November 27, 2019KR OnlineFiction

The Expectation of Cooper Hill

All my life I’ve been told I take after Sylvia Summer. Sylvia “Spoon” Summer. My great-great-grandmother. My namesake. I am Vee.

Sylvia Summer was a midwife. She kept her herbs and all her belongings in a two-wheeled cart, which she pulled from town to town, birth to birth. Her legs were long. She could cross any stream in two steps—one into the water and one out.

She settled in Cooper Hill, an eddy of a town on the Coosa River, well back in the clay beds. She was there in August 1928, when another midwife named Aunt Georgina returned from some fancy training in Montgomery. Sylvia went to meet her. All the midwives of Cooper Hill did. Aunt Georgina showed them her new leather doctor’s bag and the glass-bottled pharmaceuticals—silver nitrate, for the infant’s eyes; boric acid, better than lard for the cord; a length of sterile linen cloth, which lined the bag’s interior.

The midwives of Cooper Hill took turns carrying the leather bag up and down the street, strutting under its weight. They listened to the glass bottles chime inside. Sylvia Summer, on her turn, thumbed the clasp and opened the bag. The bag was so dark inside she couldn’t see the bottom. She reached for it with her fingers. Nothing. The bag went on and on forever. Sylvia reached her hand, her whole arm, her head and shoulders down into that emptiness.

Now, wait a minute. “That’s impossible,” I said to my grandmother. I was thirteen.

“That’s how it was.”

“I don’t believe it.”

The leather bag smelled sour inside like old milk. From its depths came a breath of hot air, a beery exhale. Sylvia Summer withdrew her head and shoulders. She snapped that bag shut.

One month later, Sylvia Summer vanished.


Sylvia was strong. She once took first place in the crosscut-sawing competition at the Montgomery Lumberjack show. She carried a pig knife with a bone handle, and she could use it. She was large. Tall, I mean. Big-boned, like my grandmother. Sylvia Summer broke chairs, sometimes got stuck in doorways. She was often mistaken, from behind, for a man. People don’t expect a woman to be so tall.

She was white, unusual for a midwife in that time. She was never trained as a midwife. Never licensed. She had no family and no home. Her only child—a boy, my grandfather—she left at a nunnery. She visited once a year. She devoted her life to the public, delivering hundreds of babies. When she started her work, an infant come to term in rural Alabama had a one in six chance of dying before it cleared the womb—by the end of her tenure, it was down to one in ten. I’m not saying that was all her doing, but she had a part.

For two decades, she corresponded regularly with Elizabeth Cromwell, a leader of women’s health reform in Alabama. I always knew she’d corresponded, but for many years I hadn’t read her letters. I’ve read them now. Sometimes I wish I hadn’t, that I’d somehow protected the Sylvia Summer of my childhood.


My grandmother was a midwife, too. She caught her last baby in the bathtub of a Red Roof Inn. That baby got her a felony conviction.

Usually, my grandmother caught her babies across the state line in Florida, where she had a birthing house with Jacuzzi tub and a license to practice midwifery. But that day, as she drove the mother and her husband toward the state line, a tractor-trailer overturned on the highway eastbound. Three lanes of traffic gridlocked. My grandmother pulled off the highway, parked at the nearest motel. She caught that baby six miles shy of the Florida border in a rented room where the bathtub faucet only dribbled. There wasn’t but an inch of water in the tub when the baby slid into my grandmother’s hands—fast and headfirst and blue as lungfish, all tangled in his cord.

My grandmother spent six minutes attempting infant resuscitation, ninety seconds administering Pitocin to slow the mother’s bleeding, eleven minutes redlining it to the Baptist Hospital where the mother was sutured, the child intubated, and my grandmother charged with practicing medicine without a license, a felony in the state of Alabama. A week later, when the baby died, she got involuntary manslaughter as well.

All of this was recorded in the court records she verified with her signature. She spent time in pretrial confinement. We visited her once on Independence Day and once on her birthday. My mother parked each time at a Payless close to the jailhouse, because she didn’t want anyone seeing her van in the jailhouse lot. People would talk, she said. They did.

