Beyond this strained family situation, the time period is the 18th century. Women vow to obey and serve their husbands. Pregnancy brings the risk of either mother or child dying. Martha lost several children and her mother and sister in childbirth. Regardless, she had eleven children. As Thomas Jefferson appears to have understood, a doctor's treatment ould bring death as well as cure. This describes a life of privilege. The situation for enslaved people is unspeakably worse.
The book with its undertones of emancipation for enslaved people and rights for women often seems quite modern. When faced with a public scandal, Thomas Jefferson realizes that any response would just fan the flames and increases the bad publicity.
Martha would be comfortable in the 21st century. She notices the asymmetry of marriage vows, the many explicit and subtle ways enslaved people are disenfranchised. She is concerned about families being broken up, enslaved women being raped, the arbitrary punishment meted out to satisfy the psychological needs of the white people and independent of any action be the enslaved people.
The author reconciles Martha's "woke" understandings and the historical record by presenting her a powerless, frustrated victim.
In the author's note at the end, she asks,
"Were there happy endings for anyone? You decide."For me, I found the story to be a tragedy, an underserved tragedy without catharsis. The lesson I took away was not to be born in the 18th century.