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  • Heroes of Hell Hole SwampPhotographs of South Carolina Midwives by Hansel Mieth and W. Eugene Smith
  • Dolores Flamiano (bio)

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The notoriously self-critical W. Eugene Smith considered “Nurse Midwife” his most successful essay. He later wrote about Maude Callen (here with a patient, 1951): “Tears cut deeply and hot through me. No story could translate justly the life depth of this wonderful, patient, directional woman who is my subject—and I love her, do love her with a respect I hold for almost no one.” Unless otherwise noted, all photographs copyright 1940, 1951 Life Inc. Reprinted with permission. All rights reserved.

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In 1940, Life photographer Hansel Mieth traveled to Hell Hole Swamp, an impoverished and predominantly African American community in the Lowcountry of South Carolina, where she photographed doctors, nurses, midwives, and patients in a remote rural clinic. The published photo-essay, “Birth Control: South Carolina Uses It for Public Health” (1940), combined two of Mieth’s passions: medical progress and race relations. She had envisioned the story as a profile of Pat Clark, the African American nurse who was her guide and became her friend. But when she saw how the editors selected, laid out, and captioned her photographs, she was appalled: “There was the picture of Pat delivering the baby, but it showed her back and it could have been any nurse. All the pictures with feeling had been carefully culled out and only the ones kept in that showed in statistical order the job the State of South Carolina was doing. How it had found a way to control its runaway Negro population through control of disease.” As a working-class immigrant woman, Mieth often felt like an outsider at Life, but this assignment revealed the depth of her isolation and filled her with anger and guilt: “They are cutting the heart out of everything I do. I am sick of it. I am sick of the whole damned job . . . They can shove their rotten magazine . . . Those people in hell-hole swamp [sic] are real people . . . I had promised that I would stand up for them. And now this. Now I’m nothing but white shit to them.”1

Eleven years later, W. Eugene Smith traveled to the same place on a similar assignment for Life, but his 1951 photo-essay “Nurse Midwife” told a very different story. Most of his photographs feature Maude Callen, an African American Episcopal missionary nurse who ran a clinic in her Pineville, South Carolina, home, where patients sometimes arrived in the middle of the night after traveling by oxcart on unpaved roads. “Nurse Midwife” made Callen famous and generated $27,000 in contributions for the construction of a modern clinic, where she worked until her retirement in 1971. The notoriously self-critical Smith considered it his most successful essay. He later wrote about Callen: “Tears cut deeply and hot through me. No story could translate justly the life depth of this wonderful, patient, directional woman who is my subject—and I love her, do love her with a respect I hold for almost no one. Humble, I am in the presence of this simple, complex, positive greatness; on and on in her self appointed rounds beyond paid-for duty.” Years later, he recalled, “There were three things about the midwife story that were important: its medical significance; the fact that it was a story of a great human being; and third, I was fighting racism without ever making racism the point. I had long crusaded against racism, not by hitting people over the head with a hammer, but by compassionate understanding, presenting something that people could learn from, so they could make up their own minds.”2

Mieth and Smith shared a belief that photography could bring social change. They viewed Pat Clark and Maude Callen as heroic healers whose stories would [End Page 72] inspire racial understanding. Both photographers shot powerful images of the most visceral human experiences: birth, death, sexuality, and disease. But Clark is barely visible in Mieth’s “Birth Control,” while Callen is the star of Smith’s “Nurse Midwife.” Smith’s essay has been celebrated...


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pp. 71-96
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