Mary Francis Hill Coley (August 15, 1900 – March 1966) was an American lay midwife who ran a successful business providing a range of birth services and who starred in a critically acclaimed documentary film used to train midwives and doctors. Her competence projected an image of black midwives as the face of an internationally esteemed medical profession, while working within the context of deep social and economic inequality in health care provided to African Americans. Her life story and work exist in the context of Southern granny midwives who served birthing women outside of hospitals.
Biography
Coley was born Mary Francis Hill in Baker County, Georgia. She was the youngest of four children, a sole-surviving twin at birth. She was raised by relatives after her parents died. She received almost nothing in the way of formal education, leaving after third grade but relied instead on practical training and apprenticeship.
In 1930, she married Ashley Coley, a carpenter, and moved with him to Albany, Georgia. He abandoned the family with ten children, and she turned to practical nursing and midwifery under the tutelage of Onnie Lee Logan. Coley was a particular type of lay midwife, often referred to as a "granny-midwife", one who was called to the profession spiritually and who apprenticed under an older midwife. Coley developed a busy practice, serving over half the families in the area and charging double the fees of other midwives ($30). Her business afforded her a home, a car, a telephone, an assistant, and a surplus of ready supplies for emergencies. She knew that many families had to save up to pay her, and she knew which families could afford more or less than others. She would also accept payment in kind in some circumstances.
Coley pursued a career in midwifery at a time of increased scrutiny and regulation (Sheppard-Towner Act or the Promotion of the Welfare and Hygiene of Maternity and Infancy Act of 1921) and during an era when public resources were invested in the expansion of hospitals and obstetric care (Hill-Burton Act of 1946) rather than the midwifery model of care. Although increased surveillance of midwifery practice cut in half the number of midwives between 1930 and 1950 (dropping from 3000 to 1,322), Coley went on to provide a range of birth and family services across Georgia for more than three decades. As an African American, she advocated for the health of Georgia's black population and was known for her willingness to work with women regardless of race in a time of segregation. It is estimated that she delivered over 3,000 babies in her career, and she offered additional services to families such as assistance in cooking, cleaning, child-minding, laundering, and helping new parents file official forms and birth certificates. She was known affectionately by her patients as "Miss Mary".
Coley served as President of the Women's Auxiliary in the Church of the Kingdom of God, and taught Sunday school classes. She died in Albany in March 1966 after a career of over 30 years as a midwife.
The Use of Midwives
Beginning in the 1920s, midwives performed almost half of the births in the United States. The Sheppard-Towner Act, introduced by the Children's Bureau, became effective November 23, 1921 following concerns of high infant mortality. The act regulated hygiene, infancy care and put an emphasis on the licensure of midwives. The Act required nurses to supervise and train midwives. By 1929, the Sheppard-Towner Act was repealed, and the use of midwives had decreased to approximately 10% of births in the United States. More than half of the women using midwives were African American. Black midwives were targeted for lack of cleanliness and lack of training. Many black women were associated with dangerous and ignorance, even while midwives attended classes and were trained on the proper protocols of creating a safe birthing environment. The Hill-Burton Act was introduced and became effective in 1946, it funded the construction of hospitals in areas that mostly used midwives. This shifted many pregnant women to use a hospital instead of at-home birthing methods. The use of hospitals for child delivery increased from 27% to 96% by 1960.