04/20/2026
Black midwives in the South kept the art of midwifery alive, along with so many mamas and babies. We owe them so much.
3,500 babies delivered. Zero mothers lost. Her own mama died 3 weeks after she was born. Margaret Charles Smith spent 35 years making sure no other Black baby grew up without one.
Three weeks.
That was how long Beulah Sanders lived after giving birth to her daughter in Eutaw, Alabama, in September 1906.
The baby was named Margaret Charles Smith, after the woman who would raise her. That grandmother had been born into slavery in 1836 and sold to a family in the Alabama Black Belt at the age of thirteen for three dollars.
So the story starts there. A mother gone too soon, and a grandmother who knew in her bones what it cost to hold a Black child in this country and keep that child alive.
Margaret Charles, the grandmother, had raised nine other children before this one. She took the baby the way you take a seed that somebody else could not plant.
She carried her to the farm and set her down. Nobody in that house could have known what the baby would become.
But the soil was already right.
By the time the girl turned five, she had caught her first baby. A relative of her future husband was in labor, and the father had gone to fetch the midwife.
Miss Margaret, five years old, was left sitting with the woman when the baby decided it would not wait. She caught it with hands too small to know fear.
When the father and the midwife came through the door, the work was already done. She would tell that story for the rest of her life, and it was never a boast.
It was a kind of explanation. Some people are handed their calling before they have the words for it.
She grew up on her grandmother's farm, pulling cotton between school days. She left school at sixteen when her grandfather died.
The farm needed her more than the classroom did. She kept reading, though.
She kept studying everything she could find about bodies and births and herbs. She was a woman with a third-grade education and a mind that never stopped working.
In 1943, against her grandmother's wishes, she married Randolph Smith. She had three sons.
When her second son came, she delivered him herself, alone in her own bed, because that was what she knew how to do. She did not officially begin training as a midwife until her late thirties.
An older local woman named Ella Anderson taught her. The apprenticeship lasted a year and paid nothing.
In 1949, Greene County issued her a midwifery permit. She became one of the county's first officially licensed Black midwives.
And here is where the scale of what she did starts to show itself.
Over the next thirty-five years, Miss Margaret Charles Smith delivered more than three thousand five hundred babies across rural Alabama. She delivered twins and breech babies and premature babies in homes with no running water.
She delivered babies to mothers who were malnourished, overworked, and sick, women the hospitals would not touch. She did not lose a single mother in the process.
Not one. Read that line again.
A woman whose own mother died of childbirth, raised by a grandmother who had been sold as a child, spent her entire career making sure no other family had to bury the woman who had just given them a baby.
She never drove a car. Not once in her life.
She walked to births through cornfields, through thunderstorms, through creeks that rose over her knees. On her longest nights, she caught four babies before sunrise.
She was paid five dollars when a family could manage it. When they could not, she came anyway.
Some left a basket of tomatoes on the porch. Some sent eggs.
Some paid her in nothing at all, and she drove the story of that night home in her own memory and called it even.
Her birth bag was small. Boiled scissors with blunt points for cutting the cord, a nail brush with wood backing and pig bristles, lye soap, clean cloths, birth certificate forms.
She also carried prayer, and what she called motherwit. That word was her shorthand for everything the medical books had not figured out how to teach.
She said once that if you know how to talk to a woman in labor, she already knows what to do. You give her love and kind words, she said, and that beats it all.
This was not some folk superstition. This was clinical precision dressed in plain clothes.
She boiled her instruments and scrubbed her hands until they cracked. She watched, she listened, she stayed.
In the Jim Crow South, Black women were often turned away from white hospital doors or placed in basement wards with broken equipment and indifferent staff. Miss Margaret knew what the hospitals would not say out loud.
A Black woman in labor was often safer in her own bedroom with a neighbor who loved her than in a ward where the nurses sometimes did not come. She was not alone in knowing that.
In the 1930s, about eighty percent of all Black births in America were attended by midwives, most of them granny midwives working in homes just like hers. Onnie Lee Logan was catching babies in Mobile, training a whole generation behind her.
