Giving Birth in Canada, 1900-1950 (review)

The history of childbirth is one of the most fruitful topics for research on the history of women and health. In Giving Birth in Canada, 1900–1950, Wendy Mitchinson provides the first book-length study of the history of childbirth in Canada. Mitchinson examines such topics as prenatal care, miscarriage, eclampsia, caesarian sections, and postnatal care. She draws on hospital records, medical journals, medical textbooks, women’s magazines, and medical advice books to analyze how the medical profession treated childbirth. She also provides some examples of women’s experiences of pregnancy and childbirth by using oral histories, interviews, and the journals of Lucy Maud Montgomery, the well-known author of Anne of Green Gables.

Mitchinson positions herself as offering a more complex history of childbirth than previous feminist scholars. She suggests that previous scholarship, some of which was written more than two decades ago, has misrepresented the medical response to childbirth. First, she claims that it has romanticized midwife birth attendants and home births as natural and noninterventionist. Instead, she argues that intervention in childbirth was not exclusive to hospital-based western medicine, but took place at the hands of midwives, as well as doctors, during home births as well as hospital births, and among indigenous people as well Euro-Canadians. Second, she insists that feminists have underestimated the professional and personal constraints that shaped physicians’ responses to pregnancy and childbirth. She points to changes in the science of medicine, for example, to explain why doctors saw birth as pathological after World War I and why they increased their surveillance of pregnant women through the expansion of prenatal care. Furthermore, she emphasizes that physicians were not a monolithic group, even though they shared certain professional assumptions about the value of science and medical school training. She indicates that physicians’ practices varied by region, and across urban and rural locations. Ultimately, Mitchinson makes very important points about the role of medicine in the history of childbirth. Yet, her criticism of feminist contributions to medical history fails to fully consider the range of previous and current feminist analyses of the history of childbirth and reproduction, some of which share aspects of her line of argument.

Despite the focus of the book on practitioners of regular medicine, Mitchinson occasionally departs from a straightforward narrative of the medical profession’s treatment of childbirth. In an interesting chapter on midwifery, for example, she notes that midwives remained important childbirth attendants in immigrant, First Nations, and Inuit communities. Yet, like doctors, midwives were not a monolithic group. As she explains, “The culture of the midwives and their communities played an important role in determining the equipment used, the people present, the position of the birthing woman, and the disposal of the afterbirth” (pp. 102–103). She draws on information about midwives and traditional indigenous healers not only to complicate the story of childbirth in Canada, but also to directly compare their health care practices to those of doctors. She wants to remind readers that physicians also practiced with a particular set of rituals based on certain cultural assumptions. They, too, were products of and producers of culture. Indeed, much of the book is focused on detailing the many similarities between doctors and other health care providers in terms of their approaches to childbirth.

Mitchinson has provided a thorough, scholarly account of the history of childbirth in Canada. She has pulled together a wide range of information and built on the scattered secondary literature on childbirth in the various provinces to provide a comprehensive overview of childbirth in English-speaking Canada. Although the research is excellent, the book would have benefited from a livelier writing style and better editing. Nonetheless, this study remains a significant contribution to the history of medicine.