Cultural Motifs Persist

After a general overview of childbirth’s shift to hospital in the early decades of the twentieth century from a national perspective, the chapter narrows its focus to the Jim Crow South. The cultural motifs established during slavery are highlighted as features of African American lay midwifery. A religious calling, an intergenerational female connectedness, and authority to practice were inherent characteristics of the midwife’s role.

Lay Midwives “Retire”

The elimination of midwifery was finally achieved when many states across the South passed legislation prohibiting lay midwifery practice. Chapter 14 uses the personal experience of lay midwives to explore various methods employed by state boards of health to control the activity of midwives and enforce retirement. As the evidence shows, the economic marketplace of childbirth became a factor in some physicians’ interactions with lay midwives; for others commitment and mutual respect rescinded state legislation for a while. For some lay midwives their duty to serve eclipsed any legal restriction.

A World of Confusion and Fog

This chapter explores how, unknown to Lovie, an underground home birth movement has quietly thrived in North Carolina in the several decades since the passage of the 1983 midwifery bill outlawing the practice of lay midwifery. This chapter also chronicles the founding in 1992 of a master’s level midwifery training program at East Carolina University in Greenville, a program that brought certified nurse-midwives (CNMs) into the eastern part of the state to train, teach and work. Two CNMs, Laurie Irwin-Pinkley and Maj-Liz Downey, befriend Lovie and facilitate her connection to the North Carolina chapter of the American College of Nurse-Midwives (ACNM). Lovie is flattered by their recognition of her as a pioneer but befuddled by the changes in her profession that make it difficult for her to identify completely with the younger nurse-midwives. Lovie tries and fails to understand her place in the new midwifery landscape.