midwife and birthing person
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When Did We Abandon Our Black Midwives?

Angela Johnson | February 7, 2022

When I told my mother that I was pregnant with my now 9-year-old son, her reaction was one that you would expect from any grandmother-to-be. She was excited about the opportunity to share holidays and family traditions with the newest member of the next generation of our family. And she couldn’t wait to put her crafting skills to work on a scrapbook to hold all of his firsts. But when I told her that her grandson would be delivered by a midwife in my Brooklyn apartment, the color left her face, and all of her excitement changed to fear. “You mean there won’t be a doctor?” and “What happens if something goes wrong?” were just a few of the questions she hurled at me to try to convince me to change my mind. And when she realized that she wouldn’t be able to talk us out of our decision, she made it known that she couldn’t be present to witness any of it. 

And she wasn’t alone. Nearly every family member or friend I shared my news with responded by expressing their skepticism, awe, or downright horror. To them, my attempt at curating a cozy birth experience that was completely unlike the cold, painful hospital birth I’d had just two years earlier with my daughter was just another one of my crazy hippie ideas. But the truth is, midwives have been bringing babies into the world since the beginning of time, and Black women have been there from the very beginning. Midwifery is an important part of our collective Black history. And in a time when Black women have a maternal death rate that is 3.5 times greater than white women, we deserve as many options as possible to experience childbirth in a way that feels authentic and safe. So I had to ask, when did we abandon our Black midwives? 

The history of Black “Granny” midwives in the USA, now known as Black Grand Midwives, reaches back to the 1600s when enslaved African women who were experienced midwives ensured the safe delivery of the babies of other enslaved women and their mistresses as well. But by the 1800s, the culture began to shift to embrace childbirth in a hospital setting and eliminate births attended by midwives. During this time, midwives were seen as less competent than white male obstetricians. Midwifery was degraded and viewed as unsanitary, and midwives bore most of the blame for infant deaths. Except for some smaller communities in the segregated rural South where Black women had less access to hospitals, the part of our culture that embraced this sacred spiritual tradition was lost. And states began to criminalize the practice by implementing laws that made lay midwifery practice illegal. Over the years, births outside the hospital continued to decline until they represented less than one percent of all babies delivered in the United States in 2004. 

Recent years have seen a resurgence of interest in midwifery. According to the NIH, births outside the hospital increased 77 percent between 2004 and 2017. Since the beginning of the COVID-19 pandemic, Black women have expressed an increased interest in out-of-hospital birth options, realizing the importance of having someone with shared values, who understands and advocate along side them in support of their individual needs. Research supports the benefits of the presence of a midwife, including a decreased risk of preterm birth, decreased infant mortality, and an increased breastfeeding success. 

But while more women and birthing people are reconnecting with midwifery, there is a severe lack of representation of Black women in the profession. A 2020 demographic report by the American Midwifery Certification Board revealed that of the nearly 13,000 AMCB-certified midwives, less than seven percent identify as Black or African-American. 

Nearly a decade later, I continue to share the story of my joyous midwife-supported home birth with any Black woman who will listen. I want them to know that midwives don’t just deliver babies, and a woman’s relationship with her midwife can last long after her baby is born. They focus on the social, emotional, and physical needs of the mother. They can provide a variety of services, including breastfeeding support, contraceptive counseling, and menopausal management. I hope that my testimony can help inspire other women of color to reconnect with a practice that has always been an integral part of our culture. 

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