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Midwives, Women and the State: (De)Constructing Midwives and Pregnant Women in Ontario, Canada

Published online by Cambridge University Press:  25 November 2011

Stephanie Paterson
Stephanie Paterson*
Affiliation:
Concordia University
*
Stephanie Paterson, Department of Political Science, Concordia University, 1455 De Maisonneuve Blvd. West, S-H 1225 - 22, Montreal, Quebec, CanadaH3G, 1M8[email protected]
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Abstract

Abstract. Ontario's Midwifery Act came into effect on January 1, 1994, at a time of radical health care restructuring, marked by hospital closures and staffing cuts. In addition, feminist backlash was rampant in the popular media. Given these conditions, some have suggested that midwifery legislation was implemented because it aligned with the government's cost-cutting initiatives, while others have suggested that the government was responding to the dissatisfaction with obstetric practice outlined by a well-organized lobby. While these factors were no doubt important in the passing of the legislation, I offer a more critical reading of the policy texts, suggesting that the legislation and its enabling regulations problematize not only costs or client satisfaction but also the knowledge of midwives and the women they serve. In framing the issue as one of public safety, the policy ensemble introduced a new form of birthing expert—the expert midwife—reimposing a hierarchical relationship in the birthing process, serving to reify medical science and to objectify birthing women. In so doing, the legislation potentially silences claims for both professional and reproductive autonomy.

Résumé. La Loi sur les sages-femmes de l'Ontario est entrée en vigueur le premier janvier 1994 au cours d'une période houleuse dans le domaine de la santé qui fut marquée par des fermetures d'hôpitaux et des réductions de la main-d'œuvre. De plus, à cette époque, les médias populaires avaient clairement adopté une position antiféministe. Étant donné cette conjoncture, on proposa dans quelques articles que cette loi fut adoptée parce qu'elle cadrait bien avec les priorités gouvernementales de coupures budgétaires, tandis que d'autres insistèrent que le gouvernement ne faisait que réagir au mécontentement à l'endroit de la pratique obstétricale exprimé par un groupe d'intérêts puissant. Ces facteurs ont sans doute joué un rôle important dans l'adoption de la loi, mais je propose, en contrepartie, une interprétation plus critique des textes de politiques publiques. J'avance que la loi et sa réglementation soulignent une problématique qui va au delà des coûts et de la satisfaction de la clientèle, englobant aussi le savoir des sages-femmes et celui de leurs clientes. En formulant le débat en termes de sécurité publique, la législation a instauré une nouvelle forme d'expertise – l'experte sage-femme – qui réimpose une hiérarchie professionnelle dans le domaine de l'accouchement, ce qui a pour effet de solidifier la position de la médecine traditionnelle et d'objectiver les femmes. Ce faisant, la loi risque de négliger les revendications d'autonomie des professionnelles et des partisanes de l'accouchement naturel.

Type
Research Article
Information
Canadian Journal of Political Science/Revue canadienne de science politique , Volume 44 , Issue 3 , September 2011 , pp. 483 - 505
Copyright
Copyright © Canadian Political Science Association 2011

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