By Historian Sarahn Henderson

Birthing babies at home with a Midwife attending is a tradition that dates back to the times from first Indigenous tribes of Georgia to the first slaves to arrive in Georgia in the mid 1700’s. From her native land, the African slave women brought traditional birthing practices, knowledge of herbal lore and natural remedies and the skills of midwifery. Midwifery has a long and ongoing history of challenges. This is a timeline of Georgia’s Midwifery story. While Indigenous People and Europeans make up the cultural tapestry of Georgia, most of what is presented below comes from the African and African American Midwife’s experience.  

Midwifery was a thriving necessity throughout the eighteenth and nineteenth century. The Antebellum Midwife is the first era of Midwifery in the south. She first arrived from South Carolina and eventually came on numerous slave ships during the Trans Atlantic Slave Trade. While enslaved, not only did she deliver babies on the plantation she lived on, she was often hired out to other plantations to deliver. She was trusted by the plantation owner and his wife and it was not uncommon for her to be summoned to deliver her in childbirth. Midwifery was a skill that was passed from one woman to another, generation after generation.

 

Old Sibby, Petersville community, ca. 1934. Old Sibby, one of the last midwives in the area. 

After emancipation, midwives stayed busy as ever while women continued to have babies. Neither black people nor poor white people, could access private or public healthcare, and midwifery remained the tradition for birth.  Especially in rural areas, the midwives would travel many miles in all types of weather, rushing to help to ease the pain of the laboring mother, and prepare to catch the baby. Midwives would leave their home sometimes not returning 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. 

Sadly, still to make ends meet, some midwives even had to take on the additional responsibility of sharecropping. The midwife would hire herself out to both black families and white, and while she was sometimes directly paid for her services, bartering was also a useful and practical method of payment-if she even got paid at all. Sometimes vegetables from the garden, hog meat from the smoke house, a fresh catch of fish or a wild rabbit from a hunt was given to the midwife as her payment. 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 1925. The Midwives were being “supervised” by the up rolling role of the Nurse Midwife, although and ironically the Granny Midwives often said they were the ones who were teaching the Nurse Midwives in home delivery. In 1925, approximately 9,000 midwives were practicing. “It’s just the last twenty years that the Granny-midwives have been on the Board [of Health],” explained Aunt Dilly, a retired midwife(in the book Folks Do Get Born, published in 1940 – Georgia

“Before that time we never had no connection with the board of Health in this state. We never had caps and masks and hospital gowns to wear, nor no nurses training us how to tend on a woman in childbed according to the New Law. I caught babies by the Old Law, and then by the New Law and I can recollect plain when us grannies was first told that according to the New Law, we was forbidden to catch babies without a license blank and was on the board (registered)”. 

This was the beginning of a new era for the African American Midwife, the Granny Midwife era. In 1940, there were 2,865 certified Midwives and new regulations were put into place to control midwifery and its standards of care. Midwives who had been relied on to deliver babies were now required by law to be trained and certified by the health department. After completing her training and passing an exam, one would be certified practice.  

Not all midwives who were passionate about their work were able to take  up this new training Some Midwives were illiterate and not able to read the exam or write preventing them from being able to become certified. The number of midwives dropped *drastically* and steadily declined over the years. This New Law opened the possibility to give birth in the hospitals regardless whether you could pay or not and government aid came into full force. Training of Nurse Midwives was put into place as they were grooming to be the torch bearers less the certified granny midwife. Expecting mothers now had more birthing options if they did not live too far in the rural areas.

In 1941, an African American Midwife named “Ms. Bea” Borders from a rural area in Camilla, Georgia founded Georgia’s first Birthing Shelter. Her husband built what was named the Georgia B. Williams Nursing Home in honor of her mother, who was a midwife, as well as her mother before her. There were times when Ms. Bea would have as many as four mothers in labor concurrently. Records of over 6,000 births took place there before it closed in 1971-the year of her passing.

Just as the Midwife torch was passed down to her as a third generation Midwife, Ms. Bea trained her daughter in-law Mrs. Arilla Smiley as a Midwife. Arilla became certified through Mitchel County’s Health Department and continued to serve the families in Camilla until she retired as Georgia’s last “Certified Grand Midwife” certified through the State of Georgia. 

