Carrying Community: The Black Midwife’s Bag in the American South

The classic 1953 documentary film All My Babies features the life and work of Mary Coley, a legendary African-American “granny” midwife.¹ The film follows Coley as she travels around her rural Georgia community carrying her ever-present black satchel. In one memorable scene, the exhausted midwife returns home after a long night of “catching babies.”² As Coley falls into bed, the camera pans to her midwifery bag, which she has hastily discarded on a trunk alongside her coat. Drifting off to sleep, Coley hears a voice in her head: that of the local white doctor, who, in an earlier training session, reminded the lay midwives that infection could result if “something wasn’t clean.” Despite her fatigue, Coley gets up and puts on the kettle. Emptying her midwifery bag of its contents, she boils and scrubs each tool in it. When she finally returns to bed, the sun has come up. Immediately, there is a knock at Coley’s door: another woman has gone into labor. There will be no rest for this baby-catcher on this morning.

The film’s intended message is about hygiene. The Georgia Department of Public Health produced All My Babies to help instruct black “granny” midwives on modern medicalized (read: white and male) birthing practices, particularly sanitation. The film thus was part and parcel of early- to mid-twentieth-century attempts to surveil and regulate lay midwives, most of whom were black, in the American South.³ This project privileged white, male, allopathic medical knowledge over the woman-dominated and community-based health traditions of black communities. Lay midwifery ended completely in most places by the 1960s, when state regulations finally shut black midwives out of business.⁴ Still, up to the 1960s, white hospitals prevented black women in the South from accessing reproductive services in white hospitals. These women continued to receive healthcare from the “grannies” who learned their trade by apprenticeship. Women like Coley, then, worked, and even thrived, in an era of transition.

The policing of midwives’ bags and what was in them was central to the mission that would ultimately destroy black women’s traditional health networks. What midwives carried in their medical satchels, and how they took care of their supplies, featured prominently in reform movements. In 1920s Virginia, for example, regulations stated that “A midwife’s bag was only supposed to contain certain items: soap, clean towels or cloth, a white apron and hat, scissors to cut the umbilical cord, silver nitrate to prevent blindness, and birth certificate forms.” A white Georgia nurse employed to educate black lay midwives in the late 1920s later recalled: “I had classes at least once a month. I taught them how to pack their supplies, wrap them and bake them in the oven at a low temperature.”⁵

Contemporary descriptions of lay midwives underscore the importance of their bags and tools. George Stoney, who directed All My Babies, recalled as a child the ubiquitous “black women” with their “black satchels” in his rural North Carolina town. Over time, midwives kept their satchels but adopted new regulations, careful to manage and sterilize the things in their bags. In her autobiography, Alabama’s Onnie Lee Logan remembered:

[gblockquote]I carry in my bag my scrub brush, my orange stick, a separate brush in a separate bag with my scrub brush in that. I sterile it when I get home and hang it out on the line to dry…I have my sterile cord and silver nitrate and whatever to go in there is all sterile and wrapped from the Bo’ad a Health…One side of my bag is my equipment such as my gown, my scrub brush, my orange stick. On the other side of my bag is all the equipment and stuff that belongs to the baby… With silver nitrate, sterile gauze, Q-Tips and all the things that goes along with my baby when I deliver it.⁶[/gblockquote]

Logan’s memories affirm her commitment to professionalism and hygiene, describing her careful adherence to Board of Health regulations and thus testifying to how black midwives attempted to work within an increasingly hostile medical system.

