During the late nineteenth and early-to-mid twentieth centuries, midwives commonly attended to women during childbirth, particularly in the ethnic communities in the North and in black communities in the American South. By the 1920s and 1930s, immigration restrictions limiting the influx of new midwives, resistance by physicians in the use of midwives, and a decreasing birthrate all led to a rapid decline in their numbers in the North. In the South, however black midwives continued their practices, at least until state health officials moved to regulate and largely eliminate a profession that they believed was obsolete.
In 1931, the Florida legislature passed a law for "the control and licensing of midwifery for the protection of mothers at childbirth and authorizing the State Board of Health to make regulations therefor." It required that midwives in Florida be licensed and that they be at least 21, be able to read the Manual for Midwives and be able to fill out birth certificates, "[b]e clean and constantly show evidence in behavior and in home of habits of cleanliness," possess a diploma from a school for midwives, and have attended, under supervision of a physician, at least fifteen cases of labor.