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.