My grandmother was sentenced to five years in prison, suspended, and a three-year probation. After that, she couldn’t get a job. Her income during probation came from sitting me Monday through Friday while my mother worked day shifts at the hospice center and accumulated evening credits toward her nursing degree. I was thirteen. I didn’t need the sitting, but my grandmother needed the money.

My mother and grandmother didn’t get along, so on Fridays my mother handed me eight twenty-dollar bills, which I ferried across the front porch to my grandmother, who sat at the table in her summer kitchen, smoking Pall Mall’s. “Count it,” my grandmother said to me, and I counted by twenties, slapping the bills down onto the cedar planks of her table, feeling awfully important and afraid—of miscounting, of coming up short, of the woman at my right elbow and the woman at my back, either of whom might declare at any moment I was costing her too much.


My grandmother told me about the Cooper Hill midwives during those afternoons she kept me, skinning empty soda cans with her fish knife.

The Children’s Bureau had called them “the Cooper Hill coven.” A collection of midwives, of course, is not a coven. It’s an expectation. The expectation of Cooper Hill was the last outpost of traditional midwifery in the state of Alabama.

Until August 1928, the midwives of Cooper Hill practiced as they had in the nineteenth century—no forceps, no ether, no twilight sleep. In Cooper Hill, when a woman was well into labor, she bid her eldest hang one bedsheet in the house window, and the news of her laboring slipped through the clay beds faster than the water of the Tennessee. One midwife came. Either Aunt Georgina or Missouria “Bama” Holley or Wanita or Rula Rousseau. Four black women who attended the mothers of Cooper Hill at their lying-in.

Sylvia joined them in the summer of 1928, because it was getting difficult for a midwife to find work in the city. She rented Aunt Georgina’s birthing house while Aunt Georgina completed some new-fangled midwife training in Montgomery. I like to think they were friends—Sylvia and Aunt Georgina—at least as far as two women, one black and one white, could have been friends in those days. Aunt Georgina trusted Sylvia enough to leave her the birthing house that summer. When Georgina returned from her training, they shared the space. For a time, they shared it amicably.

I like to think they slept, both of them, on the screened porch out back of the birthing house. They took turns on call each night, because a baby won’t wait for sunup to crown. Maybe they shared suppers of rice and black beans. Maybe they argued about the importance of sterile birthing rooms. Georgina would have favored scrubbing and douching with chlorine. Sylvia, lye and cinnamon oil. Whatever came after, I like to think they started as friends.

It changed, of course, as circumstances do. One month after Aunt Georgina returned, jubilant, from her training, there were no midwives in Cooper Hill. The expectation of Cooper Hill had been eliminated. Sylvia had vanished.

“What happened?” I’d ask my grandmother on our afternoons together. “What happened to the midwives?”

She’d spit out whatever was in her mouth (there was always something—chewing tobacco, fruit-flavored gum, ice cubes, toothpicks), and she’d say, “The doctors came.”


Dr. Simpson—“We are making progress with regard to the midwife problem. Of the several thousand midwives in Alabama, hundreds already have been eliminated.”

Dr. Nicholson—“We cannot control the midwife, and we do not believe that the midwife can be entirely eliminated at present. All we are doing is carrying out a police supervision—there is no other word for it. The women are brought to account for any infraction of requirements. We have saved the lives of babies and mothers and improved obstetrics by our work. I believe that if we had a certain number of English-speaking, intelligent young women trained to care for women in labor, we would be able to get rid of a number of the mammies.”

Dr. Furman—“The [birthing] room was jammed with men and women, some singing, some exhorting, and one fat ‘revrunt’ was kneeling by a chair at the door, praying and sweating fervently for the woman in labor to live. I commanded silence but without avail. Then I got provoked and grabbed the fat preacher by the collar with both hands and yanked him loose from that chair and out of the door. This decided action produced instant calm, and I announced that as a doctor I was supported by the strong arm of the law and that I would indict the last mother’s son of them if that room wasn’t cleared of men instantly. Then the door and windows of that shack belched buck Negroes. One elderly mamma, who seemed to be a special high priestess of the occasion, opined that the patient was permeated with some sort of Divine Essence, though she didn’t express it in exactly those words, and that it would be obviously sacrilegious to throw such obstacles as low-down common doctors’ medicine in the way of the salvation of a human soul.”


