Q&A
Jenny M Luke guides us through the role and importance of Black midwives in Southern America during the 1900s
Can you explain the key differences between the history of midwifery in the USA compared to the history of midwifery in the UK?
An essential difference in the history of midwifery in the UK and USA lies in its relationship with the professions of nursing and medicine: it was allied with nursing and not deemed economically threatening by obstetricians in the UK, whereas in the US, midwifery struggled to establish a professional space in which to practice.
The British parliament sanctioned the practice of midwifery in 1902 with the establishment of the Central Midwives Board. This formally regulated training, conducted examinations, and certified successful candidates.
It securely positioned midwifery in a medically supervised model of care and obstetricians felt neither competition nor animosity towards well-trained midwives. As a result, midwifery has maintained its position as a central component of maternity care in the UK.
At the turn of the 20th century in America, the medical establishment claimed that embracing midwifery as a branch of nursing would lessen the prestige of obstetrics as a medical speciality, as well as create economic competition. Nurses were afraid of tainting their reputation by association with midwifery, an occupation that was disparaged by racial and class prejudice; midwives were Black or immigrant. Without a clearly defined role several pathways to midwifery evolved, all governed at state level, all with an uneven distribution across the country. Contentious divisions between the various types of midwives have undermined its growth.
Can you tell us a bit about the roles of Black midwives in America before the 20th century?
Black midwifery traditions came to the US with slavery and crystallised over subsequent generations of segregation. Among enslaved people midwives occupied a position of authority within a culture of health, healing, and wellness grounded in community, spirituality, and relationships. Midwives were older women, usually mothers, who inherited the role of midwife and learned empirically. They were the symbolic mother of each child they delivered, the mother of the community, and the mother of a culture that was preserved and protected through generations of midwives. Childbirth traditions were adjusted by midwives’ occasional observation of physician intervention and skills deemed useful were adopted into practice. The upheaval of the
