Midwife Mary Francis Coley

I recently watched the educational documentary film, “All My Babies: A Midwife’s Own Story,” featuring Midwife Mary Francis Hill Coley, using the Library of Congress Youtube channel. I was so impressed by the film and it’s star actor that I wanted to write this essay about her. I invite you to watch the film for yourself, but to recap, in the film you will see a phenomenal example of an extraordinary midwife nurse in her home community practice. In light of the current worldwide discrepancies in healthcare and urgent demand for access, people could learn a lot from Mary Coley. Narrated and acted by Mary herself, the film acts as a template for any beginner to midwifery and provides sound advice to any midwife acting in a rural or field setting. In short, if left with no guidebook, and forced to perform an emergency delivery, this film could make all the difference for you. I have decided that she is the face for my inspiration board in the coming year. What the world needs now, is Midwife Mary Coley.

I live in Albuquerque, New Mexico, United States. As I write this, most members of the world, including myself, are in quarantine due to the coronavirus (COVID-19). As a member of the healthcare community, right now I am in a precarious spot, but let me explain:

I became a nurse assistant five years ago. I’m currently 36, and over the years I have latched onto many female role models. I’m the youngest of a big family and have moved many times as an adult. Over the years, I have acquired many curiosities handed down through my family, friends, or have picked up “in my travels.” What ends up happening each time you have to pack-up is inevitably you end up re-examining each belonging you own to determine if it warrants the energy required to move once more. In the end, the things we find ourselves holding onto are sometimes strange and difficult to explain or defend. Such was the case with some old publications of National Geographic Magazine I’d been lugging around for “however long” which all seemed to come from “nowhere,” a very long time before I was even “thought of.” Inside one magazine, I found a still photograph taken from the film of Midwife Mary and pasted it into the back cover of a journal for motivation. I hadn’t known anything about her before, but became captivated and inspired by the sight of her in the photo, washing a newborn infant.

I had found myself on the path to nursing reluctantly, after I had become a caregiver and home health aide for my family. The years leading up to caregiving had been spent running down a dream of trying to make a living “anywhere but here.” I had tried several times to get out of town, this time it was to Texas.

To its credit, New Mexico is a beautiful place. It’s state motto is “The land of enchantment,” and truly has so much to be proud of, but it has its problems too. I’d say a majority of youth in Albuquerque dream of leaving. Those with an education usually do. Growing up, I constantly felt torn between wanting to move somewhere where "the grass was greener," and trying to be content with staying around to "be the change." I think many of my friends have now pursued careers elsewhere, or at least that’s how it appears from social media. Sometimes I think the only decent jobs available here are for engineers, a goal that is somewhat unattainable for many. Keeping your hands clean in this town is tricky too. There is a lot of homelessness, crime, and soreness about the past. Those who are new in town will refrain, “come on vacation, stay for probation.” Cities are remote, and family obligations are heavy. The adage quickly turns to “The land of entrapment” for those who stay long enough to taste its bitter realities.

So at 29 I moved back home from Austin, TX and switched from being a waitress to a home health aide for my family. I was a glorified maid, paid in minimum wage by Medicare. I don’t want to say too much, but business, family, and healthcare are difficult boundaries to skirt. Anyone who has been a maid, a caregiver, inherited the family business or lives in their mother’s basement knows what I’m talking about. Anyway, it wasn’t all bad, but I had to quit. I had never felt very confident imagining myself in charge of other people’s health and bodies before, but after taking care of my family I decided that I was more perceptive and attentive to others needs than the majority of people I’d known. I figured I’d gained a lot of experience while taking care of my family and decided I might as well continue on by going to school to become a certified nurse assistant.

I started working at a nursing home/rehab hospital and got into nursing school. I didn’t get through the nursing school program on my first try, but the good news is that I bought the whole set of books. Since I had to wait to reapply for nursing school, I decided to bide my time and try to work on my psychology degree instead. Unfortunately I started to get overwhelmed shortly after getting through my Associate’s and decided to stop school altogether for a while. It was just too much to try to go to school full time and work full time, and I was getting old. “Oh dear, I’m childless and unmarried at age 34, why ever did I take out those student loans?”

