by Jenessa Berg
February is Black History Month, and this year we celebrate the theme of Black Health and Wellness. As the Association for the Study of African American Life and History notes, “This theme acknowledges the legacy of not only Black scholars and medical practitioners in Western medicine, but also other ways of knowing (e.g., birthworkers, doulas, midwives, naturopaths, herbalists, etc.) throughout the African Diaspora” (ASALH, 2022). We, the doulas of the Utah Doula Association (the UDA), are indebted to Black Grand midwives for the traditions and ways of knowing they preserved and passed along in the face of great oppression. The work we do today as doulas would not be possible without their work.
Who are these midwives? And what have we learned from them?
Let’s take a journey back in time, and a great big step back from our little piece of the world here in Utah.
Long before there were hospitals and doctors, there were midwives. On every continent, and as far back as we can tell, there has been a tradition of women helping other women give birth. Across time and space upon the earth, this has remained, for the most part, constant.
However, in the last few hundred years, these traditions have not been allowed to continue to evolve in the same way.
They say history is written by the victors. Along with the development of the most prosperous country in the world came the enslavement of the African people. Along with the advent of modern medicine came the criminalization of midwives. The United States of America has a history of both deeply rooted racism and misogyny. Because of the criminalization and defamation of midwives, white women lost the traditional wisdom that had helped their families for thousands of years. And because of slavery, Black women lost much more. “They took our language,” Black midwife Shafia Monroe explains on an Evidence Based Birth podcast, “They took our religion. They took our children. They took everything. Our clothes, our music, they took everything. What they did not take or could not take is how we birthed in an African-centered way, our tradition, because as a rule, when a Black woman on the plantation birthed, there was nobody there because nobody cared.”
By the 1930s, white women were giving birth almost exclusively with physicians in the hospital, but Black women were not afforded such a “luxury”. Midwives, especially Black midwives, were put under immense pressure by campaigns against them, calling them lazy, dirty, and dangerous. Then there was the passing of the Sheppard-Towner Act in 1921, which stated that midwives be regulated and educated by white male obstetricians and white female nurses. As Danielle Thompson explains, “This meant that, in one of the most racially charged eras in American history, the livelihoods of many women of color were placed directly in the hands of White actors already negatively disposed toward them for both social and competitive reasons.”
The Black midwives were typically older women, called “grannies” by the community, and often blamed for the country’s horrible mortality rates. However, government funded research showed that the Black Grand midwives (the preferred term) were actually having better outcomes than the poorly trained physicians. Modern obstetrics has come a long way, and has saved many lives, but we must emphasize that the vilification of midwives was associated with higher mortality rates (and continues to be today!). Midwifery was not allowed to continue to grow alongside obstetrics, but was replaced by obstetrics. It was thanks to the Black Grand midwives, who were heavily persecuted, that any of that traditional wisdom has been preserved. It is thanks to the Black Grand midwives that birthworkers in America today are able to complement modern medicine with ancient wisdom.
Here are some of their stories.
Perhaps the most famous of the Black Grand Midwives is Margaret Charles Smith (1906-2004). She was only about 5 years old the first time she caught a baby, and over the course of her lifetime, she assisted in over 3500 births. She served an underprivileged community in rural Alabama and attended many births that would be considered “high risk” by today’s vernacular, such as twins, breech births, and premature births. One might think that with all those potentially complicated situations and a severe lack of resources that a lot of those mothers and babies died, but that was not the case. Of the women she served, not a single one of them died from childbirth complications and very few babies were lost. In her autobiography, “Listen To Me Good,” she says: “These mothers, they still rather be in the hospital where they can whoop and holler, thinking the doctor is going to give them something to ease them pains, but the doctors won’t be there. The nurse be back there, and they come in there very occasional. You need somebody back there with you. Now a midwife, she’s got to be right there, sitting right aside the bed or sitting over you, holding you, rocking you, rubbing you” (Listen To Me Good, Smith). Today’s doulas are taught those techniques that were handed down, of loving touch and movement, and of a constant, supportive, and compassionate presence. They work both in and out of the hospital to provide that care. An oft-cited book in the doula world is “Ina May’s Guide to Childbirth.” Ina May Gaskin has been a well-known leader in the modern birth world, and she attributes much of her wisdom to listening to women- including Margaret Charles Smith. She says, “Margaret Charles Smith is a national treasure. She can teach us about courage, motherwit, perseverance, our history, and how to face what’s coming – if we listen.”
