Caregiving on the Periphery: Historical Perspectives on Nursing and Midwifery in Canada (review)

In this collection of essays, Myra Rutherdale and an impressive cadre of contributing scholars offer important perspectives on the divergent experiences of nurses and midwives in (mostly) remote regions of Canada. By providing in-depth analyses on discrete topics ranging from the initiation of midwifery services in early nineteenth-century Toronto to the training of aboriginal nurses in northwestern Canada, Caregiving on the Periphery complements and extends a growing body of sophisticated historical research on women and health care in Canada, exemplified by Elliott, Stuart, and Toman’s Place & Practice in Canadian Nursing History (Seattle, University of Washington Press, 2008) and Bates, Dodd, and Rousseau’s On All Frontiers: Four Centuries of Canadian Nursing (Ottawa, University of Ottawa Press, 2005). Drawing such diversity together under the unlikely theme of geographic remoteness, Caregiving on the Periphery offers a portrait of “woman’s” health-care territory as isolated and isolating—but happily so. Women who worked in remote settings enjoyed unprecedented levels of professional (and social) independence. Working beyond the administrative reach of physicians and health-care bureaucracies, these nurses and midwives carved out practice areas with a level of self-determination rarely afforded women caregivers in the metropolis.

Caregiving on the Periphery is divided into four parts. Part 1 focuses on the multifaceted lives of midwives and includes essays on working class caregivers in nineteenth-century Toronto, midwives and undertakers in Mennonite settlement communities, and the working life of midwife Myra (Grimsley) Bennet. Part 2 focuses on life writing in nursing history and includes essays on Hanna Grier Coome’s work in the Northwest Rebellion, gender and race in the letters of nurse Margaret Butcher, and the work and travels of Amy Wilson. Part 3 focuses on regulating nurse training and professional boundaries, and includes essays on the Indian Health Services in northwestern Canada, and nursing with the Grenfell mission stations in Newfoundland and Labrador. Part 4 focuses on northern nursing, natives, and newcomers, and includes essays on outpost nursing under the Red Cross in Ontario, the ambiguities of nursing in northern Saskatchewan, and nurses as educators in northern communities. Rutherdale’s introduction provides an effective and necessary overview of both the content and its place in current historiography. Through it, she manages to corral the range of topics, writing styles, and analytic approaches into a coherent whole.

Judith Young’s outstanding essay on midwifery in nineteenth-century Toronto and Marlene Epp’s absorbing study of Mennonite midwives exemplify the new territory covered by this collection. Drawing on rare and difficult to access resources, both studies pry open new avenues of research that go beyond emphasizing midwifery vis-à-vis medicine (i.e., as an occupation that declined because of the onslaught of organized medicine) but rather as an intriguing profession in its own right. Similarly, Jayne Elliott’s thoughtful careful essay on outpost nursing and Judith Bender Selmanotvit’s detailed essay on nurses as educators in northern communities illustrate the work and worth of nursing as mutually beneficial to nurses and northern residents. Nursing work in remote regions was crucial and all encompassing; in the absence of physicians, nurses in outpost nursing stations provided public health, diagnostic, and emergency medical services. Nurses learned and practiced medical skills independently through necessity. Having experienced high levels of independence, northern nurses resented and resisted situations that called for subservience to physicians or other “southern” authorities keen to restrict their care.

Essays by Myra Rutherdale, Mary Ellen Kelm, and Linda Kealey explore ways in which women’s writings reflected and shaped their professional identities. Rutherdale’s examination of northern nurse Amy Wilson’s travel writings in the 1950s reveals how Wilson constructed a masculinized version of a feminized profession. Kealey’s examination of nurse–midwife Myra Bennet’s career in Newfoundland between 1921 and 1953 illuminates how the profession of nursing opened up social (physical, intellectual) territory in which...