“And None of them Left-Handed”: The Midwife from Plains, Georgia

Lillian Carter and Gussie Jackson are the same age, and in the 78 years since they were born, they’ve seen a lot of changes come to southwest Georgia. For much of their adult lives, their houses have stood less than two miles from each other, and in the sparsely populated area around Plains, that makes them nearly neighbors. Both women are grandmothers several times over now, and look after their children’s children with undisguised pleasure. Miss Lillian brought four children into this world, and the recent political success of her oldest boy is clearly a source of great satisfaction to her as matriarch of the Carter dan. She speaks proudly and often of her children and their families. 

Miss Gussie gave birth to ten children, seven of whom survived the hard life of tenant farming in the pre- Depression South. She, too, speaks proudly of her offspring, yet actually numbers her children in the hundreds. For, in addition to her own, Gussie Jackson brought over 600 other babies into this world during her 32 years as a granny midwife in Sumter County. In fact, by the time Miss Lillian made her now celebrated journey to India with the Peace Corps in 1967, Miss Gussie had already spent 25 years working among her own people just down the road. 

 

I was the first midwife in my family. My mother died before I was 14 years old. So there had never been nobody in my family been a midwife before; I was the first. And I loved the job — I don’t care what nobody says, I loved doing it. 

I just always wanted to do something. I used to say I wanted to be a schoolteacher. Couldn’t make that. But I got this, and I did it for 32 years. Over 600 children, and I didn’t lose a mother in 32 years, though I did carry one or two to the hospital. 

I began when we were living on a place owned by one of the doctors in town. And living there, I always went with him to assist when the babies would come, and so I learned a lot. There was a bunch of us living there, and they would need to get somebody — you know, you always need to get somebody to help you when a person is having a baby. Well, I was always the woman they could get — I could stand it. Really, I had a better nerve. You know you can’t deliver a baby if you ain’t got no nerve. So that has a lot to do with it. 

I was just helping out then. I wasn’t getting no pay or nothing. You know, it looked like a lady be having a baby with nobody to go over there and help, and I would just help out. And right from the first time I always wanted to do it — seems like it was just in me. Once I had been with one old midwife there waiting on a baby. The old lady was there but she didn’t have on her glasses and her eyes were bad and she couldn’t see. And if she cut the cord she might have cut it too short. And then if she’d a tied it, she might of not tied it tight enough and the baby be liable to bleed to death. 

So the child’s aunt said, “Miss Liza can’t tie the cord, she can’t hardly see how to cut it. It’s too bad they have to get the doctor from Plains to come down here to tie that cord.’’ You know they weren’t strict then, but afterwards they got strict about who tied it. 

So she said, “Why you all want to get him up here? Gussie can tie it.’’ 

I said, “Can’t do that.” 

“When you tie it. . she said. I said, “I wouldn’t tie it for nothing unless the granny said tie it, and I wouldn’t cut it unless the granny said cut it.” 

She said, “Well, it’s just too bad to have to get the doctor from Plains down here just to tie and cut the cord.” So they agreed. See — I know it wasn’t violating because there wasn’t no law to it; they didn’t care who did it at that time, anybody could tie the cord. So — I tied the cord, and he’s a grown man and have children now. That was my first cord that I tied — Oscar Lassiter. But I wasn’t a certified midwife then. 

Prior to 1925, an estimated 9,000 granny midwives practiced in Georgia entirely outside the regulation of the state. Midwives often exchanged their labor on a “one neighbor does for another” basis; and because of the high cost of doctors and their scarcity in rural areas, every woman was a potential midwife. Before the state assumed responsibility for supervising and licensing midwives, training was acquired through an informal apprenticeship, and skills and knowledge were handed down from one midwife to another. 

