Trials of Labour

Trials of Labour: The Re-emergence of Midwifery

Copyright Date: 1994
Pages: 288
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  • Book Info
    Trials of Labour
    Book Description:

    Burtch examines the transformation of the role of the midwife, particularly the international resurgence of the midwifery movement over the past twenty years. He also looks at contemporary midwifery practice in Canada and the role of the state in shaping and defining that practice. Burtch deals specifically with the qualifications of midwives and the care given by them both in and out of hospital and discusses their legal status, the legacy of competition between nurses and midwives, and the impact of legal actions concerning midwifery practice. He emphasizes the pivotal role of the state in supporting midwifery and discusses the difficulties created by increasing interest in midwifery among expectant women and the social forces that inhibit the establishment of a self-governing midwifery profession.

    eISBN: 978-0-7735-6445-9
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i1-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Figures
    (pp. ix-x)
  4. Tables
    (pp. xi-xii)
  5. Acknowledgments
    (pp. xiii-2)
  6. CHAPTER ONE The Midwifery Movement in Canada
    (pp. 3-34)

    Historically, midwives have been the traditional caregivers at births. Today, midwives attend the majority of births worldwide. They are established as an integral part of maternity and infant care in virtually every country in the world. In twentieth-century Canada, however, midwives nearly disappeared as "feminine networks" lost ground to the developing science of obstetrics (Mitchinson 1991, 164). The importance of midwifery was recognized in earlier times in Canada. Colonel Sutherland's request for midwives in eighteenth-century Nova Scotia reflects their importance. Midwives were active for thousands of years among the first peoples of North America, and were an esteemed part of...

  7. CHAPTER TWO The State and Health Care
    (pp. 35-62)

    The virtual exclusion of independently practising midwives from the Canadian health care system is at the heart of the midwifery debate. In Canada and elsewhere, the considerable law-making and policy-making powers and financial resources of the state make it a pivotal force for midwives. This chapter examines various theories of the state, and offers some links between these theories and the status of Canadian midwives. As a starting-point, it is clear that the displacement of midwives was made possible with the passing of various medical acts and similar legislation in nineteenth- and twentieth-century Canada. The resurgence of midwifery as a...

  8. CHAPTER THREE Historical and Crosscultural Aspects of Midwifery
    (pp. 63-95)

    Thousands of years separate the biblical account of the midwives' defiance of Herod and the current conflicts over state policies concerning midwifery. This chapter provides an overview of major developments in the evolution of midwifery worldwide. Two broad areas are considered. The first is historical developments in formalized midwifery practice, with special attention to England, continental Europe, the United States, and Canada. This discussion goes beyond Canada's anomalous situation in not recognizing midwifery practice. In Europe, ecclesiastical and state regulation and advances in science and obstetrics profoundly affected traditional birthing cultures. Birth was claimed as part of the medical terrain....

  9. CHAPTER FOUR "To Be with Woman": Midwifery Practice in Canada
    (pp. 96-157)

    In Canada there is a tremendous controversy over the implementation of midwifery. This chapter presents a detailed examination of midwifery practice and birth outcomes, using Canadian data in conjunction with studies from other countries. Before moving to this discussion of midwifery practice - in home births and in hospital settings - it is necessary to review how the research was conducted. medical and nursing practitioners, and only a few births out of thousands assisted by community midwives in Canada have resulted in criminal prosecution or prosecutions for violations of the British Columbia Medical Practitioners Act. Although there are comparatively few...

  10. CHAPTER FIVE Midwives and the Law
    (pp. 158-189)

    A trial of labour, in obstetrical terminology, refers to a situation where a woman may not be able to deliver vaginally because of suspected cephalopelvic disproportion, or where a woman has previously given birth by caesarean section and is being "allowed" to labour for a prescribed period of time before intervention (Cohen 1991). This terminology seems apropos for midwives in conflict with the law in Canada. Unproved, not yet established, and open to suspicion for their practices and motives, midwives in Canadian jurisdictions face an unsettled, tentative situation in law and in the health-care system. The medical profession and state...

  11. CHAPTER SIX Moving into Midwifery: Paradoxes of Legalization
    (pp. 190-226)

    A generation ago, the twin issues of medicalization of birth and professional control of women's reproductive capacity brought into focus the ways in which childbirth was managed. For critics of obstetrical procedures, medicalized births reflected the (mis)management of birth. Recourse to medicated birth and rising rates of caesarean sections, episiotomies, perineal shaves, forceps deliveries, and induction of labour no longer were characterized as "progressive" birthing practices. As part of an effort to humanize obstetrics and allow for birthing situations tailored to women's needs, the movement has lobbied for the legal recognition of midwifery as a self-governing profession. Legalization would herald...

  12. Glossary
    (pp. 227-230)
  13. Table of Cases
    (pp. 231-232)
  14. Bibliography
    (pp. 233-260)
  15. Index
    (pp. 261-270)