Cutting Ties: Race and Early Infant Survival in Mid-20th Century America

In an early scene from George Stoney’s 1953 film All My Babies, a white, male Board of Health inspector informs a group of rural Georgia midwives that a baby delivered by a midwife had recently died when it should have lived. The cause of death, he determined, was an infection of the umbilical cord. The cutting of the umbilical cord is one of the first challenges of infant survival. In the first two weeks after this act, newborns are particularly vulnerable to neonatal tetanus (“lockjaw”), a fatal and swift disease that enters through the unhealed umbilical stump. In nineteenth and twentieth century U.S., this disease became associated with the death of black infants and the dangers of traditional African American birthing practices. Given the risks involved, who had the authority to cut the cord became a source of privilege and responsibility, as well as a target for surveillance. This paper examines the ideas and practices surrounding this essential, symbolic, and risky moment in childbirth. In particular it draws on midwife accounts as well as midwife investigative files dating from the 1920s-1950s. In doing so, this paper bridges scholarship in history of medicine, African American history, and historical studies of children, to reframe the transformation of expectations concerning early infant life and black reproductive care within American society.