In 1925, at the urging of the Medical Association of Georgia, the State Board of Health took the first steps toward certification and regulation of midwives. The new law substituted format instruction by the state for shared experience among the midwives, and required all candidates to attend twelve monthly classes taught by the public health nurse. By 1940, done with having children of her own, and fresh out of child-bearing neighbors, Miss Gussie wanted to ‘‘stay with it, ” and keep practicing as a midwife. But the regulations were in full force by now, and the state ‘‘had gotten strict about who tied the cord and things such as that. ” If she was going to continue to respond to the needs of her people, Miss Gussie would have to go through format training. The apprenticeship which she had served with the other midwives had established her ‘‘vocation” both in her own mind, and in the minds of her people. Though the granny midwives themselves could no longer select and train the new midwives, they continued to watch for women with the knack, and encouraged the younger women to formally take up the profession for some time after the new law had been passed; several generations of midwives were so selected before the old ways were weakened, and the decision to become a midwife was individualized. Miss Gussie was nearly 42 years old when she completed the classes and received her state certification as a midwife. But she had also received the more traditional and decidedly less format instruction given by the black community’s own practicing midwives all during the time she grew up. 

About the time I was through having children of my own, and could tend to other folks still having theirs, some older ladies down the road from where I was living were talking about the midwives, about retiring the older midwives and getting younger women. Most of them working were grandmothers or older — just old, though they was still being used. I felt like I had as good nerve as any. Bless God, bless the dead, I told one old midwife, and she say, “Put on in for it then. If firstyou don’t know, well I know and I’ll help you.” When you first started to studying for to be a midwife, your peoples would encourage you, say you had the knack and could do it. Me and her had been friends before I started, so she asked them to put me in for the classes. She knew me and how I do. 

Now the way I was taught was different than that which the midwives who came before us and were working during the time I was having children used. We had better equipment to work with than they did when I was using midwives. We had better everything by the time I got to be a midwife. You know times is changing. It used to be tougher, it really did. 

When we were first learning we met once a month with the Health Department nurses. Sometimes the nurse would meet at our homes — she’d meet at mine this time, she’d meet at the other woman’s the next. We’d all do like that and she’d get around. Wasn’t so strict for those before me. They only met every now and then for those meetings. But we had to go every month. 

And we had a lot of tests. They even taught us how to wash our hands. We had a mask, we had a cap, we had a gown, and then you had a work apron. We had to keep these clean scrubbed and sterile. If I wasn’t too tired when I got home, I’d just wash and boil them. If I was, I’d just put them in to soak. But I had two sets; that way I could always have my bag ready. And the state furnished you with caul dressing, the state furnished you with eye-drops, the state furnished you with birth certificates. And after washing the clothes, we had to iron them so we looked clean and fresh. Every midwife had the same thing. You had your gown, you had your towels, you had your orangewood stick to keep your nails clean. We had to have a physical every year, and x-rays and blood tests and skin tests. The Health Department paid for it. 

The state could train and certify, but ultimately, it was up to the women in the community, the prospective patients, to determine a midwife’s fitness, to pass judgment on her skills and "the way she do." State law required only that all women intending to use a midwife be seen regularly by the Public Health nurse beginning no later than the fifth month. These examinations permitted the doctors to screen out high risk patients. A fter the seventh month of pregnancy, those women whose physical examinations suggested the probability of a normal childbirth received a certificate from the physician which declared them safe for midwife delivery. Possession of that certificate or “pink card” was required of all women who engaged the services of a midwife. Regulations of the Department of Health made it illegal for any midwife to undertake a case not previously certified by a doctor. 

After you were certified, how it was starting out depended on how many people liking you. Some of them like you and some of them naturally didn’t, and those who did would soon come for you. Now at the first you might miss a couple, if you was out working or gone to town or something. You know, you couldn’t afford to just sit home and wait for them, so you was bound to miss a few. 

Peoples made up their minds about who to call just by however they see about a person. You know if one uses you and is satisfied, she gonna tell someone else how it was, and the next thing you gonna hear from her. And there it goes from person to person. And when you started, it would get around, and sooner or later they’d just come for you and you’d go and that’d be it. It was hard for most to start, but I had it good; people knew me, and I didn’t have it bad a bit. 

So, I got my share. I think I delivered four or five now on the basketball team at Plains High, and Lord, I just love to go up there and watch them play. They see me sometimes and you can hear them — “Hey, Miss Gussie’s here watching!” “Yeah, I’m sitting here, Here I sit.” I say, “What you all talking about me for?” I enjoy it. And when they start back playing, I’ll be there. I get there early, but I don’t never clap till the Varsity boys come out. Lord, they can play ball! 

