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James Ulman

Professor Kae Denino

English 101

10 November 1997

The progression of the time in the role of an Alabama Africa-American midwife

Listen to Me Good

(Smith and Holmes 1996) is the autobiography, which depicts the life and times of Mrs. Margaret Charles Smith, an African-American Midwife. She was born in the year 1906, Common Era and is alive to this date. Mrs. Smiths philosophy for the natural life event of "birthing babies" is simple. "let nature take its course." (qtd. Smith and Holmes 82) "when the apple is ripe it will fall." (Smith and Holmes 82) Her role as a Midwife in these life events is this as she sees it; she is "witnessing births, not managing deliveries." (Smith and Holmes 82) This brings me to my first point of interest within the text of Listen to me Good, so Listen to Me Good! The role of a Midwife as stated in the opening statement of chapter four is this;

"Midwifes excel in ushering normal and healthy births, and many of Alabama midwifesí practices are models in the field. These include keeping the mother active as long as possible during labor; helping the mother feel strong enough to endure labor through relaxation, comfort, and support; respecting a motherís ability to birth her own baby; supporting a womenís birth in a familiar setting; rubbing and massaging a women as needed in pregnancy and in labor; encouraging alternative (upright0 birthing positions; delaying cutting of the umbilical cord; keeping mother and baby together as much as possible right after birth; encouraging breast-feeding; and limiting the use of technological and pharmaceutical interventions." (qtd. Smith and Holmes)

"This [Midwife model of care] traditional system passed on by the elder women of the community included African elements, Native American practices, and standard medicine." (qtd. Smith and Holmes 43) Although she is not actively practicing her craft with women in the birthing room today, she is still active as an advisor to those women who will listen to her, good (Smith and Holmes 13). The role of a midwife for Mrs. Smith began prior to Mrs. Smiths becoming an official Midwife. This lives on

today, though she no longer practices her art in the traditional occupation of a Midwife. She accomplishes this by informing those who will listen of her past successful home births, that she was in attendance of. She advocates for the Home-Birthing model of care as an appropriate treatment for pregnant women. She substantiates this rationale with data obtained by Nurse-Midwifes who sought to obliterate the practice of home birthing and lay-midwifes, instead the data these nurses collected supported what Mrs. Smith already knew. The mortality and morbidity risk rates were minimal and remained in a state of homeostasis with the use of midwifes when compared to hospital and physician delivered births (Smith and Holmes 63, 114, 115, and 139 through 145). Mrs. Smith remains active as she often attends national lay-midwifery meetings and conferences as a life long member of M.A.N.A. Midwives Association of North America (Smith and Holmes 4). ĎJust a generation ago, midwifes attended most Alabama women. Young adults in Eutaw, still shout, "Mrs. Smith delivered me!" (Smith and Holmes 13).í

Mrs. Smiths interest in childbirth was active prior to her "seeing her flowers" [menstruation] (Smith and Holmes 32). When she was a young child she believed that babies came out of tree stumps. She stated "I would look in every stump and ainít seen none yet." (qtd. Smith and Holmes 32) It was a sign of the times that such taboo subjects were not discussed especially sex and childbirth.

The issue of time brings me to my second point of interest within the material authored in the text of Listen to Me Good (Smith and Holmes 1996). Time is the underlining force; time changes the method used to discriminate, but not the attitudes of those who are culturally bias. Mrs. Smith practiced her art with the wisdom of the generations and the experience that time affords us. Ď "Before and after the movement, we had midwives." Surely time will come again for midwifery in Alabama: Midwives like Mrs. Smith specialize in waiting on time. (qtd. Smith and Holmes 14)

In 1949 Mrs. Smith obtained her permit to practice as a member of the state sanctioned organization for lay-midwifes, as a Greene County official midwife! Prior to this event, Mrs. Smith was practicing illegally and without any physician back up for emergencies (Smith and Holmes xvii and 67). The statement "Midwives specialize in waiting for time" (qtd. Smith and Holmes 14) do not only reflect her occupations as a midwife, but encompasses the realities of bring poor and a person of color in Greene County, Alabama. Time is not measured on a calendar, but rather it is measured as Pre- or Post- desegregation. Mrs. Smith just calls it "the movement"(Smith and Holmes 13, 14,and 116 through 120). It was this movement that allowed the practice of lay-midwifery to expand and eventually become extinct in Alabama. This caused the Caucasian physicians and nurses to accept Negro lay-midwives as equals, and thus provide services for their clients. It was around this time that Medicaid was inacted and the financial barrier to gaining the access to hospitals and standard medicine was lifted. With the new client base and funding available the established medical community saw a lucrative untapped resource for income potential, all that was in their way was the lay-midwives and the tradition of home-birthing.

This brings me to my third and final point of interest. The only way to profit as a provider of Obstetric Services was to force the women clients into "birthing" in the sterile and expensive hospital environment. Now that it was mandated for area hospitals to accept people of color as clients and not with "Jim Crow Laws" the separate but equal .facilities, hospitals sought the funding of Medicaid to reimburse the poor clients they were forced to provide services for. Medicaid would only reimburse hospital births and not home-births (Smith and Holmes 19, 20, 35, and 103) In 1977 Greene County started its own ambulance service, (Smith and Holmes 139) the stage was set and now the lay-midwives were on their way out. The poor and unorganized lay-midwives were out maneuvered legally in the legislature. They were replaced with Nurse-Midwives and hospitals. Physicians who feared losing their hospital privileges and/or Malpractice insurance only provided maturnity services in the expensive and reimbursed hospital environment.

This was a win win situation for everyone except the maligned lay-midwives and the clients who sought home birthing. As I stated earlier home births are safer and have an increased level of comfort for the birthing mother and the newborn infant (Smith and Holmes 63, 139 through 143,114 and 115).

In conclusion I must say the authors use of dialect, contributed to the color and character of the book. The style of the writer and Mrs. Smiths inability to keep focused on the current topic, caused a lot of confusion keeping the chronological order of events within perspective. I reread the book and the subject and thoughts jumped off the pages to my mind. I can hear her saying Listen to Me Good

The association between Mrs. Smith and midwifery is a holistic mix of her lifelong experience and wisdom. The practice of "Birthing babies" allowed Mrs. Smith a rare opportunity. For a women of color in the South to be part of the intimate birthing environment of Caucasians and people of color both, gave Mrs. Smith a unique perspective and outlook on life. This increased her social and financial status among the citizens of Greene County, Alabama (Smith and Homes 7). Mrs. Smith is an example of the power of the mind to overcome obstacles placed in your path through the journey of life. She says it in these ways; "Whatever the mind lies on, itís there. Iím staying on it." "Itís better to eat shit with chickens than to just sit ther and let somebody do you wrong." (qtd. Smith and Holmes158) The essence of the book is how the ruling class of Caucasian s has taken, given, and then took again, from the people of color. Mrs. Smith states it this way "time to be a midwife I did that myself." (Smith and Holmes xvi) Mrs. Smith starts the book with a quote from herself this is how I am ending my report on the role of an African-American midwife in Greene County, Alabama. This says it all;

"Just donít tell them all you know. Thatís one thing you donít do. You tell them what you want them to know, and what you donít want them to know, donít tell them. You got to use common sense here, because we got a long ways-like a long ways-still to go." (qtd. Margaret Charles Smith, Smith and Holmes 15)

The progression of the time in the role of an Alabama Africa-American midwife

Works Cited

Smith, Margaret Charles and Linda Janet Holmes. Listen to Me Good: The Life Story of an Alabama Midwife. Margaret Charles Smith and Linda Janet Holmes. 1996