According to Jeanne Boydston, ‘female wage-earners occupy an anomalous position in the story of the transition to capitalism in the United States’.Footnote 1 This anomalous position is derived from the fact that traditionally, household labour has been unpaid. That is, wives, sisters, and daughters have never been formally compensated for their work on behalf of their husbands, brothers, and fathers. When voluntary (non-indentured/non-enslaved) female domestic labour first entered the American market in the early eighteenth century, employers had to contend with two historical incongruencies: first, women were requesting monetary compensation for work that, when normally performed by female members of the household, had no recognized pre-set value. Second, unlike industrial labour, which occurred in the ‘public’ sphere, ‘private’ household work could not be pro-rated based on an hourly schedule. As a result, it was difficult to determine the exact length of a workday, or the tasks it should involve. Even though these issues, for the most part, had been settled by the late eighteenth century (the time period of the Ballard diary), women's domestic work remained a problematic source of compensated labour during the capitalist shift that occurred during the early American Republic.Footnote 2
According to William Ray Arney, midwifery was a source of household labour that essentially circumvented the difficulties posed by female domestic work during the early years of American independence because it occupied the interstices between the private and public spheres.Footnote 3 Its ability to elude criticism and transcend categorization as a ‘valueless’ source of women's work finds its origins in the American colonies, where midwives were perceived as members of a respectable profession (they were even granted priority on ferry boats to the Colony of Massachusetts). The midwife was an important, indispensable figure in every colonial community, and thus never lacked employment. Moreover, the fact that midwifery was a specialized skill that complemented women's duties in the domestic sphere strengthened its position as a legitimate, socially acceptable female occupation and as a well-paying source of income in the public sphere.Footnote 4 As midwives acquired agency as lay healers within their own households and communities, they were able to carve a significant economic niche for themselves in the male-dominated capitalist society of the early American Republic.
As Boydston states, ‘recent work in women's history has demonstrated [that women's paid labour and participation in the growing capitalist economy] provided an important resource for household adaptation during the transition into a market economy [1776–1820]’.Footnote 5 Ulrich's interpretation of Martha Ballard's diary exemplifies this historiographical trend, especially when one ‘considers midwifery, as a specialty within a larger neighborhood economy, as the most visible feature of a comprehensive system of early healthcare, as a mechanism of social control, [and as] a strategy for family support’.Footnote 6 Interspersed in the diary are specific accounts which provide greater insight into how Ballard used her skills as a midwife and a resourceful housekeeper to deconstruct the marginality of female medical attendants, and make substantial economic contributions to her family and local community.
Between 1785 and 1812, Ballard documented, in great detail, the 800 plus deliveries she attended in the Kennebec River Valley towns of Hallowell and Augusta, Maine, as well as other events such as marriages, deaths, encounters with acquaintances, local scandals, and the activities of her extended family. Her ledger is significant not only because it helps reconstruct rural turn-of-the-nineteenth-century life, but also because it provides concrete information on the types and amounts of payment that midwives, such as Ballard, received. Furthermore, the diary clearly illustrates that during this historical period, even rural working women had access to cash and store credit. This is probably due to the respect accorded to midwives, and the fact that men in Kennebec usually paid for their wives' deliveries in tangible currency.Footnote 7 During the 1790s, a single delivery usually earned Ballard six shillings, ‘paid in cash or credit at one of the local stores’. However, she often received other forms of payment which were reflective of the ‘economy of the town’.
In the course of her career, Ballard received everything from shingles to a pair of flat irons. Most payments were in food, textiles, or household necessities: cheese, butter, wheat, rye, corn, baby pigs, turkeys, candles, a great wheel, unwashed wool, checked cloth, cod, teapots, thimbles, a looking glass, handkerchiefs, and snuff.Footnote 8
There are also instances where she received more than six shillings: if a horse was needed to bring Ballard to the parturient or if medicine had to be administered (the length of the labour did not impact her fee).Footnote 9
As Ulrich illustrates, Martha Ballard's role as an economic provider was not confined only to the realm of childbirth.
