Week 1: History of Professional Midwifery in Ontario

Question 1

What happened post WW2?

Answer 1

Medicalization of birth and
eradication of midwifery

Question 2

What happened 1960’s-1970’s?

Answer 2

womens movement

Question 3

What was the Midwives role during 1970’s-1980’s?

Answer 3

▪ Few midwives
▪ Practiced alegally

Question 4

What was Canadas association for midwives in the 1980s?

Answer 4

Canada is the Western industrialized nation to have no formal provisions for
midwives

Question 5

During the 1980s what were the 2 distinct midwifery groups?

Answer 5

▪ Ontario Association of Midwives
(OAM) – lay midwives
▪ Ontario Nurse-Midwives Association
(ONMA) – nurse midwives

Question 6

What happened in 1983?

Answer 6

Health Care Professions Act opens

Question 7

What did it mean for the Health Care Professions Act to open?

Answer 7

▪ Review the role of ALL health care professionals in Ontario
▪ Health Professions Legislations Review (HPLR)
▪ OAM and ONMA contacted to be included

Question 8

What were the key principles submitted by the OAM and ONMA under ‘Midwifery Coalition’?

Answer 8

1. Self regulation
2. Multiple routes of entry to practice
3. Access to hospitals
4. Public funding

Question 9

What was the professional doctor opinion on midwifery in 1983?

Answer 9

College of physicians and surgeons of Ontario declare homebirth unsafe
▪ Professional misconduct to assist or support it

Question 10

What big event happened in 1984 and what did this lead to?

Answer 10

Death of baby Daniel McLaughlin-Harris
▪ Coroner’s inquest
▪ Strong support and commitment to an autonomous, self-regulated midwifery model
of care
▪ Large amounts of media coverage
▪ Jury recommendations that midwifery be integrated into medical system and be
self-regulated

Question 11

What happened in 1987?

Answer 11

▪ Report of the Task Force on the implementation of Midwifery in Ontario (2 lawyers, a family physician and a nurse educator who had prior training as a
nurse-midwife)
▪ HPLR recommends midwifery be included in legislation as self regulated
model

Question 12

What happened in 1989?

Answer 12

▪ Minister of health announces midwifery to be recognized as a regulated
health care profession

Question 13

What happened in 1993?

Answer 13

▪ Midwives become a self regulated publically funded profession in Ontario
▪ Creation of the College of Midwives of Ontario
▪ Midwifery Education Program (MEP) begins at a consortium of Universities
across Ontario

Question 14

What happened in 1994?

Answer 14

▪ Registered Midwives first began practicing as legislated midwives in Ontario

Question 15

What are some perceived benefits of legislation and regulation?

Answer 15

▪ Considered more legitimate
▪ Costs covered, rather than clients paying out of pocket
▪ More accessibility
▪ Larger group of clientele
▪ Greater protection with regards to legal process
▪ Able to offer choice of birthplace (home or hospital)
▪ Able to offer continuity of care
▪ Funding for midwives
▪ Participation in policy changes

Question 16

What are some of the concerns or challenges associated with legislation and
regulation?

Answer 16

▪ Limit midwives’ practice
▪ Deny consumer self-responsibility
▪ Midwives may become new group of ‘childbirth authority’ which was against their
philosophy of care
▪ Not directly regulated by their clients
▪ Medicalization of midwifery care

Question 17

How did midwifery education change with legislation?

Answer 17

▪ Pre-legislation was self directed, self motivated, largely community based
▪ Midwifery Coalition argued that to work as primary health care providers, a standardized education program was necessary
▪ Compromise was formal model with apprenticeship