Inequalities in Modern Midwifery

As a history student with a passion for understanding the relationship between past and present medical and scientific discourse, it is understandable that I would write a thesis about this topic. Further, it seemed an apt opportunity to examine contemporary health inequities by using history as a guide. This approach would nurture both of my academic passions while simultaneously reinforcing the explanatory power of the people and institutions that came before us and whose legacies permeate our day to day. 

One such disparity that I’ve always found off-putting is the discrepancy in maternal health outcomes between black and white mothers. According to the CDC, pregnant black women face a mortality rate three times higher than their white counterparts. Academia, of late, has pondered this puzzle too. Publications from Duke’s own faculty, such as Jennifer Nash’s Birthing Black Mothers, to Deirdre Cooper Owens’ account of the grim genesis of gynecology in Medical Bondage: Race, Gender, and the Origins of American Gynecology, have examined this topic. With a rich foundation of secondary sources to turn to, my goal for this summer has been to identify a primary source base that addresses similar questions from a slightly different angle—whether geographically, thematically, or temporally—or, better yet, which offers a new subset of questions begging reflection. 

Given the proximity of the Duke University Medical Center archives, it made sense to turn here first. The off-campus building that houses old patient records, professor’s letters, and journal articles, amongst other memorabilia, provides a wealth of information—more than could ever be processed in a lifetime. The excitement of immersing myself in these archives led me to center my project around Duke and the Durham area. 

Meanwhile, a video advertisement I stumbled upon helped further center my research question. “All My Babies” is a public health video released by the Georgia Department of Public Health in 1952 in which a white, male doctor informed so-called “granny midwives” as to how they needed to help before, during, and in the wake of childbirth. This left me to wonder first, how someone so far removed from the physical experience of a delivery garnered the authority to instruct others on the ways on which one should be conducted. Second, it made me wonder about the history of black females as midwives. After all, the term “granny midwife” is indicative of a profession with enough of a basis to earn a title in the vernacular but one which connotes condescension. With this, my project has grown to examine occupational power in the context of the hospital: a question which bridges questions of educational pedagogy and patient care, gender and race. 

To this end, the most fruitful archival research thus far has been looking through the Eleanor B. Easley Papers: a collection containing lectures, paperwork, and presentations belonging to Dr. Easley. Not only was she a pioneer at DUMC, particularly the Department of Obstetrics and Gynecology, but she also went on to found the Durham Women’s Clinic. Of note to my project is her work with midwives; she brought Nancy Carreras, Duke’s first midwife, to the university. However, Carreras was notably a white woman of Irish-descent compared to the historically black midwives that Duke and the North Carolina Department of Health spent decades condemning their practice. 

With a Campus Institutional Review Board approval in the works, I hope to have access to contemporary midwives who have worked with the Durham University Medical Center, or at least in the vicinity, who can put a personal spin on the insights I have gleaned from the archives. Perhaps more importantly, I am hopeful that listening to more contemporary experiences can help illuminate the parallels between past and present and the ways in which the former persists in the latter.