She was a midwife, and more. Between August 3 and 24, 1787, she performed four deliveries, answered one obstetrical false alarm, made sixteen medical calls, prepared three bodies for burial, dispensed pills to one neighbor, harvested and prepared herbs for another, and doctored her own husband's sore throat. In twentieth-century terms, she was simultaneously a midwife, nurse, physician, mortician, pharmacist, and an attentive wife.Footnote 10
Ballard received payment for some of these services, especially for the herbs and medicinal advice she dispensed. Not only did she grow the herbs in her own garden, thereby using her skills to make concrete contributions to her domestic and local economies, but she also instructed other women on how they could use their specialized household talents to improve their families' financial situation. Thus by 1800, the domestic knowledge of skilled, resourceful American women, such as Martha, had begun to become a commodity with a socially determined value.
According to Boydston, female contributions to ‘household economies may well have encouraged in women a sense of competence and, to some degree, social autonomy. The market transition gave new context to women's labor, within which the work gradually assumed new economic meaning and gave rise to new economic relations.’Footnote 11 One economic relation that can be observed in the diary is the delegation – or multitasking – of housework. Ballard describes the gendered division of labour that occurred on the family farm through her accounts of the planting and harvesting of flaxseed. Her husband, Ephraim, would plant the flax, and, along with some of the male neighbours, would ‘turn and break it’. The women of the Ballard household (e.g. Martha and her daughters, Hannah and Dolly) also had their own specific tasks. They weeded and harvested the flax, and, along with other members of their female kinship network, ‘combed, spun, reeled, boiled, spooled, warped, quilled, weaved, bucked, and bleached the ripe plant into finished cloth’.Footnote 12 Moreover, they also engaged in the fibre arts (needlework, quilting, knitting, crocheting, and the fabrication of clothing, usually from the beginning of the production cycle), and used the linen they produced to sew quilts, which were known throughout their small Maine village for their quality and design.Footnote 13 Thus, these women not only used their domestic skills to prepare the flaxseed, but also engaged in the complete life-cycle of the crop, from production to consumption. In the end, this translated into monetary gain and a redefinition of their economic importance.
As Joan Jensen has observed, ‘the ideology of self-sufficiency of New England farms in 1800 was based to a great extent on the ability of women in the household to provide a surplus for the local market’.Footnote 14 This is illustrated through Ballard's participation in the processing of flaxseed, which was part of the complete web of domestic tasks that she performed – all of which provided goods for the local market: she sewed her own linen, grew her own vegetables and herbs (as previously mentioned, she often used the latter to treat illnesses she encountered in her medical practice), slaughtered farm animals, made candles and soap, knitted articles of clothing, and raised enough turkeys to last from August to November. As Ulrich conveys, Ballard's contributions to her domestic economy were augmented by her ability to negotiate and trade the goods she made with (male) neighbours. On 29 July 1786, Ballard wrote: ‘I went [this] afternoon to Mr. Edson's. Carried 32 skeins of Linning warp for her to weave, 11½ skeins of Tow yarn, and 8 of cotton [sic]. The girls went to Mr. Savage's for green peas. I let them have 1 lb. of butter.’Footnote 15 Informal bartering and formal monetary exchanges at the general store were part of women's work in rural New England, and they appear frequently in the Ballard diary. Ballard's resourcefulness and successful networking skills clearly translated into economic savings for her family. Combined with her earnings of six shillings per delivery, ‘which was comparable to what Ephraim could claim for a day spent “writing plans” or appraising an estate’, the Ballards were able to enjoy a relatively stable economic life.Footnote 16
Through their own brand of participation in the economy, early Republican women like Martha Ballard were able to acquire a certain degree of financial independence and social respect, which they used to challenge traditional gender roles such as the ‘masculine’ occupations of commerce, wage-earning, and the support of families.Footnote 17 Because Ballard's status as a local midwife was not overtly challenged by the developing, male-dominated, medical profession, she was able to maintain both her cultural authority and economic autonomy. According to Ulrich,
