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CHAPTER 2 Canadian Midwifery: Blending Traditional and Modern Practices Cecilia Benoit and Dena Carroll e history of midwives is virtually absent from tandard medical historical texts and nursing _ecords, yet Canadian midwives have survived in various forms, despite difficult circumstances, internal divisions over education and practice, and ongoing struggle to achieve autonomy and recognition as health professionals on par with physicians and nurses. For Aboriginal midwives, the history of midwifery has been further affected bycolonialization , criticism of traditional healers, and the imposition of Western medicine. A genuine retelling of the history of midwifery in our country is overdue. In this chapter we examine Aboriginal midwives, traditional lay/granny midwives and finally nursemidwives , ending with a postscript on the present day status of midwifery. We draw upon a diversity of sources to highlight common themes that mark the history of midwifery. Despite the continuum of midwifery types, differing in regard to their recruitment , training, place of work, access to technology and economic rewards for services rendered, all midwives perform common activities during pregnancy and childbirth, and provide not only emergency, but social and emotional care, for birthing women. Given the challenges to their autonomy that all midwives have faced, past and present, from other professionals as well as their clients, there has also been a great range in public perceptions surrounding their occupation . It is now common knowledge that pregnancy and childbirth are as much a social and cultural process as they are biomedical and thus require sensitivity by health providers to women's personal needs. Aboriginal Midwives The history of Aboriginal midwives predates European settlement in Canada; its survival has ebbed and flowed, but its traditions have been revived in parts of Canada in the last decade. Despite few historical accounts of early traditional midwives in pre-contact societies, there is reference to Aboriginal women (and sometimes men) who occupied privileged positions in their communities, providing maternity and general health care. Due to the sacred nature of childbirth and dependence on oral history stories about midwifery and childbirth were seldom recorded.1 Young girls were chosen at an early age to be apprentices, though few actually occupied the role of midwife until later in life, attending the births of their female relatives in order to build a solid basis of local knowledge and rituals. They were sometimes taught to recognize the "birth energy" — a special communication between the labouring woman and her baby. Skills included the preparation and administration of herbal medicines, acquiring knowledge of T Figure i Cradleboard for carrying baby Northern Plains ca. 1895 Canadian Museum of Civilization, X-V-no human anatomy, and the cultural and spiritual knowledge related to childbirth. Recent linguistic research suggests the term midwife focused on the roles and responsibilities of providing care for women in need, and lifelong commitment to their children and families. The Nuu-chah-nulth people, located on the West Coast of BC, translate the term midwife as "shecan do everything ," the Coast Salish of Vancouver Island,BC, describe the role as "to watch/to care," and the Chilcotin people of the province define it as "women's helper." Anthropologist Franz Boas described thecomplex social organization of pregnancy and childbirth in Aboriginal societies, noting that often one or more trained midwives stayed with the woman during labour.2 Traditional stories and dances, such as the Atlak'am masks and legends of the G*exsem of the Kwakiutl people, illustrate the spiritual and cultural connection between midwife, mother, and child. Aboriginal women elders (also referred to as "grannies or aunties") assisted with births. Katsi Cook Bareiro, Akwesasne midwife, director of the Lewirokwas (Pulling the Baby Out of the Earth)midwifery program and former midwifery instructor at Six Nations Birthing Centre at Grand River,Ontario, emphasizes how roles were passed down from generation to generation. Katsi notes that her midwife relatives required no sanction from an outside medical, legal, or political authority, nor were they required to have a formal midwifery certification. Considered "keepers of the culture," due to their rich personal experience of childbirth and other aspects of female life, their role was to help pass down moral and ethical values through generations.3 Using a holistic approach to childbirth, considerable time and attention was given to the needs, concerns, and obligations of the birthing woman, an approach that still exists today. Pregnant women were required to follow specific regulations, rituals, and obligations, pay careful attention to their activities , and avoid certain social networks and foods, in order to ward...

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