(women singing) ♪ Be sure his name ♪ ♪ the date, ♪ the place are right.

♪ ♪ If not, in time ♪ ♪ he'll be in ♪ quite a plight.

♪ ♪ Check and re-check, ♪ ♪ then have ♪ the mother sign ♪ ♪ and you will have ♪ ♪ great peace of mind.

♪ (female speaker) Now and then, I forget.

Well, now, I forget a lot of 'em.

But I always wanted to keep up with my babies and remember how they looked and how they acted and all like that.

It just felt like they was a child of mine.

I call her Mama because at that time, you couldn't help but say, "That's my mama."

She was the one that brought you into the world, though your blood mother had a part with it.

But had it not been for Mrs. Matthews, no telling where I would be.

(women singing) ♪ ...shall not be moved ♪ ♪ on my way ♪ to Heaven.

♪ ♪ I shall not ♪ be moved.

♪ ♪ Just like a tree ♪ that's planted... ♪ (female speaker) They'd have a midwife who could deliver at home, and if you had a family, you'd be with your family.

If you had children, they'd be there.

If anybody goes to deliver one baby, the next baby, they want me to come back.

And I'd go back, just the whole family.

I would deliver the mother and go and deliver her daughter then deliver grandbabies and all that.

I don't care how big they is.

I don't care how big or old they is, they is still my babies.

They gives me big kisses.

I order, come give me a kiss!

They give a big kiss.

White and colored.

The 1920s is when there were probably almost 4,000 granny midwives in the state of South Carolina, and I think if you'll look back in the history, 80% of the births in South Carolina were delivered by granny midwives.

Now, the granny midwives were women who oftentimes did not have formal education or preparation, most likely did not, and were women who were respected in their community and known in their community, and they delivered at home.

(female speaker) Before that, they were just on their own.

They decided they were gonna be midwives.

You would see them with a basket and a little black bag.

And with the condition in the South, particularly at that time with the, particularly the poorer population, the black population, somebody had to move in there and make sure that women had as much of a safe delivery as possible.

And Dr. Sheriff was obsessed almost that this was going to be done if she could have anything to do with it.

The granny midwives had been around long before Dr. Sheriff, but she introduced standards that were so important to make sure ladies knew what they were doing, that they did it well, they had training, and they were on site doing things for the safety of the woman in labor.

They had midwife institutes, then they had training, and they had to go through tests, and a very colorful group of ladies who were these midwives.

They were the ones who were the community leaders, the people who the mothers relied on to give them the prenatal care and to help them after the baby was born.

So because they were considered such an instrumental force in the health care in these communities, the midwives were extremely important to pull into the state plan for how to improve the health of mothers and babies.

Dr. Sheriff decided she would train these midwives.

She would provide midwife institutes for them, bring in specialists who would talk about proper nutrition for mothers and babies, bring in nurse midwives who had an education and a degree to talk to the midwives, and these institutes were held on a regular basis.

The midwives in some cases were even taught by the Adult Education Department to read.

Many couldn't read and write, but they were good at delivering babies.

(female speaker) We taught some things they should do when they first go to a patient, find out her health problems, the problems of the family, especially if there was a baby coming in, to take that baby as part of the program.

You knew that cleanliness was next to godliness.

That was one of the things we were taught, to be true and clean to our patients, and that's what we would do.

[women singing] My role was to try to help them learn more about food and nutrition and its relationship to the development of the fetus and the health of the mother.

And they had a lot of influence, not only with patients, but in their community.

They were important people.

We learned how to tie the baby's navel cord and put the drops in their eyes.

We was trained to do everything.

We had a big doll baby.

We had a cord running from this doll.

We'd cut the cord and tie it, everything by a doll baby.

(female speaker) You had to have those uniforms cleaned.

You had to have your cap cleaned.

The cap was white; the uniform was blue.

The shoes was white.

You had to have, your apron was white, and you had to have them ironed and cleaned every morning.

Every day, you had to have that.

If you had enough that you didn't have to wash and iron so much, you just were lucky.

Oh, we used to look beautiful, in a long line, giving thanks before we'd get to breakfast.

I had loved to stay them two weeks.

I would love to see how things is now.