several doctors, including some from neighboring towns, occasionally attended births in Kennebec, but their work was supplementary to that of midwives. Martha herself attended 60 percent of the births … and she was not the only female practitioner active at the time. Martha and her peers were not only handling most of the deliveries, they were [also] providing much of the medical care as well. In Martha's diary, it is doctors, not midwives, who seem marginal.Footnote 18
As Ulrich maintains, Ballard was often the primary healthcare provider of her local community, and her results were comparable to formally trained doctors. Thus her ‘experience made Martha a formidable competitor for young physicians.’Footnote 19
While it is true that at times Ballard's compensation was significantly less than the fee normally paid to physicians (six shillings versus ten pounds), one must consider the context in which these amounts were given. In rural Maine, a fee of six shillings was a much more substantial amount of money than in urban New York. Moreover, at times, Ballard did receive equal, or close to equal, compensation for her services. In February 1810, she nursed John Davis for approximately seventeen days, and was given ‘$8.50 for her work alone; [that is] she was paid an average of fifty cents a day … contemporary physicians charged from fifty cents to a dollar for each visit, including medicine’.Footnote 20 Although it is difficult to equate the length of a physician's visit with the length of a typical ‘day’ for Ballard, one has to take into consideration travelling expenses, and room and board. Physicians were not readily available in rural Maine, and, as a result, could spend an entire day visiting and treating a patient. Ballard, on the other hand, was a member of the local community and did not incur large travelling expenses. Consequently, her net payment of fifty cents a day, just for her labour (any medicine she might have used was probably extra), can be equated to the gross payment received by physicians (which included medicine and did not take into consideration personal expenses such as staying overnight at a local inn). Ulrich also argues that physicians received more monetary compensation than midwives only because they were more likely to ask for it. Because of their position within the community, midwives were more aware than physicians of the financial situation of their clients. As a result, they were not as likely to demand a specific fee, and tended more often than not to rely on the judgement of their clients.Footnote 21
Even though a few elite women in the Kennebec River Valley began to employ the services of physicians, they did so mostly in cases of difficult deliveries, which had little monetary impact on Ballard's practice. According to Ulrich,
we should not conclude … that [Kennebec's] elite families were abandoning traditional delivery en masse. Whether status is determined by position on the tax list, by education, or by election to public office, Kennebec's elite were as likely as ordinary families to employ Martha Ballard. At the end of the [eighteenth century], she performed two-thirds of the deliveries in the town, whether the babies were the children or grandchildren of public officials and merchants, or of ordinary timbermen and farmers.
Ulrich supports her assertions with statistics:
ten of the twelve wealthiest men on the tax list for 1790 are known to have had children or grandchildren born before 1800. Martha performed deliveries for eight. Of the twenty-five men who held town, country, or state offices between 1785 and 1796, nineteen are known to have had children or grandchildren born before 1800. She performed deliveries for fourteen.Footnote 22
When physicians did appear during one of Ballard's deliveries, the climate of the birthing room was one of co-operation, not antagonism, further illustrating the extent to which midwives were able to negotiate a place for themselves within turn-of-the-nineteenth-century, male-dominated, American society.
As Ulrich's study of the Ballard diary illustrates, early Republican women used their tradition of household labour in the private sphere to carve themselves a place within the public sphere (i.e. the burgeoning capitalist culture of the United States). Turn-of-the-nineteenth-century America was thus not only an era of economic revolution, but also of gender transformation – an era when women's travails in the interstices between the public and private spheres were connected to the survival of the nation. This connection not only increased the social and economic value of women's domestic work, but also assisted midwives, such as Martha Ballard, in maintaining positions of power within their communities and guaranteeing their families economically stable lives. As Ulrich reveals, it is through the analysis of such textured – yet frequently overlooked – primary documents that scholars can begin the process of reconstructing the hidden ways in which the historically voiceless (e.g., women and peoples of colour) helped build the American nation from within the margins.
