A Little History of Midwifery in Ontario
- 1950’s, midwifery had all but disappeared in Ontario.
- 1970's the practice of midwifery began to emerge again in Ontario
- 1983 status of midwifery in Ontario was established to promote legislation and recognition of midwifery, MFT-O
- 1991, Bill 56, the Midwifery Act was passed
- 1993 it was proclaimed, making Ontario the first province in Canada to recognize, regulate and fund midwifery as part of the health care system.
- 1993 the IRCM concluded its work, and the Transitional Council of the College of Midwives of Ontario (CMO) was appointed by the government
- Registering the province’s first 71 midwives
- 1994, the CMO was established to administer the Midwifery Act in accordance with the RHPA and to protect and promote the midwifery model of practice that was created by women and midwives
Like most of North America, Ontario historically had a tradition of lay midwives who attended the births of family, friends and neighbours. This tradition of community midwifery began to decline around the turn of the century until, by the 1950’s, midwifery had all but disappeared in Ontario.
It was not until the 1970's that the practice of midwifery began to emerge again in Ontario, fuelled in large part by consumer demand. This “new” midwifery care was influenced by the natural childbirth movement principles that pregnancy and birth are normal, healthy, family events and that pregnant women themselves should be the primary decision makers about the health care they receive. Community midwives, together with the women they served, developed a model of care based on the principles of informed choice, continuity of care, choice of birth place, non-authoritarian relationship between woman and caregiver, time spent with women, and appropriate intervention.
In June 1983, a small group of midwives, consumers, health care providers and other supporters of midwifery met to discuss the status of midwifery in Ontario. Subsequently, the Midwifery Task Force of Ontario (MFT-O), a consumer-based lobby group, was established to promote legislation and recognition of midwifery. Around the same time, the association of practicing midwives (Ontario Association of Midwives) and nurse-midwives association (Ontario Nurse-Midwives Association) joined together to form the Association of Ontario Midwives (AOM). The AOM represented midwives from all backgrounds and presented a vision for integrating midwifery into the healthcare system.
The MTF-O gained support from women and their families seeking an alternative to the medical model of childbirth and maternity care. Over the next several years, the AOM and the MTF-O worked together to advocate the creation of midwifery as a recognized profession.
In 1991, Bill 56, the Midwifery Act was passed and on December 31, 1993 it was proclaimed, making Ontario the first province in Canada to recognize, regulate and fund midwifery as part of the health care system.
The passage of the Midwifery Act, 1991, coincided with the passage of the Regulated Health Professions Act, 1991 (RHPA), which included midwifery as one of twenty three regulated health professions, based on principles of accountability and reflection of the public interest, and governed by professional, self-regulating Colleges.
With the stage set for the introduction of registered midwives upon proclamation of this legislation, the Interim Regulatory Council on Midwifery (IRCM), an interdisciplinary body, was created in 1989 to develop the standards for this profession.
In consultation with practicing midwives, other health professions and midwifery consumers, the IRMC developed the regulatory framework for the profession, creating policies, standards of practice, and qualifications for entry to practice. The Council also worked with the provincial government and the Ontario Hospital Association on changes to ensure that midwives could attend births in hospitals.
In January 1993 in accordance with the RHPA, the IRCM concluded its work, and the Transitional Council of the College of Midwives of Ontario (CMO) was appointed by the government. Over the period of a year, the Transitional Council completed the work necessary to begin regulation of the profession with proclamation of the RHPA and the Midwifery Act.
The Transitional Council designed and implemented registration procedures, including registering the province’s first 71 midwives. The Transitional Council also began the development of a Prior Learning and Experience Assessment Program to recognize the skills of midwives trained outside the province. At the same time, the Ontario Midwifery Education Programme (MEP) was established and admitted its first class of students into a four year baccalaureate program.
On December 31, 1993, the RHPA and the Midwifery Act were proclaimed. “Midwife” became a protected title, and only individuals registered with the CMO became eligible to practice midwifery in Ontario and receive funding.
Midwives were now recognized as autonomous practitioners, within the health care system, and Ontario hospitals became a part of the history of midwifery as they granted practice privileges for midwives.
On January 1, 1994, the CMO was established to administer the Midwifery Act in accordance with the RHPA and to protect and promote the midwifery model of practice that was created by women and midwives.
Excerpted from the website of the College of Midwives of Ontario (www.cmo.on.ca)
