Colonial power


Infant mortality was high in the Danish West Indies, for which reason the health care system from early on had a focus on the midwives. The position and the education as a midwife was one of the few offices women had access to. It provided a special status.
Image from the orphanage of the Danish Deaconess Community (Diakonissestiftelsen) in Frederiksted.
Image from the orphanage of the Danish Deaconess Community (Diakonissestiftelsen) in Frederiksted on St. Croix, c. 1910. The Deaconesses collaborated with the local (untrained) midwives and amongst other things taught them how to ligate the umbilical cord. This procedure made it easier to avoid infection and to reduce child mortality. Maritime Museum of Denmark, file no. 000029330.

Beginning in 1768, there was a royal midwife employed in each of the towns of Christiansted, Frederiksted and Charlotte Amalie. The royal midwives were government employees and educated at The Royal Maternity and Caring Institution in Copenhagen, quite like the midwives in the Danish midwife districts. Until the first half of the 1800s, the midwives were all Danish.

The lack of trained midwives

But there were many children born in the Danish colony. Consequently, three royal midwives were not enough to take care of the hundreds of pregnant enslaved women and newborn children each year. The royal midwives’ task was primarily to take care of the Euro-Caribbean women, and women in the towns in general. When an enslaved woman was to give birth, the so-called plantation midwives stepped in, who were also enslaved.


Even though the royal midwives in principle had a monopoly on midwifery, they actually competed heavily with local Euro-Caribbean and Afro-Caribbean women in helping those giving birth. This is evident from the many complaints from the royal midwives. For example, midwife A.C. Lindefield wrote in a complaint to the government on September 18, 1786, that she was unhappy about the bread being taken from her mouth by the plantation midwives.

… It will therefore most graciously be permitted for me to present how I daily find that the bread is taken from my mouth not only by whites but also by a number of Negresses and mulattoes here in town who deliver and assist during labor whites as well as enslaved laborers, even though I am always and have been helpful to both rich and poor when they have called me…

Slave midwives

Not every plantation had a slave midwife, but there was always one in the vicinity. She was typically over 40 years old and had reduced fitness for work, just like the plantation nurses.

Education of local women as midwives

Beginning in the 1820s, and possibly earlier, some planters began to pay to have their slave midwives trained by the royal midwives. The training period was two to three years, and after passing an examination at the royal district doctor (Landphysicus), she was licensed as a plantation midwife.

But there were too few licensed plantation midwives. Therefore Governor-General Peter von Scholten presented a proposal in 1832 to send ten selected Afro-Caribbean women on a one-year educational stay at The Royal Maternity and Caring Institution in Copenhagen. After the examination, they would return to their new positions among the rural districts of St. Croix. But nothing became of the proposal, because the planters would not pay for it.

Infant mortality declined

Not until fifty years later, in 1885, did the authorities introduce a midwife system on St. Croix resembling what von Scholten had proposed. The island was divided into nine districts, each with a trained midwife. The midwives were local women who were sent on educational stays at the Maternity Institution in Copenhagen. Here they were taught together with midwives from Greenland, Iceland, the Faroe Islands and Denmark. The result was that infant mortality fell significantly in the rural districts on St. Croix.


Niklas Thode Jensen, For the Health of the Enslaved: Slaves, Medicine and Power in the Danish West Indies, 1803-1848. Copenhagen: Museum Tusculanum Press, 2012.

Peter Hoxcer Jensen, From Serfdom to Fireburn and Strike: The History of Black Labour in the Danish West Indies, 1848-1916. Christiansted, St. Croix: Antilles Press, 1998.