Hilla Sheriff was born in Pickens County, in the rural South Carolina upcountry in 1903. She attended the College of Charleston for two years and then transferred to the Medical College of the State of South Carolina where she received an M.D. in 1926. Following this degree she did an internship at the Hospital of the Women’s Medical College of Pennsylvania in Philadelphia and residencies in Washington, D.C. and New York City before returning to the South Carolina upcountry and opening a pediatrics practice in Spartanburg in 1929. When she established her practice there were a very small number of licensed female physicians in the state and this trend continued for decades—well into the 1950s South Carolina would have fewer than forty women physicians.
After two years in private practice, Sheriff took on a role in public health when she became Medical Director of the American Women’s Hospital (AWH) unit for Spartanburg and Greenville counties. Her administrative responsibilities broadened in 1933 when she was named chief health officer for Spartanburg County and the first female public health officer in the state’s history. Through the remainder of the decade, in addition to become the first American woman to receive a Master of Public Health (Harvard, 1936), she dedicated her time to combating endemic diseases common among poor, rural African Americans and white mill workers like diphtheria and pellagra and advancing contraception and family-planning as legitimate public health services.
Under the auspices of the AWH she designed a mobile health clinic to reach residents excluded from accessing health services at hospitals due to their remote location, poverty, and segregation. The clinic was equipped with running water, electricity, and gas and could seat up to sixteen people. In addition to treating disease and teaching proper hygienic techniques and preventative medicine, Sheriff used the kitchen in the mobile clinic to provide education on cooking and canning in order to prevent diseases such as pellagra that were caused by nutritional deficiencies.
Another chief concern of Sheriff’s was improving maternity care in an area of the country that was served largely by overburdened
midwives and had a high rate of infant mortality. She established a maternity clinic staffed by female doctors and nurses in the Parker District of Greenville County in 1932 and a similar clinic attached to the Spartanburg General Hospital the following year. The clinic offered pre-natal and childbirth services, ten days of post-natal in-clinic care, a follow-up examination after six weeks.
One side effect of this type of standardization of maternity care throughout the South was the decline in the number of midwives in the region, and Spartanburg County during Sheriff’s tenure was no exception. During her seven years as chief health officer the number of registered midwives dropped from eighty-six to thirty-one. In the 1930s, progressive, white public health administrators like Sheriff were caught between the long-practiced cultural traditions of those they served and rapidly modernizing professional healthcare. They understood the necessity of midwives in a rural county with a small p
rofessional medical presence and the value of the services midwives provided in these communities—not only during childbirth but also afterwards when midwives would often stay to help with household chores and childcare. However, public health officials were also committed to a rigorous training and registration process in an effort to standardize modern practices among midwives to improve rates of infant mortality. This process played out throughout the South with varying degrees of hostility from midwives, but in Sheriff’s case it seems a level of mutual respect between the parties prevailed. In a letter written to Sheriff in 1940 after her move to Columbia, an ex-colleague noted that “I felt we couldn’t manage them [the midwives] anymore without you…several of them had seen your picture [in the newspaper] and said they saved it.”
During her time in Spartanburg Sheriff also secured money from the Milbank fund for contraceptive research and a family planning clinic in 1935. Her clinic was the first of the sort that was officially associated with a county health department in the country, and she went to work immediately studying the high maternal death rates in the state. Her results showed that the majority of women who died in or shortly after childbirth often did so after a high number of pregnancies. Armed with this information and accompanied by statistics showing that women in South Carolina married earlier and used contraceptives less frequently than their counterparts throughout the country, Sheriff undertook a campaign to distribute contraceptive information and low-cost products that women could control like spermicidal jellies and diaphragms to married couples. Clinics based on her model appeared throughout South Carolina in 1936, and by 1940 maternal and infant death rates had dropped by almost 25% due to a combination of her program to train midwives and family planning services.
In 1940 Sheriff moved to Columbia to assume the position of assistant director in the state board of health’s Division of Maternal and Child Health. The following two decades were dedicated to developing statewide programs to license and train midwives and preventing child abuse. She was a key figure behind the passage of a state law requiring physicians to report suspected cases of abuse. After over four decades of public health work, Sheriff retired in 1974 and was awarded the Order of the Palmetto the following year. Even after retirement she continued her advocacy for public health, touring South America to counsel organizations providing local, grassroots medical knowledge. Hilla Sheriff died in Columbia in 1988 and is buried there in Greenlawn Memorial Park.
All photographs from Hilla Sheriff papers, South Caroliniana Library, University of South Carolina