I kept up with my babies after they were born. I got a book which has their names and the dates of their birth, and I keep it near and look over it from time to time. 

We had to fill in the birth certificates, put the name in and the date, the mother and the father, their names, and get that or mail it one to the Health Department. And I had to sign it. Most of the time the people had a name already, cause we couldn’t turn in the birth certificate without it. But I tell you the truth, some of them babies I couldn’t get the names while I was out there, so I’d name the babies good enough on the certificates, and the people would say okay later when I told them. 

It was interesting business to me. There’s just so many things to know, so many things you want to know about. They told us all the danger signs you know, and I never had any trouble, cause if a woman wasn’t right, they wouldn’t give her that card. I had several ladies in my time who didn’t have the card, and most I just carried on to the hospital. I couldn’t work with them myself, cause you see I wanted to keep my job, and they take away your license for that. 

Though called out in the middle of the night to “see about a woman” in labor, a midwife could not legally attend that delivery if the woman did not have her card. In such cases, the midwife was required to send for a physician, or if possible, arrange for the woman to be taken to the nearest hospital. Transportation was not always available, however, and there was seldom time for the long journey in any case. Despite the regulations, white doctors were often reluctant to travel out to the country on such short notice, especially when a midwife was already present at the bedside. As a consequence, most doctors were more than willing to delegate their authority in extraordinary circumstances, provided that the midwife notified them as soon as possible and brought both mother and baby to the hospital for a follow-up examination. 

A girl, she came here and she didn’t have no card for her and wanted me to see to her, so she came here and lay down. I said, “You gonna have to go somewhere else if you ain’t got no card for yourself, nothing to say you got a blood test.” So she kept talking about how she was feeling and finally asked me, “What you gonna do?” I said “We gonna have to take you to the hospital; you ain’t got no card and I can’t do it.” So we started on to the hospital and the baby come fore we got there. We just take it on to the hospital, they dressed it and fixed it up. Our Public Health supervisor, Mrs. Flahive, always told us, “There be sometimes you get in a terrible fix. Sometimes you go there, and the baby ain’t there yet. But before you can look around you, when that baby is ready to come, it come and can’t help. It’s always best to save a life then to let it die. There’s always a way out of it if you do right. So if a child is ready to be born when you get there, see about it, and then call the Health Department.” So that would relieve me, knowing that you could go on ahead if there was no other way. 

We were directly responsible to the Public Health nurses, but I’ve called doctors about a baby a time or two when I had to. Dr. Logan in Plains was always so nice. I’d call him in the case of a woman without no card and he’d say, “You go ahead, and report to me when you’re finished. I’ll stand between you and the law.” But not all of them was like that. Every now and then I had to call this other doctor in town, and he made me kind of mad cause you’d call needing help and he didn’t want to give no help. He’d say “Well, I’ll do it this time, but I ain’t gonna do it no more.” Real nasty like. 

But I had good support from the nurses right up until I stopped. And I tell you one thing that made me love our nurses so good. If I did wrong and she said something to me, no one else heard what she said. And if someone else did wrong and she say something to them, I didn’t hear what she said. She didn’t drag it out in front of the group and make you feel bad. All our Public Health nurses were white, but even back then we didn’t have no problems with them. They was all real nice. 

Although state law required that all women planning to use a midwife notify both the midwife and the Public Health clinic no later than the seventh month of pregnancy, in reality a midwife had to be ready to go on a case on a moment’s notice. Even planned deliveries could not be scheduled with more than rough guess accuracy, and unexpected cases often came with no warning at all. Small wonder then that Health Department regulations also required that all midwives "keep their bag packed, supplied, and ready for use.” 

Plenty of times they’d come for me without any notice. And though I might be in the middle of something, well I’d have to drop it right there and go on. But that’s what I promised and so that’s what I did. And, when I was working, if they called me, I went. Somebody’d come pick me up at work. Every job I was working on, if they came after me, I’d go with them. Cause the people I be working for, they’d know I was gone to deliver a baby. Folks knew I was a midwife when they hired me, and knew I was bound to go when I was called. I wanted to do it, and that’s what I had to do to keep up. You accept that when you start in. Whenever they need you, you got to be ready to go. Else there ain’t no sense in doing it at all if you can’t go when the people need you. 

