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The Bigger Picture

Interpret What Happened from Martha's Point of View

So what happened according to Martha's diary?

On October 10, 1794, Midwife Martha Ballard officiated at the birth of Tabitha and Henry Sewall's first-born. The labor, probably either its length or intensity, alarmed the family. They summoned a new, young doctor in town, Benjamin Page. He gave the laboring mother a tincture of opium, which put her to sleep and stopped the uterine contractions. The opium may also have caused her to vomit. Around evening when the laudanum wore off, labor resumed and the delivery took place without mishap.

If we examine Martha's choice of words closely, what can we conclude about the personal meaning of this event for Martha?

10 6

Birth David Sewalls Son.

Cloudy. at mr Sewalls, they were intimidated & Calld Dr Page who gave my Patient [20] drops of Laudanum which put her into Such a Stupor her pains (which were regular & promising) in a manner Stopt till near night when Shee pukt & they returnd & Shee was Delivd at 7h Evn of a Son, her first Born. I left her Cleverly at 10 & walkt home. I receivd 12/ as a reward. at Ditoes. Birth 39th. mr Perham Sleeps here. Dolly is unwell.

Sometimes a careful reading of a historic text can allow us to interpret the personal meanings of events. Martha used the word "intimidated" to account for the Sewalls' call to Dr. Page. Contrast the word "intimidated," which describes the Sewalls' fear, with Martha's own assessment of the progress of the labor as "regular and promising." Does this imply that Martha believed the Sewalls' fears were unfounded? Martha wrote, "Page ... gave my Patient 20 drops of Laudanum which put her into Such a Stupor" that her labor pains "Stopt till near night when Shee pukt & they returned." Martha's writing seems to be telling us that she believed it was only after Dr. Page's drugs had been vomited up that Tabitha could have a successful delivery. Note that Martha wrote "Page gave... MY patient 20 drops of Laudanum;" in her eyes Tabitha was never Dr. Page's patient. Martha delivered the baby and "left her Cleverly," and "received 12/ as a reward." In describing that she left her patient "Cleverly" and was rewarded, Martha was regaining her control over the situation.

We have interpreted this passage to say that Martha felt that the presence of Dr. Page was an unnecessary intrusion, interfering with the natural course of labor and with her own practice. We can verify or perhaps modify our interpretation by looking at other entries about deliveries.


Understand What Happened in the Context of Martha's Practice

Overwhelmingly, the births at which midwife Ballard officiated were normal, and no doctor was called. In only two cases, midwife Ballard decided to summon help according to the old standard: call a male doctor when the mother or child is dead or in danger of dying without extraordinary medicinal or surgical intervention.

So now we see the laudanum incident embedded within twenty-seven years of mostly uneventful deliveries. We see that this new Dr. Page, this man-midwife, was not respectful of the female midwife’s usual authority. With much to learn, he contested the usual wisdom of letting a "promising" labor take its course unimpeded.

Was this a typical birth for Midwife Martha?

Traditionally, female midwives attended normal births. When an abnormal birth threatened to cause death, then a male surgeon would be called to remove the fetus surgically. This often ended in the death of mother or child if they were not already dead. After the invention of the forceps and improved understanding of anatomy, the coming of the man-midwife did not necessarily mean death. Nevertheless, historians have estimated that around 95% of births in eighteenth-century England and the early U.S. were normal. In her own practice, Martha Ballard handled most difficulties herself, if they arose. Her diary shows that she called upon male doctors for help in deliveries only twice between 1785 and 1812.

Investigate Further:

• Read the two diary entries that recount the two times that Martha called in doctors to help her with a difficult delivery: November 11, 1785 and May 19, 1792

• How many times was a doctor called in by someone other than Martha? What percentage of her cases would that be? You can try to answer these questions by reading all of the diary entries that mention doctors.

Search the Online Diary with the keyword "birth" to read all 2,789 of Martha's entries about births.


Was Dr. Page typical of the doctors Martha encountered?

Many entries demonstrate that, for the most part, Martha Ballard and the older male doctors coexisted peaceably. Midwife and doctors cooperated, often visiting the same clients. Doctors dispensed imported medicines to midwives and to patients. At times, a doctor was called by the midwife to treat herself or her family. Likewise, at times, the midwife was called to treat a doctor or his family. Only a very occasional, surprised entry shows a doctor confronting the midwife unpleasantly.

Dr. Page might have become like the others, but the older doctors practiced medicine part-time, while Dr. Page aimed to build a full-time obstetrical practice. Thus, in Hallowell and Augusta, Dr. Page was atypical indeed.

Investigate Further:

• Find out more about Dr. Page in the "Dr. Ben Page, a man-midwife" section, especially the Dr. Ben Page: in Martha's Diary page where you can compare some of Martha's entries about Dr. Ben Page to those about other doctors in town.

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