Feminizing obstetrics or medicalizing midwifery? The discursive constitution of midwifery in Ontario, Canada

Abstract

The politics of midwifery in Ontario, Canada, offers rich insights into feminist policy and policy analysis, illuminating both challenges and opportunities for social change. In this article, I employ the discourse coalitions framework to investigate the claims-making process during early debates of midwifery. I argue that early midwifery advocates framed the debate around the issue of patriarchal politics, connecting the ‘colonization of wombs’ with gender inequality more generally. Once entering mainstream public dialogue, however, the rhetorical power of the scientific-medical discourse proved too strong, prompting midwifery advocates to employ frames congruent with its principles, including competence, safety, and expertise. The effect was twofold: first, it created an observable cleavage between pragmatic and radical midwives and midwife supporters; second, the resulting legislation, rather than offering a challenge to the scientific-medical model, actually served to reproduce it. In doing so, it has effectively objectified the birthing woman, replacing the physician as primary decision-maker with an ‘expert midwife’, while obscuring and potentially silencing claims for reproductive autonomy.