The ‘Respectable’ Black Midwife vs The Respected Black Midwife

I wanted to highlight something about imagery, history and Black midwives that I think is crucial, since I’ve been seeing more and more people talk about them in places I wouldn’t necessarily expect — which is great! I came across a few items online that honored their legacy. In particular they discussed their significance and praised the images and talked about how they showcased reverence and respect for them. One is the image above, of about 20 Black midwives and a couple of white women that I pulled from a site that discussed Black southern culture and which also was making a special article to highlight how these once-central figures in the community delivered most of the babies and took care of the community across generations, but are not practicing as much as they once were.

Image is of a number of Black midwives in a classroom setting while a while a white woman instructs the group. There are also two other white women in the room, off to the side.


Image of just over 20 midwives and a white woman on the left.

Black midwives were once at the crux of communities. They were central figures who used innate wisdom, spiritual guidance, birthing and care-taking practices that had been preserved and transmitted across generations. Just over a year ago I was at a community event in Jackson, Mississippi that was a gathering to raise awareness on Black midwives in the state — (the Scott Ford Houses), when one of the speakers mentioned that the health and well-being of Black people hinged on the midwife — she tended to us and made sure we were cared for. I love honoring the legacy of Black midwives. But I also find myself bothered by the fact that the deeper issues are not explored and when images like the ones above are discussed the undercurrent of the era is that far from being a moment in history when Black midwives were respected – when in fact these were the moments where Black midwives were the most disrespected and in the throes of being regulated and subsequently dismantled.

Aside from these types of images, in another instance the film All My Babies: A Midwife’s Own Story, has been praised as one that honors the legacy. I recently ran across an article talking about how this film is a representation that respects these women. I’ll admit myself that once upon a time this film used to give me deep and loving sentiments — all day long — until I started learning more about the history of Black midwives. Now, far from filling me with warm sentiments, this film nearly infuriates me. When I taught Medical Anthropology and Global Health (in short, a course that looks at how culture influences healthcare and how we seek that healthcare) one of the subjects I make sure we cover is birth. We examine questions such as ‘Why do we go to the hospital when we’re ready to have a baby?’ We watched this film in class and afterwards, during the discussion I asked students about their thoughts on the film and to talk about what was happening throughout. Understand that my class began with learning about the history of Black women and Black people as medical test subjects and clinical material, as we discuss the rise of the medical establishment, at least in the U.S. They are also required to read African American Midwifery in the South: Dialogues on Birth, Race, and Memory, where author Gertrude Fraser talks about the history of Black midwives and how they became barred from practicing, so they do have some knowledge of this already. We discussed biomedicine and the complications when it came to Black women who were delivering babies. One of the students said ‘this film is actually getting people to practice biomedicine’ — in other words — it is making them move away from traditional ways of healing and instead requiring them to concentrate on what the state deems acceptable. The burgeoning medical establishment deemed Black midwifes inferior. Black midwives were blamed for maternal-infant mortality, and avenues were created that made it extremely difficult to continue in this tradition, if not impossible while others were barred from practicing and some even prosecuted. As such, they needed training, regulation and eventually would be totally dismantled. Here is the synopsis to this film:

This beautiful film is the story of “Miss Mary” Coley, an African-American midwife more than half a century ago in rural Georgia. Conceived as a demonstration film for illiterate “granny” midwives, its production sponsored by the Georgia Department of Public Health, All My Babies quickly transcended its initial purpose. It was used around the world by UNESCO and has become an enduring classic of non-fiction film.

I have held, in my hand, original documents from these moments in history in the early 20th century, when the Black midwife came under scrutiny, and found many examples of this at the beginning of her imminent regulation. One such illustration that really stands out came from the mouth of F. J. Underwood, a medical doctor in the south. In 1925 Underwood gave a speech before the Public Health Section of the Southern Medical Association about ways to ‘improve’ midwifery. Below is a small excerpt from that egregious paper:

What could be a more pitiable picture than that of a prospective mother housed in an unsanitary home and attended during this most critical period by an accoucher filthy and ignorant and not far removed from the jungles of Africa, laden with its atmosphere of wierd (sic) superstition and voodooism…

When it is taken into consideration that at the end of the year four thousand two hundred and nine midwives were actively engaged in the work, that ninety-seven percent were of African descent, all of them untrained, unlettered, and fettered by the grossest superstition, without any idea of what constitutes physical cleanliness, and with a hand-me-down idea of dietetics.

Peculiar economic living conditions, however, make midwifery a necessity. In a state where there is a population of one and three quarters millions of people, fifty percent of whom are colored, with about one thousand physicians, only, practicing obstetrics, it is not possible for the physicians to care for all of the mothers during the prenatal, lying-in and post-natal periods….

There are many other instances. Many midwife advocates, writers, and scholars have notated this disdain from the state towards Black midwives. They made sure they mentioned that the reasons some Black midwives even practiced as long as they did is because to the establishment they were considered a ‘necessary evil’ until more professionals could be properly trained. In this case ‘professionals’ meant white male and white female healthcare practitioners. The Black-white ratio and rural locations in the south meant Black midwives needed to continue to practice — at least until the ‘problem’ was rectified. Therefore the states began implementing policies and procedures for these Black women, which included overseers and newly-implemented medical protocol — i.e. the white woman instructing Black women — her instruction garnered from white men. Images of this timeframe are easy to spot because of the uniformity of midwives they’re usually all dressed alike, in groups and there’s usually a white woman or white women ‘presiding’ over them, often a Public Health nurse ‘teaching’ them proper medical technique: remember, Black midwives had a tradition where knowledge was passed down from generation to generation, and often a new midwife began practicing under an apprenticeship and not in classroom-like settings.

At the end of this speech Underwood mentioned a few suggestions for improving midwifery (in this case in the state of Mississippi):

  1. Get younger women 
  2. Enforce the law
  3. Send educational literature, occasionally (of course this was to midwives who were mostly illiterate)
  4. Elimination of some, and rigid enforcement of regulations by Health Department
  5. Closer supervision and higher standards

I’ve written before about this trajectory, but nowhere in media, I believe, are the culmination of these tactics more evident than in All My Babies, which is below. If you’ve watched it before — watch it again. Then contextualize the writings above with the messages in the film.

I didn’t write this post to discourage folks from celebrating Black midwives regardless of whatever capacity they happen to be in. Far from it, I want you to ensure you celebrate every aspect of these incredibly wonderful figures. But it’s important to know history, and to understand that Black midwives didn’t collectively decide one day to stop a tradition that spanned countless generations and across continents. I think it’s useful and important to know this history and to understand it within context.

My challenge to anyone who comes across this post is to do some digging. In addition to the Black midwives you see in images and films such as these, find Black midwives before they were regulated. Then, get to know them — learn more about their herstory and share that info with anyone you can to ensure you keep their stories alive. This will be another way to truly honor their legacies.

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