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Older black woman bent over organizing here equipment
Midwife wrapping her kit to go on a call in Greene County, Georgia, Jack Delano, 1941.

Honoring African American Contributions in Medicine: Midwives

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This guest post was authored by 2020 Junior Fellow Sophia Southard, University of Kansas Graduate, B.A. in History. Sophia is starting the MLIS program at the  University of Pittsburgh Online, Fall 2020. This is the first in a series looking at African Americans in the business and sciences.

Drawing of a rural scene showing a midwife assisting an African American woman in childbirth in front of a log cabin as Union soldiers watch the event.
The U.S. Calvary taking a lesson in surgery – Farmington, Mississippi, April 22, 1862. Adolph Metzner, artist.

The practice of midwifery within the African and African American community has roots dating back to the 17th century, when Europeans brought African slave women skilled in midwifery to the United States. These enslaved women, in turn, passed on their knowledge to others.

Centuries later, during the early to mid-20th century, African American midwives continued practicing midwifery in rural Southern communities, even as hospital doctors and physicians replaced most midwives in Northern communities.

For each delivery they made, African American midwives could receive as little as two to three dollars in payment. At times, they even received payment in the form of livestock, such as a chicken.

Photograph shows African American woman walking on dirt road with her back to the camera holding a bag in her right hand and a cabin off to the right in the distance
Midwife going on a call, carrying her kit, Siloam, Greene County, Ga. (vicinity). . Jack Delano, 1941. Part of the FSA/OWI Collection.

The Beginning of Health Care Reforms

Beginning in the 1910s and 1920s, public health care reformers and physicians pushed for the elimination of midwives. They believed that the infant mortality rate had a direct correlation with “the ‘unsanitary and superstitious’ practices of traditional midwives.” However, in rural Southern communities, this simply wasn’t practical, so reformers urged midwives to apply for permits and to attend classes where they could learn about safe and sanitary practices. In the January 13, 1919, issue of the Richmond Times Dispatch, the reporter stated, “In numerous localities, the negro ‘mammy,’ or the self-taught midwife, still assumes serene and undisputed responsibility for ushering in the new inhabitants of her particular neighborhood.” Two years later, in 1921, Congress passed the 1921 Sheppard–Towner Maternity and Infancy Protection Act, which provided federal aid for programs related to mothers and newborn babies, as well as midwife training programs.

A midwife’s training might have come in the form of watching films, such as “All My Babies.” Filmed in the early 1950s, the training recording followed Mrs. Mary Coley, an African American midwife practicing in Albany, Georgia, as she met with expectant African American mothers and attended classes.

At a class meeting, a doctor said that a baby died of an infected cord. He believed this occurred because of unsanitary conditions. For example, the midwife might not have boiled their scissors for long enough or their dressings weren’t sterile.

Nevertheless, African American midwives continued to play essential roles in rural Southern communities. In the Chronicling America database, several local newspapers in the 1940s had a section on local births and deaths, which included whether an African American midwife attended the birth. In the May 25, 1940 issue of The Henderson Daily Dispatch, the writer reported that out of a total of 62 births, “Midwives attended at 36 of the births and physicians at 26 of the births.” Clearly, midwives remained an essential provider of health care in smaller towns.

The End of African American Midwives?

In a headline titled, “Negro Nurses Wipe Out Midwifery in Memphis Area,” the reporter quoted a worker in the public health nursing services as saying “that the work of Negro nurses in the city and country during the last 40 years has wiped out the midwifery trade among Negroes.” The woman went on to note that “In 1920, there were more than 400 of these midwives; in 1950, only two.” She also explained that the public health nursing services extolled the black nurses who were “participating in the elimination of the ignorant Negro midwife.” Her beliefs echoed health care reformers and physicians from decades earlier, as she cited statistics regarding the significant drop in the African American infant death rate.

Drawing shows plants used by traditional African American midwives with a doctor's bag, medicine bottles, and scissors used by licensed midwives and public health nurses after the state of Georgia began regulating childbirth in 1925.
The Old Law and the New Law, Clare Leighton.

There can be no question that African American midwives in rural Southern towns played an integral part in their communities. To this day, certified professional African American midwives continue to practice midwifery in the United States. To learn more about the historic role African American midwives have played, follow the links below.

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Please note that terminology in historical materials and in Library descriptions does not always match the language preferred by members of the communities depicted, and may include negative stereotypes or words some may consider offensive. The Library presents the historic captions because they can be important for understanding the context in which the images were created.

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