They Took the Midwife + the Land at the Same Time

My beloved grandmother Bernice was born in 1926. At home, in eastern North Carolina, in the dead of winter with midwives + her mother’s sisters in the room.

I used to romanticize those details like charming, warm + cozy snippets in my mind, like something from a fairy tale or something that happened long ago in a far away land.

The truth was a far more harsh reality. There wasn’t anything charming about it. In 1926, there really wasn’t an alternative option. What happened, how it happened was the system.

Across the rural South in that time, most Black women gave birth at home with a Black midwife. This wasn’t only because a hospital was unavailable, though one often was. It was because that is how birth worked + how it functioned for several generations. These women were thoughtfully known as granny midwives + they were far from average. They were the original conjure woman. The medicine woman. A healer + root worker. These women were the community’s health infrastructure. They caught the babies, they sat with families in postpartum for weeks, they understood herbs + they knew everybody’s history because guess what? They likely caught that momma too.

When I 1st came into birth work, wide eyed + bushy-tailed, I had SO many questions because there was so much that didn’t make sense. If that was the system, the community taking care of itself, where the hell did it go in the last 100 years?

Where did the granny midwives go?

The simple answer is medicine got better, slightly more accessible + women began choosing hospitals. That is the version the majority of us heard + just accepted.

That is not what happened.

What happened is capitalism + policy.

How policy pushed Black midwives out

In 1921 the federal Sheppard-Towner Act pushed states to build maternal + child health programs. Sounds like a good thing right? Well, in the South, what was built was virtually a permit system. Midwives now had to register with the county. Public health nurses inspected their bags, nails, homes, everything they could get their hands on. There were required trainings, required meetings, some of which were called “midwife clubs”, where women were trained + also watched.

If you read the state health department records from those decades, the language is literally right there in black + white. Granny midwives were labeled as dirty, ignorant + as a necessary evil to be tolerated only until something better arrived. It’s actually written there, that exact way by officials about the women who were successfully delivering the majority of the babies in their counties.

How the laws closed it down

Then, as if by design, as time passed the permits got harder + harder to renew. Eventually some counties stopped issuing them altogether. In the 1960s, Medicaid arrived + by the 70s hospital birth became payable for poor Black families for the first time, + the economic floor that was holding up community midwifery started to fall apart.

Not too long after that, the laws closed it down.

The state of Alabama demonstrates the clearest phase-out of midwifery. In 1976 the legislature passed a law that ended the legal practice of lay midwifery. Within five years time, there were essentially no lay midwives practicing in all of Alabama. It stayed that way for four decades + non-nurse midwives were not legal there again until 2017.

Margaret Charles Smith delivered more than three thousand babies in Greene County, Alabama. She was still actively working in 1976 when the state stopped issuing permits. She didn’t retire, she was forced out. Completely legislated out, without a second thought, of a profession she had practiced her entire life.

In Motherwit, Onnie Lee Logan told her version of this. Gertrude Jacinta Fraser documented the whole machinery of it all in African American Midwifery in the South. This is not hidden history, or some big secret. It is the same story in a different font, it is history that nobody taught us.

They took the land at the same time

Truth Moment? It’s the dates that get me every time.

That same time frame where all of this changed, was doing something much deeper to us.

Black land ownership in this country peaked around 1910, at around sixteen million acres. Between 1910 + 1997, Black families lost about ninety percent of that farmland. The USDA has concluded one of the leading causes of Black involuntary land loss was land being passed down without clear titles. A 2022 study put the present-day value of what was lost at around three hundred twenty-six billion dollars.

I don’t know, guys. Ninety percent, is a lot. In the same century, same region, same families. All affected.

They took the land, they took the midwife + they did it ALL at the same time, using the exact same instruments. Not with conspiracy. With red tape + steps. Permits, courthouse steps, paperwork + men in offices deciding what counted as legitimate.

What we lost when the midwife left

I want to really be precise about what that cost us. This is much bigger than acreage + a job title.

The granny midwife wasn’t just a service provider. She was a pillar in the community + the archive. Everything she knew lived in her hands, her mouth + her heart, because it was never allowed to be in a book. What she knew, what was inside her spirit + inner knowing isn’t something that could be taught from a book. Which plant or herb. How long. When to worry + when to wait. What the women of the house needed, what was required after delivery + who brought what.

When you remove the practitioner, you do not just lose the practice. You erase the record. There isn’t a library to go back to. The knowledge was the woman + the stories she shared in a hushed voice.

I know this personally.

Yes, I know that my grandmother was born at home on a cold December day, but I do not know the name of the midwife that caught my grandmother in 1926. I cannot find this information out either. There isn’t anybody left in my family to ask. That name got said less + less until the very last person who knew it was gone.

Now if we take the time to set this against my own birth story. 2006. I was twenty-two, alone in a hospital. People talked at me instead of to me. When I said something was wrong, I wasn’t believed + ended up in an emergency C-section nobody had prepared me for.

1926: a room full of women who knew + loved her.

2006: a room full of strangers who did not.

Eighty years. One family.

Where we are now

Then look at where we are now. Black women in this country are still about three times more likely to die from pregnancy-related causes than white women. We are still less likely to be believed when we report pain. That number does not float in from nowhere. It is downstream of a century in which the people who knew us were removed from the room + replaced with a system that never knew us at all.

I want to be clear, I am not arguing every woman should give birth at home. Those that want to do that, should take the time to properly research + make the best decision for their family. I am arguing that something functional was dismantled on purpose + we have been told that it fell apart on its own.

The reason that I do this work, the reason there are doulas + the reason I keep saying we need to hold the whole arc instead of one chapter is because somebody has to be the woman in the room who knows you.

That role was never retired. It was taken.

Which means it can be rebuilt.

Questions, answered

Next week I’m diving into the small scale version of how we rebuild. What you can do in your own kitchen, on your patio, or porch, with the people who are still here to ask.

XO

Denawa Deniece