access to reliable cures? Ulrich’s book illuminated the transition by bringing to life the world that that profession aimed to replace. The protagonist of her story was not the male doctor, armed with dramatic therapies and the fees to match, but the skilled, trusted, and highly effective midwife. The book helped shake a common assumption about the inevitability of “progress.” Professor Brandt encouraged his students to ask not “Why did scientific medicine take so long to arrive?” but rather: “How could such a questionable and insecure set of practices ever have gotten a foothold?”
When I taught A Midwife’s Tale in my own course years later, however, it was for a different purpose. Here I was focused less on the content than on the historian’s method. For Ulrich’s book illustrates perhaps better than any book I have ever read the challenges, frustrations, and thrills of being an historian. Reading it is like having an apprenticeship with a master of the craft. I used the book in a course designed to teach undergraduates and graduate students how to think historically and work with primary sources. But I believe that any historian, from the novice to the seasoned scholar, can learn from the book.
Close reading: the primary document as a work of literature
A Midwife’s Tale is divided into ten chapters, each one beginning with a transcribed excerpt from Martha Ballard’s diary, and each followed by an essay in which Ulrich analyzes and interprets the excerpt. The excerpts are much longer than a typical quotation: they amount to several pages and usually consist of a dozen or more consecutive entries from a given year. So, from the start, Ulrich does something unexpected for an historian: she lets us have direct and relatively unfiltered access to her main primary source. But what a source it is! Full of mundane details– the weather, Martha’s coming and goings, whom she saw and what she did, from pulling flax to delivering a baby– the diary at first glance seems utterly boring and unimportant. What could such a record possibly tell us? Other historians have dismissed the diary as “trivial,” and even by Ulrich’s own admission it was “difficult to use” (33).
But Ulrich shows us how to read the diary and how to learn from it. She not only tells us what she learned from it, she also lets us in on how she actually went about making her interpretation. The difficulty of the diary as a source makes Ulrich self-conscious and reflective about her source and her craft. We get a feel for what it was like to travel the distance from the raw diary to the finished historical interpretation. Along the way there are clues to be discovered if we read the diary closely enough; connections to be made to other documents and themes to be drawn out; and sometimes dead ends to encounter. “Both the difficulty and the value of the diary,” Ulrich writes, “lie in its astonishing steadiness,” in its patient, daily documentation of twenty-seven years of Martha’s life (21). Ulrich mines that steadiness for all she can learn from it, considering the diary in its fullest and broadest contexts. In doing so, she gives us a remarkable glimpse into how an historian goes about reconstructing the past.
On a first pass through, the diary seems entirely opaque, nothing but a jumble of names and trivial details. But with Ulrich’s guidance, a world of significance is revealed. Treating the diary essentially as a work of literature worthy of close reading, the historian draws our attention to metaphors and sentence structure, tone and irony, and pulls out meaning from them. Consider a sequence of entries from April 1789, in which Martha crosses and re-crosses the Kennebec River to attend a delivery. “On first reading,” Ulrich points out, “the reader is unlikely to notice a subplot being played out” (21). She then teases apart the excerpt to reveal that Martha was actually attending two different deliveries, that one of the babies had been conceived out of wedlock, and that the father in the other case was rotting in debtors’ prison. Ulrich seized on the last point by noticing that Martha wrote of going to “Mrs.” Hussey’s house. Since in Martha’s world houses belonged to men, this detail was a subtle hint that Mr. Hussey was absent. For Ulrich–as for Martha– truly nothing was trivial.
Martha was not an introspective or demonstrative diarist, so when she did confide her feelings, Ulrich found it significant. The ironic tone Martha used to describe a male physician in town pointed to veiled critique, while Ulrich read sympathy into Martha’s apostrophe “poor mother,” referring to one of the midwife’s overburdened patients (43). The kind of language Martha used– in one place, conventional religious phrases alternating with narrative, in another the use of an unusual expression or striking metaphor– are all grist for Ulrich’s mill. “Individual entries may seem flat and unrevealing,” Ulrich writes. But “even the most routine and formulaic pieces of information are useful,” and the historian uses them to unfold the numerous stories the diary contains (169).
