Dissertations, Theses, and Capstone Projects

Date of Degree


Document Type


Degree Name





Barbara Katz-Rothman

Subject Categories

African American Studies | Medicine and Health Sciences | Sociology


African-American, Midwives


Within the last decade, historical and contemporary accounts of midwives, along with the efficacy of the Midwives Model of Care for pregnancy, childbirth and general women's health, have become increasing popular in mainstream publications and documentaries. Yet, very few of these accounts represent historical or contemporary black midwives (and midwives of color, more generally). Despite a long history of midwifery in the black community, black women currently represent less than 2% of the nation's reported 15,000 midwives. Relatedly, black women and infants experience the worst birth outcomes of any racial-ethnic cohort in the United States.

In the early 20th century, as the obstetrics-gynecology specialty sought to advance and secure professional boundaries and homogenization, physicians of this time began recording the "midwife problem." Publicly labeling the primarily immigrant and midwives of color (the majority of whom were black women) attending approximately 50% of the nation's births at the time as dirty, ignorant, evil and the like had a profound effect in nearly eradicating midwifery. Despite a revival of midwifery during the 1960s and 1970s, 1% of today's United States births are attended by midwives, of which black midwives and black mothers are but a fraction of that 1%.

This qualitative study of 22 contemporary black Certified Midwives, Certified Nurse-Midwives and Certified Professional Midwives, of varying ages, years of experience and U.S. region, seeks to understand how a very racist and classist denigration of black midwives in the early 20th century is still manifesting itself in their experiences and perceptions of predominantly white midwifery education programs and professional organizations. These reported experiences of institutionalized racism and negative, controlling images of blackness is what I have framed as "the contemporary midwife problem." This samples' perceptions of the social operation of racism, and its impact on poor black birth outcomes and black women's relative underutilization of black midwives, is also explored.

Federal and local policy implications are discussed.