Giving Birth in Canada, 1900-1950 (review)

Childbirth is a fundamental social and biological activity. Because the event acutely brings together the individual with the larger medical and cultural milieu in which it takes place, its history can help dissect the complexity of the past—especially one area of that past that has been of recent interest to historians, the relationship between women and medicine. In Wendy Mitchinson's able hands, this is exactly what Giving Birth in Canada accomplishes. Mitchinson focuses on the first half of the twentieth century and on English-speaking regular medicine, reading deeply and widely in original research in hospital records, physicians' writings, popular literature, and interviews with physicians and women, and at the same time pulling on a rich secondary literature on the subject rooted in recent local Canadian studies. Her book is now a benchmark for all future historians.

As in the United States, and to a lesser extent in Western Europe, Canadian childbirth practices became increasingly medicalized during this period. Mitchinson traces the process as it developed, moved increasingly into the hospital, and adopted high technology and high medical intervention rates, and she sets these developments alongside the simultaneous continuation of traditional midwifery practices and First Nations' experiences. She intersperses compelling individual stories with larger analyses. All the while, she reminds the readers of the high maternal mortality rates in Canada and understands the various cultural and technical interventions in that context. She insists that all cultures and all systems tried to intervene in labor and delivery, which was often perceived as dangerous. Thus she forces readers to see the medical interventions of this period—the increasing use of forceps, anesthesia, labor induction, cesarean section—as different only in degree from more traditional practices of stretching the cervix, squatting over steam, or putting a knife under the bed. For all interventions, Mitchinson emphasizes difference and diversity within the various systems. Physicians were not a monolithic group, nor were aboriginal midwives. Each individual practitioner, working within his or her general framework, tried in each case particularly, as best he or she knew how, to deliver a live baby from a live mother.

Mitchinson is sympathetic to physicians, especially the lone practitioner faced with a difficult labor. She is sympathetic to birthing women who push for safer deliveries. She is sympathetic to traditional practices and alternatives to medicalization. She is less sympathetic to "feminist historians," who she believes romanticize midwifery and are too critical of medicine. Since most historians, feminist and otherwise, have long since rejected a simple "woman as victim, male doctor as villain" interpretation, Mitchinson's repeated hammering on this point seems to be setting up a straw issue merely to put herself above the fray. Rather, she joins a growing number of historians in Canada and the United States, as well as in Europe, Latin America, and Asia, seeking nuance and complexity in their reading of childbirth history and of medical history more generally.

Canadian historians of women and medicine have produced a rash of important scholarship in recent years. Yet Mitchinson and others feel that their work has not been adequately recognized and incorporated into the historical mainstream of the United States and Western Europe. Scholars do not look to Canadian experiences as relevant to a broader international experience. In this book, with its breadth of all Canada during a crucial half-century of changes in childbirth practices, and with its magnificent depth of research and insight, Mitchinson might actually succeed in changing that status quo. As she imagines, perhaps "some future anonymous reader of a British or American study will offer the novel critique that it should go beyond its national boundaries and take Canada into consideration!" (p. 11). This book leaves me optimistic that such a...