Nurse Midwife (1951/2013)
W. Eugene Smith’s Landmark Photo Essay, ‘Nurse Midwife’
In December 1951, LIFE published one of the most extraordinary photo essays ever to appear in the magazine. Across a dozen pages, and featuring more than 20 of the great W. Eugene Smith’ pictures, the story of a tireless South Carolina nurse and midwife named Maude Callen opened a window on a world that, surely, countless LIFE readers had never seen — and, perhaps, had never even imagined. Working in the rural South in the 1950s, in “an area of some 400 square miles veined with muddy roads,” as LIFE put it, Callen served as “doctor, dietician, psychologist, bail-goer and friend” to thousands of poor (most of them desperately poor) patients — only two percent of whom were white.Calling Maude Callen a heroic figure — especially today, when the word “hero” is thrown around like confetti — might strike some as problematic. She was, after all, not really risking her life in her daily and nightly rounds. But how else should we characterize a woman who saved so many others through her work, and who firmly, compassionately delivered into the world so many children who, without her intervention, might well have died at or shortly after birth? What else do we call someone who dedicated seemingly every waking moment to helping others — in a time and place where pain and want were the rule, rather than the exception?The article in LIFE, titled simply “Nurse Midwife,” that chronicled Callen’s work and her unique role in her community is a companion piece, of sorts, to Smith’s 1948 essay, “Country Doctor.” Spending time with the two essays, one gets the sense that Maude Callen and Dr. Ernest Ceriani of Kremmling, Colorado — while physically separated by thousands of miles, as well as by the even broader, thornier barrier of race -— would not only understand one another, on an elemental level, but that each would recognize something utterly familiar in the other. Their lives and the landscapes they navigated might have been as different, in critical ways, as one can possibly imagine; but in the essentials, they were kindred spirits. They were healers.Here, LIFE.com presents “Nurse Midwife” in its entirety, as well as images that Smith shot for the story but that were never published in LIFE.The story in LIFE began this way, setting the stage for what one reader called, echoing the numerous awe-struck letters to the editor published in a later issue, “one of the greatest pieces of photojournalism I have seen in years”:Some weeks ago in the South Carolina village of Pineville, in Berkeley County on the edge of Hell Hole Swamp, the time arrived for Alice Cooper to have a baby and she sent fr the midwife. At first it seemed that everything was all right, but soon the midwife noticed signs of trouble. Hastily she sent for a woman name Maude Callen to come and take over.After Maude Callen arrived at 6 p.m., Alie Cooper’s labor grew more severe. It lasted through the night until dawn. But at the end she was safely delivered of a healthy son. The new midwife had succeeded in a situation where the fast-disappearing “granny” midwife of the South, armed with superstition and a pair of rusty scissors, might have killed both mother and child.Maude Callen is a member of a unique group, the nurse midwife. Although there are perhaps 20,000 common midwives practicing, trained nurse midwives are rare. There are only nine in South Carolina, 300 in the nation. Their education includes the full course required of all registered nurses, training in public heath and at least six months’ classes in obstetrics.Maude Callen has delivered countless babies in her career, but obstetrics is only part of her work… To those who think that a middle-aged Negro [sic] without a medical degree has no business meddling in affairs such as these, Dr. William Fishburne, director of the Berkeley County health department, has a ready answer. When he was asked whether he thought Maude Callen could be spared to do some teaching for the state board of health, he replied, “If you have to take her, I can only ask you to join me in prayer for the people left here.”For W. Eugene Smith, work mattered. Throughout his legendary career, he sought out and chronicled the lives and the labor of people who knew their craft. Whether he was photographing a world figure like Dr. Albert Schweitzer in Africa or anonymous Welsh coal miners; a doctor in the Rockies or a midwife in South Carolina; Smith saw something noble in hard work, and something profoundly admirable in men and women who cared enough to do their work well.But one would be hard-pressed to find anyone who ever appeared in LIFE’s pages whose humble and necessary work merited more admiration than that of the unforgettable, unbreakable nurse midwife of Smith’s 1951 photo essay. After the piece was published, LIFE subscribers from all over the country sent donations, large and small, to help Mrs. Callen in what one reader called “her magnificent endeavor.” Thousands of dollars poured in — sometimes in pennies and nickels, sometimes more — until, as LIFE later reported, she was overwhelmed by the response.“Halfway through a recent day’s mail, [Mrs. Callen] said to her husband: ‘I’m too tired and happy to read more tonight. I just want to sit here and be thankful.'”Eventually, more than $20,000 in donations helped to build a clinic in Pineville, where Mrs. Callen worked until her retirement in 1971.In later years, Maude Callen was still (rightfully) being celebrated for her life’s work. She was honored with the Alexis de Tocqueville Society Award in 1984 for six decades of service to her community, and in 1989 the Medical University of South Carolina (MUSC) awarded her an honorary degree, while the MUSC College of Nursing created a scholarship in her name.Maude Callen died in 1990 at the age of 91 in Pineville, South Carolina, where she had lived, and served, for seven decades.Liz Ronk, who edited this gallery, is the Photo Editor for LIFE.com. Follow her on Twitter @lizabethronk.Caption from LIFE. Weary but watchful, Maude sits by as mother dozes.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Waiting, the young mother leans forlornly against the window, ignoring sympathy and looking for Maude's car.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Frightened and sick, the nervous mother is helped by Phoebe Gadsden, the first midwife she called. Mrs. Gadsen, a practicing midwife who attended Maude's classes has helped at several deliveries but felt that this one needed special attention and so decided to ask Maude to come and supervise.