And boy, I had the worst time with my husband when I first started out. Oh boy! Back when I was taking the lessons and studying about it, he didn’t want me to do it. Started talking about how I had to cook for him. 

“You’ll be gone a lot,” he said. 

I said, “Ahh, won’t everybody be having a baby every day.” 

“But I’m gonna need somebody to cook.” 

I said, “I ain’t gonna cook all day everyday. Just get up and fix you something yourself. If I get on sick, you going to get up and fix it and if I die you gonna fix it or get somebody else, one. You oughta be ashamed of yourself. You oughta be glad I can get it.” 

“Ain’t gonna do me no good.” 

I said, “It’s gonna do you a heap of good.” “Well, the money you make is gonna be your own.” I said, “Sure. You go with me one time when I go to see about someone, I give you a part of it.” But he never came—and I didn’t want him following me. He couldn’t take it. Well, after he see that I was going to do it, he got over it. And those times when they come for me, if they didn’t have a way to fetch me with them, well — he would take me. One time, when we was staying out back where Loudrell and Mamie Pope used to stay, one night a man come at me on a bicycle. 

He said, “I’m on a bicycle, I’ll pull you.” I said, “You won’t pull me.” Yeah, I told him, I said, “Uh huh,” I said, “Roy, get up and take me down the road.” He laughed about that man coming to get me on a bicycle. But my husband Roy took me to deliver that baby. And lots of others. 

Most of the places where I stayed at, they always fixed me something to eat and treated me nice. “Lay down Miss Gussie, don’t you set up and lose your strength till the time comes.” Usually there’d be two or three women setting around, but I didn’t have no help till the baby comes. The husbands, they stayed away from there. The women say that they didn’t want them around, and I didn’t either. I didn’t need them, so the women just say, “Ahh, just let them go on then.” 

One time I did have a case where a man wanted to sit up in there. He was just a friend of the woman, not her husband, who was out in the other room. He was just sitting there looking until I said, “You know, you can’t stay in here, you gonna have to get out a here.” 

“Sam said I could come in here.” 

“If it’s your wife you can stay in here,” I said, “but if it ain’t your wife YOU can’t stay in here. I got to catch the child and you ain’t gonna be in my way.” 

“Well, Sam said so.” 

I say, “SAM - COME IN AND GET THIS FOOL OUTTA HERE!! He ain’t gonna stay here. I ain’t gonna be worried with him.” 

Sam come in and say, “You come out of there. You know you ain’t got no business setting up with Miss Gussie and the others in there working.” I said, “This is my job and I’m gonna work with it, and 1 ain’t gonna fool with you.” And so he went on. But most of the men people, they don’t want to be there. My husband didn’t; he didn’t want no part of it. 

I just always wanted to be there from the start. And I must have been pretty good to deliver thirteen for one woman alone. And I delivered four white babies in my time. But white people didn’t use us midwives as a rule — they could pay the doctor and go on to the hospital. Had six sets of twins too, but none more than twins. And with the twins I never knew about them till I got there and they got there. And I never lost a mother, and none of my children are left handed as far as I know of. All that work, but I enjoyed it you know; it was so good. I always wanted to do something for someone. 

Given the history of midwifery, and its honored place in almost every culture, the exalted status currently enjoyed by doctors in the developed countries of the West is a comparatively recent and unusual development. Even in the western world, evidence of the professional standing previously enjoyed by midwives is found in records. For example, in London three hundred years ago, one William Silk, an English surgeon, married a midwife. She paid the equivalent of $3 for her license to practice; her husband, the surgeon, $2. Nurses and technicians were created because doctors needed them. But since you must get born before you can get sick, the midwife has always preceded the doctor. Midwifery is not a product of manmade science and technology, but a creation of human nature, the result of the instinctive knowledge shared by all human beings, that a woman in labor needs the help and support which she can only get from another woman. 

To be sure, the granny midwives who delivered nearly 70% of all black babies in the South during the ’30s and early ’40s did provide several generations of women with services which doctors were either unwilling or unable to provide at equivalent fees. Compared to the wages earned by nurses, midwifery paid very little, and some of the time paid nothing at all. 