Like other midwives, Logan also, however, went beyond what was required. According to Logan, “When I went home after delivery I would carry whatever needed back. Food, soap, sheets, clothin that I could make. I would sit down a lot a days and just make not only the lil baby somethin to put on, the other babies too as well somethin to put on.”⁷ Midwife Susie Cook McMahan, who serviced miles of rural, poor land in Western North Carolina for decades, remembered that she often supplied her patients with the things they might need to care for infants. When McMahan encountered one particularly destitute family, she helped as best she could, remembering: “When I got there the baby was born and they didn’t have nothing to put on it. I took the things I had and wrapped it up the best I could.” Later, in a similar instance, McMahan delivered a baby on straw and then swaddled it “in some cloth she had in her midwife’s bag.”⁸ Mary Lucy Miller, a black midwife who worked in rural Virginia until 1963, also kept spirits of turpentine in her bag because “sometimes you come to a place where someone’s had a bee sting.” In her bag were other remedies, disinfectant, and bandages–just in case her patients should need them.

In 1958, Nursing Outlook magazine published “What’s New in the Nursing Bag?,” highlighting what it described as the progress that had been achieved in recent decades. Now, with the advent of plastic, nursing and midwifery tools would be lighter, allegedly easier to clean, and more cost-effective.⁹ Change continued: by the 1960s and 70s, domestic midwifery had given way to hospital-based nursing, making the once-common midwifery satchel a nostalgic thing of the past.

Desegregation of hospitals coincided with decline of the “granny” midwife in the late twentieth century. As a result, black women gained access to reproductive care via hospitals and white doctors. This transformation was traumatic for both midwives and parturient women. It not only ended centuries of healthcare traditions and deprived a generation of women of their livelihood, but it also gave white physicians more control over black women’s bodies. The effects included high maternal mortality rates that continue to this day as well as reproductive coercion such as forced sterilization.

The persistence of black midwifery through the middle of the twentieth century is a remarkable yet still understudied phenomenon, revealing much about women’s health networks in a hostile age. Black lay midwifery provides a window into the persistence of reproductive traditions and the ways that African-American communities supported each other in the Jim Crow South.

A 1993 traveling exhibit focusing on African-American traditions and heritage featured over 200 historical items. The “granny” midwife’s bag was one of them.¹⁰ Some retired midwives kept the things they carried, and the bags they carried them in, for decades. A 1989 Virginia newspaper article, which reflected on the career of Hattie Warren, contained an image featuring “the contents of [Warren’s] black midwife’s bag.”¹¹ Similarly, a 1978 piece on 102-year-old Tennessee baby-catcher Minnie Conley discussed Conley’s work in the context of material culture. The image accompanying the article is one of Conley “in her white gown, cap, and [with her] bag of instruments.”¹²

Midwives such as Mary Coley carried much more in their bags than required medical equipment. More than a mere site of regulation, Coley’s midwifery bag is almost a character in All My Babies. Always by her side and essential to her mission, it represents her work in the community. It signifies not only the tensions and changes brought about by increased regulation, but also the essential role of the African-American “granny” midwife in Southern communities and the significance of the things related to childbirth.

The things that midwives carried in their bags mattered. They carried not only medical supplies and baby clothing, but also the hopes and dreams of struggling communities in the Jim Crow South. Black lay midwives carried traditions and the knowledge of their ancestors. They carried essential medical knowledge that was in danger of being lost. They carried, and preserved, community, and their legacies persist through black women’s health activism today.

Cara Delay

Cara Delay, Associate Professor of History at the College of Charleston, holds degrees from Boston College and Brandeis University. Her research analyzes women, gender, and culture in nineteenth- and twentieth-century Ireland, Britain, and the British Empire, with a particular focus on the history of reproduction, pregnancy, and childbirth. She has published in The Journal of British Studies, Lilith: A Feminist History Journal, Feminist Studies, Études Irlandaises, New Hibernia Review, and Éire-Ireland and written blogs for Nursing Clio and broadsheet.ie. Her co-edited volume Women, Reform, and Resistance in Ireland, 1850-1950, was published with Palgrave Macmillan in 2015, and her monograph on Irish women and the creation of modern Catholicism is forthcoming from Manchester University Press. At the College of Charleston, she teaches courses on women’s history and the history of birth and bodies.

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