“Sylvia was right there in Cooper Hill when they arrived,” my grandmother told me, as she cut newspaper into strips to paper her cupboards.

August 29, 1928. The doctors came on horseback. Three of them from the Children’s Bureau, sent “to inspect the midwives of Saint Clair County at Cooper Hill for compliance with industry standards of cleanliness, equipment, and medical procedure.”

The doctors forced the midwives from their birthing houses out into the street. A routine inspection. One doctor took Aunt Georgina’s leather bag and spilled it onto the gravel. Georgina had removed the glass bottles, stored them in a wooden chest in her birthing house. She’d replaced the bottles with sturdier spice jars and tobacco tins, in which she stored her new pharmaceuticals. She’d substituted newspaper for the linen lining, afraid of staining the white fabric with stool, afterbirth, or blood.

If newspaper lining and tobacco tins had been her only infractions, she might merely have been fined. But later that day, behind Georgina’s birthing room, the doctors found a two-wheeled cart containing savin and tansy, rue and yarrow. Abortifacients.

Aunt Georgina was charged with possessing illegal pharmaceuticals that could endanger an infant. She would later be sentenced to two years in Wetumpka Women’s Penitentiary.

My grandmother heard the story from her father, who heard it from a nun, who heard it from a carpenter, who saw it happen.

But what about Sylvia? Where was Sylvia Summer when Aunt Georgina was charged?

My grandmother lifted her hands, palms up. “That was the day Sylvia vanished.”

Three thousand Alabama midwives vanished in the twenties. To vanish might have meant any number of things. Murdered. Married. Brought up before the law. Crossed into Tennessee in the bed of a potato truck. Got a bit of land and kept to herself.

When my grandmother told me this story, I took Sylvia’s vanishing to mean she, too, had been a victim of the day’s proceedings. But then I read her letters.


The letters are addressed to Elizabeth Cromwell, who appears in a number of academic journals as a proponent of midwife education and women’s rights. Both Sylvia Summer and Elizabeth Cromwell followed Onnie Lessing—a respectable Montgomery midwife—in their teens. Their apprenticeships overlapped a year, 1913. In Elizabeth’s earliest journal, Sylvia merits just a footnote, her name listed along with two others as “my fellows.” This must have been efficiency, not indifference, because for years after they stayed in touch.

Working closely with the doctors, Elizabeth Cromwell established nurse-midwife training programs in Montgomery. From her journal—

“July 25, 1928—Walked five miles today to Hilton Head to instruct nine midwives. The demonstrations consisted of bedmaking, bathing of baby, enemas, douches, etc. We made newspaper pads and bedpans. We use newspaper in every available way. I make an effort to keep each demonstration so simple it will be applicable to any home, no matter how poor, that the midwife might enter in her work.

“After each lesson, we arrange the mammies in a line. Dressed in snowy cap and gown, they present their little leather bags, one by one, to the nurse for inspection. Each bag is proudly opened to reveal a perfectly ordered interior.”

This was Aunt Georgina’s class.


The first letter. August 2, 1928. Dearest Liz,

“Georgina’s just come from your school in Montgomery. She can’t stop talking about you, her new methods. I tell her I don’t need any new methods. What was good enough for Onnie is good enough for me. When did you get so high and mighty? I ask her. Georgina hardly hears me. I didn’t expect her to return. I thought she’d stay in the city like the rest of your midwives, where there’s a doctor at hand for every hiccup, every milk-eye. I suppose I should congratulate you. Soon you’ll have a hand in every corner of the state.

“Georgina says she attended a Mrs. Himmel in Montgomery, delivered a stillborn. This Mrs. Himmel was my patient not but a year ago. She’s the doctor’s patient now and Georgina’s by extension. Georgina knows she was a patient of mine. She says there’s hardly a woman in the city these days not attended by a doctor at her lying-in. That’s your doing.”

Some might read resentment in this first letter from Sylvia, a swelling bitterness. I read distress, the anxiety of a woman who chose a road she expected to follow for decades and now watches it dwindle to little more than a deer path.

