Implementing the Changes

With county and state structures in place this chapter focuses on the ways in which licensed midwives adapted to the regulations and supervision and the improvisation that was required to transfer the “new laws” into the community in the face of overwhelming poverty. Ensuring attendance at prenatal clinic and adequate preparation for delivery were hallmarks of the midwife’s role, as were home demonstrations of the ideal delivery room. Using a deep foundation of trust and authority midwives were able to distance themselves from traditional practices that were no longer permitted, however evidence suggests that on occasion the regulations stipulated in the midwife manual were overlooked for a number of reasons. The chapter demonstrates how supervising public health nurses used the midwife’s bag to monitor adherence to the rules and how it came symbolize the modern licensed midwife.