"Motherwit" and "common sense" were the watchwords of Onnie Lee Logan's career as a lay midwife in Mobile County, Alabama.
Although she received little formal education, endured the Depression and faced a racist society, Onnie Lee Logan experienced her life as the triumphant fulfillment of a dream to be one of those who could bring babies into the world, as her mother and grandmother had done before her.
Her story, told in the soft, now vanishing dialect of the Deep South, is powerful and fascinating oral history. Motherwit follows her life through her work as a servant for a wealthy Mobile family, her troubled marriage during the Depression, and her struggle to become a licensed midwife. We watch as she delivers the babies of both black and white women of Alabama--losing only one baby in 40 years. Onnie Lee Logan's forbearance in the face of the crushing prejudice of the rural South makes inspiring and unforgettable reading. When she passed away in 1995, the New York Timesdeclared her a “folk hero,” and Time called her book “a feminist classic.”
"An amazing story. A heroic woman and life after my own heart." Alice Walker
"To have told her own story, to have borne this eloquent witness to her life is Onnie Lee Logan's final triumph." Ellen Douglas in the Washington Post Book World
The work that follows is the text of an oral autobiography told to me by a black granny midwife in Mobile, Alabama, during August 1984. Many white Mobilians knew Onnie Lee Logan only as a maid who for many years was an integral part of a prominent family’s household, and it was through these people that I came to know her. Onnie always regarded midwifery as her real life’s work, however, and the inspiration for this project came not from me, but from her overwhelming desire “not to die with it,” as she said—not to die without sharing the “wisdom and knowledge” but especially the stories from her lifetime of experience. Onnie, a semiliterate woman with little formal education, told me she was “gonna write this book” if she “had to scratch it out” herself. “I got so much experience in here that I just want to explode,” she told me. “I want to show that I knew what I knew—I want somebody to realize what I am.” Hers is the story not only of midwifery, but of her personal odyssey as a rural black woman determined to lead a life of meaning and fulfillment.
Onnie Lee Logan was born around 1910, the fourteenth of sixteen children in Sweet Water, Marengo County, Alabama. Like all her brothers and sisters before her, Onnie was delivered by a midwife. Indeed, in that year, one-half of all births in America were attended by unlicensed, untrained midwives. In Alabama, Onnie’s mother was one of these midwives. Onnie’s grandmother, who had been a slave on a nearby plantation, had also been a midwife. Inspired by the stories about her grandmother, by the example of her mother, and by the gospel of service her family instilled in her, Onnie decided as a young girl to become a midwife herself.
Lay midwives like Onnie’s mother and grandmother, known by the community as “grannies,” were simply women experienced in assisting other women during labor and childbirth. Midwifery began centuries ago and persevered through time as little more than the practice of childbearing women calling upon other women in their community to serve as birth attendants. Even in twentieth-century America, midwifery had not departed from its age-old origins. At the time when midwives were delivering one-half of all babies born in the United States, there were no training programs to educate midwives and no laws in any state to regulate their practice. Childbirth and midwifery both took place outside the realms of law and medicine.
Soon after 1910, when the United States discovered it had the third-highest infant and maternal mortality rates in the world, midwifery came under heavy attack. Doctors called for the elimination of midwives and the growth of obstetrics as the only way to impose standards for the care of pregnant women and newborns. They agreed the midwife should have no place in modern medicine, but also conceded that midwifery was a necessary evil until the practice of obstetrics became universal. While promoting the gradual abolition of all midwifery, they proposed for the interim a plan of midwife control and education.
By 1930, this plan was so well under way that only 15 percent of all births in America were attended by midwives, who were now regulated by laws and trained by boards of health in most states. Significantly, 80 percent of these midwives lived in the South, where physicians had always been extremely scarce and the population had the highest percentage of black, poor, and rural citizens. In 1915, for example, the progressive state of Massachusetts had been able to outlaw midwifery altogether. On the other hand, in 1919, Alabama was just passing its first law to regulate midwifery. Because of its unique cultural circumstances, the South was decades behind the rest of the country in establishing obstetrics for the care of all childbearing women. Midwifery became a Southern black phenomenon, and the South became the repository of the so-called midwife problem in America.
