Quite a bit of buzz about this one ... had a bit of a wait at my library, and moved it up my list to read when it came in so I could return it and get it back in circulation. Popular book. 

I liked it - not quite a 5* read for me, but it was very good. Historical/realistic ... but also a little mystery and murder (and rape). More sex than I would think ... I'm not sure why I always seem to imagine that things were MORE strict in the days gone by. Here, is sounds like almost everyone is getting it on before marriage. And unfortunately, not always willingly. More than one rape is central here.

Martha Ballard (a true name from history with a written journal ... I'd never heard of her before though) is a midwife and does some doctoring. She's called in when a frozen corpse is discovered, and from there, there is a whole mystery regarding the murder (or was it suicide?) There are many characters and several side-stories going on, as well as "flashbacks" to reveal Martha's history. It presents an interesting view of the time (1789/1780 for the main storyline),  medical/births, the law, the treatment of women (some discussion of Indians and Negros as well).

As for the story itself ... I felt like I totally figured things out WAY before the characters did (it seemed obvious) SPOILER

when Martha visits the new couple, discovers the pregnancy and says to Sam "Do not be overly hard on yourself" and the two give a look Martha cannot decipher ... well duh, Sam was there at the water that night/apparently there is something off with this pregnancy//there probably wasn't only the one rape//May was raped by Joshua Burgess and Sam is the one who killed him ...

It was all interesting and kept me engaged. I got to know and care about the characters. One of the "memories" telling about when the children were younger and diphtheria came was a hard hitter emotionally. 

First person/present tense for the main storyline (most of the book), past tense for the flashbacks and journal entries.  No numerical chapters, Six parts, with several chapters (headers are the location) in each part ... but not having numerical chapters makes it a little harder to locate certain sections or move between formats (from audio to Kindle ... I had both).   There were many "Ballard's Mill" chapters, Oxford/Massachusetts were "past" chapters, a prologue/end in third person/present tense.

In the author's notes, the author clarifies that this is "inspired by real events, as opposed to being based on them" ... great liberties taken with dates and details. The author's notes definitely deserve a read. They were included in the audio (much appreciated). The author's notes are voiced in audio by the author (much appreciated! So much more personal). 

No profanity, but some violence/sex/rape ...

I would give it a thumbs up/recommendation.