Document Type


Degree Name

Doctor of Philosophy (PhD)




Faculty of Arts

First Advisor

Cynthia Comacchio

Advisor Role

Dissertation Advisor


This dissertation considers the differences, as well as the similarities, between midwifery and childbirth practices in Ontario and in Britain in the first half of the twentieth century. Addressing the modernization of medical practices on either side of the Atlantic, the periodization of this project reflects the increasing concerns about maternal and infant morbidity and mortality alongside medical and political attempts to ensure the involvement of trained medical professionals during pregnancy and childbirth. In Britain, the establishment of the 1902 Midwives Act regulated midwifery so that only midwives approved by the Central Midwives’ Board were allowed to practice. British midwives helped to improved maternal and infant health and welfare by making childbirth a co-operative, medically-managed event in conjunction with physicians. The medical training of midwives and physician support meant that British midwives thus participated in, and contributed to, advances in obstetrics through their access to obstetrical medicine and technology. In contrast, physicians in Ontario worked to exclude midwives from participation in the modernization of birth management, emphasizing a physician-exclusive concept of “medicalization”. Under Ontario legislation, only physicians were legally allowed to act as primary attendants during childbirth, and nurses and midwives were prohibited from practicing midwifery. Nurses and midwives in Ontario, unlike their counterparts in Britain, were excluded from developments in obstetrics. This study challenges the medical profession’s claims that the exclusion of midwives in Ontario was necessary for maternal safety or the medicalization of childbirth. The British alternative, where midwives were seen as partners rather than obstacles, illustrates that medicalization in the interest of maternal and infant safety could be integrated, effectively and efficiently, with the work of midwives. By ensuring that midwives were trained medical professionals with access to obstetrical medicine and technology, greater numbers of British women had widespread access to affordable medical attention during childbirth, at an earlier date, than was possible for Ontario mothers having to deal with the physician-centred model. Comparative maternal and infant mortality statistics for the first half of the twentieth century indicate which was the more effective approach in saving mothers and babies.

Convocation Year