Celebrating National Midwifery Week: Honoring the Guardians of Birth
Have you ever thought about how many people you know who have used a midwife? Perhaps you can trace this tradition back to your grandparents or even great-grandparents. Midwifery has been a fundamental part of childbirth for centuries, with a rich history spanning across various cultures and communities.
In the United States, midwifery encompasses several types, each offering unique care:
Traditional/Lay Midwives: Uncertified and unlicensed, they are often self-educated or trained through apprenticeships. Their practice varies significantly by state due to legal restrictions.
Direct Entry Midwives: This group includes Certified Professional Midwives (CPMs), Certified Midwives (CMs), and Certified Nurse-Midwives (CNMs). They often specialize in homebirths and birthing centers.
Certified Professional Midwives (CPMs): Certified by the North American Registry of Midwives (NARM) after extensive training and apprenticeship, though their legality varies by state.
Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs): CNMs are registered nurses with graduate-level midwifery training, while CMs have similar training but are not nurses.
Midwifery care is characterized by:
Monitoring: Physical, psychological, and social well-being of the mother throughout the childbearing cycle.
Education and Counseling: Providing individualized education, counseling, and prenatal care.
Continuous Support: Hands-on assistance during labor, delivery, and postpartum.
Minimizing Interventions: Reducing unnecessary technological interventions.
Referrals: Identifying and referring women who need obstetrical attention.
A Brief History
Midwifery has been around for thousands of years, with women helping other women through pregnancy and childbirth, often passing down knowledge through generations. In many cultures, midwives were the primary birth attendants. Indigenous communities, African, European, and Asian societies all had their own traditions, rooted in spirituality, herbal medicine, and community-based care. However, as modern medicine developed in the 19th and 20th centuries, the field of obstetrics, dominated by men, began pushing midwives out.
The rise of obstetrics wasn’t just about improving care—it was deeply rooted in patriarchal and racist systems that sought control over childbirth. By the early 1900s, male doctors were campaigning hard against midwives, promoting hospital births as more scientific and safe, even though many physicians had little training in childbirth. This shift was especially harmful to Black midwives, often referred to as "granny midwives." These women were the backbone of birth care in many communities, especially in the South, where they attended up to 75% of births, serving both Black and white families. Despite their crucial role, laws, racist policies, and medical campaigns gradually pushed them out of practice, erasing much of their influence.
By the 1980s, only 2% of births in the U.S. were attended by midwives. This decline was the result of decades of systemic efforts to medicalize birth and exclude midwives from the process. But things began to shift again in the 1960s and 70s, with the Women’s Movement sparking a renewed interest in midwifery and natural birth. By 2020, midwives attended almost 12% of births in the U.S., showing a growing recognition of the value midwives bring to the birthing experience.
While the profession has come a long way, we can’t forget the legacy of Black grand midwives and their vital contributions. Their care was holistic, focusing on the physical, emotional, and spiritual well-being of mothers and babies. Sadly, the exclusion of midwives of color has had lasting effects, and today, less than 5% of U.S. midwives are people of color. But as more people recognize the need for inclusive, community-centered care, midwifery is slowly reclaiming its place as a powerful, empowering force in childbirth.
Benefits
Midwifery care offers numerous benefits:
Fewer Interventions: Reduced need for epidurals, spinal analgesia, and instrumental births.
Lower Preterm Birth Risk: A 24% reduction in preterm births.
Increased Spontaneous Vaginal Births: Higher likelihood of natural births.
Reduced Artificial Interventions: Decrease in the use of artificial rupture of membranes and episiotomies.
Successful Outcomes: Lower cesarean rates (17.2%), higher VBAC success rates (78.6%), and higher breastfeeding initiation (92%).
Home Birth Benefits: Lower cesarean rates (5.2%) and high intact perineum rates (49%).
I’m incredibly proud that our city has honored its midwifery heritage with the renaming of streets in McDonough to celebrate Mary Alberta Childs and Hattie Miranda Stewart Barnes. These remarkable midwives delivered nearly 2,000 babies in our community between 1910 and 1960.
Reflecting on my own family history, I’m thrilled to share that my great-grandmother, Helen, delivered 12 babies at home with the assistance of a midwife. This personal connection deepens my appreciation for the midwifery model and encourages me to explore options outside the traditional obstetric care model.
10 of my great grandmother's children, her first she had at 15 years old! She had one stillborn. My grandmother is standing on the far right in the white.
As you think about your own family history and the stories of those who came before us, consider exploring options outside the traditional obstetric model. It might be the right path for you, just as it was for generations of families before us. There’s a rich legacy of midwifery that continues to provide empowering and supportive care—why not explore it for yourself?
