African American Midwifery in the South: Dialogues of Birth, Race, and Memory (review)

In recent years, a plethora of autobiographical accounts, oral histories, and novels have attempted to capture the experiences and “mother wit” of the aging African-American and Chicana midwives of the South and Southwest. Historians have tended to focus more on the struggles to regulate and remove midwives from the birthing chamber, or to recalibrate their successes against the obstetricians who fought to regulate and replace them. Fraser brings together the reflexive voice of a Jamaican-born “outsider,” historical data, a critical understanding of how race plays out in Southern daily life, and carefully crafted fieldwork. The result provides us with more insight into how, as she subtitles her book, “dialogues of birth, race and memory” are created in a Virginia African-American community rather than merely adding another monograph on the twentieth-century midwife struggle to the existing historiography.

Fraser begins by making the midwife experience central to southern black life by focusing on one community. She interviewed those who remembered midwife birthing as well as former midwives. She also uses historical data for a sophisticated re-reading of the state medical journals and the larger context of public health efforts to survey, control, and care for the black community. She places her fieldwork data within a nuanced understanding of how silences are used in African-American communities, while public memories are both constructed, and “stigmatized traditions and experiences” are hidden (7).

Fraser weaves rich methodological discussions about public memory and race relations into her narratives. Her multilayered approach circles the question of midwifery by presenting a history of the early twentieth-century mechanisms for midwife control and an examination of “three prevailing historical narratives: the ‘great’ men, the midwife on the rebound, and the suppressed midwifery narratives of southern midwifery history” (35). Further, she applies the anthropological frames that explore the human body in its physical, cultural, and social contexts, providing superb understandings of the “cosmologies of the body” developed in a black community (218).

Fraser portrays midwives as liminal figures, circulating as links to the surveillance power of state officials and protectors of black community autonomy and secrets. She thoroughly discusses how trained midwives with the new birthing “science” could become the agents that obscured the economic reasons for the high black infant and maternal mortality rates and reinforced records of racial purity demanded by racist state law. But her careful interviewing and analysis demonstrate how communities came to understand and remember this power. Fraser banishes forever the naive view of midwives merely as community heroines, state agents, or dangerous amateurs. Specialists may find familiar some of the reworkings of the midwife control debates. But thoughtful new insights and critiques of the existing historiography are abundant.

This book is an excellent contribution to the growing literature on the inexorable intertwining of race, gender, science, and medicine. It is a terrific example of how reflexive anthropology and historical analysis can be enriched in the hands of a thoughtful and sophisticated scholar.