Although the last twenty years have witnessed the publication of several works addressing the politics and institutions of women’s health, the history of midwifery in the Middle East remains relatively understudied. Those works that examine the social position of midwives in the colonial period typically chart an arc in which the growth of hospitals and Victorian gender norms reduced women medical practitioners to mere assistants to male doctors, with the “respectable” figure of the “nurse-midwife” rising as a replacement for the dangerously autonomous traditional midwife and the colonial medical regime deliberately suppressing the indigenous. In this historiographical context, this paper presents a brief social biography of Alya “Um Hadi” al-Zayyat, a retired midwife who has inhabited the center of social and political life in Tyre for the past half-century. Its primary purpose is to trace the construction of Um Hadi’s local social authority, following her education and professionalization as a medical practitioner in Lebanon, Transjordan, and Palestine and the development of her social network following her return to Tyre in late 1947. Drawing upon oral interviews with members of Um Hadi’s professional, personal, and philanthropic networks, an examination of account books, photographs, and other documents from the Zayyat family papers, as well as archival research in the American University of Beirut School of Nursing’s institutional records, this paper attempts to use Um Hadi’s education and early medical career to highlight interactions between colonial and indigenous systems of medical training, practice, and professional legitimization that defied their usual antagonism. My central argument is that Um Hadi built her influence on the back of the social and professional legitimacy conferred by both indigenous and colonial systems of midwifery. The dearth of medical infrastructure and regulatory enforcement that characterized mid-20th century southern Lebanon, I argue, allowed Um Hadi to transform the government-issued clinical licenses that normally would have restricted her social networks into a powerful form of social capital and enabled her to practice a hybrid form of midwifery that incorporated elements of the typically contradictory indigenous and European medical regimes. This account thus offers a complication of existing literature that frames the weakness of the Lebanese state as an impediment to women’s social and professional advancement while pointing to conditions in which colonial medical regimes might fail – for a time – to subjugate and eliminate indigenous medical practices that comparatively empower women practitioners.