Onnie Lee Logan (approx. 1910-1995), an Alabama midwife of African and Native American descent, has inspired many by what she calls her “motherwit.” “There was a higher power and God give me wisdom. Motherwit, common sense. Wisdom come from on high. You got it and you cain’t explain how you got it yo’self. It’s motherwit.” (Motherwit, Dutton) As doulas with various belief systems, we might call this intuition, spirituality, following your gut instincts, inspiration, personal revelation, or something else. In Onnie Lee Logan’s 40 year career as a midwife, she had an excellent record and only lost one baby. That did not stop the local government from outlawing midwives without official training and demanding she retire. Her response was thus: “I don’t need a permit to deliver no babies. … I know they cain’t stop a daddy from deliverin his own baby. I wouldn’t be a bit surprised if I was asked to he’p a daddy.” (Motherwit, Dutton)
Another Black Grand midwife we’ve learned from is Mary Hill Francis Coley (1900-1966). Mary Coley caught over 3000 babies in Albany, Georgia. She believed in caring for the families not just during the birth, but also in those tender and raw few days that follow. Her approach to postpartum care involved cleaning, cooking, and caring for the entire family as long as they needed. Her work has inspired today’s postpartum doulas, who go into homes and do whatever they need to do to ensure that the mothers are able to heal and the babies are well cared for. After giving birth, most women don’t see their provider for six weeks and receive very little support. Traditionally, this lack of support was virtually unheard of, and midwives like Mary Coley helped keep this age-old style of postpartum work alive.
For Gladys Nichols Milton (1924-1999), midwifery was a family affair. She was a midwife in Florida from the 1950s until her death. As a child she was markedly curious about “the birds and the bees” and later followed in her aunt’s footsteps and became a midwife. She opened a birth center called The Milton Memorial Birth Center, named in honor of her daughter, Ellen, who died after being hit by a drunk driver. Later, another daughter, Maria, worked at the Milton Memorial Birth Center as a midwife. Maria says of her mother, “What my mother did is say, ‘It’s good that you have all the book stuff, but not everything is in the book … try to have a little common sense. That’s what you need sometimes.’ And also, ‘Don’t call women patients because there is a subliminal message that they are sick, call them your clients, call them your women.’” Gladys Milton’s birth center burned down two different times, and she was unjustly targeted by the Florida Department of Health and Rehabilitative Services, who shut down her birth center and suspended her license. Eventually both those actions were reversed. Still, Milton persevered, led by her belief that she was called by God to be a midwife. “I was born to be one,” she said. “Nothing I tried to do succeeded when I wanted to waver away from midwifery.” Doulas and other birthworkers have followed her example, regularly choosing to call the pregnant people they work with clients rather than patients, and recognizing that being “book-smart” isn’t everything.
The story of Biddy Mason (1818-1891) is one that hits particularly close to home for many of us in the UDA- she was enslaved by Mormon Pioneers. She was enslaved from birth and separated from her own mother. She learned about herbal remedies and the art of midwifery from the older women who raised her. As a young adult she was sent to work for Robert and Rebecca Smith, who had recently joined the Church of Jesus Christ of Latter-Day Saints. They forced her to travel by foot across the plains with them to Utah, and later, to California, where enslavement was illegal. They continued to hold her and her three daughters captive anyway. After about 5 years in California, they wanted to force Biddy and others they had enslaved to come with them to Texas, where enslavement and trafficking were legal. Biddy was frightened that she would be separated from her daughters. Fortunately, when friends of Biddy’s heard this, they called the Sheriff and the Smiths were apprehended. The Smiths claimed that Biddy and her family were coming with them to Texas of their own accord, so it was her word against theirs. It was against the law for a Black person to testify against a white person in court, so her word was not even heard. However, thankfully, the judge still signed Biddy’s petition, and she and her family were officially free. Though she’d been enslaved and denied the opportunity to learn to read or write, she started a business as a midwife/nurse and became very successful. After a few years, she was highly respected and one of LA’s wealthiest women, and used her fame and fortune to bless the lives of others. She organized what is now the oldest African American Church in L.A., The First A. M. E. Church, fed and sheltered the poor, visited prisoners, donated to charities, and helped found a traveler’s aid center and an elementary school/day care for Black children. As a midwife, nurse, and philanthropist, her personal proverb was this: “If you hold your hand closed, nothing good can come in. The open hand is blessed, for it gives in abundance, even as it receives.” Her heroic trailblazing efforts show that each birth is not an isolated event, but that the health of mothers and babies is linked to their surroundings. Her work is fundamental to the work we do as doulas to connect others with resources, to give generously even as we receive, and to care for families outside of the single day of birth.
