I recently came across the 1978 memoir, Sister Stella's Babies: Days in the Practice of a Nurse-Midwife, by Sister Mary Stella Simpson, DC, RN, CNM in which she describes her days and nights organizing a pilot project to reduce the staggering infant mortality rate in Mound Bayou and other towns in Bolivar County, Mississippi. While on a home visit with a mother pregnant with her fifteenth living child, she wrote, “After I listened to the baby's heartbeat, I let [the mother] listen. She was so thrilled to think that the baby ‘Could do that’before he was born.” Imagine how this woman's way of thinking changed after hearing her baby's heart beating inside her womb. Seeing Sister Stella, and the women, children and families she served, in simple, often candid, yet stunning black and white photographs changed my way of thinking about the beauty in the tedium of her work in that Southern rural county. In one photograph, a beautiful African-American girl's face, smiling, hopeful, radiant, is cradled by Sister Stella's white hands—workworn and tender. These are the hands of a midwife, and these are images that move people, call upon people to act differently, and to think differently.

Midwives have an intimate understanding of the importance of timing. We do, after all, calculate cycles, time contractions, assess heartbeats, and count breaths—all done with the knowledge that even though our timing may be perfect, babies will arrive on their own schedules. Be that as it may, timing is an art. For years I have reminded myself and others [that], “In order to make a difference, you have to be different!” And so, it is with this issue that we recognize the appropriate time to “be different” about our expression of the art and science of midwifery. The Editorial Board and I proudly affirm the Journal's dedication to excellence in the art and science of midwifery. We may be fueled by Eleanor Roosevelt's proclamation that you must, “Do what you feel in your heart to be right—for you'll be criticized anyway. You'll be damned if you do and damned if you don't.” Or perhaps we are tempered by her more tender words, “I think, at a child's birth, if a mother could ask a fairy godmother to endow it with the most useful gift, that gift would be curiosity.”

As we begin to explore a more visual expression of the art and science of midwifery, it becomes fair to ask: “Will the expression of art diminish our credibility within the scientific community?” and “How can we artistically represent what is inherently scientific?” Interestingly enough, one of the most esteemed medical journals, the Journal of the American Medical Association, finds a way every month. The November 2000 issue had on its cover a striking birth image, and inside, the highest quality scientific/medical articles, poetry, first-person pieces, science briefs, and an historical page. A cover line on the August 2000 American Journal of Public Health, read, “Images of Health: Demonstrating Measurement to Midwives.” Inside, an archival photograph from the 1930s documented a training course for nurse-midwives conducted by the New Jersey Department of Health. During a recent NIH research review, a colleague showed me the cover story of the UAB Nurse Scientist, Fall 2000, entitled, “The Art of Investigation: Nurturing a Culture of Inquiry.” In it, I found refreshing research summaries with artful views of nursing and science, including one entitled, “Guiding Parents in the Art of Touching Babies.” As midwives, we publicly celebrate these artful expressions of childbirth, midwifery, and women's health, yet privately we may suppress our own artful expressions, for a host of professional or personal reasons.


Loving Hands, 1985, L. Paine.

Now is the time for us to lay claim to our own expressions of art and science, and contribute a long-absent perspective from the women's and family health, pregnancy and childbirth equation. After much patience, with this issue of the Journal, we lay claim to the art and science of midwifery in new and different ways—especially as they relate to the hallmarks of midwifery that have served as our core.

It is our hope that you “think different” about midwifery art and science, and begin to participate in the tapestry we have begun to weave, and will continue to weave with each successive issue. We invite you to lay your hands on this issue, to read, to write, to criticize, but above all, to “think different” about the art and science of midwifery, and celebrate it—publicly and privately.