A SUMMARY OF THE HISTORY OF MIDWIFERY IN NEWFOUNDLAND AND LABRADOR

There have always been midwives. Aboriginal people had midwives and so did the settler people.

1892 -    Sir Wilfred Grenfell came to the northern part of the province.

1893 -     The first civilian hospital outside of St. John’s was built in Battle Harbour. This was staffed by nurses who were also midwives. As more hospitals and nursing stations were constructed in Labrador and Great Northern Peninsula, more nurses who were midwives, from the UK and the USA, were hired to staff them.

1920 -     The Government of Newfoundland implemented Chapter 235: An Act Respecting the Practice ofMidwifery. The Government appointed a Midwives Board to examine and provide midwives with a license to practice. Nurses who were midwives were recruited from the UK to work in out ports.

The Midwives Club started for “lay” midwives. A course of instruction was given at weekly meetings and then they sat the examinations set for them by the Midwives Board.

1924 -    The Newfoundland Outport Nursing and Industrial Association (NONIA) was established to assist the outports to pay the midwife nurse and to supply the drugs and equipment, with money obtained from the selling of crafts.

The S.A. Grace Mate Trinity Hospital commenced training women in midwifery and paediatric care. (The School of Nursing did not open until 1929 when the hospital became the S.A. Grace General Hospital).

1934 -    The Commission of Government in Newfoundland resulted in health reforms introduced by Leonard A. Miller. Cottage hospitals were to be built and the government was to be responsible for Outport Nursing (instead of NONIA) and a programme for midwifery education (instead of the Midwives Club and the S.A.Grace General Hospital).

1949 -    Newfoundland joined Canada, a country where midwives were not recognized.

1958 -    Hospital Insurance Plan for free hospitalization with a bonus for physicians treating patients in a hospital rather than at home. Women now did not have to pay to give birth in a hospital.

1963 -    The last licence was issued to a midwife.

1974 -    The Atlantic Nurse-Midwives Association was formed.

1979 -    The first nurses were admitted to the midwifery programme part of the Outpost Nursing diploma programme at Memorial University of Newfoundland.

1983 -    Changed name from Atlantic to Newfoundland and Labrador Midwives Association (NLMA). Was part of the Alliance of Midwives, Maternal and Neonatal Nurses of Newfoundland and Labrador (the Alliance) until the Alliance ceased in 1996, when there were no nurses willing to form an executive. The NLMA then continued as a separate association.

1986 -    The midwifery diploma programme was discontinued as of necessity classes were small, because without legislation there were limited opportunities to practice skills in the clinical areas.

1990 -    The Northern Childbirth Workshop, held in Makkovik, recommended that traditional and southern midwives return to practicing in the communities.

1991 -    The Provincial Perinatal Advisory Committee’s report on the 1990 conference recommended having midwives and that “there should be good financial incentives to keep General Practitioners and Midwives doing low risk obstetrics, leaving the high risk cases to specialists”. “Consumers need to be encouraged to establish lobby groups”. An inquiry into having midwives practice was started two years later.

1993 -    The provincial Government appointed an Advisory Committee on Midwifery.

1993 -    The Provincial Advisory Council on the Status of Women recommended that “the provincial government introduce legislation regulating the legal practice and standards of midwifery”. They recommended that the public should have direct access to midwives and also recommended that if a midwife has successfully completed a midwifery program, she does not also have to be a nurse.

1994 - Friends of Midwifery consumer/advocate group formed in St. John’s.

1994 -    The Working Group on Women’s Health recommended that the provincial Government legalize midwifery.

1994 -    The Final Report of the Provincial Advisory Committee on Midwifery was submitted which stated that “midwifery is safe, cost effective and acceptable to consumers as a means of providing quality care for childbearing women and their families. . . . Midwives emphasize the importance of providing choice of caregiver, control over womens’ birthing experience, and continuity of care.”

1996 -    The Newfoundland and Labrador Health Care Association resolved to “lobby the Department of Health to begin implementation immediately” of the recommendations of the Advisory Committee.

1996 -    The NL Midwives Association and the Friends of Midwifery NL made presentations to the CEO of the Health Care Corporation St. John’s, and the CEO Avalon Health Care Institutions Board.

1996 -    The NL Midwives Association and the Friends of Midwifery NL made a joint presentation, at the Hotel Newfoundland, to the Social Policy Advisory Committee of the provincial Govt. Strategic Social Plan. When the report was published midwifery was omitted which has resulted in midwifery not being considered when sections of the Strategic Social Plan have been implemented.

1999 -    February - The NL Midwives Association and the Friends of Midwifery NL submitted a joint brief “Midwives in the Community” to Health and Community Services St. John’s.

1999 -    The provincial government appointed a Midwifery Implementation Committee to advise on the development of legislation related to midwifery and to provide recommendations related to the scope and standards of midwifery practice, midwifery education and registration requirements, and eventually a Board.

1999 - The Friends of Midwifery became the Midwifery Coalition of Newfoundland and Labrador.

2001 -    The NLMA name changed to Association of Midwives of Newfoundland and Labrador (AMNL) (because the Newfoundland Medical Association had changed its name and taken the NLMA initials).