When we started out, I delivered one $10 baby, then it went up to $15, then eventually it got up to $35. All the midwives used that. We had to agree; I couldn’t charge no more than someone else, and she couldn’t charge no more than me. You couldn’t charge nobody more than that; if you did, they would take your license. I didn’t always get paid. Some people, they mean to pay you; then some people don’t mean to pay you. If a fellow mean to pay you, he’ll look after that. And a lot of them, they didn’t pay me, but the white man they working for did. He sure did, yeah. He used to see me out there after the babies come and he’d ask me, “Gussie, did you get your money?”

 I said, “Yes sir, I got my money.” 

“Well,” he said, “I tell everybody down there you got to get your money. They pay the doctor so they got to pay you too, just the same.” So I most always got my money. I understood how it was with them, and they could see how it was with me. We all got along good. 

The advantages of a midwife-assisted delivery were more than financial, however. One other consequence of midwifery was of even greater importance than the low costs. Every state which used certified midwives in a well-regulated system under the supervision of the Public Health Department found that the quality of care provided by midwives soon equalled that provided by physicians. Furthermore, according to a report issued by the White House Council on Child Health and Protection in 1932, three Southern states — Alabama, Maryland, and Virginia — showed considerably fewer deaths by childbirth among black women attended by midwives than among those attended by physicians. 

Doctors trained to cure diseases tend to view birth as an illness which requires their assistance and, more often than not, their active intervention. Midwives, on the other hand, were rigorously taught to view birth as a natural process. They were carefully schooled in the ways in which they might assist that process, from antepartal to postpartal care for mother and newborn, yet throughout their brief training they were reminded that their role was primarily a passive one. State Law (Georgia Rules and Regulations for Midwifery Chapter 270-5-7) prohibited midwives from engaging in the practice of medicine, and warned that “a midwife shall not intervene with the natural course of labor. ” All of the training manuals carried this emphasis and the specific procedures learned by the midwives presupposed the organic naturalness of normal childbirth, and protected it from unwarranted interference. Granny midwives were forbidden by state law to do much more than watch and wait with the mother until the baby had actually been born. Midwives were trained in patience and schooled to wait by the bedside until nature took its course. 

You know I’ve had babies to come, their heads supposed to come first, well I’ve had them their feet come first and then I’ve had them breach — their butts come first. And all you can do is just wait on time. It’ll move itself. And it always did. Once in a while the cord would drop down first for some, though it never happened that way with me. But if it did drop down far enough you tied it next to the baby then you tie it up above and then you cut it. But I ain’t never had none of that. All this business, they just teach you all these things at the clinic, and if you can pay attention when they tell you these things you’ll be ready. But if you don’t pay attention, well something will come up you don’t know about when you’re working. 

With babies which come earlier than they’s supposed to, you either took them with the mother to the hospital, or called for someone to come get them if you had no way to get them there. If you was able to get a way, you just wrapped that baby up and take him to the hospital. They see about them. If the mother start to hemorraging, you could take her stomach, you know, like this and massage it until you could feel it look like it form up. But I ain’t never had none of that. 

If the woman started to tear and she needing stitches, all we could do was take her to the hospital and let them see about her. But most of them didn’t need such. When they get tired of it all they bear down, and the baby be born without the tearing. Yes sir, I seen a heap of babies born. And it’s not hard work. I never had no afterbirth come ahead of the baby. But there’s nothing you can do till the baby gets there, and then you move the baby, and you try not to let water get in its mouth. 

To keep the bed from getting wet, some of them had rubber, you know, under the sheets. Some of them had paper padding — you can take 16 sheets of newspaper and make a pad and put a cloth over it. And so, we always got by, however it was. Everybody didn’t have the same. But you always used what they had, and if it was good, you didn’t say nothing and if you was in a place that was bad, you go out and did the same thing and didn’t say nothing about it. You can’t go out and talk about how “so and so is bad," cause you gonna work for more than one person. And not only that, but if I talk about what you got, somebody’s gonna tell you what I said and that’s gonna make the next person say, “I ain’t gonna use her; she talks about what she sees.” So you just got to keep quiet. 

