Midwifery in Historical & Modern Canada

Brian Burtch (1994) reviews the efforts of Canadian midwives to establish midwifery as a respected occupation in his Trials of Labour: The Re-emergence of Midwifery. The book outlines key historical developments shaping the destiny of Canadian midwifery, challenges by midwives to the negative labels applied to them, resources used by midwives to advance their cause, and arguments for and against the legalization of midwifery in Canada. Each of these aspects will be examined in an effort to yield a comprehensive view of the midwifery issue in historical and modern Canada.

Midwives have at various times in their past been virtually outlawed out of existence, yet they have managed to have some staying power in spite of opposition from the organized medical community. Their history has been one of ups and downs; in times of need, as in the case of rural, sparsely populated areas, midwives were a welcome necessity. In more modern times, as population increased and society became more concentrated in urban areas, midwives were replaced by a burgeoning health care system.

The 1795 Medical Act in Ontario prohibited midwives the practices of physic and surgery, yet in 1806, that decision was reversed to even allow midwives to practice without a license. In the mid-nineteenth century, midwives were more favourably looked upon, as legislation from this period verifies. Three bills to regulate or exclude domestic midwifery practice were defeated between 1845 and 1851. "Neverthele

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hose who used their services" (p. 54). The Female Medical Society (1862-1872), an important force in the midwifery movement in England, was instrumental in strengthening the argument for midwifery (Burtch, 1994, p. 70). Canada did not need to import trained midwives from abroad, however, because its own formation of the Victorian Order of Nurses (VON) in 1897, was a movement designed to promote the tradition of birth as a neighbourly and community-oriented event (Burtch, 1994, p. 192). Needless to say, the VON initiative to provide training to lay midwives floundered under virtually unanimous opposition from the medical profession. Still, midwives continued to provide a needed service to women who sought them out. Although not recognized by the medical establishment, they provide what the hospital setting cannot--a continuity of care, before, during, and after delivery. Such an approach has perpetuated midwifery in spite of the negative labelling leveled against it. In addition to opposition from the organized medical community, midwives have had to face a media which typically focuses on the most dramatic aspects of an issue. When there has been an infant death (in rare circumstances) associated with an attempted home birth

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