Distress, as well, in the lines which follow—“Yesterday, I went with Georgina to a birth. The infant’s shoulder wedged against the mother’s pelvis briefly, and Georgina fretted. The doctor’s on his way, she told the mother. What doctor? There’s not a doctor for thirty miles, no doctor coming nor needing to come. The mother couldn’t be brought to care, of course. She’d been eight hours in labor. She couldn’t have roused herself for the Savior. The doctor’s on his way, Georgina said. On his way, on his way. A little song, she sang for herself. I suppose you taught her to sing it. I’ll tell you I much disliked the sound of it.”


“You’re just like Sylvia,” my grandmother often said. I loved to hear her say it. It was the nearest she or anyone came to complimenting me.

But how was I like Sylvia? I asked. At thirteen, I hoped to be X-rayed, scalpeled, dissected, revealed in that way to myself.

My grandmother smirked. “You’re nosy,” she said.

I was. “Where’d Sylvia go?” I always asked. “When she vanished?”

“Tennessee,” said my grandmother.


Florida. Down to the river to pray. Next door. Bottom of the deep blue sea.

My grandmother offered dozens of possibilities, but she always ended with this—“She was swallowed whole by that doctor’s bag.”


August 14, 1928

Dearest Liz,

Rula Rousseau died yesterday. There is a shadow over the clay beds. Half the population of the Hill fell out into her hands. She was headed up the hill to a birth. They found her sitting against a red oak, dead. She was old. The hill is steep. She was hurrying, some trouble with the mother. Her heart gave out, most reckon. Georgina’s locked herself away in her room. Georgina followed her as a girl, browned her linen, cooked her cords in the ashes for years. She’s grieving.

I might stay in Cooper Hill. Without Rousseau, the midwives will be hard-pressed to see to the needs of every woman. Georgina doesn’t want me here. There’s no place in Cooper Hill, she says, for my herbs and old-fashioned opinions. I should have left two weeks ago, she says, the day she returned from Montgomery.

She’s wrong. I should have left five months ago. I should have kept drifting, town to town. I let myself be seduced by this place, the Tennessee and the quiet and the crayfish out of the shallows.

It’s a mistake to stay, but I won’t be run off by Georgina. There’s no place for me in Montgomery. You know it as well as anyone. Here, at least, there are women who choose my black haw over Georgina’s aspirin. I only wish I could count one true friend among them.

Your Silver Spoon


The doctor’s bag caught Sylvia Summer by her skirt. It spun her around, tossed her into the air and stretched open as she plummeted. It nearly split, attempting to accommodate the considerable breadth of Sylvia’s shoulders. Sylvia Summer made no sound as the bag swallowed her. The bag snapped shut. A tiny red tongue flicked once around the handle to polish it, then the tongue disappeared as well.

“That’s ridiculous. You made it up.” At thirteen, I had no patience for fantasy.

“I didn’t.”

“How could you know that?”

The doctors saw it. The midwives watched it happen. The townspeople had gathered. They saw it. They still talk about it. They say Aunt Georgina rushed to open the bag after, but there was nothing inside save the newspaper lining.

“You don’t know she was eaten. Sylvia might’ve jumped into the bag. She might’ve been trying to escape the doctors.”

“That bag’s the last place she’d decide to go.” My grandmother turned her head, blew smoke just past my left ear. “Besides, she left her cart.”

“Her cart?”

My grandmother studied me. “You’re a whore,” she said, delighted. She leaned her chair back on two legs, kicking her feet up onto the table. “What wouldn’t you do for a story? I might tell you to lick the wax from my ear, you’d do it.” She loved to find these little flaws, desires, any hold she might have over me.

She wanted to impress me. I was, that year, her only company, her only regular audience. This, I think, was the reason for her fantasies. The women in my family have always been capable of invention.

“What do you mean, she left her cart?”


That third letter. August 23, 1928. To Elizabeth.

Georgina’s insufferable. Last week, she snuffed the candle Missouria had lit beneath the birthing bed. The mother wasn’t more than twenty. Her first delivery, and Georgina starts an argument in the birthing room.

She calls my black haw and cohosh tea “rat piss.” Tells the women who come looking for it they’d do better drinking right out of the Tennessee. She’s lost me more than one patient. There’s talk of women traveling to Gadsden for their deliveries, and I don’t blame them.

