The History & Necessity of Black Birthworkers
Note: *While the terms “women” and “maternal” are used in this piece, this essay refers to people of all genders who can give birth.
Black women are 3-4 times more likely to die during childbirth than people of other races.
How many times have you heard this statistic, or some iteration of it? I’ve heard it dozens of times, and it never ceases to shock me. It’s true – the maternal mortality crisis is a critical issue worldwide, but especially in the United States, and it can all be traced back to the hundreds of years of systemic racism and discrimination Black women have faced in this country. That is why Black birthworkers have historically been and continue to be extremely important in caring for Black birthing people, making direct impactful change in their communities.
A birthworker is someone who provides care to a person before, during, and/or after giving birth. The most common types of birthworkers are doulas – non-medical professionals who provide mental, emotional, physical, and advocacy-related support to birthgivers. On the other hand, midwives are medical professionals who can deliver babies and provide other types of reproductive and gynecological care through a holistic lens. There are a wide range of professionals engaging in maternal health work outside of standard doulas and midwives, from perinatal support specialists to postpartum doulas and lactation consultants.
The history of birthwork traces back to the Transatlantic Slave Trade where knowledge from West African birth traditions survived the Middle Passage and was brought to the United States. These medical practitioners, equipped with indigenous wisdom, took care of enslaved pregnant people, their babies, and even pregnant slaveholders. Post-emancipation, “granny midwives,” as they were called, took care of pregnant people of all races across the country, often being the only care providers especially in rural communities. Granny midwives were extremely revered, maintaining social networks in their communities and providing spiritual and healing insights alongside their birthing and overall health knowledge.
All My Babies: A Midwife’s Own Story is a 1953 film released by the Association of American Medical Colleges to help train OB/GYNs and midwives. It shows a Black midwife, “Miss Mary”, or Mary Francis Hill Coley, who cares for the pregnant people in her community. She is a granny midwife, meaning that she is a trusted birthworker who has been doing this work for years. All My Babies reflects systemic inequities in maternal health care for Black birthgivers that are still present today.
The film focuses on her care of two specific patients, Ida Fleming and Maribel Dudley. Maribel has a husband and two children, and they seem financially stable, living in a house in a middle-class neighborhood. Meanwhile, Ida also has a husband, but she struggles to eat enough nutritious food for herself and her child in the womb. They just moved to the town and live in a rundown shack in a field, not having any neighbors nearby. However, despite the difficulties she faces in providing care to Ida, Miss Mary embodies the praxis of “meeting people where they’re at” and cares for both patients with the same treatment and respect.
Additionally, in the film, Miss Mary and other granny midwives are seen in a classroom being taught by a white male doctor and a white woman public health nurse. The doctor and nurse say that the reason a newborn baby died recently is because they, the midwives, are not sanitizing properly before, during, and after the births. They are seen showing the midwives how to properly sanitize the space and cut umbilical cords. This paints the Black midwives as incompetent and incapable of doing what they have been doing for decades and centuries beforehand. Black women have been successfully and properly delivering children, with Miss Mary in real life delivering over 3,000 babies herself, way before maternal health became co-opted by medical institutions.
All My Babies is emblematic of the importance of as well as the systemic pushout of Black birthworkers. Nevertheless, Black birthworkers are stepping up and taking care of their communities, even in the face of an overmedicalized, capitalist healthcare system taking the lives of Black birthgivers left and right. Birthworkers need and deserve to be fairly compensated for their work – multiple states still do not offer Medicaid reimbursement for doulas, and if it is offered, it’s a very difficult process for doulas to become registered. Grantmakers and policymakers need to create long-term investment in community-based doula services and overall increase reimbursement for doulas so they can sustain themselves, while at the same time not restricting, diluting, or enforcing too much oversight on birthworkers.
Additionally, you can support birthworkers who are on the ground doing this work. There are various mutual aid fundraisers that directly provide financial support to birthworkers. Also, continuing to learn about the Black maternal health crisis, investing in birth centers and the midwifery model of care, and possibly becoming a birthworker if you feel called to do so, will help move this work forward.
Black birth is sacred and powerful. It is all our responsibility to support the birthing people in our lives, ensuring that they and their child(ren) have safe birthing experiences allowing for healthy generations to come.
Nadia L (she/her) is a reproductive justice and health equity advocate born, raised, and currently based in Northern New Jersey. She is a Spring 2024 graduate …
More By This Author
Related Resources