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Maude gets ready in kitchen by lamplight ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. In deep pain, the 17-year-old mother writhes, mumbling prayers while Mrs. Gadsden holds her hand ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. 4 A.M. As hard labor begins, the face of Alice Cooper seems to sum up all the suffering of every woman who has ever borne a child.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. 5:30 A.M. A few seconds after the normal delivery, Maude Callen holds the healthy child as he fills his lungs and begins to cry.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. 5:40 A.M. The long suffering over, the mother first sees her son. She had no name for him, but a week later she chose Harris Lee.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. 5:45 A.M. The mother's aunt, Catherine Prileau, tries to soothe her so that she will go to sleep and begin to forget her misery.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. 6:20 A.M. Her work over at last, Nurse Midwife Callen quietly takes the first nourishment that she has had for more than 27 hours.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Maude at 51 has a thoughtful, weary face that reflects the fury of her life. Orphaned at 7, she was brought up by an uncle in Florida, studied at Georgia Infirmary in Savannah, became a nurse at 21.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. After another delivery Maude departs at 4:30 a.m., leaving the case in charge of another midwife. Since she is already up, she is likely not to go to bed but to continue through rest of morning.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Healthy twins, who were delivered a day apart last year by Maude, get a quick once-over when she stops in to see them and pump herself a drink of water. Only about 2 percent of her patients are white.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Tuberculosis case, 33-year-old Leon Snipe, sits morosely on bed while Maude arranges with his sister for him to go to state sanatorium. W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Accident case is brought to Maude's door one night. Annabelle Fuller was seriously cut in an auto accident and Maude had given her first aid. Now the girl returns to have her dressings changed.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Crippled girl greets Maude at her door. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. New dresses for 9-year-old Carrie (right) and 8-year-old Mary Jane Covington were dropped off by Maude on her way to a patient. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Simple kindness overwhelms an old man. Frank McCray had a headache one day in 1927, soon was paralyzed, and has been in this chair ever since. He broke down and wept when Maude stopped in.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Extra duty assumed by Maude includes cashing of relief checks and dealing with storekeepers for several people who are mentally incompetent or, like this man, blind. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Store-bought-food donated by Maude fascinates youngsters outside log cabin. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. After a call she wades back to her car. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Dying baby who is suffering from acute enteritis is rushed to hospital. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Transfusion was almost impossible because fever's dehydration had affected arm veins and doctor had to try one in neck. Baby died before he could get blood flowing.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Dr. W. K. Fishburne, head of the Berkeley County health department, examines a patient brought to hospital by Maude.W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Outside a clinic held in school, crowd waits to see Maude. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Inside a church. Maude inspects a patient behind a bedsheet screen. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Making a delivery pad in patient's home according to classroom method. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Incubator is made of box and whisky bottles full of warm water. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Crib is made of an old fruit crate propped near a cold stove. ...W. Eugene Smith—Time & Life Pictures/Getty ImagesCaption from LIFE. Teaching a midwife class, Maude shows how to examine a baby for abnormalities. She conducts some 84 classes, helps coach about 12 new midwives each year. ...W. Eugene Smith—Time & Life Pictures/Getty Images"Nurse Midwife" as it appeared in the Dec. 3, 1951, issue of LIFE. (NOTE: This gallery is best viewed in "full screen" mode. See button at right.)


Life MagazineNot published in LIFE. Nurse midwife Maude Callen, South Carolina, 1951.W. Eugene Smith—Time & Life Pictures/Getty ImagesNot published in LIFE. Pregnant woman, South Carolina, 1951.W. Eugene Smith—Time & Life Pictures/Getty Images"Nurse Midwife" as it appeared in the Dec. 3, 1951, issue of LIFE. (NOTE: This gallery is best viewed in "full screen" mode. See button at right.)Life MagazineNot published in LIFE. Newborn delivered by nurse midwife Maude Callen, South Carolina, 1951.W. Eugene Smith—Time & Life Pictures/Getty Images"Nurse Midwife" as it appeared in the Dec. 3, 1951, issue of LIFE. (NOTE: This gallery is best viewed in "full screen" mode. See button at right.)Life MagazineNot published in LIFE. Nurse midwife Maude Callen, South Carolina, 1951.W. Eugene Smith—Time & Life Pictures/Getty ImagesNot published in LIFE. Nurse midwife Maude Callen (right), South Carolina, 1951.W. Eugene Smith—Time & Life Pictures/Getty Images"Nurse Midwife" as it appeared in the Dec. 3, 1951, issue of LIFE. (NOTE: This gallery is best viewed in "full screen" mode. See button at right.)Life MagazineNot published in LIFE. South Carolina, 1951.W. Eugene Smith—Time & Life Pictures/Getty ImagesNot published in LIFE. Nurse midwife Maude Callen, South Carolina, 1951.W. Eugene Smith—Time & Life Pictures/Getty Images"Nurse Midwife" as it appeared in the Dec. 3, 1951, issue of LIFE. (NOTE: This gallery is best viewed in "full screen" mode. See button at right.)Life MagazineNot published in LIFE. Child treated by nurse midwife Maude Callen, South Carolina, 1951.W. Eugene Smith—Time & Life Pictures/Getty Images"Nurse Midwife" as it appeared in the Dec. 3, 1951, issue of LIFE. (NOTE: This gallery is best viewed in "full screen" mode. See button at right.)Life MagazineNot published in LIFE. Nurse midwife Maude Callen, South Carolina, 1951.W. Eugene Smith—Time & Life Pictures/Getty Images