Obstructed Labour: Race and Gender in the Re-Emergence of Midwifery.

Margaret Kechnie is head of the Women’s Studies Program at Laurentian
University and the co-editor of Changing Lives: Women in Northern
Ontario.

Ontario feminists celebrated the legalization of midwifery in Ontario in the early 1990s. The focus was not so much on midwives as workers, but on the fact that women would have more choice in how they gave birth. There was much to celebrate. Midwives practised in Ontario during the 19th century, but the rise of professionalized medicine in the final decades of that century severely restricted their activities; by the 1950s midwives had all but disappeared from Ontario.

Demands for a return to midwifery began to emerge during the 1970s, but those demands were generally ignored by authorities. In subsequent years a variety of circumstances, not the least being a desire on the part of the provincial government to reduce health care costs, led to another movement to recognize midwives. In the years following legalization, the focus was on a philosophy of care that centred on the mother.

Fifteen years after legalization, the author looks at the profession through an inclusive lens and finds the profession wanting. The demand that midwives be educated using a white, middle-class, Canadian model has left many midwives—ones trained under a different midwifery education model than the one accepted by the leaders of the midwifery movement in the early 1990s—out in the cold. Credentialism is a problem in Ontario; many immigrants have been denied work in their field because they lacked what Ontario considers to be appropriate standards of education and workforce experience and there appears to be little attempt to find ways to rectify the problem. The midwifery profession has not escaped credentialism and, as the author points out, the inevitable result is racial exclusion. Not only does this exclusion prevent many visible minority women from practising midwifery in Ontario, where few such women have gained access to the midwifery profession, but it denies pregnant women from these minority groups from access to midwives from their own culture to assist them during the birth process.

Nestel’s book is very important to our continuing struggle to understand racism in Ontario and it must cause us to reassess the politics of inclusion.