The author of “the birth house” lives with her husband and two sons in an old birth house on the Bay of Fundy.  I finished reading this clever debut novel by Canadian author, Ami McKay, yesterday.  I was both entertained and educated. 

Midwifery, particularly the apprenticeship of Dora Rare (the main protagonist), is the binding theme throughout the tale.  Yes, there is also love (won and lost), the complexity of family relationships, the hardships of the late 1800’s and early 1900’s in a small east coast harbour town on the wrong side of a mountain, tragedy, both personal and historical – the book touches on WWI, the 1917 explosion in Halifax Harbour, the Spanish Influenza epidemic, the 1919 tragedy in Boston when a house-sized molasses fermentation tank exploded, as well as allusion to the beginnings of the suffragist movement – all cleverly woven into a captivating narrative.

The birth house is a very good read about women fighting to retain control over their bodies, particularly the right to say where and how they would birth their children.  In fact, it is such a good read, that it left me wanting to know more about the current status of midwifery in this country.

My Own Experience

Birthing my own two boys was done in hospital, first time in 1968.  I didn’t know there was any other option.  I was young and afraid and did what was the accepted norm at the time.  I remember the cold room, glaring white lights, and attendants swathed in dark green scrubs.  I especially recall the large circular mirror reflecting occasional snippets over the doctor’s shoulder of the gruesome scene going on between my stirrup-propped knees.  My only rebellious moment was to yell, “Someone cover that god damned mirror” over and over until I was obliged.  There was no joy in the birthing process – it was all business – an impersonal, clinical and strange business from which I was completely disconnected by the foreign language of medical terminology, the terrifying array of medical instruments, the masked faces of strangers and the total lack of explanation about what was going on ‘down there’.  It took six years to get pregnant with the second boy, but the process in 1975 was no different, no less sterile and no less remote or frightening. 

Would I have chosen a midwife either time if I’d known? Dunno. But the sense of sisterhood portrayed so beautifully in MacKay’s book, makes me think I might have forgone a supposed pain-free delivery for the intimacy of women helping women bring new life into this world.

Catching My First Baby

I was in my 40’s when I got to see things from another viewpoint, helping to catch a baby by choice.  One of the traditions of the First Nation my good friend belongs to involves selecting life guides for a child while still carrying it.  I was one of five chosen and was alarmed to discover that the responsibility included helping to birth the child.  In traditional terms the life guides are first to greet the newborn, even before the parents.  There was no epidural, no masked attendants, no medical instruments, no mirrors of any kind – just a group of women helping the mother call the baby down.  We were in a softly lit and homey birthing room of the nearest town’s hospital.  My friend was traditional in many ways but also modern enough in the absence of a qualified midwife to want a back up if anything went wrong.   The small room was crowded with life guides, aunties, sisters and daughters.  Although the attending physician regularly checked progress, this birthing was women’s work!

Midwifery Today in Ontario and Canada

  • In 1991, Bill 56, the Midwifery Act was passed, making Ontario the first province to recognize, regulate and fund midwifery as part of the health care system.
  • In 1992 The Ministry of Colleges and Universities announced a baccalaureate program in Health Sciences (Midwifery) for the education of new midwives to be offered at three Ontario institutions: Laurentian, McMaster and Ryerson Polytechnic Universities.
  • With the proclamation of the Midwifery Act in 1993, midwifery became a self-regulated health profession in Ontario. The term “midwife” became a protected title and midwives were recognized as autonomous practitioners within the health care system. 
  • On January 1, 1994, the College of Midwives of Ontario was established to administer the Midwifery Act and to protect and promote the midwifery model created by women and midwives.
  • Midwifery Education in Canada (  The Canadian Midwifery Regulators Consortium (CMRC) is a network of midwifery regulatory authorities from Canadian provinces and territories where midwifery is regulated.  Members include:
  • The CMRC’s mandate is to facilitate inter-provincial mobility, to advocate for legislation, regulation, and standards of practice that support access to a high standard of midwifery care across the country, and to provide a forum for Canadian regulators to discuss and take action on issues of mutual concern.
  • Midwifery Scope Of Practice according to CMO (Midwifery Act, 1991) “The practice of midwifery is the assessment and monitoring of women during pregnancy, labour and the post-partum period and of their newborn babies, the provisions of care during normal pregnancy, labour and post-partum period and the conducting of spontaneous normal vaginal deliveries.”
  • Midwifery Bridging Project ( is a multi-jurisdictional
    project designed to help midwives educated outside of Canada to use their skills in a Canadian context.
  • College of Midwives of British Columbia
  • Alberta Midwifery Health Disciplines Committee
  • Saskatchewan College of Midwives
  • College of Midwives of Manitoba
  • College of Midwives of Ontario
  • Ordre des sages-femmes du Québec
  • Midwifery Regulatory Council of Nova Scotia
  • Northwest Territories Health Professional Licensing (Midwifery)

Copyright © 2010, Cheryl Andrews