(female speaker) Penn Center, better known as Penn School, was established in 1862 by missionaries for free persons of St. Helena Island.

We have on exhibit in the museum the midwife's apron, cap, and scale for Maggie Smalls, who is one of the better known midwives on St. Helena Island.

It's said she's delivered over 2,000 babies.

Mrs. Smalls died in 1987, and she has a lot of children still living here on St. Helena.

The midwives were a grand group of women.

Many were bright, even in the era when a lot of them couldn't read and write.

They were dedicated to the women, babies, and families in their communities, and they did a good job with very little.

Yes, when I first started, I went to this patient house.

My son took me to the patient house, and I was going to visit, because I had to make three visits in the home before the patient have the baby.

I went to check on this patient.

I hadn't never seen her.

Didn't even know her.

I didn't have no way there.

She live a long ways from me, about five miles, I think.

My son took the wagon, and we went, and when I got there, her mother was an old, old, old, old mother.

She was an old lady.

She come to the door.

She said, "Oh, you made it then."

I said, "Yeah."

"Well, come on in!"

She said, "She there in the room.

She had that thing last night."

"Had what thing last night?"

She said, "She had her baby."

I said, "Oh, she had the baby."

I said, "If she had the baby, then who was the midwife?"

"Ain't nobody, ain't nobody been here "since the husband going for you.

Ain't nobody been here."

I said, "Where is she?

She in the bed?"

I say, "How you feel, honey?"

"I feel all right."

And she had all these little pillows piled up.

I said, "Well, where's the baby?"

She said, "The baby down in there."

I said, "In there where?"

"She's under the covers."

I said, "My God, you'll smother the baby to death!"

And I dug, took this cover, all these little pillows off this baby, and the baby got some breathing, the baby's like, "Oooh.

Somebody help me."

[laughing] Grandmama's about to smother the baby to death!

(male speaker) Baby all right?

The baby's all right!

(female speaker) At time I've had to wade to go to the person house.

Take off my shoes and wade.

The water seemed like a pond.

Everybody had to wade to get to the house.

I had to wade too.

(male speaker) It was a flood.

It was a flood.

My husband, I asked him, "You'll have to get me a car "because I can't take this... "load I got with the horse and buggy."

So the first Ford he bought, maybe gave $100 for it.

It was an A-Model Ford, and I drove that Ford 12 years.

Had a many a baby in it.

[chuckling] I didn't call no ambulance.

There was mighty few I would call a ambulance for.

I would take 'em in my automobile, and if the baby come before I get to the hospital, I done stop beside the road and deliver it... and turn around and go back home.

I done did that plenty times.

[laughing] I remember her always talking about, in the planning stages, she would not only tell them what to prepare when the baby came as far as clothing, to take care of yourself-- not to the extent we do now, but general things as far as health.

In addition, she would also tell them, "You're gonna plan for clothes, "plan food for the baby, but also for how you're gonna pay me!"

Oh, yeah.

I was paid one time with a pig.

That was the onliest one I was paid because when I first started delivering, you wasn't given but $6 for a baby.

And then sometimes, we didn't get all of that.

They'd pay me three, and after that, they'd bring me three more.

Some of them, you don't never get paid.

Do we get paid for all them-- No, ma'am.

How about the man asked, you asked the man for money, and the man told you he had no money.

He was going to come back.

She said, "He won't pay me.

Don't look like he gonna ever pay."

He didn't ever pay her.

This was a young girl, and after I delivered a baby, the father came and asked me would I accept a pig and a barrel of corn.

I told him yes.

And some places that I went, they would give, you know, things like that.

I charged $35 on the first go round, for about a year, a little bit better.

And the ones that really, well, couldn't pay-- a lot of people always were not able to pay.

We'd just go on and deliver 'em anyhow.

And later, they would try.

From then on, they'd tell us we could go up to at least $100.

And then I got one little boy I delivered.

He said, "Mama ain't never paid you."

He said, "But I'll always remember you."

And if that child ever hit town anywhere, he's come and he gonna give me something.

If he don't bring me nothing but a Co' Cola, he'd bring me something.

And you know, that's a good feeling, things to remember-- people remember you like that.

Midwives at that time practiced almost solely in the home, and unfortunately, some of the morbidity and mortality that occurred was due to inescapable factors such as extremely low socioeconomic status, very poor hygiene.

