Midwifery History Canada

I’m posting this article from 1991 to make the history of midwifery struggles in Canada available online. Thanks to Andre Picard, writer for the Globe and Mail (Canada) for granting permission. Gloria

Midwives no longer shrugging off attacks
ANDRÉ PICARD, The Globe and Mail (Canada)
Friday, November 29, 1991

THE death of a baby last week in Montreal has reignited the debate over one of the most emotional social policy issues in the province – midwifery.
Isabelle Brabant, a self-trained midwife who has delivered more than 400 babies, arrived at a hospital less than 10 minutes after the baby stopped breathing during a home birth and her resuscitation efforts failed. Doctors were also unsuccessful in reviving the infant.
Dr. Augustin Roy, president of the Quebec Corporation of Physicians, wasted no time condemning the tragic events, saying “home birth is a quasi-criminal act for a woman who has had a cesarean in the past.”
In the past, proponents of midwifery have shrugged off such attacks, saying doctors are more interested in maintaining the status quo (including revenues from hospital births) than in improving the quality of treatment.
Yesterday, however, they decided to draw a line in the sand.
“We’ve tolerated this witch hunt for long enough,” said Marie-Claude Desjardins, president of Naissance-Renaissance. “We demand that obstetrical violence end. . . . We demand that respect of women begin.”
Michele Champagne, president of the Quebec Alliance of Practicing Midwives, said: “Midwives are not endangering the lives of women and children any more than doctors are, and to suggest otherwise is a lie.”
Statistics compiled by the Office of the Coroner show there are about 350 deaths a year of children in their first week of life. One a day.
In the past five years, six of those deaths have been after midwife- assisted births. One a year.
There were about 97,000 births in Quebec last year, slightly more than 1,000 of them midwife-assisted.
Yet, midwifery remains in a strange sort of legal limbo. Last year, the government announced, as part of its massive health-reform package, plans for pilot projects that would lead to the licensing of midwives and their practicing in hospitals alongside doctors.
But the plan is stalled by the insistence of doctors’ groups that “self-trained” midwives be ruled inadmissible.
Because midwifery is not formally recognized in the law, there are no standards, but the Association of Practicing Midwives insists on all its members having a minimum of three years of training, and that at least two qualified midwives assist in home births. But, as the law stands, midwives are banned from doing their work in hospitals.
Polls in the province show 80 per cent of voters in favour of legalized midwifery, and legalization of the practice in Ontario has turned up the heat to the point where Quebec Health Minister Marc-Yvan Cote warned doctors that if they continue with their obstructionist tactics, he will skip pilot projects and go directly to legalization.
Three years ago, Ms. Brabant was attending another birth where the baby died. The subsequent coroner’s inquest, which many feared would be the death knell of the movement, exonerated her, and support for the cause has grown tremendously.
This time the Office of the Coroner has decided an inquest is not even warranted. That fact, coupled with the reaction of Dr. Roy, has convinced midwifery proponents that victory is near.
Micheline St-Onge, a parent whose child died during birth at a hospital, drove the point home, by bringing the debate back to its roots.
“We have to do everything to ensure the comfort of women and the safety of their children, so ultimately they must be allowed to make the choice between having their baby delivered by a doctor or a midwife,” she said yesterday.
“Very few people know just how painful it can be to lose a child,” Mrs. St-Onge said. “Why have things degenerated to the point where we have lost sight of that, where the death of our children is used merely to score” debate points.
“No child’s life should be cheapened to that point.”

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