Looking back moving forward: The history of midwifery in Western Australia

Abstract

Problem: To date there is has been very little research into midwifery in Western Australia (WA), therefore this paper addresses a significant gap in the literature. The aim of this paper was to gain insight into the history of midwifery in WA.

Background: Since the beginning of recorded history midwives have assisted women in childbirth. Midwifery is recognised as one of the oldest professions; midwives are mentioned in ancient Hindu texts, featured on Egyptian papyrus and in The Bible. Up until the seventeenth century childbirth was the responsibility of midwives, but the gradual emergence of barber-surgeons, then man-midwives and obstetricians heralded a shift from women-led and community-supported birth to a patriarchal and medical model. Throughout the twentieth century childbirth practices in the Western World have continued to change, leading to a move from midwifery-led care at home to doctor-led care in the hospital.

Discussion: The first non-Indigenous Australian midwives were not formally trained; they came on ships bringing convicts to Australia and are described as 'accidental' midwives, as assistance in childbirth came from whoever was available at the time. This period was followed by what was called the 'Aunt Rubina' period where older married women helped younger women in childbirth. Throughout the early 1800s untrained or 'lay' midwifery care continued alongside the more formally trained midwives who had arrived with the colonists. From the early 20th century, when birth moved into the hospital, midwives in WA have been incorporated into the hierarchy of the professions with obstetrics as the lead profession and midwifery considered a speciality of nursing. The role of the midwife has been subordinated, initially controlled by medicine and then incorporated into the institutions and nursing. The increase in legislative and training requirements for midwives throughout Australia and the move from home to the hospital, gradually led to the decrease in autonomous midwives working within the community, impacting women's choice of birth attendant and place of birth.

Conclusion: The historical suppression of midwifery in Australia has impacted the understanding of the role of the midwife in the contemporary setting. Understanding the development and evolution of the midwifery profession in Australia can help future directions of the profession.

Keywords: History of medicine; History of midwifery; History of nursing; Midwifery; Nurse midwives; Western Australia.