I’ve tried telling Georgina the women here want a birthing candle, want to cook the cord. Wanita and Missouria try. Georgina doesn’t want to hear it. The doctor’s techniques plus mine, she says, and I’m twice as sure of success.

You’d say she’s right, of course. You and Georgina both think you know better than the rest of us. But I can tell you when she’s up against the grindstone, Georgina’s no different than I am. Yesterday, she saw to a girl looking to restore her menses. The girl was thin-hipped and young and dizzy when she stood. She had no reason to bring that baby to term. Georgina closed me out of the birthing room, but she let Wanita stay. Wanita told me Georgina fixed that girl with savin twice boiled and strained through a cloth. Just as I’d have done.

You might not have such a handle over your nurses, Elizabeth, as you believe. At the end of the day, however you dress her up, Georgina’s a granny, same as I am. If you won’t call her back to the city, I’ll see to it she goes myself.



Six days after Sylvia Summer posted this last letter, the doctors arrived in Cooper Hill.

It’s possible their coming had nothing to do with Sylvia’s letters. Perhaps the inspection was already scheduled. But I think the doctors came because of the letter. Elizabeth Cromwell couldn’t afford to have her trained midwives performing abortions, especially not herbal abortions.

Sylvia knew that. Sylvia planned it all.


I was twenty the year I read these letters. The Department of Public Health made them public, part of a national campaign to improve transparency within the organization and “come to terms with the racial injustices of our past.”

I took the letters immediately to my grandmother. It had been three years since I’d seen her. She’d invited me—for dinner on a Thursday, for Sunday brunch. I was always busy. I was choreographing a ribbon dance with the Colorguard or traveling with the French horns to Tallahassee.

“Letters from Sylvia,” she said when I arrived. “That’s a treat.”

She’d set a table in her summer kitchen with potatoes and pinto beans and succotash, and she insisted we eat before reading the letters. I ate little, because she’d creamed her potatoes with mayonnaise and cooked the beans in, of all things, lard.

“My eyes aren’t what they used to be,” she said, when I attempted to foist the letters on her. “You’ll have to read them to me.”

I did. I read without stopping, without looking up from the page to gauge her reaction. When I’d finished, I asked—in the clipped, unemotional tone with which a young journalist deals a violent but necessary blow—“What did Sylvia carry in her cart?”

Drop-daisy. Oil of cloves. Pennyroyal. Savin.


Certainly. Savin.

But savin was illegal. Savin caused abortion. Abortion was illegal.

Any midwife worth her salt kept savin on hand.

Did she have savin in her cart on Cooper Hill? Was it her cart they found in back of Aunt Georgina’s house? Was it her cart that got Aunt Georgina arrested? Was it her fault?

Was it savage, my grandmother’s grin? I think it was savage. The smile of a woman who knows something you should have realized long ago. Because you haven’t, she must tell you, must tear the caul away from the hideous, squalling newborn. “It might have been. It could have been. I never said she was nice.”

Sitting there in front of my grandmother, I felt not disappointment, not betrayal, but a heady sense of importance—one of those rare moments whose significance is realized not in retrospect but right there, in the moment itself. My grandmother sponged the last juice from her plate with a puff-roll, appearing utterly at ease, unaware that the foundations of the world had shaken and rearranged themselves.

“She framed Aunt Georgina. She sold Aunt Georgina out.”

“Oh, she wasn’t after Georgina. Georgina didn’t mean a thing to Sylvia. Sylvia was after Elizabeth.”

“She was awful. She was racist.”

“No more than the next person.” My grandmother spooned the last of the beans directly from the serving dish into her mouth and said, mouth full, “I know you admired Sylvia. Something of a hero for you.”

“She never was,” I said. “For you, maybe.”

“You loved those stories. You’d always ask me for those stories.”

“I never asked.” And if I had, what of it. I was thirteen.

Later, she lit a cigarette, lit one for me without asking if I smoked. I didn’t, not regularly, but I did with her that afternoon. She seemed to have forgotten the letters entirely. “You remember the day I was arrested?” she asked.

