The terrible predicament the Jeffersons, and other couples, faced—marriage with no birth control—pitted Jefferson's own sexual desires against Martha Jefferson's health, and Martha lost. Jefferson, it must be said, acted in accordance with the mores and expectations of the time. Martha Jefferson probably did as well, for she and Thomas were raised in a society where husbands were expected to have unfettered access to their wives' bodies, and girls were raised to submit. This is not at all to suggest that Martha did not benefit in her sexual life with her husband, that she was not a sexual being herself. The reality was, however, that she and other women had to think about sex in a different way than their husbands. As an elderly man, Jefferson remembered his marriage as "ten years of unchequered happiness." But he had survived his marriage, and we cannot simply assume that Martha Jefferson, who did not survive, felt the same about it—that she was unequivocally happy to have to endure nine months of pregnancy, six times within ten years, and to be brought to death's door nearly every time. For practically her entire marriage she was either pregnant or lactating. Her body was not her own. Women of the eighteenth and nineteenth centuries ... expressed exasperation with constant childbearing. In fact, women have rather dramatically shown the world, and everyone inclined to romanticize perpetual pregnancy, how they really feel about the matter. In every society where they have had the choice, they have dropped the birthrate down to at or below the replacement level. After all her struggles with childbearing, Martha Jefferson died at age thirty-four, when she did not have to. Jefferson understood this, and it fueled his agony.