So, however, you got a pad on the bed and maybe the water break just ahead of the baby coming out, well you pack something or other around it. And then you got cotton wipes to clean out his ears and nose and mouth, and silver nitrate drops for his eyes. And I just let them cry by themselves. I never hit them. Some of the time they’re fixing to cry before the time they even get out of there. And I like it when they holler. You got a good baby if he hollering when he coming outta there; if he holler, you got a fine baby. No, I don’t never spank them. But other people spank them, or say they do. 

Now, I’d keep the woman in bed two or three days, whatever she feel like. If she feel like sitting up the first day, well let her go ahead. Even get up and walk around if they want. If they could do it, it was good for them. I think they should be quiet for a few days, but moving is okay and good for them. Most of them said that the time of the full moon was best for having a baby, and it seemed to be true near as I can remember. 

Now, a lot of people, they don’t nurse their babies from the breast the way we did. You see, we didn’t have none of that canned kind of milk, so we nursed our babies. Look like most of them that come from the hospital don’t do that no more. And another thing, you see we tie that cord with two tapes, leaving a stub about this long; first we’d tie it here and then you tie it there; and you tie it good and tight, that’s another good rule. And when that cord comes off you put a little alcohol on it with cotton, tuck it in and then you bind it up. You put the band on just as soon as the baby be born, and let it stay until the cord gone. Maybe change it sometime if the baby’s band gets dirty, you know. How long you leave it on, how long it takes, depends on the size of the cord. If it’s a large cord, it takes longer than a smaller one. The larger the cord the longer it took. I haven’t done it for a time now — the cord, I mean. But I could do it again and tie it right. But I ain’t gonna have to. 

Statistics indicate that a large percentage of maternal mortality follows operative interference. Physicians are not patient waiters. Nothing in their long years of training or experience has prepared them to sit by the bedside of those mothers who are normal, and watch while a natural process takes place in a routine manner. Ten years or more of university education makes most doctors constitutionally unable to sit with a woman through the long hours of her labor and not do anything. 

Well, if they started to hollering when it hurt, I just let them go on, less it got too noisy. Sometimes I had to holler myself, “If you don’t hush I gonna leave you.” I said, “You hollering like somebody’s beating you.” And they hush up. They do. “Instead of hollering, just push a bit.” 

And sometimes you have one that just quit on you. My daughter was like that. Some of them after a while start to holler, “I can’t, I can’t, I can’t, I can’t, I can’t, I can’t, I can’t, I can’t, I can’t.” I say, “You can, you can, you can, you can, you can, you can, you can.” I tell you, once they find out that you give up, they’ll give up. But if you stand out there, they see you mean business, and they come along before too much time. I had a hard time myself, with a couple of my own. But I had a daughter who was gonna take all week to do when her time came. She don’t be doing nothing but crying and carrying on. She don’t be trying to have no baby. I went back and forth over to her house there for a week! And I talked to her. I got tired of it, too. Finally, I started up home, and here come her husband wanting me to come on and see about her. I said, “She ain’t gonna do nothing when I get there.” 

He said, “Lady, you going?” 

“Well, I already been there two days; no, I reckon I ought to stay here.” And she didn’t do nothing that day. Well, the next day here he comes again. “I reckon she’s gonna be ready this time.” 

“She ain’t gonna do nothing,” I said, “but if I go this time and she don’t do it, I ain’t going over there with you after her no more.” 

“Well somebody’s got to —” 

I said, “Well let you see about her then.” 

He said, “Come on, I’ll take you in my wagon.” So, there we were again. 

I said to her, “Well, what’s happening?” She said, “Nothing.” I said, “Well listen, you get up out of this bed and walk around.” 

“No, I don’t feel like it.” 

I said “You feel like lying around; get up, you been laying around now too long. Get up and walk. ” So she got up. So she messed around there and messed around till I said, “You ain’t doing nothing but wasting my time. Let me tell you one thing now. I been coming over here all the week. I say you ain’t trying to have no baby. You could have done had this baby the other day but you just wouldn’t do it. Just holding it back. Ain’t no need to hold it back; you got to do it.” 

