Granny women were healers and midwives in Southern Appalachia and the Ozark Mountains, documented as practicing from the 1880s to the 1930s. They were usually elder women in the community and were often the only practitioners of healthcare in the poor rural areas of Southern Appalachia. They seldom expected or received payment, and were respected as authorities on herbal healing and childbirth. Their role is well-described by John C. Campbell in The Southern Highlander and His Homeland[1]:
There is something magnificent in many of the older women with their stern theology -- part mysticism, part fatalism -- and their deep understanding of life. ..."Granny" -- and one may be a grandmother young in the mountains -- if she has survived the labor and tribulation of her younger days, has gained a freedom and a place of irresponsible authority in the home hardly rivaled by the men of the family. ...Though superstitious she has a fund of common sense, and she is a shrewd judge of character. In sickness she is the first to be consulted, for she is generally something of an herb doctor, and her advice is sought by the young people of half the countryside in all things from a love affair to putting a new web in the loom.[1]
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In the late nineteenth and early twentieth centuries, few doctors practiced in rural Southern Appalachia. The few physicians that practiced were often poorly trained, inept, and even dangerous through most of the nineteenth century. Civil War doctors, for example, had no knowledge of germs, did not endeavor to keep their hands clean, and often explained away disease as the will of God. The quality of their education varied widely, and states lacked uniform licensing requirements.[2] With few effective drugs available, doctors often gave patients purgatives and emetics, believing that the causes of illness could be forced out through the stomach. Most rural Americans preferred the gentler and more familiar herbal remedies provided by Granny women.
Granny women’s medicine was handed down orally from generation to generation, in a time and region where most women were illiterate. Granny women usually learned remedies and healing methods from other women healers, either family members or neighbors..
Granny women were experts of local pharmacology, and had a sophisticated knowledge of local plants. They knew how much of each ingredient to use, how long to boil, and how much to administer. They knew whether the herb should be decocted (boiled), infused (not boiled) or emulsified (used in an ointment). Their medicine often called for the leaves of a plant to be used for one ailment, the roots for another, and the berries for another. Granny women knew how to process each herb or plant so as not to affect its potency, exactly when to harvest each plant, and how to avoid harmful side effects that accompanied each plant.[2]
The following is a traditional plant-based medicine for whooping cough:
Boil blossoms in water and strain. Add honey; bottle. Dosage: 1 teaspoon twice daily.
At the turn of the 20th century, granny women attended to roughly fifty percent of the births in Southern Appalachia.[3] During the late nineteenth century and early twentieth century, childbirth was dangerous, and granny women played an integral role in the survival of women in rural areas.[2] Even when a doctor was called to attend a birth, the baby was often born before the doctor could make the trip to a rural home; thus, mothers often had a granny woman in attendance in case the doctor was delayed. In instances where the doctor attended the birth, granny women often still assisted, as there were no trained nurses available at the time.
Granny women were not formally trained in midwifery, though those that were literate often carried a “midwife’s book” to reference during complicated births.[2] Granny women used a variety of techniques during the delivery, including superstitious rituals, pharmaceuticals, and herbal remedies. Often, granny women used rituals designed to give mothers psychological relief, such as having a woman hold her husband’s hat to symbolically bring him into the delivery room. Some other uses of ritual were placing an axe under the bed to symbolically “cut” the pain, or opening all the windows in the house to symbolically open the birth canal.
Granny women often used herbal remedies, such as blackberry tea to prevent hemorrhaging, raspberry tea to relax the uterine muscles, or slippery elm bark to speed delivery.[2] In addition to these plant medicines, Granny women often relied on pharmaceuticals such as laudanum, morphine, and quinine, which were readily available at local drugstores. When a mother’s pain became unbearable, granny women were not opposed to offering a morphine tablet.
Granny women, unpaid and having nothing to gain from speedy labors, were far less likely than doctors to use forceps, and generally allowed nature to take its course.[2] Unlike doctors, granny women did not see their work as being complete once a mother had delivered a child, and often stayed to care for the newborn and the recovering mother. Thus, granny women provided a quality of care that physicians could not.
As physicians grew in numbers during the early twentieth century and more rural residents had access to conventional medical care, the number of practicing granny women swiftly declined. The developing medical profession began to insist upon formal education, standard examination procedures, and licensing requirements for all practicing physicians and healers. The great majority of granny women, having no formal training and often illiterate, were unable to meet these new requirements.
Some historians believe that paid physicians, seeing granny women as competition, launched a deliberate campaign to force them out of practice. Sandra Barney states, “If doctors were to be seen as the only legitimate childbirth attendants, they had to encourage mothers, and by extension their families, to reject midwifery and embrace modern, scientific medicine.” [4] Physicians accomplished this goal by enlisting “volunteers from their social and economic class to assist them in reshaping expectations about health and healing.”[4] While some granny women may have continued to practice healing in secret, by the early 1900s, few were visible in their communities.