On Sunday, April 18, Martha Ballard visits May Dawin, who is six months pregnant and worried she might be carrying twins because of her size. Martha examines May carefully, feels only one baby, and explains that May looks so large because she is small and carrying the baby straight out front. Martha also checks May’s discomfort, finds pain in her lower back from the baby’s weight, and reassures May that nothing seems wrong.

After the examination, Martha helps May dress and gives her a syrup of goldenrod and bearberry to reduce the swelling in her ankles. Martha instructs May to take only a teaspoon at bedtime and warns that it will likely send her to the chamber pot during the night. The mild spring air and muddy thaw mark a change in the season as Martha prepares to leave.

Before going home, Martha walks to the barn to speak with Sam Dawin, whom she finds frustrated with a warped ox yoke he left out in the winter weather. Sam offers to pay Martha, but Martha tells him to wait until the baby is born because these visits are included. When Sam anxiously asks after May, Martha reassures him that May is well, confirms that she is carrying only one child, and tells him the baby seems large. Because May’s pain comes from pressure on her lower spine, Martha instructs Sam to give May frequent back rubs and to send for Martha if regular pain begins.

As Martha and Sam say goodbye at the hitching post, the calm domestic scene is abruptly broken when William Pierce rides up in fury and shouts Martha’s name. Martha immediately recognizes his anger and braces herself, while Sam’s protective reaction suggests the tension is obvious. William orders Martha to come with him at once, declaring that Sally is dying and accusing Martha of being to blame.