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While women rarely appear in formal medical reports generated within Uganda, biomedically trained women outnumbered men in mission medical institutions.  Much of the provision of and teaching about biomedicine in Uganda was in the hands of women missionaries, or in the hands of the Ugandan women that they trained. The first formalised biomedical training programmes for women in Uganda were midwifery schools, and these midwives staffed a network of maternity and child welfare centres that stretched across the country. The main goal of these centres was to reduce maternal and infant mortality, but while infant mortality has been drastically reduced over the course of the twentieth and twenty-first centuries, maternal mortality rates in Uganda are still very high, in large part because even today, only 57 percent of women in Uganda have ‘skilled’ assistance in their deliveries. There are a variety of reasons that so many women give birth without a biomedical professional attendance, but significant among them is many women’s – or their relatives’ – reluctance to deliver in health centres.

Drawing on interviews with midwives, traditional birth attendants, and community members in Uganda, and on hospital, mission, and government records, this paper will discuss the reasons why women have chosen to engage with biomedical services while pregnant and delivering babies, why they have chosen not to, how those choices have changed (or not) over time, and why. Specifically, it will focus on the role of the midwife’s ‘character’, or behaviour, in encouraging and discouraging women from coming to biomedical health centres for antenatal care and for deliveries. For many Ugandans, especially in rural areas, midwives were the first point of contact with biomedicine, and this paper explores changing ideas about health and health seeking behaviour through these women and their social presence in communities.