Downtrodden, and looking for a change, I did what any normal woman would do; I started browsing men on an online dating site. I found a guy who seemed like a great match, but as I got further into the relationship, he became more and more controlling. By my 36th birthday, I decided I needed to leave. At this time COVID-19 was just officially declared a pandemic. The problem was, I had already been unemployed for a year because of my husband’s pre-coronavirus "germaphobia." He had demanded that I quit my job shortly after I had moved in with him because he thought I was bringing home illnesses. In truth, I think he used his phobias and hypochondria as a way to control me, more than I believe that he truly was sick and afraid. Nevertheless, I was now in a situation where I had no savings and was dependent on strangers to take me in for shelter. I was so lucky to have met an older woman and her son who had offered me a bed, which I will continue to be eternally grateful for. If it weren’t for a talk I had with her on the phone previously during a fight I was having with my husband, I would not have had the strength or hope to have left him when I did.

Now, a short time later, we are all observing quarantine. I have so many conflicting feelings again. It is tempting to want to return to being a nurse assistant because I would be hired right away with the demand so high, and probably at a higher wage than before. I’m seeing all my old co-workers out there on the front lines and also feeling called to service, but I am feeling held back by not wanting to endanger the people who just recently saved my life. I know how risky working in the healthcare industry is right now and am scared of the consequences for myself too, but looking for work in other fields is limited for me right now. If I had made it through nursing school, the job would look a lot more desirable with higher pay, but unfortunately, I am still looking at a nurse assistant pay grade. For now, I am reluctantly staying out of it, while still looking for ways to help.

For these reasons, Midwife Mary Coley inspires me. In her film, she shows how important midwives are to a community. When a woman becomes pregnant, there are many socioeconomic factors that can suddenly come into play or become apparent in addition to or in accordance with biological factors. Midwives have a unique window of opportunity to provide positive intervention in the home for individuals and families that can ultimately uplift the overall general well-being of the entire community. Midwife Mary highlights the range of differences in quality of life between socioeconomic classes at home and how they may affect a pregnancy or the well-being of an expectant mother. She shows how differences in belief systems can affect the outcome of a pregnancy and the mother’s health in plain and simple terms. She guides us with practical examples of how to address healthcare disparities with families. Midwife Mary emphasizes the most critical aspects of performing a safe childbirth with limited resources in a rural setting, and what I find even more impactful, is with what tremendous foresight she and her contemporaries must have had to use a fairly new innovation in technology: videography, to multiply her impact in teaching generations of midwives that would come after her. Her film documents real standards of living in the rural south of the United States during a segregated post World-War II.

What I love about the field of healthcare is, when it comes down to it, what matters most is if you can do the job, or not. A piece of paper is nice, and it is important to hold your practice to the highest standard possible by using the most currently available evidence-based research, but in the end, what really makes someone a nurse is skill. Skill is something that no paper can give, or take away. Life happens. We have seen that worldwide this year. Sometimes we have to go with what we are given. If an emergency arose, and I were unable to find a licensed midwife, I could at least use Mary Coley’s video as a guide to do my best, and first "do no harm." Midwife Mary Coley inspires me to continue to learn nursing by pushing me to continue to read my books. If I have the knowledge, that is half the battle. Jumping into life and taking the responsibility is the hardest part, and usually it happens before we feel we are ready. Nothing can prepare you for life. Experience is the heart of it.

This film is exactly what the healthcare community should be doing right now. We do not want to put too much knowledge in the hands of people who may not respect it or abuse it, but at a time so dire, we should be thinking about all the ways we can use technology to raise the collective standard of living and advance healthcare access worldwide. Video, AI, computer programming, digital printing, live streaming, and bio-engineering should all be utilized as tools to reinvent healthcare practices and spread awareness and knowledge of the latest science in nursing, nutrition and general hygiene. There is so much we can be doing right now to utilize every skill we can think of to take care of the citizens of the world. We just need to recognize each other’s talents and unite across societies to make this progress a reality.

Katherine Hall, March 26, 2020; @Katherinetreks, Albuquerque, NM