These midwives, their traditions, and their spirit, have laid the groundwork for birth work as we know it today through the safeguarding of woman-centered care. Whether we have knowingly recognized it or not, we benefit immensely from the work they have done. Black birthworkers today continue to be essential and deserving of our respect and support. Amidst huge racial disparities surrounding both maternal and fetal outcomes, Black birth-givers are deserving of the best possible care. The uncomfortable truth is that systemic racism has caused these disparities. Shafia Monroe explains, “We didn’t cause this problem… We’re victims of it. We’ve done amazing as Black people, to still be strong, resilient, as wonderful as we are. The trauma is so nonstop and so ongoing, so definitely, if you’re a White provider, when you see your Black patient client, please be extra nice to them. Offer them water, just be supportive. If they want to talk to you about something, listen with an open mind. Don’t take defense. Don’t say, ‘Well, I’m not racist. I like everybody. That’s not me.’ It probably is you because you don’t even realize you have implicit bias. Just be humble and you can journal about how you feel later. Just let them talk and listen, and validate. That’s the most important thing. ‘I hear what you’re saying. I’ve heard those things happen before. That must be horrible. Anything I can do to help?’ Or just listen and then go back and try and make some changes.”
Regrettably, the UDA has not historically been an ally to birthworkers of color in our community. We are concerned with our past and current misdoings and are seeking to learn more and do better, to fight against racism individually, collectively, and systemically. We continue to work towards allyship, knowing that we have much to learn and unlearn. As we honor Black History month this year, we celebrate the Black midwives who kept the wisdom and care of midwifery alive, against great persecution. We owe these midwives so much, and we thank all of the birthworkers, past and present, for truly striving to make the world a better place.
“| Midwife Saint: Mary Francis Hill Coley.” Georgia Public Broadcasting, https://www.gpb.org/georgiastories/stories/mary-francis-hill-coley. Accessed 26 Feb. 2022.
Alabama Women’s Hall of Fame – Kathleen Mallory. http://www.awhf.org/mcsmith.html. Accessed 28 Feb. 2022.
“Article Text-5292-1-10-20190803.Pdf.” Google Docs, https://drive.google.com/file/d/1E9Sq0N-SeEi-iab2YQ0c4zVUMrw6daSy/view?usp=embed_facebook. Accessed 26 Feb. 2022.
BLACK HISTORY THEMES – ASALH – The Founders of Black History Month. https://asalh.org/black-history-themes/. Accessed 26 Feb. 2022.
“Black Midwifery’s Complex History.” UVA School of Nursing, https://www.nursing.virginia.edu/news/bhm-black-midwives/. Accessed 26 Feb. 2022.
Bridget “Biddy” Mason (U.S. National Park Service). https://www.nps.gov/people/biddymason.htm. Accessed 28 Feb. 2022.
Dekker, Rebecca. “EBB 152 – Shafia Monroe on Traditional Black Midwifery, Spirituality, and Community Advocacy.” Evidence Based Birth®, 11 Nov. 2020, https://evidencebasedbirth.com/shafia-monroe-on-traditional-black-midwifery-spirituality-and-community-advocacy/.
EDITORS, THE. “The U.S. Needs More Midwives for Better Maternity Care.” Scientific American, https://doi.org/10.1038/scientificamerican0219-6. Accessed 26 Feb. 2022.
Florida’s `Granny Midwife’ Persevered In Face Of Grief, Fires And Bureaucrats | The Seattle Times. https://archive.seattletimes.com/archive/?date=19970105&slug=2517273. Accessed 26 Feb. 2022.
From Enslaved to Entrepreneur: The Biddy Mason Story. www.youtube.com, https://www.youtube.com/watch?v=kmt6hK4Y4sU. Accessed 26 Feb. 2022.
Logan, Onnie Lee, and Katherine Clark. Motherwit: An Alabama Midwife’s Story. Untreed Reads, 1989.
Jr, Robert Mcg Thomas. “Onnie Lee Logan, 85, Midwife Whose ‘Motherwit’ Drew Praise.” The New York Times, 13 July 1995. NYTimes.com, https://www.nytimes.com/1995/07/13/obituaries/onnie-lee-logan-85-midwife-whose-motherwit-drew-praise.html.
Saluja, Bani, and Zenobia Bryant. “How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States.” Journal of Women’s Health, vol. 30, no. 2, Feb. 2021, pp. 270–73. DOI.org (Crossref), https://doi.org/10.1089/jwh.2020.8874.
Smith, Margaret Charles, and Linda Janet Holmes. Listen to Me Good: The Story of an Alabama Midwife. Ohio State University Press, 1996.
“The Milton Women’s Women.” Northwest Florida Daily News, https://www.nwfdailynews.com/story/news/2019/02/17/legacy-of-laurel-hill-midwives-photos/5945141007/. Accessed 26 Feb. 2022.