In honor of Women's History Month, I'd like to explore a little-discussed but crucial league of black healthcare providers known as "granny midwives."
Up until the mid-20th century, when obstetricians and hospitals became the primary location for delivery, these midwives provided most of the care for poor and rural pregnant women--black and white--throughout the South. Granny midwives were healers trained in their communities, a legacy of slavery but also central to health care during segregation.
One of these healers was an Albany, Ga., woman named Mary Coley. Affectionately known as "Miss Mary," Coley delivered more than 3,000 babies during her 30-year career. In the 1952 documentary "All My Babies: A Midwife's Own Story," we see her providing this essential service to two women at their homes at a time before hospital-based obstetric care became widespread and accessible to low-income and black women.
Coley is the central character and narrator of the documentary produced for the Georgia Department of Health by filmmaker George C. Stoney. "All My Babies," which was used to train midwives in Georgia and other parts of the American South, follows Coley into the homes of two women under her care. One is affluent with two healthy children, electricity and other amenities in her home. The other is clearly much poorer, and she lacks basic necessities such as food and electricity. We also see the actual birth of one of the women in Coley's care--a beautiful and intimate scene.
A main emphasis of the film is cleanliness and hygiene practices for the midwives, including sterilizing cloths, rags and equipment by boiling it on the stove and handwashing.
But this emphasis also foreshadows the eventual decline of the granny midwives and the messaging used to discredit them.
By the 1970s, births in hospitals attended by doctors and nurses (and later, nurse midwives) became the norm and these community midwives were phased out. This was done both by passing new laws and policies regulating the practice of medicine and who could provide services like attending childbirth, and through messaging campaigns that implied midwives were uneducated, dirty or even practicing witchcraft. By 1975, only 0.3 percent of all births were attended by a midwife outside a hospital.
In Alicia Bonaparte's dissertation, "The Persecution and Prosecution of Granny Midwives in South Carolina, 1900-1940" she describes how these campaigns also used sexist and racist undertones to discredit the practicing midwives. "Some physicians even labeled grannies as 'a cross between a superstitious hag and a meddlesome old biddy,'" she writes. "[This] evaluation served as an attack against the very bodies and ages of black women who were well respected in their communities."
"All My Babies" is a respectful approach to Coley's work as a midwife, and she's portrayed as an accomplished woman in her community. But it also reveals her deference to the white doctor and nurse at the county clinic, and it even shows her questioning her own hygiene practices after a lecture by the doctor.
Home-birth midwifery has seen a resurgence in the last few decades, as midwifery community gets organized and finds legal pathways toward practice through policy change. While the rate of out-of-hospital birth has increased significantly in the last 50 years, from 0.3 percent in 1975 to a little less than 2 percent of all births, black women are still primarily delivering in hospitals. Only 0.49 percent of black mothers chose to birth at home between 1990 and 2012. While home birth used to be the only option for low-income women, it's now primarily for those who can afford to pay for the midwife's services out of pocket since many insurance plans don't cover non-nurse midwives or home birth. It's ironic and a bit sad that the tables have turned so dramatically, and a legacy of healers has been restored only to the most affluent, and mostly white community that now seeks it out. There is a growing movement of midwives of color who seek to bring these traditions back to their communities, but growth is limited by these financial challenges.
Although it is often scripted--it was intended to be used as a PSA, after all--"All My Babies" is an important depiction of the black women who brought generations of babies into the world. Their traditions now only live on in the margins. You can watch the full film for free online through Snag Films.