Now Rosa Mae is sitting there and she say, “Oh Miss Gussie, you’re mean. What do you think you’re doing talking to her like that?” All I know is that I laid her out and in a few minutes she had her baby. 

Rosa Mae says, “Miss Gussie, you knowed what you was talking about.” 

I said, “Yeah, I know, she could have had that baby the day before yesterday, but she just wouldn’t do it. Just draw up. She know what she got to do the minute she done have it.” 

“Well, she sure done move when you laid her out there, Gussie.” 

“Yeah, I done laid her out — I’m tired of you now.” I say, “You worry me every night and every day here I come over here and you ain’t doing nothing. I’m tired of you.” But I didn’t have too many like that. There is so many that know just what to do but can’t bring themselves to do it right off. Sometime you got to count the contractions, but the most of them when they get started they come on. 

Then, once the baby was born, you had to wait for the afterbirth. Sometimes I would have to wait longer for the afterbirth than for the baby. Cause once the baby has come, some don’t want to work no more. One woman I finally told, “You ain’t about to have that afterbirth. There ain’t no use in me staying round.” I knowed she could have it, she could just bear down and be through with it. I been over there since Saturday night and I was wore out. I said, “There ain’t no use in me staying around here and laying out waiting if you ain’t even trying to have it. You could have had that afterbirth.” 

She said, “Ohhhhh, Miss Gussie, it hurt!!” 

I said, “You think I don’t know it hurt? But you better bear down now and be done with it.” 

“I can’t do it!” She got to crying then, saying that she couldn’t do it, hurt too much, stuff like that. 

I said, “You can have it. If you done have the baby, why not have the afterbirth? I done tied the cord and the baby, he all fixed up and sitting over there, and you still not finished! And it’s less painful than having the baby. You see, everything’s done over, you ain’t got nothing left to do but kick it on. Everything is over.” But some folks, they just won’t do it! 

You can feel a woman’s stomach and tell if she gonna have that afterbirth. If there is a knot there, that afterbirth is gonna come. And if it’s flat like my stomach here, then you take her into the doctor so he can see to her. When it did come we had to look it over to see if it was all there. If it was, okay then. If it wasn’t, and waiting didn’t bring it on, then we took her and it to the hospital for the doctor to see about them. When the afterbirth did come, we always burned it. You see, if you just throw them away, some of the dogs around there be likely to get at it. 

One woman I had a real time with. She had the baby, and she wouldn’t have that afterbirth. Her brother told her, “If you was my wife I’d leave here, and when I come back here the baby be 35 years old and you still not have the afterbirth.” Lord, if I didn’t laugh, let me tell you the truth, I laughed till I just cried. Yes, said if she was his wife he would leave her there and when he come back that baby be 35 years old. Lord, that tickled me so bad. Yes sir — I had a good time while I was working. 

Though the granny midwife can be deservedly proud of her past, she has no future in Georgia. Because the medical profession has always assumed that idea! childbirth requires hospital delivery by a physician, most doctors begrudged the midwives their role in maternal health care. Citing new hospital construction and expanding state health services, the medical establishment finally succeeded in ending the certification of new midwives in 1963. 

Practicing midwives continue to be recertified but their numbers have declined rapidly. Already weakened by attrition, the granny midwives sustained a further blow when Medicare and Medicaid were created in the late ’60s, and made hospital deliveries economically possible for many who would otherwise have used a midwife. Doctors who had previously certified patients for delivery by midwife found hospital deliveries at once more convenient and more lucrative; they began advising their patients accordingly, and ceased to cooperate with midwives. And since the hospitals did not require regular check-ups, but would accept patients at any stage in their labor on an emergency basis, many women found them more convenient as well. Certainly the mystique which surrounds medical technology in this country has also contributed to the decline of midwifery throughout the rural South, and the subsequent rise in the total of hospital births. Now there are only 58 granny midwives active in Georgia, and their 250 deliveries in 1976 accounted for less than one percent of the state’s total number births. And state health officials expect that number to decrease to zero by 1980. 