Some of it was due to inadequate resources even in the event of a high-risk pregnancy or a complicated pregnancy or an infant in trouble.

(female speaker) The baby was born, just laying there, nothing.

Saying nothing.

And I gave it mouth-to-mouth, and in the meantime, called the doctor.

The doctor never did come, and this mother, she's havin' a fit because she had two boys, and she's wanting a little girl so bad.

"Oh, my baby dead."

I said, "No, it ain't."

She said, "Oh, yes."

I said, "It's not."

I kept working on that baby.

I got that baby to start breathing.

That was a happy time of my life!

You know?

The mother, "Oh, my baby alive."

I said, "Your baby is alive."

I have delivered a baby up the street there, and when I got through, I had to go to the grocery store.

They ain't had no money to pay me.

And about a month...

I believe two months later, I kept up with the woman.

I buy her food, and I buy her milk and things, and said, "You know, this woman need attention, more nourishment or something like that."

Said, "The more food I take to her, the littler she gets."

And the family said, "We went up there and we talked with her," and they had to take the baby.

Sent him to some of the family.

She find out the girl was a tuberculosis patient.

Mm-hmm.

And they treated her, and they sent her off, but she lived about six months.

And after she died, the neighborhood have to take up money to help bury her.

Somebody said, "She ain't got nothing to be buried in."

I said, "Well, all right.

We'll get some material."

And said, "Who gonna make it?"

I said, "I'll do it."

Pull out a sewing machine, and me and Sarah Lloyd made that shroud.

I was in some close corners, but I got out, me and the Lord, together.

Doctor would have lose a patient round there in his hospital if it wasn't for me being there and knowing what to do.

Doc was so scared.

She was hemorrhaging, you know.

The baby was already born.

He look in his book.

Couldn't stop it to save his life.

So he look right at me.

He said, "Do something, Mary!"

I went to the basket and got the baby, put the baby to the breast, stop it just like that.

Minute the baby drawed, it stopped.

He said, "Oh, Mary, you know more than I know."

He said this patient would have died before I got her to the hospital.

(women singing) ♪ We are climbing ♪ ♪ midwives' ladder.

♪ ♪ We are climbing ♪ midwives' ladder.

♪ ♪ We are climbing ♪ midwives' ladder.

♪ [singing indistinctly] (female speaker) It was decided in the early '70s the granny midwife program would be phased out.

Times have changed.

Back in the '30s, we had several thousand midwives who were active and doing an excellent job.

In the '70s we were down to 200.

People were not coming into the field anymore, and medical technology was changing.

Hospitals were available.

We were interested in high-risk pregnancies to make sure they had proper care, and things just moved on.

We didn't stop on our own.

They stopped us from delivering babies.

They say you have to go to college to be a nurse midwife.

We had to stop because the doctor say so.

I was not ready to stop.

I still was a young woman.

I still was in my fifties!

(male speaker) How did you feel?

I felt really bad.

Hurted me so long.

Nobody knows how it hurted me.

And it was at that time that a new voice was heard, which was the voice of younger women, younger healthcare and maternity care consumers who were in effect saying, "Wait a minute.

"We don't necessarily see "the midwife concept as being obsolete, "and we request that you rejuvenate it, "bring it back to life, "and do not erase the option "as a viable option in maternity care in South Carolina."

Our state licenses midwives, but they have to show that they've had a course of study.

Personally, I chose a correspondence coursework that I felt would give me the educational background that I would need.

There are, let's see, it's 25 birth that you assist with, fifteen births that you actually deliver, sixty prenatal checks, fifteen postpartum checks of the mother and the newborn.

And then after you've documented that you have done those things, then you can apply for testing through the Health Department.

One of the big problems is is that people don't realize that we're practicing and that there are even midwives still today, so we always are stumbling upon people that wish they had found us earlier or are glad they found us in time.

Lay midwives in this state of South Carolina do very few births a year.

There are a number of reasons for this.

The first reason is that we have very few licensed lay midwives.

We only have five.

Lay midwives in this state at this time deliver only in the home, and we only have about 50 or less lay midwifery deliveries a year at the present time.

