On October 22, in the wake of the outcry caused by the unveiling of Bill 15 by Minister of Health Christian Dubé, the Coalition for Midwifery organized rallies in several cities in the province, allowing citizens to express their concern about the future of the profession. These threats were named in the open letter published on September 27 in The duty.
In summary, it is the loss of professional autonomy that is feared with its impact on the rights of people who use their services. Because subordination to doctors – whatever the route -, who act according to very different paradigms and a culture of care, can lead to a distortion of the services offered by midwives and strongly demanded by the population. Let us note in passing that this letter-manifesto, which initially obtained the approval of some 500 individuals and organizations, has to date collected more than 12,000 signatures of support.
The Midwifery Coalition is far from a new organization. For three decades, this alliance has ensured respect for the rights of women and pregnant people through its support for midwifery practice. Why such a bias in the situation of a so-called advanced country where, seen from afar, everything already seems to be going well in the world of birth? To understand this, we have to go back to the 1970s and 1980s when women and groups of women, encouraged by a feminism in turmoil, loudly expressed their dissatisfaction, sometimes their anger, about the conditions of childbirth. Their discontent is due to various causes, like the broad spectrum of obstetric and gynecological violence which has been widely discussed in recent years. (As space does not allow us to provide documentary evidence, we suggest that those interested read the work of Andrée Rivard, History of childbirth in modern Quebec.)
The difficulties they highlight concern in particular the hypermedicalized model of childbirth prevalent in hospitals. From the beginning of the 1960s, for various reasons, the hospital had become the almost sole place for childbirth. The habits acquired in hospital obstetrics involved many constraints and disturbances for the “parturients”, but also having to be administered a range of medications, to undergo instrumental interventions and to submit to technologies. Violations of dignity and self-determination (such as lack of consideration for consent) were also among the complaints made by women. Particularly in large cities, it was almost impossible for a woman who wanted to have a physiological birth.
For those who campaigned for changes, the integration of midwives — professionally autonomous — into the health system was considered the most promising way to allow pregnant women who wanted to do so to obtain demedicalized services and give birth outside a hospital center. Having thought this through carefully, there was still a long way to go.
Before midwives were finally legalized in 1999, activists, with limited resources, had to be extremely determined and very active to achieve this result. The few midwives acting legally could not have achieved this without the support of these thousands of people. In 1993, the alliance of activist forces (under the auspices of the Regroupement Naissance-Renaissance, today the Regroupement Naissance Respectée), now called the Coalition for Midwifery, proved crucial in what was ultimately a victory for them. Since the powerful medical associations had done everything during these years to block the project.
At the time, the Coalition brought together several high-profile feminist associations, including several affiliated with the Fédération des femmes du Québec. Still alive, the Coalition has since been enriched by several new member groups, associated with the feminist, community and trade union movements (made up of 15 national organizations representing some 800,000 people).
Midwives carry out a mission that was entrusted to them several decades ago. This is what the Coalition reminds them, always ready to mobilize when the fundamental principles and the development of the practice are threatened. This very particular history and the demedicalized approach of midwives who work with “non-sick” but pregnant people should convince the government that different treatment must be given to them when it comes to making important decisions concerning them. . Minister Dubé’s repeated argument on the need to eliminate “silo” practices in the health system should not involve them, especially since midwives already collaborate with their counterparts in the sector hospital.
The current approach aims to enjoin Minister Dubé to consider what the representatives of the Coalition for Midwifery have to say to him, which first implies agreeing to hear them. The Coalition has long had legitimacy to represent and defend the rights of women and pregnant people.
Decision-makers must take note of the fact that never again will people with a uterus accept that arrangements affecting their rights in matters of childbirth and their body are taken by a majority of men and without them being consulted.
*Also co-signed this letter:
Marise Bachand, historian, professor of history / Chantal Bayard, sociologist, lecturer / Diane Gagné, professor of industrial relations / Céline Lemay, midwife, lecturer / Pascale Navarro, doctoral student in social communication / Anne Roy, professor of educational sciences / Meygan St-Louis, doctoral student in history / Naïma Hamrouni, philosopher and professor in the department of philosophy and arts.