“Ms. Mary, Ms. Mary”, the father yelled, as he knocked frantically on the door during the middle of one winter night. “The baby is coming, and we need you now!”exclaimed a father in the 1950’s classic teaching documentary “All My Babies”. This documentary was filmed for Georgia’s Health Department to be used as a training tool for Midwives on the importance of cleanliness. Like Ms. Bea and Arilla Smiley, Ms. Mary is a classic example of the midwife who was certified by the health department in the south during the Jim Crow and Segregation era. As the Nurse Midwife began to enter the work force, the numbers of Grand Midwives continually faded. Mothers were being pressured  to deliver in the hospitals through the use of promoting the hospital as “cleaner” and placing the blame of high mortality rates on the Granny Midwives. Pictured below, Mrs. Mary Coley on “All My Babies”

In some parts of Georgia, during the 30’s, 40’s and 50’s delivering your baby in the hospital became an option, many mothers did not trust doctors and preferred staying home to deliver their baby with their Community Midwife. Expecting mothers in rural Georgia went to the clinic on Wednesdays for their prenatal checkup. If they were considered healthy to deliver at home, the doctor would give the mother a green card to present to the midwife. If the mother did not have this card, it was against the law for the midwife to deliver her baby and the mother would deliver in the hospital. 

Grady Hospital (Atlanta, Georgia) did allow African American women to deliver, but only on the segregated C and D wings of the hospital known as “Colored” Grady. Only in rural counties with no hospitals or doctors did the “Certified” Granny Midwife continue to serve. In 1965, the number of midwives serving Georgia’s home birthing population dropped to just 297- a decrease of 2,568 midwives over 25 years.  

In 1983, Midwives, two African American Atlanta-based midwives set out to meet and learn from some of Georgia’s living legends. Ms. Arilla Smiley was the youngest of the bunch. Over the course of thirty years of field research, discovering the true stories of Georgia’s African American Grand Midwife. In 1985, Dua Afe, a fresh generation of uprising African American Indigenous Midwives, hosted the first African American Midwifery conference of its kind in Atlanta, Georgia. It was at this conference that Grand Midwives from Georgia and Alabama were asked to come as guest honorees. It was then decided that the name Grand Midwife would be used in place of Granny Midwife. In 1983, Ms. Arilla Smiley took the Atlanta-based now Grand midwife, along with her to a few births in Camilla, Georgia where she received the torch to continue the legacy of Midwifery and shared it alongside the training of of her student, and now elder midwife based in Atlanta. 

1985, the Georgia Midwifery Association was formed to provide standards and guidelines for Direct Entry Midwives who practiced in out of hospital settings. At the time of formation, all Direct-Entry Midwives were welcome. One of the African American elder midwives was a co-founder, and another temporarily the President.

In 1987 Georgia Midwives applies for licensure and were denied. 

The first African American Midwife to graduates from Georgia’s one and only Nurse Midwifery school (Emory University) in 1992 and begins a hospital and home birth practice. She started her midwifery journey in New York, traveled to The Farm in rural Tennessee to study under Ina May Gaskin, and later went to nursing school working in Grady as a nurse, and rural Georgia helping to deliver babies before going onto become a Nurse Midwife. She later became a Certified Professional Midwife as an expert tester for the NARM exam, and official board member in 1994. She sat on the original board for Midwives Alliance of North American (MANA), and was the first and only African American midwife to ever sit on those boards.

Between 1995-1996 Georgia’s Midwives presents House Bill 635-tabled 

2006 Georgia Midwives presents HR 1431 

Mrs. Smiley was honored October 15, 2005 at the International Center for Traditional Childbearing, Fourth Annual Black Midwives and Healers Conference also held in Atlanta Georgia. She was the recipient of The Lifetime Achievement Award for her career as a midwife. Mrs. Arilla Smiley passed away in 2010 in Camilla, Georgia. Although she is no longer with us, she and the legacy she left behind is a pillar in her community as an African American Midwife, still continues today. 

 Mrs. Arilla Smiley, 2008

In 2015, the Department of Health redefines the word Midwife to mean Nurse Midwife.  https://dph.georgia.gov/sites/dph.georgia.gov/files/1338_001.pdf

In August, 2019, the first Black (Afro-Aboriginal Metis American) Georgia candidate, sat for the NARM exam, earning her Certified Professional Midwife credential. In September, she earned the Midwifery Bridge Certificate meeting the standards of the US-MERA. She currently is the only black primary midwife in Georgia to hold this credential, partnered with a grand-midwife who is a retired Certified Nurse Midwife and CPM.

In 2019 and 2020, The Citizens for Community Midwives Bill is introduced SB 267 and the Georgia Midwifery Association introduces Midwifery Bill’s No. 717 both for the licensure, decriminalization and for the use of the title Midwife. House Bill 717 is exclusively for CPM (Certified Professional Midwife) through the North American Registry of Midwives (NARM), whereas Senate Bill 267 was inclusive of all educational paths to Midwifery. 

In 2020, there are over 50 Midwives serving Georgia’s urban and rural communities seeking licensure. 

In February, 2020 new Senate Bill 334 “The Community Midwife Act” was dropped and legislative efforts continue.

As long as there are babies being born, there will always be Midwives.