African American Midwifery in the South

Starting at the turn of the century, most African American midwives in the South were gradually excluded from reproductive health care. Gertrude Fraser shows how physicians, public health personnel, and state legislators mounted a campaign ostensibly to improve maternal and infant health, especially in rural areas. They brought traditional midwives under the control of a supervisory body, and eventually eliminated them. In the writings and programs produced by these physicians and public health officials, Fraser finds a universe of ideas about race, gender, the relationship of medicine to society, and the status of the South in the national political and social economies.Fraser also studies this experience through dialogues of memory. She interviews members of a rural Virginia African American community that included not just retired midwives and their descendants, but anyone who lived through this transformation in medical care--especially the women who gave birth at home attended by a midwife. She compares these narrations to those in contemporary medical journals and public health materials, discovering contradictions and ambivalence: was the midwife a figure of shame or pride? How did one distance oneself from what was now considered "superstitious" or "backward" and at the same time acknowledge and show pride in the former unquestioned authority of these beliefs and practices?In an important contribution to African American studies and anthropology, African American Midwifery in the South brings new voices to the discourse on the hidden world of midwives and birthing.

This book provides an important contribution to the literature on midwifery and reproductive health care. Fraser deftly weaves ethnography, historical analysis, and findings from many studies of midwifery, pregnancy, and birth experiences to make her arguments. But the appeal of this book goes well beyond its significance for the history, anthropology, and sociology of midwifery. Scholars interested in the complex interrelationships between sexism, racism, health, and health care will also find a wealth of interesting and provocative facts here., Fraser, an anthropologist, documents the sad demise of the African American lay midwife. Using ethnographic and historical research methods, she chronicles the community health role of the southern African American midwife as well as birth norms within the community. She also documents the actions of the white medical, public health, and nursing professions to ‘improve’ birth outcomes; one such action included ridding themselves of the ‘midwife problem.’ Fraser focuses on one rural Virginia county during the first half of the 20th century, but she compares and contrasts her findings to research from other parts of the South, the North, and other places in the world. She reaffirms the well-documented medicalization of birthing in the US, but uniquely adds the exacerbating influence of race. Drawing on medical journal articles of the period, two sections establish the historical and political context and the accepted medical knowledge surrounding birth; a final section relates the recollections of the community itself, the midwives and the women who were cared for. Here the reader will learn much about the realities of qualitative research. Relevant to the obvious anthropological and health care communities, but also to historians and students of women’s and African American studies., This is a powerful, intriguing, and quite original book. It includes important new research, and grapples with some of the issues at the forefront of anthropological theory. It speaks directly to an important and diverse set of audiences: scholars and students of women’s studies, women’s history, women’s health scholarship, African American studies, African American health scholarship, and medical anthropology. It illustrates the complex intersections of gender, race, and class in the study of American society., A fine work. In addition to telling a truly remarkable story, it touches on several areas of theoretical concern, including class, race, and gender; oral history; resistance and accommodation; and pluralistic medical systems.

Gertrude Jacinta Fraser is Associate Professor of Anthropology, University of Virginia.