Midwives have always been the unsung heroes of childbirth, often challenged by the medical establishment. Despite the hurdles, their dedication has never wavered. Over time, the education of midwives has improved, but their compassionate care remains unchanged.
In an article by Kathleen Fahy from Southern Cross University, she highlights the uphill battle midwives faced to prove their worth in the medical world. Since the early days of white colonization, midwives provided the majority of maternity care in Australia. Women had control over their birthing experiences with the support of midwives, a practice that went largely unchallenged until the late 1800s.
Historically, midwives were often working-class, largely uneducated women. Their inability to read and write created a significant power gap, making it difficult to contest doctors' claims of being safer practitioners.
As the number of General Practitioners (GPs) increased, midwives were seen as competition. Doctors in the Australian Medical Journal suggested that establishing a relationship with pregnant women was the quickest way to build a general practice, aiming to become the family's trusted physician.
Despite this, midwives remained popular within communities, known for their high regard and lower fees compared to doctors. The community often viewed midwives as equally, if not more, effective than doctors.
In their quest to dominate maternity care, GPs sought ways to justify their involvement in all births, not just complicated ones. The development of obstetrical forceps by the Chamberlain family in the 17th century marked the beginning of medical intervention in childbirth.
Between 1886 and 1928, medicine formed an alliance with nursing, gaining legal and disciplinary control over midwifery. But the tide is turning. State health departments now recognize the safety, satisfaction, and cost-effectiveness of midwifery-led care.
Women and midwives are advocating for woman-centered birthing, and their voices are being heard across various media. Amidst an Australia-wide shortage of obstetricians and GP obstetricians, governments are motivated to offer maternity services closer to home.
Kathleen Fahy notes a synergy between maternity consumers, midwives, and the government. In New South Wales, the government has committed to expanding midwifery-led care models, including publicly funded homebirths.
St George Hospital pioneered this initiative in 2005, establishing the first publicly funded homebirth model in NSW. This model, based out of the hospital's Birth Centre, aimed to provide equitable access to homebirth services.
Today, the struggle for maternity services continues at both state and national levels. Thanks to feminism, women and midwives are more powerful than ever. With government support for university education, midwives now have a stronger voice. Together, they can challenge anti-midwife ideologies with robust research and unwavering resolve.
References
E, Willis (1983). Medical dominance: The division of labour in Australian health care. Sydney: Allen & Unwin.
Fahy, K. (2007). An Australian history of the subordination of midwifery. Women and Birth, 25-29.
Homer, C., & Caplice, S. (2007). Evaluation of the publicly-funded homebirth program in South East Sydney Illawarra Area Health Service. Sydney: Univeristy of Techonology Sydney .