Mary Francis Hill Coley, one of Logan's students, was working in Albany, Georgia. She delivered more than three thousand babies and was followed for four months in 1952 by a documentary crew making the film "All My Babies."
Maude Callen was working in the South Carolina lowcountry. Margaret Charles Smith was walking the backroads of Greene County.
A whole network of Black women was holding the next generation of America in their hands. And the country was preparing to shut them down.
The campaign started early. The Sheppard-Towner Act of 1921 created federal funding to "educate" community midwives, but the funding went mostly to white public health nurses and white male doctors who treated Black midwives as obstacles to be removed.
The Hill-Burton Act of 1946 poured federal money into hospital construction. The new hospitals often built segregated wings, or no wing at all for Black patients.
Between 1930 and 1950, the number of midwives in Georgia alone dropped from three thousand to about thirteen hundred. By 1950, more than eighty percent of American births were in hospitals.
Black midwives were being pushed out of a profession they had held together since slavery. In 1976, Alabama passed a law outlawing traditional midwifery.
About one hundred and fifty Black midwives received letters telling them they could no longer deliver babies. Jail was the threat if they did.
The state gave Miss Margaret a grace period because her record was too clean to ignore. She kept working quietly until 1981, when her permit was allowed to lapse.
And then the silence. The long, heavy silence of a tradition that had carried Black America for three centuries being boxed up and put away.
What filled the gap is what we are still living with. Black mothers dying in hospitals at two to three times the rate of white mothers.
Pain dismissed. Symptoms unheard.
Epidurals denied. Cesareans pushed through over objection.
A medical system that cannot seem to find its way back to what those grannies already knew. Which is that a frightened woman in labor needs to be seen first and examined second.
Miss Margaret lived long enough to watch the damage being measured. In 1983, the town of Eutaw gave her the keys to the city, the first Black American to receive them.
In 1996, at the age of ninety, she sat with the researcher Linda Janet Holmes and dictated her life story into a book called "Listen to Me Good." She knew nobody else would tell it right.
Ina May Gaskin, the white midwifery elder who helped revive the profession in this country, called her a national treasure. The Congressional Black Caucus honored her in Washington in 2003.
She died in November 2004 at the age of ninety-eight, on the same farm where her grandmother had raised her.
Before she died, she got to witness something that most people do not live to see. She was present at the birth of her own great-grandchild.
Four generations of one family, held in one family's hands.
You think about that and the arithmetic gets heavy. A mother who lived three weeks past the birth of her daughter, and a daughter who lived ninety-eight years and delivered three thousand five hundred other people's daughters and sons without losing a single mother in return.
That is one way to measure a life. That is one way to measure what a community can hold together when the state has no interest in holding it for them.
Miss Margaret did not leave behind medical journals. She left behind the living.
Every Black American whose family can be traced back to the rural South likely has a granny midwife somewhere in their line. Quietly making sure the thread of life did not snap in a decade when the country was trying to let it.
Their bags were small. Their hands were steady.
Their kitchens smelled of lye soap and coffee and cornbread. Their work was the floor under the whole house.
When the state ripped that floor up in the name of progress, a lot of people fell through. A new generation is building it back now.
Black midwives, Black doulas, Black birthing centers are opening in cities and small towns, claiming back what Miss Margaret and all the women like her held for so long. They are reading "Listen to Me Good."
They are watching "All My Babies." They are sitting with elders in Alabama and Georgia and the Carolinas, asking the questions that should have been asked fifty years ago.
Margaret Charles Smith is gone. But the farm is still there, and the grandchildren are still there, and the great-grandchildren are still there.
Three weeks and three thousand five hundred.
The woman who was never supposed to survive lived to ninety-eight. In that long life, she reached back to the grandmother who had been sold for three dollars and forward to the babies who would carry her name in their own families for generations, and she held it all together with two hands and a small black bag.
That is the legacy. That is the tradition.
That is the reason we say her name.
I put a lot of effort into researching and sharing stories that matter. If you'd like to support the work, here's the link:
https://buymeacoffee.com/blackhistoryarchives
Every coffee helps me keep creating.
