ON Chiropractic
FEATURE STORY / FROM MARGINAL TO MAINSTREAM
Later, transplanted European midwives
played a role in the expansion of the
settlements that became Canada. But,
by the early 20th century, the practice
of midwifery in most parts of the
country was illegal. It was not until the
1980s that midwifery re-emerged in its
modern form.
Since then, the profession has
experienced a substantial expansion of
the role it plays in the Ontario health
care system. This prompts one to ask how
Ontario’s midwives were able to travel the
distance from their practice being illegal
to their current role in just a few decades.
One might also ask what chiropractic can
learn from the evolution of midwifery, as
this profession endeavours to be recognized
as the spinal health care experts in the
province’s health care system. The same
way that midwives are the province’s expert
primary care providers in what is known as
“normal” or low risk birth, chiropractors
have the training and expertise to be
Ontario’s primary musculoskeletal
care providers.
L
ike chiropractic, midwifery has
evolved over time. In Canada, the
government sanctioned practice
of midwifery pre-dates Confederation by
almost 200 years. In 1691, the government
of New France, now Quebec, established
three autonomous branches of medicine:
physicians, surgeons and midwives.
From 1755-1764 the government of
England compensated British midwives
who settled in Nova Scotia. As late as
1843, municipal officials in Quebec were
granting midwifery licences. It was when
the Medical Council of Canada formed in
1912 that the practice of midwifery was
marginalized and then criminalized in
most parts of Canada. Quebec rescinded
the certifications of the province’s midwives
in 1944.
This began a long period when
obstetricians were responsible for essentially
all pregnant women and births in Canada.
Some midwives continued to practice in
secret, predominantly in rural areas. But,
with training no longer readily available,
midwifery all but disappeared along with
the choice of care provider that midwives
presented Canadian women.
The resurgence of the practice began
in the 1970s. Of the various preconditions
to the resurgence of midwifery, one stands
out. The modern feminist movement in
North America empowered women to
think, act and speak as individuals. The
Ontario Nurse Midwives Association was
founded in 1973, though the practice of
midwifery remained illegal. The Charter
of Rights and Freedoms came into effect
in 1982.
By the beginning of the 1980s
midwives were secretly practicing in
greater numbers. Some of those women
were inspired to become midwives when
their own children were born. Dissatisfied
with the standard care of the time, women
began attending births and learning
everything they could about the practice
of midwifery. As the practice was still
illegal, training was cobbled together from
textbooks, conferences and sympathetic
doctors. Some apprenticeships and
international training opportunities
were available.
Of course, each birth they
attended was a significant risk. In 1983,
an ambulance had to be called when
complications necessitated the movement
of a woman under the care of a midwife
to a hospital. The midwife hid her
medications in a bathtub and was prepared
to be arrested for practicing medicine
without a licence.
It was in 1986 that the Ontario
Government recognized the role that
midwives might play in the province’s
health care system. In 1987, the
Report of the Task Force on the
Implementation of Midwifery in Ontario
was published and established the
regulatory framework of the profession.
Two years later the Interim Regulatory
Council on Midwifery was established.
That co uncil’s work culminated in the
Royal Assent of Bill 56, An Act Respecting
the Regulation of the Profession of
Midwifery. Within two years of the
passage of Bill 56 three Ontario
universities established undergraduate
degrees in Midwifery. Then in 1994
the passage of the Midwifery Act
designated midwives as regulated health
professionals under the Regulated
Health Professions Act.
L
isa Weston was a midwifery client
in the early days of the profession’s
most recent regulation. Today
she is a midwife practicing in the eastern
MIDWIFERY TIMELINE
1691
1755 1764
1861
EARLY HISTORY
Midwifery
recognized as an
autonomous
branch of medimedi
cine in New
France (Quebec)
20
British
government
compensates
British midwives
who settle in
Nova Scotia
SPRING/SUMMER 2013
Medical Council
of Canada
eliminates
midwifery in
most of Canada
Midwifery
certificates
repealed in
Quebec
CRIMINALIZATION
Florence
Nightingale
opens Kings
College Hospital
School for
Midwives
1912
1944
1976
1986
1987
1989
1991
MODERN RESURGENCE
World Health
Organization
declares support
for midwifery
Ontario Government
announces inteninten
tion to establish
midwifery as a
recognized part of
the Ontario health
care system
Laurentian,
McMaster, and
Ryerson begin
offering undergraduate degree
programs in
midwifery
GTA and Durham Region. She is also the
President of the Association of Ontario
Midwives. When she was asked to recount
those exciting and fateful days in the
late 1980s and early 1990s, she first thinks
of the consumer demand that played a
pivotal role in securing support for
midwifery at Queen’s Park. “Midwives
were called to serve by their community,”
she said. “Consumers had a very loud voice
in saying what about midwifery worked
for them.”
Combined with the views of
midwives, this input from the consumers
of midwifery played a pivotal role in the
establishment of the core values that govern
the profession to this day. “Midwives and
clients together were very clear about
the vision that they had for midwifery,”
Weston explained.
The core values of midwives are
contained in what are called the three
pillars of midwifery care. The first is
Ontario Midwifery
Act comes into
effect, formally
designating
midwifery as a
regulated health
profession in
Ontario
Aboriginal Midwifery training
programs begins operation at
Tsi Non:we Ionnakeratstha
Ona:grahsta on the
Six Nations Territory
in Ohsweken, Ontario
HEALTH SYSTEM INTEGRATION
Ontario publishes
Report of the Task Force
on the Implementation
of Midwifery in Ontario
Canadian Confederation
of Midwives is
constituted
Ontario
Government
creates
Interim
Regulatory
Council on
Midwifery.
Bill 56, An Act
respecting the
regulation of
the Profession
of Midwifery,
receives Royal
Assent
1993
1994
2000
2012
Ontario announces
funding for two
midwifery-led
birth centres
www.chiropractic.on.ca
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