In competition with a powerful medical establishment nurse-midwifery has struggled to gain legitimacy and carve out a space in which to practice. This chapter provides some historical background of the American College of Nurse-Midwives, the importance of “whiteness” to the preceding professional body, and the effect that state legislation has on the growth of the profession. The experience of Dr. J. Edward Hill demonstrates the benefits of a collaboration between physicians and nurse-midwives.