2001 -    The AMNL signed the Mutual Recognition Agreement on Mobility for Midwifery in Canada as a non-regulatory association which had participated in the development of the document.

2001 -    October - The AMNL submitted “Health Investment in Funded Midwifery” to Health Forums 2001.

2001 -    The Midwifery Implementation Committee completed its mandate, but no final report was issued. Information is unavailable regarding the report to the Minister. The date for legislation was to be the Fall of 2001.

2002 - January - The date for legislation was to be the Fall of 2002.

July - “Although a target date of Fall 2002 was identified for drafting legislation, it is unlikely that other professional groups will be in a position to move forward for some time” to be included in a canopy act.

October - “It has been decided that self-regulation of the midwifery profession will be temporarily postponed”. Apparently the definition of “temporarily” is “indefinitely”. “In the meantime, I [the Minister] would encourage the Association of Midwives of Newfoundland and Labrador to continue with its efforts of advocacy and education in the area of midwifery”.

2002 -    April - The AMNL submitted “Midwives and Health Care” to the Commission on the Future of Health Care in Canada”.

2002 -    December - the Newfoundland and Labrador Public Health Association (NLPHA) requested the Minister to reconsider his decision to postpone midwifery legislation.

2003 -    February - the Minister replied to the NLPHA stating that midwifery legislation could not be passed as it did not meet the requirements of the government’s white paper. The NLPHA requested their representative on the Primary Health Care Advisory Council to promote midwifery which provides primary health care for women.

2003 -    The questionnaire regarding Primary Health Care Renewal was obtained, completed and submitted to the office of the Primary Health Care, Govt. of Newfoundland and Labrador.

2003 -    March - the consumer/advocate group was reformed and returned to the previous name of Friends of Midwifery of Newfoundland and Labrador.

2003 -    March - the St. John’s Chapter of the AMNL was invited to complete and submit a Strategic Planning Questionnaire for the Health Care Corporation of St. John’s, which was done.

2003 -    March - the AMNL submitted a requested paper, with appendixes, on “Midwifery in Newfoundland and Labrador” to the Women’s Policy Office of the Govt. of Newfoundland and Labrador.

2003 -    April - the AMNL made a complaint to the Office of the Citizen’s Representative for the Province of Newfoundland and Labrador on behalf of the members who were appointed to the provincial Midwifery Implementation Committee. The main points were that “Members of the AMNL were misled regarding midwifery legislation” (when told that legislation was imminent), “Members of the AMNL wasted much time preparing materials for the MIC” (estimated for some at about 400 hours each), “Members of the AMNL question what information was given to the Minister” (as no final report was ever given to the MIC members)”.

2003 -    May - the document “Midwifery in Newfoundland and Labrador” with appendixes was given as requested, to the Program and Development Officer, Status of Women Canada, St. John’s.

2003 -    September 25 - the Atlantic Centre of Excellence for Women’s Health (ACEWH) held a consultation meeting at the Fairmont Hotel, St. John’s, to which various stakeholders were invited. The reason for this ACEWH meeting was “in the interests of sharing resources and ideas regarding the introduction of a fully-funded, autonomous midwifery profession [as] a reality for women in Atlantic Canada”.

2003 -    December - the AMNL sent letters to the Minister of Health and the Deputy Minister of Health of the newly elected provincial conservative government.

2004 -    November - the AMNL sent a letter to the newly appointed provincial Minister of Health requesting legislation for funded autonomous midwifery and that the work of the Midwifery Implementation Committee continues.

The following are examples of where more information regarding the history of midwifery in Newfoundland and Labrador may be obtained:

Benoit, C. (1991). "Midwives in passage". St. John's: ISER, Memorial University of Newfoundland.

McNaughton, J. (1989). "The role of the Newfoundland midwifer in traditional health care 1900-1970". Unpublished doctoral dissertation. Memorial University of Newfoundland.

Nevitt, J. (1978). "White caps and black bands". St. John's, Jesperson.

"Report of the Northern Childbirth Workshop". (Held at Makkovik, Labrador, January 30 to February 1, 1990).

North West River: Labrador Inuit Health Commission. Other materials which have been researched in this province:

Beaudry, R. (1997). "Women's lived experience with midwifery support: A phenomenological study". Unpublished masters thesis. Memorial University of Newfoundland.

Corkum, D. (1998). "Breastfeeding: Attitudes, perceptions and practices in Labrador". Goose Bay: Local Public Health Information Development, Melville Hospital. (Includes the midwives located at Melville Hospital).

 Okalakatiget. "Prenatal awareness" video. Available from the producer, P.O. Box 160, Nain, Labrador, A0P 1L0 (Fax: 709-922-2293)

O'Leary, S. (1998). "Motions". A celebration of lifecycles video. Available from the producer, P.O. Box 1132, St. John's, NF, A1C 5M5 (Telephone: 709-722-4662)

 Plummer, K. J. (1999). "Government-sanctioned midwifery in Canada, 1919-1991". Unpublished master's thesis. Yale University School of Nursing (contains much information about Newfoundland and Labrador).

Plummer, K. J. (2000). From nursing outposts to contemporary midwifery in 20th century Canada. "Journal of Midwifery & Women's Health", 45(2), 169-175.