Each Southern state varied in its treatment of this “problem.” Alabama’s 1919 law officially recognized midwifery and placed it under control of the county boards of health. At first, many counties did little more than register midwives. Gradually, a more complete system developed in the bureaus of child hygiene and public health nursing. Potential midwives received instruction from public health nurses; were given written examinations; were subjected to monthly inspections of their equipment bags, their person, and their homes; were required to attend monthly meetings; and were expected to comply with all the stipulations concerning equipment, uniform, and personal hygiene. In addition, they could attend only normal deliveries. Ten years after the passage of the law, the essentials of this system were intact in most counties in Alabama.
Nevertheless, doctors and health officials in Alabama as in other Southern states would never be happy with any midwife program. It was the Southern states, with their high rates for blacks, that were largely responsible for making the national infant- and maternal-mortality rates so high. The medical establishment in the South condemned the “ignorant” black granny midwife as the source of the problem and began to work diligently toward establishing universal obstetrical care for indigent and rural blacks and whites.
In 1947, when Onnie wanted to become a midwife in Mobile County, Alabama had the highest maternal mortality rate in the nation. Midwives were attending one-fifth of all births and one-half of all black births in Alabama annually. To receive her license, Onnie had to undergo a nine-month training program and then submit to rigorous supervision and regulations from the board of health for annual renewal of her permit. For instance, her patients were required by law to receive prenatal care from a doctor, who then signed a release for home delivery, but was expected to come to Onnie’s aid if she ran into difficulties or emergencies.
During her first eighteen years as a midwife, Onnie’s patients were mostly poor black mothers living in Prichard and Crichton, the black areas of Mobile. She also attended many poor white mothers who lived in the rural areas of Mobile County. This type of clientele was traditional for the black granny midwife.
By the mid-1960s, the number of maternity clinics had finally caught up with the needs of rural and indigent patients, and Alabama’s maternal and infant mortality rates had decreased dramatically. When the Maternal and Infant Care (MIC) clinic was established in Mobile, the number of Onnie’s patients also decreased dramatically. After this time, those who engaged Onnie’s services were usually lower-middle-class white fundamentalists who wanted their babies delivered in the same way that Moses had been—by a midwife.
Those white patients who could afford a hospital delivery began having difficulties getting their doctors to sign the release for home birth. Some doctors openly complained about being deprived of a delivery fee. At the same time, many physicians’ partnerships were beginning to institute policies against signing releases for midwife delivery because of the malpractice liability involved.
In 1976, granny midwifery was outlawed in Alabama. Onnie was allowed to continue practicing until 1984, when she received a rather abrupt letter from the board of health indicating that there was no longer a “need” for her services and that her permit would not be renewed. She was the last granny midwife in Mobile and one of the last in Alabama.
Despite an impeccable record as a granny midwife, Onnie was stripped of her vocation and barred from performing a service as old as the human race. She had prepared herself to serve a need that existed in the rural, black, impoverished Alabama where she was born. But while she was becoming a midwife, the world that had called her into service was changing into one that did not want or “need” her. In 1931, a doctor in Magnolia, Alabama, had told her she would make a good midwife. Fifty years later, a doctor in Mobile told her it was a shame that she never became a physician. Caught in the flux of a changing culture, Onnie made for a very unusual victim of historical “progress.” She faithfully and successfully served one world only to be told by the next that she was no longer needed.
Ironically, in 1989, Alabama’s maternal and infant mortality rates are now again among the highest in the nation. The severe shortage of obstetricians appears to be responsible for the problem. In Alabama, as in many other parts of the country, doctors are leaving obstetrics in droves because of malpractice liability. In many rural Alabama counties today, there are no obstetrical services available whatsoever. Sometimes women in labor must drive for hours to reach the nearest hospital that provides obstetrical care. One solution currently under serious consideration is the establishment of a nurse midwife program. And so the history of midwifery may have come full circle.
Onnie’s story is a part of this history. But more important, this is the story of the personal triumph of a Southern black woman so proud of what she had done with her life that she felt compelled to share it with the world.