Setting the diary in its contexts
However closely she reads it, Martha’s diary was not the only source Ulrich used. The historian compares it to and reads it alongside many other kinds of documents: court and church records, advice manuals, sermons, newspapers, correspondence, and other diaries, using each of the excerpts from the midwife’s diary to illustrate a broader theme in eighteenth-century social history. The period from 1785 to 1812 was certainly full of political upheaval, power struggles, wars, and new governments. Ulrich argues, though, that to limit our gaze to such public matters is to see literally only half the picture. Equally striking were the social changes that accompanied the political revolution: changes in family life and marriage customs, in healing practices, religious observance, and the gendered division of labor. The private world– a world organized and inhabited by women and children– supported, complemented, and sometimes intertwined with the public world of men. While public documents like court records tell us of men’s activities, Ulrich uses Martha’s diary to uncover the mostly forgotten, perishable, invisible activities of women. The weaving of a blanket, the harvesting of a garden, the nursing of a sick child, and the web of human relationships and exchanges that underlay such work, are hardly ever memorialized in leather bound books or stone monuments. Ulrich reminds us that this mostly unseen world existed and that an eighteenth-century town like Hallowell was sustained by both men’s and women’s work. Thus the historian uses Martha’s diary to tell the story of a rape in the town from the woman’s perspective, or to show how imprisonment for debt affected relationships in one family. This private, human world was not timeless: change happened here too, as it did in the public realm. The growth of religious pluralism was a fact of life in Hallowell. Comparing Martha’s diary with a contemporary record kept by her fellow townsman Henry Sewall, Ulrich shows that while Henry’s diary dwells on matters of abstract doctrine, Martha considers the arrival of the new minister in town and the personal troubles he and his wife faced. Martha’s diary vividly personifies the new “scientific” obstetrics by the bumbling Dr. Benjamin Page. Ulrich points out that, rather than simply running in parallel, the social shifts could be understood as actually related to the political upheavals, though historians are only beginning to reveal and analyze these relationships. “It is not as easy as it once was to dismiss domestic concerns as ‘trivia,’ ” she observes (27). Ulrich’s book places Martha’s diary in the broadest possible contexts and takes it on its own terms without hero worship or Whiggishness: “Her story allows us to see what was lost, as well as what was gained, in the political, economic, and social transformations of the eighteenth and early nineteenth centuries” (32).
History and imagination
Finally, I appreciate A Midwife’s Tale perhaps most of all because Ulrich’s voice is present in it. She is not afraid to make an assumption, to use her imagination, to infer, to speculate– and to make it clear to her readers that that’s what she’s doing. Most works of history keep this interpretive, imaginative process a secret, hidden away behind the footnotes, as if their authors are nothing but objective transcribers of their sources, invisible screens through which we see the past directly and immediately. We all know, or should know, that this is not how history is done, not how historians really reanimate the past. We all know, or at least we’re told, that the work of history is and must be subjective. But Ulrich is the only historian I know of brave enough not only to admit to this practice but to exemplify it: history writing is interpretive, yes, and–at its best–imaginative.
Martha’s diary goes only so far in describing her world: for all its pages, it is a laconic document and it leaves much unsaid. To help us understand it, Ulrich uses her own imagination. To explain the meaning of Martha’s curious idiom “I find my house up in arms,” Ulrich sketches this scene for us: “A house could be an adversary. Turn your back and it rippled into disorder. Chairs tipped. Candles slumped. Egg yolks hardened in cold skillets. Dust settled like snow. Only by constant effort could a woman conquer her possessions. Mustering grease and ashes, shaking feather beds and pillows to attention, scrubbing floors and linens into subjection, she restored a fragile order to a fallen world” (219). Or, discussing Martha’s delivery of twins, an event embedded in social detail, Ulrich imagines the texture, the feel of the midwife’s journey:
Where is the center of the picture? Is it Martha Ballard scrambling up the icy bank, Mr. Dingley grasping one arm, Mr. Graves reaching toward her from above, while Ephraim slowly turns his boat in the ice-rimmed river below? Is it Mrs. Byrnes, exhausted from her eight-hour labor, bearing down for the second delivery? Is it Mrs. Conry easing two perfect babies into the cradle, or the three drowsy women leaning toward the kitchen fire, the midnight cold at their backs, small clouds of mist above their whispers?
“There is no center,” Ulrich writes, “only a kind of grid, faint trails of experience converging and deflecting across a single day” (183). Martha’s diary is a terse record, quiet and undemonstrative; clearly her emotions and her ways of expressing them were different from ours. She did not use her diary to pour out her feelings. But Ulrich helps us to understand and empathize with her without sentimentalizing, by imagining what some of those feelings must have been like– resentment at her hotheaded son or ungrateful husband, frustration with the lack of household help, pride in her garden, grief at the death of her niece.
Ultimately Ulrich faces, as all historians must, the fundamental unknowability of the past. In spite of her voluminous and close reading of primary documents, the historian cannot trace every thread, tie up every loose end, track down every name, or make sense of every reference. “The problem is not that the diary is trivial,” Ulrich explains, “but that it introduces more stories than can easily be recovered and absorbed…. [S]uch stories tell us too much and not enough, teasing us with glimpses of intimate life, repelling us with a reticence we cannot decode” (25). Sometimes Ulrich uses an assumption– trustworthy because it is so well grounded in her research–to leap over a gap in evidence, but sometimes she has to admit that we just don’t know. The most vivid and thorough reconstruction must leave things that cannot be discovered or understood. How much must lie forgotten and unknown! Ulrich is brave enough to admit to this basic mystery at the heart of historical research. Despite the riches she has uncovered in Martha’s diary, Ulrich also uses it to remind us of the insufficiency of written records in representing the fullness of real life.
 Laurel Thatcher Ulrich, A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812 (New York: Vintage Books, 1990).