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Ancestral Roots and the Challenge of the Lay Black Midwife

This post was inspired by The Suga Podcast with Mama Glow Founder, Latham Thomas. Listen to our full conversation below:

Time & Life Pictures Getty Image Grand Midwife Maude Cullen (1898-1990)
Time & Life Pictures Getty Image Grand Midwife Maude Cullen (1898-1990)

Catching and receiving babies was just as much an art as it is a science. Way before government regulations marginalized and shut out the lay midwife in the early 20th century, birth work began way before the Transatlantic seize of Africans to America. 

“Through most of the twentieth century, black lay midwives were the mainstays of reproductive health care in African American communities, especially among the poor. In the rural South in the 1930s, they attended 80 percent of black births and 20 percent of white births. With black physicians few and far between, at least three thousand midwives, most of them black, practiced in Alabama. More than four thousand served in North Carolina. In the Mississippi county where AKA women ran field clinics, two African American physicians practiced among 130 midwives. Even when white doctors were willing to take care of blacks, which most were not, black women usually preferred to be in the hands of midwives.”1

Mississippi midwives; Millie Simpson, Hattie Stone, LouAnna Bell, Rhoda Morris & Maggie Venzant.
Mississippi midwives; Millie Simpson, Hattie Stone, LouAnna Bell, Rhoda Morris & Maggie Venzant.

“Birth workers were revered as spiritual healers, family counselors, lactation consultants, postpartum doulas, nutritionists, vessels of resources, and care.” This rich skillset was passed down and continued through slavery and the African Diaspora 2. 

  • Black Midwifery in the U.S. and the Caribbean have roots that trace back to West Africa
  • Vis-a-vis childbirth, a customary delivery of a woman squatting surrounded by her sisters and family, some who worked as midwives
  • Spiritual overtones of a woman squatting spoke to the  fruitfulness of the earth
  • Burial of the placenta and the umbilical cord was thought to restore fertility and help heal the womb
  • The name given to the newborn in the Yoruba tribe in Nigeria referred to the circumstances of its birth
  • It endured across the Middle Passage this tradition withstood being stolen and forced to a new land. It was passed down to family members and close relatives usually
  • Birth work on plantations required that these wise women attend slave births, slaveowners wives births, mistress births while caring for their own children
  • After Emancipation birth workers beyond the age of reproduction were labeled “Grannies”. This was seen as a term of derision and was replaced in the early 80s with the term “Grand” in Atlanta, GA by a community-based Midwifery and Childbirth Educators collective called Dua Afe,  Whole Woman Inc.  
Photo of Alabama midwife’s hands by Sharon D. Blackmon,  c1981. Courtesy of Sharon D. Blackmon
Photo of Alabama midwife’s hands by Sharon D. Blackmon, c1981. Courtesy of Sharon D. Blackmon
  • Midwifery was a learned skill passed down through observation, apprenticeship to women with little education, little to no access to medical care
  • Half of all births at the beginning of the 20th century were attended by midwives
  • Birth work was a community designation or it was considered a calling. In rural areas often there was only one or two serving an entire community, or towns, serving Blacks and Whites who could not afford, did not have time or the means to access physicians, hospitals or whose trained staff was not interested in traveling to the homes of poor Blacks and Whites
  • Midwives handled births and complications. They were sent for during times of illness and deliveries 


Aunt Dora Green, traditional midwife, Eufaula, Alabama, the late 1930s. WPA Writers’ Project. Courtesy of Alabama Department of Archives and History, Montgomery.
Aunt Dora Green, traditional midwife, Eufaula, Alabama, the late 1930s. WPA Writers’ Project. Courtesy of Alabama Department of Archives and History, Montgomery.
  • The 1920s and 1930s States expanded reproductive healthcare in rural areas which required training in standardized training programs
  • Lay Black midwives were left out of this major effort to standardize reproductive care
  • The 1940s The Tuskegee School of Nurse-Midwifery opened to train professional nurses who would replace midwives
  • Black midwives faced great scrutiny if they continued their traditional practice outside the supervisory board standards of internal examinations, dress, administering of ancestral medications 
  • The cost of delivering a baby for a Black lay midwife would be between $5-$10 or in the form of groceries or household goods
  • Turning these costs over into a system led by White male doctors would prove more profitable for the states to design and control visits, cost of care, and reproductive health in a racist system that would mostly treat Black families with condescension

If you’re intrigued about training to become what Latham Thomas calls a culturally-competent doula, Greek for a helper, or to become an even better Mama (as if that were possible!) visit: https://blackmidwivesalliance.org/webinars| https://mamaglow.com/gatherings/| https://doulatrainingsinternational.com

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