Nurse midwifery deliveries, on the other hand, range between two and three percent of all the births in South Carolina each year.

It's going up each year.

Nurse midwives are first registered nurses, and then they go on to have further education in either a master of nursing program like ours or a certificate basic nursing education program, which is post basic nursing.

MUSC started this program in the early '70s around 1973, and it is the only nurse midwifery education program in South Carolina.

We have a long history of preparing excellent practitioners for the state and for the country.

More and more obstetricians are going totally to gynecology and not doing obstetrics at all, and this is creating a void, and I think the nurse midwives fill this void very, very well.

In obstetrics, everyone is concerned about being sued.

It's a very high-risk area for that, but we have an extremely low incidence of that.

I think it's because there's been research showing the more rapport you have with your client, the less likely you are to be sued, and nurse midwives are very famous for the rapport that they develop with their clients, the teaching, togetherness during the labor experience.

I feel we take much more time, do a lot more teaching, take into account their family background and what's going on in the family.

I think we're more interested in sending that baby into a healthy environment.

Physicians don't have the time to do that.

They are very backlogged.

I don't think it's necessarily that they don't want to do that.

They don't have time, whereas midwives in general see low-risk women, and at the practice where I work, we allot more time per appointment.

Just really would hope more black women would get into nurse midwifery, and I do feel it's sad that a lot of certificate programs are closing.

I think there's room for a whole range of different types of practice, from people who have good technical skills to people who want their PhD and be educators.

Well, basically the midwife would have a more holistic approach to the birth and would spend a great deal more time with the mother prenatally, during the birth, and after the birth.

Her time is less costly than a physician.

Maybe that's why she can afford to spend time with women, the families, the newborns.

There's a lot less intervention and a lot more responsibility that's taken on by the woman.

Some people are a lot more comfortable going into the emergency room and saying, "Here I am.

You do it now."

People who tend to have their babies at home say, "I'm going to do this."

We aren't for everybody.

The ones who come to us are ones who accept our type of care because we take care of the normal pregnant women, and there's, some of us, we bear off from normal.

We do collaborative care with a physician.

The midwife model of care embraces what we call the physiologic conduct of labor, and the physiologic conduct of labor allows that women do know how to give birth successfully, and that in this important work, they need guidance, they need monitoring, and they need support.

Occasionally, there will be a need for intervention.

The technology is really wonderful that we have, and we do need to use that sometimes when it comes to pregnancy and childbirth, but people often forget that pregnancy is a normal event, and too often they let technology get in the way of the normal event.

[woman gasping] Take a breath and do it again.

There you go.

[mother moaning] Take a breath and do it again.

[mother moaning] [mother gasping] [murmuring] (female speaker) In obstetrics, we're taking care of two patients, one we're unable to see and touch.

Our skills have to be very keen to take care of a patient who you cannot see or touch.

(women singing) ♪ ...over the hills ♪ ♪ and everywhere.

♪ ♪ Go tell it on the ♪ mountain that Jesus... ♪ It was exciting to start delivering babies because I enjoy it.

It was bringing-- it was just helping bring life.

Seemed like I was helping somebody.

♪ ...over the hills ♪ and everywhere.

♪ ♪ Go tell it ♪ on the mountain... ♪ I'm a little piece of leather, but I'm well put together.

That's me.

♪ ...over the hills ♪ and everywhere.

♪ I remember, folks one time was talking, says, "I just wouldn't be a midwife.

That's a filthy job, mm-mm."

I said, "Well, you can go to cook a meal, "and I've seen some people with nasty cooking worse than my labor cases."

♪ Go tell it ♪ on the mountain ♪ ♪ that Jesus Christ ♪ is born.

♪ I think I would like to live in a house by the side of the road and be a friend to man.

(male announcer) This program of song and spirituals came to you from the Pee Dee Midwife Institute.

I liked it.

I loved it, really enjoyed it.

I enjoyed midwifery while I was doing it.

(announcer) There were 115 midwives participating in this program.

Mothers and babies should be our first priority, for babies are our future.

(female speaker) Yeah, I'm happy.

I'm happy of my midwife work, and I'm happy for y'all to come and put me on TV after all those years.

All of those years, somebody thought about me.

[chuckling] (female speaker) Every life is worthy of the best care that can be given.