A Tribute to North America’s Most Experienced Homebirth Midwife Cynthia Caillagh

This past weekend I celebrated the life of Cynthia Caillagh Midwife in rural Wisconsin, on the farmland that first served as her refuge and grew into her vision of a birth center serving the local Amish community and beyond. It was a small gathering—small compared to the largeness of this person for so many people, small compared to the place that Cynthia deserves in the history of midwifery and home birth in North America. 

Cynthia was a traditional midwife and remained committed so until the moment her body could no longer sustain her spirit and mission—I learned that two women gave birth in the center and one showed up for an early prenatal appointment while Cynthia lay in her final hours of hospice upstairs. Those of us who gathered agreed this was exactly how she wanted it to be.

But many of us, perhaps selfishly, also wished Cynthia had taken the last year to write her memoir, to record her knowledge—which initially was given to her in the 1960s by a traditional midwife relation of her Cherokee grandfather’s (Cynthia told me he believed this was her destiny). This is an extremely rare and unique lineage, given how few indigenous North American midwives remained at the time. We wished Cynthia had left a document for the younger midwives who are struggling against the persistent force of medicalization, not only of birth but of their profession as well. We wished she had taken more time to spend with her family. But Cynthia embraced a pre-capitalist ethic of service. A midwife “does not exist for herself. She exists for and through her community,” she once told me.

Cynthia served communities in the Syracuse and Buffalo corridor in the 1970s and 80s until New York State Assembly drove many midwives like her to disperse; she practiced underground by necessity in the 1990s in Virginia, which left her vulnerable to the law; and she rebuilt her life and work and finally became licensed and legal in Wisconsin, where I first met her in early 2006 when I was working on Pushed. 

She was a feminist to the core: women and their autonomy came first, always, without apology. In Wisconsin, she called her practice “Matrifocal Healthcare and Midwifery Services.” In New York, in the 70s, she set up clinics providing abortion and contraception and co-founded one of the country’s first rape crisis centers. She told me about going to NOW meetings in the early 90s and making the feminist case for midwives’ patient-centered model of care (and failing to convince the leadership this had anything to do with their cause). 

Cynthia was an old-school liberal, believed in government for people not profit, believed in regulation to protect people and planet from corporate pillage; defended free speech and freedom from government interference in private lives and protection from discrimination; believed in diverse gender expression and peoples’ right to love and marry regardless of sex, and had relationships with men and women. She also found allyship and community with people of vastly different political persuasions yet held them close, believed in finding common ground and humanity; she did not believe in dividing people into tidy ideological boxes. This openness was for me one of her most important teachings.

And Cynthia was a realist: she had a deep respect for biology and a deep respect for medical technology and understood the limits of each. No pregnancy guarantees a baby, she would often tell clients; the most meticulously planned birth does not guarantee a happy story. Life is pain and joy, relationships have beginnings and endings, not always under our control. “You cannot guarantee life,” she said. “Yet we live in a society that wants those guarantees.”

For Cynthia, birth was a vital organ of community: how humans come into the world, how we support these givers of life—and she would not stop using the words "women" and "mothers"—how we treat the process, determines how we will care for ourselves and each other—or not. She wanted birth to be this fundamentally important to women and families so we would fight for better care. 

Cynthia became much more than a subject and source; I asked her to attend the birth of my own child and was blessed these last 10 years that she took on a grandmotherly role in my life (right around the time that I no longer had my own grandmothers--one of whom, as I write this, would have turned 99 today). Like many others, I had hoped to receive Cynthia's love and wisdom and enthusiasm (and sometimes stern guidance) and delicious recipes for many more years. I also hoped she would take her knowledge and experience more public. She attended nearly 5,000 births (all kinds) over the course of her life, and I am certain she was among the most knowledgeable and skilled midwives on the continent. She also held ways of knowing that few have proximity to, ways that were passed down to her through the ages, ways that survived colonialism and genocide and organized medicine.

But Cynthia did not seek the spotlight; her purpose was genuine care and connection, not schmoozing or birth politics—she had intentionally detached herself from that world. She did organize two forward-thinking conferences in the last decade, one centered on the microbiome in birth and the other on breech skills (she was incensed that otherwise healthy women are forced to have major surgery, major recoveries, and higher lifetime risk because most providers do not learn or cannot practice these skills). 

Otherwise she was content to limit her sphere of influence to her corner of rural America and devote herself to the “Plain” communities surrounding her farm. She held deep respect for the Amish families who do not fear birth or death, who live close to the land and close to each other. She also served women from literally all over the world—they would often call her in their final weeks of pregnancy because they were desperate to avoid unnecessary surgery, desperate for someone who was willing and capable of standing by them. She always found a way. 

I’m posting this in the hopes that the thousands of people she served, many of whom may not even know she has passed, have a record. And that perhaps this finds its way to inspire others to document her contributions and legacy. And most of all to honor this phenomenal woman in the virtual world as I did on her beautiful land. May she rest in peace and may her legacy carry on.

Jennifer Block is an independent journalist who writes frequently about health, gender, and contested areas of medicine. Her articles and commentary have appeared in The BMJ, The Washington Post Magazine, Newsweek, The Cut, The New York Times, the Los Angeles Times, the Guardian, Pacific Standard, The Baffler, and many other outlets. Her first book, Pushed, led a wave of attention to the national crisis in maternity care and was named a “Best Book of 2007” by Kirkus Reviews and a “Best Consumer Health Book” by Library Journal.