马皇后尽心抚养和培育，对刘炟的关怀无微不至，虽然她的宫中婢仆成群，她仍然事事亲力亲为，以至于劳累憔悴。她在这个孩子身上所付出的母爱，甚至远远超过宫中其她妃嫔养育亲生孩子的付出。母子关系胜似亲生。

公元75年明帝去世，太子刘炟即位，是为章帝。马皇后被尊为皇太后。刘炟对于自己的养子身分，其实是非常清楚的。但是他更清楚的是马太后对自己多年的养育，他打心里觉得自己的母亲就是马明德。因此，虽然他登基为帝，贾贵人仍然仅仅是以先帝嫔御的普通身分在南宫生活而已，贾氏族人也没有谁享受尊荣富贵。

章帝即位后第二年，天下大旱，一些溜须拍马的大臣趁机上书朝廷，认为天旱的原因是没有封赏外戚，请求皇帝将皇太后的两个弟弟加封侯爵。但是马皇后没有答应，她专门为此发下了一道诏书：“凡言事者皆欲媚朕以要福耳。昔王氏五侯同日俱封，其时黄雾四塞，不闻澍雨之应。又田袜、窦婴，宠贵横恣，倾覆之祸，为世所传。故先帝防慎舅氏，不令在枢机之位。诸子之封，裁令半楚、淮阳诸国，常谓‘我子不当与先帝子等’。今有司柰何欲以马氏比阴氏乎！吾为天下母，而身服大练，食不求甘，左右但著帛布，无香熏之饰者，欲身率下也。以为外亲见之，当伤心自敕，但笑言太后素好俭。前过濯龙门上，见外家问起居者，车如流水，马如游龙，仓头衣绿，领袖正白，顾视御者，不及远矣。故不加谴怒，但绝岁用而已，冀以默愧其心，而犹懈怠，无忧国忘家之虑。知臣莫若君，况亲属乎？吾岂可上负先帝之旨，下亏先人之德，重袭西京败亡之祸哉！”

这道措辞严厉的诏书，再一次拒绝了为马氏家族封侯的可能。却为后世增添了一个新成语：车水马龙。

章帝读了母亲这道诏书，不禁悲叹不已，再次向母亲求情：“汉朝兴盛，舅氏被封侯，就像皇子被封王一样，是应该的。母亲诚存谦虚，难道要让我做不孝顺舅父的皇帝？何况舅舅中，一位年老，两位患病，如未加封之前有个三长两短，我只好抱刻骨之恨了。应该选一吉时加封，不可等待太久。”

马明德答道：“我思虑再三，我并不是想得谦让的好名声而让儿子的名声受损，而是马家无功于国。如今又逢大旱，百姓生活困苦，这时要是封赏外戚，有违我的心意，并不是孝顺我。如果一定要封赏，必须等到阴阳调和，边境清静的时候。”

章帝即位四年后，果然其年旱涝之灾俱无，五谷丰登，边境也平安无事。高兴的章帝立即决定晋封三个舅舅为列侯。

马皇后知道后，认为为人应当知进退，不能有奢念，希望他们能够明白自己的苦心。三兄弟遂只接受了封爵，辞去职位，不再参政议事。

东汉一代，皇帝大都年幼无知，年轻的皇太后往往要依靠外戚来把持朝政，只有马皇后一人，以史为戒，禁止外戚参政。马皇后一生勤俭、朴素、谦逊、知书识礼、明理达义。公元79年马皇后因病去世，谥号“明德”，享年41岁。她的所作所为对明帝、章帝、两朝的政治有着积极的影响，《续烈女传》称赞她“在家则可为众女师范，在国则可为母后表仪。”

Empress Ma devoted herself to caring for Liu Dan. Even though she had a lot of servants in the royal palace, she took care of the baby boy by herself and wore herself out. The amount of care and motherly love that she gave to the boy as he grew up surpassed what other royal concubines gave to their own natural children. Empress Ma and Liu Dan were very close.

In 75 A.D., Emperor Liu Zhuang died. Liu Dan, the crown prince, ascended to the throne. He named Empress Ma the Empress Dowager. He knew that Empress Ma wasn't his birth mother, but he also knew how much love she had given him over the years and treated her as his own mother in his heart. After he became the emperor, he didn't give any special treatment to Madam Jia, his birth mother. Madam Jia lived out the rest of her life in the royal palace as one of the many royal concubines of the previous emperor. Her family also didn't receive any special honor or recognition.

One year after Liu Dan ascended the throne, a major drought broke out. Certain royal officials wanted to flatter Empress Dowager Ma's family using this opportunity. They told the emperor that the drought had taken place because Ma's family hadn't been properly honored, and urged the emperor to bestow the rank of Marquis on the brothers of Empress Dowager Ma. Empress Dowager Ma refused to grant the request. She wrote a harshly worded edict and denied the request. When the emperor read the edict, he was very moved. He told his mother, "The Han Dynasty is very prosperous. To honor my uncles is the same thing as giving my sons the titles of duke. It is supposed to happen. You are so modest. Do you want me to be an emperor who doesn't show the proper filial respect to his uncles? Among my three uncles, one is elderly and two are ill. If something happens to them before I give them the proper titles, I will regret it for the rest of my life. We should find an auspicious time to honor them properly and shouldn't wait too long."

Empress Dowager Ma replied, "I have thought about this issue quite a bit. It is not that I want to have a reputation of modesty to the point where I'd allow my son's reputation to suffer. It is just that the Ma family hasn't made any contribution to the country. Right now there is a major drought and our people are suffering. If we honor my family at such a time, it is against my wishes, and it is not showing filial respect to me. If you must honor them, you should wait until the weather is good and our border is calm."

Four years after Liu Dan ascended the throne, the country enjoyed great weather and an excellent harvest. The border was also calm. The emperor then bestowed his three uncles with the title of Marquis.

After Empress Dowager Ma learned about it, she felt that people shouldn't be greedy, and she didn't want her brothers to exert too much influence at the royal court. She let her wishes be known to her brothers. After they accepted the title of Marquis, they resigned from their official posts and stopped participating in the country's political affairs.

During the Eastern Han Dynasty, many emperors died young, leaving behind young sons to inherit the throne. Most of the young Empress Dowagers relied on their own families to run the country, resulting in many tragedies. Empress Dowager Ma was the only exception. She learned from history and forbade her family from holding too much power. She lived her entire life in a modest, low-key and frugal way. She was a very learned person and possessed a sharp mind. She died in 79 A.D. at the age of 41. She made huge contributions to the rule of her husband and her son. Records of Upright Women Part II has the following praises for her, "As a young girl, before she was married, she was an example to all young girls. As the mother to the country, she was an example to all empresses."