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Birth Behind the Veil: African American Midwives and Mothers in the Rural South, 1921-1962 by Kelena Reid Maxwell A Dissertation submitted to the Graduate School-New Brunswick Rutgers, The State University of New Jersey in partial fulfillment of the requirements for the degree of Doctor of Philosophy Graduate Program in History written under the direction of Deborah Gray White and approved by ________________________ ________________________ ________________________ ________________________ New Brunswick, New Jersey October, 2009 ABSTRACT OF THE DISSERTATION Birth Behind the Veil: African American Midwives and Mothers in the Rural South, 1921-1962 By Kelena Reid Maxwell Dissertation Director: Deborah Gray White By the early twentieth century, the majority of white women living in the United States were giving birth in hospitals under the care of a physician. In 1921, the majority of women who gave birth under conditions that were indigenous, eclectic, spirit based, and not according to the standards of modern medicine, were the rural black women of the South. African American midwives and women of the South maintained the core qualities of the home birthing traditions, handed down through a matrilineal system of recruitment and training from the period of enslavement throughout the twentieth century. This occurred amidst a major program of midwife training and regulation. Public Health officials of the early twentieth century urged midwife regulation as a temporary measure. Medical professionals considered the lay midwives of the south a necessary evil. They were necessary because the population they served was left out of a medical system that operated according to the practices and laws of racial segregation. They were evil, however, because they were believed to carry disease, to be incapable and inherently responsible for elevated levels of infant and maternal mortality in the ii South. Yet health authorities could think of no better solution then to train and regulate the best of the practicing lay midwives and eliminate those whom they considered unwilling to follow safe practices. Despite the beliefs of the medical community, African American childbearing women of the South relied upon the services of lay midwives. The transition from home to hospital birth was not a smooth transition for rural southern women. There were socio- economic barriers to a hospital birth for many. However, there were also cultural and spiritual reasons for their preferences. They did not appear to associate midwives with unsafe conditions. In fact, the reverse was the case. This study examines the movement from the lay assisted births of the early twentieth century through the medicalized events of the later decades. African American women of the South approached modern medicine in various ways, yet always through the multiple lenses of racial segregation, deep spiritual beliefs surrounding childbirth, and the viewpoints of their ancestors. These factors were more prominent in impacting the birth experience then the views, perceptions, and regulations of the health care professionals who were officially responsible for the birth event. iii Acknowledgement and/or Dedication I would like to acknowledge my academic advisor and chair of my committee Deborah Gray White. Dr. White has read each draft of this dissertation with care and wisdom. Her comments have allowed me to transform this document into a dissertation worthy of the history department of Rutgers University. I would also like to thank the other members of my committee: Phyllis Mack, Keith Wailoo, and Evelyn Brooks Higginbotham for their support and comments. This dissertation is dedicated to my immediate family. My children, Joshua and Skyler, are truly inspirational. They have provided me with more love, laughter, and joy then I could have imagined. My husband Martin is perhaps the only other living adult besides myself, who always knew I would finish. Thank you for your support. All members of my family have been supportive, but my mother Miki deserves a great deal of thanks for the countless hours of babysitting she did in the past year so that I could finish. A special thanks also goes to my brilliant sister Jessie who has always been a source of encouragement, and who provided some very important technical support. iv Table of Contents Abstract ii – iii Introduction 1 - 3 Chapter One: The Veil 4 - 34 Chapter Two: Traditional Practices and the Spirituality of Childbirth 35 - 82 Chapter Three: The Surveillance of Birth 83 - 115 Chapter Four: Tuskegee University and the Efforts to Transform the Pracitces of Alabama’s Traditional Midwives 116 - 153 Chapter Five: Visual and Discursive Portrayals of Midwives 154 - 180 Conclusion: A New Relationship to Modern Medicine 181 - 191 Bibliography 192 - 201 Curriculum Vitae 202 v 1 Introduction There are many untold stories of the black South during racial segregation. Countless moments remain hidden from the analyses of historians and scholars of every field. However, some of the most sacred and protected events of human life are those that can reveal the most about the experiences of African Americans. Childbirth is one of these events. The following chapters are an attempt to unfold the events of the experience of birth among the childbearing women of the black south during the height of racial segregation. My objective is to analyze the complex interaction of race, class, religion, and health. In doing so I hope to demonstrate that even the most personal and passionate aspects of the lives of African American women during the twentieth century were subjected to medical and moral scrutiny. Their reactions to this scrutiny were equally passionate and complex. They reveal something of the inner lives of black women during a time and place when their bodies and souls were being dehumanized by the outside world. The first chapter provides an explanation of my use of the term, “the veil,” as well as a historical overview of the time period covered, a discussion of sources and an acknowledgment of previous publications. The second chapter is an analysis of the traditional practices and rituals of childbirth. It shows how the techniques of childbirth are a union of folk traditions, Christian beliefs, and medical procedures. This chapter demonstrates that spiritual beliefs are at the foundation of the work of midwives. 2 Chapter three discusses the surveillance of birth among African Americans in the South. This chapter includes a discussion of the social and racial anxieties generated by public health officials in the South, and the midwife regulation programs that were influential in transforming the experience of childbirth. The fourth chapter deals with Tuskegee University programs of the 1930’s and 1940’s. Medical officials of Tuskegee were preoccupied with the practices of Alabama’s traditional rural midwives. They focused on gathering information from area midwives, training, and improving the health conditions of the surrounding community. This chapter also includes a series of profiles of lay midwives who were active in Talladega County, Alabama from the 1930’s through the 1950’s. The focus is on the transitional figures of the time period. For the first time there were midwives who were active in the South who had gained the majority of their training from their local health department, instead of from elder midwives. The final chapter of the dissertation is an analysis of the visual and discursive portrayals of midwives commonly found in medical journals in the 1940’s. It discusses the three most common methods of portraying the traditional midwife: derogatory language, photography, and use of dialect. Untrained midwives were often described as ignorant, and dirty. Medical journals of the time period often juxtaposed these images with ones of trained midwives who were often described as neat, orderly, and bearing the physical markers of a medical professional. They were making the point that state regulation had transformed the midwife. Indeed it had. But in ways that were not always publicized in these journals. African American midwives of the South began to take a more active erole in spreading health care information throughout the South. They encouraged the women under their care to be seen by a physician at least once during their pregnancies and helped increase attendance at prenatal and maternal 3 clinics in their communities. There had been many changes along the way from 1921, and yet the spirit of the black midwife remained with childbearing women of the black south through the final transition to the hospital room. 4 Chapter One: The Veil I was plowing in the field, plowing cotton, when a voice within told me he wanted me to be a midwife, to take care of mothers and babies. The Lord showed me just how it was to be done. Testimony of lay midwife – Northern Florida1 The Negro is a sort of seventh son, born with a veil, and gifted with second sight in this American World. W.E.B. DuBois2, Some superstitions which came up provoked argument among the midwives. Somebody said a baby born with a veil could foresee the future and see spirits. She said when little children stop, shiver, and “scrunch up” they are seeing spirits. Marie Campbell3 The craft of midwifery has a long tradition of being associated with the divine. Oral testimonies of female African-American midwives are rich with descriptions of visions and direct communication with God. Testimonies, such as the one noted above, is indicative of the relationship African American lay midwives felt with a divine being. They believed they were called by God to be midwives, and that The Lord guided their work. The notion of “the veil,” which was put forth by W.E.B. DuBois in the early twentieth century is helpful in understanding the role that midwives played in the communities they served. There are multiple meanings of the “veil,” in this study. Midwives commented on the physical veil, or caul, that some infants were born with.

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