October 16th 2006 - Before There Were Doctors, There Were Midwives
Midwifery was a skill that was brought over from Africa during slavery. It was passed down from one generation to the next. A midwife was noted for her intuition and medicinal knowledge and was often sought after for her experience in herbal remedies and healing. Most people referred to the granny as the Country Doctor, for she was sometimes known to heal the sick, set bones and aid the dying. The midwife was respected in her community, and was held in high regards.
It wasn’t that long ago when fathers traveled by foot or mule seeking the help of the granny midwife, while the mother waited at home, laboring for the birth of her baby. “Ms. Mary, Ms. Mary”, he would yell, as he knocked on the door sometimes during the middle of the night. “The baby is coming, and we needs you now!” Many times the midwives would travel many miles in all types of weather, rushing to help ease the pain of the laboring mother, and prepare to catch the baby. Midwives would leave their home sometimes not to return until days later awaiting the arrival of the newborn. In most cases, the midwife would stay a week or two to help the new mother and her family. Like the Doula (one who mothers the mother) today, she would tend to the siblings, prepare meals, do the laundry and take care of the home. This allowed the mother to get to know her baby and heal faster. This was back in the days when birthing at home was the norm. This was back in the days, when Black women had no choice but to birth at home. However, for many women, birthing at home was a favorable option. Not only did the mothers trust being in the care of the midwife, women had a greater trust in the birthing process and in their body’s ability to birth. Midwifery care is still an option today, although midwifery care in the home is a rarity.
Today, the midwife is still looked upon favorably. She is sought after by women who are looking for a more personal relationship with her. She is reputable for her patience, knowledge in natural pregnancy, birth and well woman gynecological care. In Georgia, there is the CNM (Certified Nurse Midwife) and the DEM (Direct Entry Midwife). CNM’s primarily serve women in the hospitals. Although home birthing is not as popular as it was earlier, there has been a comeback for home births and DEM. Today, women are realizing that the old way is actually better and just as safe as the hospital, provided that she is healthy and has proven herself to be low risk.
Some women state that “back then, we had no choice, now we can have our babies in the hospital.” Even though that may be true, women are recognizing that they have a better chance having a natural birth by staying at home attended by a midwife. Although there are fewer midwives who deliver at home, those who have taken on the “calling” do it because there is a need. Women are asking for her services.
According to the Department of Human Resources, the Medical Association of Georgia passed a resolution requesting the State Board of Health to assume the responsibility of supervising and certifying midwives in 1924. That year, approximately 9,000 midwives were practicing. In 1940, 2,865 were certified, in 1946, 1,787 and the last count was 297 in 1965. By then, a campaign was well on its ways to eliminate the granny midwife from maternity care all together. In 1951, the Nurse Midwife project began. It was the intention of the State to replace the granny midwife with the Nurse Midwife. Only in rural Georgia where there were fewer doctors, were Grannies still in practice. Although it is documented that this movement was to reduce Georgia’s infant mortality rate, it was clearly a means of generating more revenue for hospitals and to increase the income potential of Doctors. For Georgia’s infant mortality rate continued to be high and still is today. Eliminating the Granny Midwife was not viable solution.
The most recent data report (1999), (according to Georgia’s DHR), places Georgia at 13th highest in Infant Mortality among all the states. In fact, Georgia’s infant mortality was/is primarily due to poverty, low birth weight, poor health and nutrition, and inadequate prenatal care, to name a few. Racial disparity obviously has its place in this continued problem. The DEM (like the granny midwife) is a community midwife. She maintains a close relationship with her mothers throughout their pregnancy, provides prenatal and parenting education, promotes breastfeeding and remains a support for the growing family.
Such is the case with Mrs. Arilla Smiley, one of the last living granny midwives in Georgia to retire. Mrs. Smiley was trained by the local Health Department in Brunswick Georgia and apprenticed with her mother in law, Mrs. Beatrice Borders (whom she followed in the footsteps of her mother Mrs. Georgia Willams and her Grandmother Mrs. Katie Jones). She received her license to perform midwifery in 1963 and retired in 1987. During a recent conversation I asked Mrs. Smiley how she got involved in birthing babies. She said, “I was called to be a midwife by God. Ms. Bea just took me along with her. If I got concerned about a birth, I’d go to quiet room and pray. You know, you have to talk to God like he’s your friend, that’s how you pray. I’d tell him, now You the One who called me to serve, I didn’t come asking, so I need your help. And He would make things alright, you’ve got to take God with you.” During her career as a midwife, Ms. Smiley delivered over 1,000 babies in Mitchell County. “Mothers would come to us to deliver their baby’s. They would get their prenatal care from the clinic (which ran once a week). If the mother was healthy enough to have her baby at home, the doctor would give her a green card to give me. I couldn’t deliver a baby without that green card.” explained Mrs. Smiley.
Mrs. Smiley was honored Ocotber 15, 2005 at the International Center for Traditional Childbearing, Fourth Annual Black Midwives and Healers Conference, held in Atlanta GA. She was the recipient of The Lifetime Achievement Award for her career as a midwife.
Arilla, My Friend...Sarahn
Birth in the Tradition/ Mother's Keeper
Atlanta, GA 30349