During this time of political and moral crisis we can't forget how legislation has altered the healthcare landscape of America in the past with minimal improvement for which it was intended.
The Sheppard-Towner Act of 1921 -- sometimes called the Maternity Act – was proposed "to reduce maternal and infant mortality." During the time this legislation was introduced, childbirth was the second leading cause of death for women in America. About 20% of children in the United States died in their first year and about 33% in their first five years.
This Act was designed to encourage states to develop programs to serve low income women and with it ushered in federally financed maternal-child healthcare that changed the face of the profession of midwifery. Unwittingly, American women exercised their political freedom and supported the first major legislation to address maternal and infant mortality; which was deemed a woman's issue and subsequently caused many Black midwives to be forced out of their profession. Yet, the health disparity was not resolved with the elimination of Black midwives from our health care system and Black babies are still twice as likely as white infants to be born at low birth weights, be born prematurely and die in the first year of life.
This is important because we have to remember that many healthcare providers did not provide care for us. We were not allowed to birth in most hospitals so we had our babies at home. And if there was a hospital that we could go to it was usually not accessible because of the distance and lack of transportation with the majority of Black Americans living in rural communities in the South until the great 'Migration North'. So, due to this lack of access to medical care Black midwives were the primary health care providers caring for us and with their knowledge of herbs, and naturopathic medicine their skillful hands have saved many lives!
According to chattel records, the first African (Black) Midwives arrived in America in 1619, bringing with them centuries of healing wisdom from diverse African cultures and their rich traditions of pregnancy care for women. Their knowledge allowed them to continue to care for African and white women in this country and extend this care to include the entire family. African (Black) Midwives not only provided prenatal care and "caught" babies, but provided primary care for women, pediatric care for newborn infants and children, and medical care for men when necessary. The 'Black Granny Midwife' is a part of American history that many are unfamiliar with, but is woven into the historical fabric of the medical and midwifery profession in this country. The legacy of their work has gone unnoticed for far too long and this fact becomes even more important as the tradition of midwifery is being re-birthed and our contributions to this field are being left out.
Gratefully, the documentary film, Bringin in Da Spirit by Rhonda L. Haynes documents this historical event explaining how legislative action combined with racist propaganda was used to change an entire health care system and way of life; which contributed to the development of health disparities that continue to exist to this day. It demonstrates how Black midwives were used as scapegoats for the high infant mortality rates in the south (when in fact their outcomes were better than physicians) to eliminate their practice because this legislation provided reimbursement for obstetrical care making Black women attractive to white physicians as a new customer base. Instead of addressing the real issues of poverty e.g. sanitation, inadequate nutrition and overwork; which were contributing factors to infant mortality rates they attacked the Black midwives and their practice as the source. So, in the first half of the 20th Century, American Midwifery did not disappear it was racialized!
If you haven't seen this film it is worth watching and is available through California Newsreel. It is a wonderful film that documents this history as it chronicles the life and accomplishments of Black midwives in this country and explains their work, compassion and dedication to the Black community. As a Black midwife I am honored to be counted amongst these incredible women and to have the opportunity to recognize the important role that Black midwives have and continue to play in impacting positive health outcomes in the Black community.