Midwifery in Canada.

• Author: Mah, Connie L.

Midwifery is a health care profession distinct from nursing. Midwives specialize in providing primary care to women during pregnancy, labour, birth and postpartum in relation to low risk prenatal, intrapartum and postnatal care. They promote the natural birthing process of normal vaginal deliveries without drugs or surgical interventions, and are trained to handle low risk normal births as well as breech births and twin births. They are trained to provide physical examinations, screening and diagnostic tests, and to assess the normal progress of pregnancy and birth, including detecting complications and making assessments of risks in mother and child, at which point they would refer the women to physicians.

History

Although midwifery had been practiced throughout history, some with formal training and some without, it was rejected as folk medicine in Canada and the United States in the early 20th century in favour of modern advancements in the medical profession. Consequently, midwifery was either replaced by medical doctors (obstetricians) or regulated.

In Britain, midwifery legislation was implemented in England and Wales in 1902, Scotland in 1916 and Northern Ireland in 1918. In 1925, the United States adopted a nurse-midwifery model from Britain, which was a combination of nurse and midwife, requiring training in both; although primary care for childbearing women continued to be provided by nurse-midwives, family nurse practitioners and physicians.

In 1976, the World Health Organization agreed with the International Council of Nurses and the International Confederation of Midwives that midwifery should be recognized as an autonomous discipline.

Midwifery in Canada

Starting in the 1990s, midwifery began to be legally recognized as a profession in certain Canadian provinces and territories by the introduction of provincial or territorial legislation to regulate midwifery.

In Canada, midwifery falls under provincial and territorial jurisdiction, and has only been recognized in relatively recent times. Starting in the 1990s, midwifery began to be legally recognized as a profession in certain Canadian provinces and territories by the introduction of provincial or territorial legislation to regulate midwifery. In 1994, Ontario and Alberta were the first provinces to implement legislation to regulate midwifery.

In Canada, the midwifery model promotes normal birth, women as the primary decision maker (by providing women with information so they can make informed decisions about the birthing process), and continuity of care (from pregnancy to postpartum).

Alber...