African‐American Midwifery, a History and a Lament

Abstract

The medicalization of fertility and infertility, pregnancy, abortion, contraception, childbirth, and postpartum care has not always worked in the interests of women. It has had particularly devastating effects on African‐American women. Their fertility has been managed for hundreds of years, first as slaves forced to have children for owners, then as objects to be experimented on without anesthetics, and finally as mothers sterilized without their consent. The relatively high rates of infant and maternal mortality, along with limited access to safe and high‐quality reproductive services, are continuing signs of such devastation. This article discusses the history and consequences of the medicalization of pregnancy, contraception, and abortion in America. Attention is drawn to the ways in which the profession of medicine took control away from midwives, the traditional birth attendants and pregnancy caregivers, and the particular consequences for African‐American women. Ultimately, we posit that greater access to midwifery care could lower infant and maternal mortality rates and improve reproductive services. The reintroduction of spirituality through midwifery would also restore the important role of “wise women” in supporting women, babies, and communities.

Abortion and Black Women's Health Networks in South Carolina, 1940–70

“…This woman, they argue, likely 'had knowledge of how to avoid either pregnancy or childbirth and used it until she could bear children in freedom'. 22 Dorothy Roberts argues that 'the brutal domination of enslaved women's procreation laid the foundation for centuries of reproductive regulation that continues today'. 23 Indeed, Black women interviewed in South Carolina in 2016 made clear links between the past and present, paying tribute to the connections between their own practices and those of their enslaved ancestors.…”

Oral Histories of Nurse‐Midwives in Georgia, 1970‐1989: Blazing Trails, Building Fences, Raising Towers

“…They were often older women with many children of their own, but the term granny fails to portray the wisdom and skill these midwives possessed. The term grand midwives offers a more appropriate nomenclature for these African American midwives who preceded nurse‐midwives in Georgia and is used throughout the study …”

“…Nurses joined physicians in a campaign to eliminate midwifery, which was at that time a source of competition for the developing medical specialty of obstetrics. Medical, nursing, and public health professionals used racial and gender‐biased campaigns to discredit and eliminate the grand midwives . Midwives were not responsible for the disproportionate rates of maternal and infant mortality among African Americas in the South; the rates would likely have been higher without their work.…”

“…The term grand midwives offers a more appropriate nomenclature for these African American midwives who preceded nurse-midwives in Georgia and is used throughout the study. 4 During the late 18th century, physicians began to attend childbirth. A marked increase in puerperal fever and obstetric interventions ensued under the care of physicians.…”

“…Medical, nursing, and public health professionals used racial and gender-biased campaigns to discredit and eliminate the grand midwives. 4,6 Midwives were not responsible for the disproportionate rates of maternal and infant mortality among African Americas in the South; the rates would likely have been higher without their work. However, public health reformers dismantled midwifery in impoverished areas of the South, depriving many women of experienced birth attendants.…”