Reviving Grand midwives and community-based birth care in Maryland

Long before hospitals were accessible to many Black families in Maryland, grand midwives were delivering babies, supporting mothers and sustaining entire communities.

During segregation, when Black women were often denied care in hospitals, community midwives stepped in. Their work was rooted in tradition, faith and necessity. Advocates say it saved lives.

The history of midwifery 

Midwifery is part of a long human story for Taiwo Adeloye Ajao, advocacy director with ARISE Black Midwife.

"Midwifery is not a new thing. From the beginning of time, midwives have been out here," she said.

The practice traces back to West Africa, where birth work was sacred and deeply respected. That tradition carried through slavery and into Black communities across the South and in Maryland. It was documented in the 1952 film "All My Babies," which followed a Georgia midwife serving families in her community.

Adeloye Ajao said the role of grand midwives in American history is often overlooked.

"We know America was birthed by those grand midwives even during the time of slavery," she said. "Grand midwives were the ones providing that support and really birthing families, regardless of racial differences."

Reshaping Black maternal care

By the early 1900s, childbirth in Maryland had become increasingly regulated. 

Licensing requirements and federal policies, including the Sheppard-Towner Act of 1921, reshaped maternal care and led to the decline of many Black midwives.

Jael Marajh, a midwifery graduate awaiting board certification, believes racial discrimination played a significant role.

More than a century later, disparities in maternal health remain stark. 

According to the Centers for Disease Control and Prevention (CDC), Black women die from pregnancy-related causes at rates more than three times higher than white women. Their infants face mortality rates more than double the national average.

Marajh says research shows culturally aligned care can improve outcomes in cities like Baltimore.

"Baltimore has a high maternal mortality rate, as the studies show that having culturally congruent care makes a difference," she said.

Working with a midwife 

For Baltimore mother Alicia Sneed, that kind of care shaped her own birth experience. She chose to work with a midwife.

She said seeing a provider who shared her cultural background created an immediate sense of trust.

"Even with any culture, when you see someone of your culture, you walk into the room and you know there are some things that they understand that someone who is not of your culture doesn't understand," Sneed said.

She described the experience as empowering and collaborative.

"My birth was coordinated by me but managed by a caring practitioner," she said.

Advocates say today's revival of Black midwifery builds on the work of women like Mama Claudia, a grand midwife who served families throughout the Washington, D.C., Maryland and Virginia region and traveled to Baltimore to provide in-home support.

"She was a grand midwife in the DMV area, and she would come to Baltimore and support families in their homes here in Baltimore," Adeloye Ajao said.

ARISE Black Midwife, an initiative connected to HELLO Baby events, was inspired in part by that legacy, she said.

Interest in community-based birth care grew during the COVID-19 pandemic. As hospitals reached capacity and visitor restrictions limited support systems, more families looked for alternatives.

"2020 was known as the year of the midwife, because while hospitals were full or couldn't take more people or you couldn't have your families in communities, midwives were coming back into the home," Marajh said.

Advocates say the legacy of grand midwives is not simply a chapter of history. As maternal health disparities persist, they argue that community-rooted, culturally informed care could be part of the path forward.