All those people weren’t on the welfare then and used us more, till the welfare came and they could get a doctor all the time and go to the hospital and not have to go to the clinic no more and it all be paid for. Then what use they got for midwives after that? Specially since they can’t get it paid for like they could the doctor in the hospital. 

And you know, they ain’t training no more midwives in Sumter County, or the whole of Georgia no more, as far as I know. Ain’t heard of none leastways. Them’s still practicing now come up a long time ago. You know Willa Mae Champion? Well, she come up after I had been delivering for a while. We had plenty — we had about 17 or 18 in our class. We had a good group. Willa Mae come up the same way, though her group was much smaller, maybe six or eight, and hardly nobody come up after that. We used to laugh about the first baby Willa Mae had, how she give up, how she talked with me after her first time. Said she was through with it! Said, “Oh Lord, Miss Gussie, I can’t do it.” So I sit down and I wrote her a long letter. She say she got that in her trunk even now. Said I give her the mostest encouragement. Because she says she was ready to quit! And you know, the nurse was so nice to her, and she hadn’t got certified yet. She respected her training, and though it was lacking a few weeks till our anniversary, when we come up and get our licenses, when she called her and told her, she told Willa Mae to just go right ahead with it. That was so nice of her to let her go ahead with her first call. Well, come May, I hear Willa Mae be the last one of us practicing in these parts. 

The welfare, now, it’s made it tough on midwives. Since it came, most people won’t be bothered no more with clinic, they just go to the hospital when their time finally does come. I don’t know if welfare would let them go to midwives if they wanted, but most don’t even want to no more. The hospital just looks better, I don’t know why. It costs a heap of money, I do know that. Folks are getting spoiled with the hospitals, and the stuff they can give you there for the pain and the doctors taking the babies. I wouldn’t want no doctor to take my baby. I’d rather have it, and know when it come. 

The State Public Health Department points out that granny midwives are being “replaced” by nurse-midwives, registered nurses who have taken an additional one to two years of training to be certified in midwifery. But there are at present only 22 certified nurse-midwives practicing in Georgia, and all but five are working with regular obstetricians in private practice. Though their presence at bedside will continue to humanize maternal health care for their patients, their services are available only to those who can afford them. And in view of the resistance of the medical establishment toward enlarging the role of the nurse-midwife, it is unlikely that their numbers will increase significantly in the near future. Nurse-midwives are, at best, a long-term solution to an immediate and pressing problem. What was once a major part of the statewide system of maternal health care has been deliberately phased out over the last 15 years (and with it one source of competition for doctors), and nothing has been developed to take its place for the large number of people who can neither qualify for Medicare, nor afford the high cost of private health insurance. 

Health services which were once available for $35 now cost $500 for a hospital delivery (payment due before admission in many cases), and $600- $700 for a private physician. And women who were once able to continue a rewarding tradition of service among their friends and neighbors by attending free classes once a month for a year, must now find both the time to spend three or more years in school, and the money to pay for it. For patient and practitioner alike, midwifery has become a privilege reserved for the middle class. And it is a privilege that is much appreciated. There are three nurse-midwives currently practicing in Americus, nine miles from Plains, and the obstetricians with whom they are associated have as many patients as they can handle. 

Meanwhile, there have been no deliveries reported by granny midwives in Sumter County since 1975. And Willa Mae Champion, the last active granny midwife in the area, who must deliver six babies a year to maintain her certification, has traveled as far as Atlanta, 140 miles tb the north, to take a case; she wants to keep up her practice. That won’t be possible much longer. 

Some ask me how I ever took a vacation? Well, I didn’t vacate. Oh, every now and then I’d go and then somebody else would get that baby there — Miss Brown, Miss Angry, Miss Champion, or somebody. There was always somebody. But soon enough there won’t be. 

Yeah, it was good. I enjoyed it. I don’t know no other work I could have done I would have enjoyed so good. Just to think that you bringing people in the world, you’re helping somebody that needs help and that’s good. I don’t think I could have gotten as much joy out of doing anything else. I’d a heap rather do that than just schoolteach. I get joy out of delivering babies and when I see people that I delivered. I sure do. And there are a lot of them here in Plains. Yeah, in Americus, up north, all down Highway 19 going to Albany, over in Smithville. They’s a heap of them all around.