The midwifery practice in Quebec represents a movement rooted in women’s autonomy, equity, and the humanization of childbirth. For decades, families and activists have opposed the medicalization of childbirth, seeking a return to more personalized care. As childbirth moved into hospitals in the 1950s, many women felt their experiences became overly clinical. The midwifery movement emerged from a desire to reclaim more personalized and respected birthing practices, and this history continues to shape birthing options today.
We spoke with Sarah Landry of Mouvement pour l’autonomie dans l’enfantement (formely Groupe MAMAN) to gain insight into this journey. She shared how early advocacy efforts laid the foundation for the practice of midwifery’s legalization and continue to drive the Movement’s mission today.
The Push for Legalization
It took decades of advocacy to transition midwifery from an unregulated practice to an integral part of Quebec’s healthcare system. By the 1960s, hospital births had become the norm, moving away from traditional home births. Dissatisfaction grew throughout the 1970s as women increasingly shared difficult experiences related to hospital-based childbirth and began to demand more of the father’s role in the birth experience. A desire for compassionate, personalized care drove the call for this change.
A major turning point was the “Giving Birth or Being Gave Birth” conferences, which Sarah described as a trigger for the movement to demand midwifery be a professional practice. The push emphasized equity and bodily autonomy. Sarah noted, “The belief that the medicalization of birth is only necessary for a certain number of pregnancies [was a core part of this advocacy].”
Despite forming strategic alliances with feminist organizations like the Fédération des Femmes du Québec, medical opposition significantly delayed progress. “The challenges of obtaining legalization due to pressure from medical associations delayed the deployment of midwifery,” Sarah said. It is important to note that between 1999 and 2005, this setback was significant because home births had been common before that.
Impact of Legalization and Evolving Relationships
Legalizing home births in 2005 was transformative, giving women the choice of home, birthing centers, or hospitals. “Access to different choices of birthing locations became possible again for women followed by midwives,” Sarah shared. Yet, tensions between midwives and medical institutions persist, with ongoing pressures affecting midwives’ ability to deliver personalized care.
The Movement’s Role and Advocacy
The Movement has been central to advocating for families and midwives. “Groupe MAMAN was created in a birthing center by women who wanted to promote natural childbirth and the experience of being accompanied by midwives,” Sarah explained. Over the years, they have actively participated in pilot project evaluations and collaborated with organizations like the Regroupement Naissance-Renaissance (now Regroupement Naissances Respectées) to push policy changes that protect and expand midwifery practices.
Today, the Movement continues representing families and pushing for midwifery practices based on trust and community. The Movement is taking a leading role in the upcoming general assembly on midwifery practice, where they will help shape the future of midwifery in Quebec. Funded by the Quebec government, these general meetings will bring together key stakeholders to discuss and set the main directions for the development and future of midwifery services.
Sarah emphasized, “The Movement, therefore, intends to represent families on the steering committee, widely distribute the survey intended for families who use midwifery services, and finally mobilize member groups and members of the Movement to participate in the general assembly that will close the general assembly.
By continuing its involvement in events like the orientation committee of the General Assembly and its advocacy efforts, the Movement ensures that midwifery practices in Quebec maintain a holistic and personalized approach to serve Quebec communities well.
Reflections and Future Outlook
Sarah reflected on victories like the return of home births and funded birthing centers but noted that access remains unequal. “Midwives and women campaigned for the legalization of midwifery practice for one big reason: to promote universal and free access to all women who wanted midwifery services,” she said.
However, midwives must be trained to meet demand. “We definitely need a change… to significantly increase access to midwifery services,” she stated. The Movement is committed to ensuring midwifery remains accessible and non-medicalized. Mouvement pour l’autonomie dans l’enfantement stands firm in supporting women’s rights and autonomy in childbirth. By advocating for informed, personalized care and challenging policies that compromise the well-being of families, the Movement continues to be a vital force in shaping the future of childbirth practices in Quebec.
