The History of Black Midwives
In 18th and 19th century America, most midwives were enslaved Black women who learned midwifery through personal experience and traditional knowledge passed down from generation to generation. These Black women were the ones to ensure safe deliveries for fellow slaves. When slave owners realized the level of expertise the midwives had, they started using them for their own family births. Some enslaved midwives were even paid, as was the case with Kate – a woman enslaved by George Washington in 1794.
After slavery ended, the role of Grand midwives persisted in poor rural communities in the South. Both white and Black families relied on these community-based practitioners for pregnancy, birth, and postpartum care, as they were too far from a hospital and often could not afford to go. The Grand midwives were highly respected and seen as pillars to the communities they served.
The rise of obstetric and gynecological medicine in the 19th and early 20th century, however, brought more men to the practice of delivering babies. Over time, the male-dominated OBGYN medical establishment systematically robbed midwives of their power as community healers by passing laws requiring licensure and painting midwives who practiced without a license as dangerous and uneducated.
In the 20th century, midwifery practitioners sought to overcome the barriers set in place by creating a formal training program for nurse-midwives, enabling the role of a midwife to become recognized in hospital settings. However, the formalized structure of midwifery education, in combination with the decision to allow each state to regulate its own midwifery laws, presented profound barriers for midwives of color during a time when institutionalized racial segregation existed throughout the United States.
Many Black midwives like Mary Francis Hill Coley, a midwife in Albany, Georgia, utilized the tools and training of the mostly white medical establishment to care for her most at-risk patients. In the 1953 documentary, “All My Babies,” Coley demonstrated how a well-trained lay midwife could deliver healthy babies even in the poorest conditions while acting as an intermediary between patients, nurses, physicians, and members of the local community.
Today, midwives continue to go against the grain of the medical industrial complex and promote physiological birth. However, health disparities faced by patients of color, particularly Black women, remain prevalent in the United States. According to 2022 data from the CDC, Black women face a 3 to 1 mortality rate compared to white women, and a 2020 CDC study reported that Black midwives only made up 7% of all certified midwives in the U.S.