Of course, I remembered. I’d watched from my mother’s minivan, parked in the lot of the Baptist Hospital. My mother cracked the windows of the minivan and told me, “You stay right here.” I watched my grandmother attempt to climb into the police cruiser with her hands cuffed behind her. She couldn’t, so they took away the cuffs. They let her use her hands to pull herself up into the shotgun seat. I watched her settle her purse on the dash and mouth instructions to my mother through the window as the cruiser pulled away. It was easy, on that day, to imagine she was leaving in a cab to spend a few weeks at the Bay, as she often did in summer.

“I saved her life that day,” she said to me. “The mother’s life.” This I hadn’t heard. “The doctor told me when we arrived at the hospital. He said giving her Pitocin right away like I did saved her life.”

My grandmother, all her life, called doctors shysters and quacks. She refused to stand in the same room with them. She refused to attend my birth, because my mother chose to deliver in a hospital.

“The doctor said it,” she repeated, as if his being a doctor added legitimacy to his words.

It would be years before I wrote an essay—“Why My Grandmother’s a Felon”—about her case and the long history of Alabama’s anti-midwife legislation. So long I would forget this moment, forget the way her words lifted and restored me, calmed my nerves, set me up on some platform she couldn’t reach and would never reach. She’d revealed herself, her hypocrisy. It would be years before I sat down to write that essay, but this was the moment when writing it became possible.


One month before my grandmother’s death, my mother called me. I was living in Oregon, writing copy for an ad agency.

“She’s been asking why you never come to see her,” my mother said. “Seeing as how those afternoons you spent together were so rich.”

I was silent. I didn’t understand.

“In your article,” she said. “You wrote how rich they were.”

Had I written that? Had I used that word, “rich”? I suppose I had. I must’ve. I didn’t remember. I’d published the essay five years before and hadn’t read it since. I had no intention of reading it again. It seemed the work of an altogether different person, and I resented my mother holding me responsible for it.

“She called me after it came out. She was peeved.”

“I defended her. I was only defending her.”

“Don’t take it up with me. I’m only telling you she didn’t appreciate the way you made her out.”

I never did visit my grandmother. She’d have wanted to reminisce about Sylvia. “You’re like Sylvia,” she would say, and how would I defend myself?

My grandmother died of an ingrown toenail, an infection any course of antibiotics would have cleared in a week. I felt a certain satisfaction, hearing from my mother how she’d packed the toe with willow bark and boneset. You expect certain things of a woman like that.


In 1933, as part of the Federal Writers Project, Aunt Georgina, “one of the last practicing granny midwives,” was interviewed by an oral historian from the University of Tennessee.

[Georgina]: I never did want to be a midwife. The Lord told me I was to be a midwife, and I told Him, “No, thank you.” I saw what Miss Rula Rousseau went through, up all hours of the night and how she had to travel.

But He said, “We’ll that’s what you’re going to be.”

Everywhere I went after that babies would fall out of their mothers, fall right in front of me, and I didn’t have a choice but to catch them. It was catch them or let them drop onto the floor. They started calling me a midwife. I couldn’t stop them doing it.

[Interviewer]: But you were trained as a midwife?

[Georgina]: I met a doctor told me I could train up at no cost to myself. I trained up at the Montgomery School. We followed the doctors. We went around with them, helped with the setting up and the cleaning up. Sometimes we delivered the baby ourselves, because the doctor was late getting to the birthing room. We had these leather bags to take around with us—nice bags with glass bottles right inside for the medicine.

[Interviewer]: You were arrested. When was that? Do you remember that day?

[Georgina]: The day? The day wasn’t interesting. Other people, maybe, were interested in the doctors. I’d seen enough doctors by that point to be sick of them. There was one doctor, after it was all over, he picked up my doctor’s bag and polished the handle with his shirtsleeve. I remember that, because it’s something I’d have liked to do.



Dodd, Ruth. “An Open Air Class.” The Public Health Nurse, 1921.

Furman, R., M.D. “Ignorance, Superstition, Quackery.” Journal of South Carolina Medical Association, 1916.

Maxwell, Kelena. “Birth behind the Veil: African American Midwives and Mothers in the Rural South, 1921–1962.” Dissertation. October, 2009.

Nicholson, William, M.D. “Discussion on the Midwife.” Journal of the American Medical Association, 1916.

Southern Medical Journal. January 1, 1922.

White, Deborah. Ar’n’t I a Woman?: Female Slaves in the Plantation South, 1985.