To give birth or to be given birth? It's up to us to decide which deliveries we want!

As Québec government prepares to pass Bill 15, despite widespread criticism, Tënk has decided to partner with the Movement for Autonomy in Childbirth, a feminist organization defending the rights of pregnant women and their families, to mount programming around the feminist reappropriation of childbirth. Here we share the open letter from the Coalition for Midwifery.

Bill 15: no to the medical guardianship of midwifery ! *To sign the open letter, click here.

When he tabled his voluminous reform bill last spring, Health Minister Christian Dubé wanted to "make the healthcare system more efficient". To achieve this, the Minister was counting, among other things, on better collaboration between the various professionals within the network and a reduction in the weight of physicians in decision-making processes. Noble intentions, some might say...

Medical subordination

During the week of September 10, as the detailed study of Bill 15 continued in the National Assembly, the Minister's real objectives became clearer: to place midwives under the hierarchy of a medical director, and to subject their work to the evaluation of a professional council made up of a strong majority of doctors, where they will always be in the minority. Midwives will lose the professional autonomy for which they have fought for almost half a century.

After all, midwives see childbirth as a normal biological process that belongs to the individual, and carries a profound meaning for the woman and her family.

Bill 15 is nothing less than a medical trusteeship of midwifery practice, and this without the main stakeholders - midwives and users - having been consulted. What is being decided is the end of the midwifery profession as it has been called until now.

An attack on fundamental rights

The year 2024 marks the 25th anniversary of the legalization of midwifery in Quebec and its integration into the healthcare network. This legalization was the fruit of so many years of struggle for the recognition of this essential profession, which relies on women's freedom to make their own decisions.

Women have long demanded to be able to choose their place of birth, to choose the type of care they wish to receive throughout their pregnancy, during childbirth and in the weeks following.

If midwifery and the birthing centers where it is offered have been able to develop despite the prejudices midwives face, it is precisely because of their professional autonomy, protected by structures and mechanisms set out in the current Act respecting health services and social services.

Almost 25 years later, the Minister is threatening to undermine the very foundations on which the profession was built and developed.

With this bill, women and pregnant women have every right to wonder whether, at the end of the day, they will still be able to exercise their fundamental right to choose, by and for themselves, what they consider to be the most desirable and respectful course of action for their pregnancy, childbirth and baby.

Will it still be possible to choose?

Many clinical situations that are currently discussed in depth by the family and the midwife will be subject to limitations. Discussions take time. Appointments of 45 minutes to an hour are one of the most appreciated and important elements of follow-up with a midwife.

Placing midwives under the supervision of other professionals who practice in a different and distinct paradigm of care will encourage the growth of a pathological approach to pregnancy and childbirth. Experiencing vaginal birth after caesarean section (VBAC) in a birthing centre or at home; deciding on pregnancy diabetes screenings or ultrasounds, it's possible with midwife monitoring. All choices that are under threat.

With the development of rules that will have to be approved by the medical profession, and the lack of midwives available to accompany families through this major event, we ask: will being able to choose to give birth at home still be possible?

Evidence from scholarly studies and recommendations from international health bodies such as the WHO confirm the positive impact of autonomous midwifery practice, focused on supporting the physiology of the perinatal journey.

Time to mobilize

Today, we're launching a call for widespread citizen mobilization to prevent midwifery in Quebec from being placed under medical guardianship. "Neither pope, nor judge, nor doctor, nor spouse, it's up to women to decide", a slogan that is as relevant today as it ever was.

We won't let it happen!

The Movement for Autonomy in Childbirth is a national feminist organization that collectively defends the rights of pregnant women and their families. The organization supports their autonomy in their peri-pregnancy journey and campaigns for everyone to have access to the healthcare of their choice.

The Movement :

Raises awareness and provides information to women and pregnant people to support their full autonomy and ability to make informed choices;
Defends access to quality, universal and free public perinatal services that are culturally adapted and meet people's needs;
Promotes reflection, consultation and exchange between citizen groups and between committees of people who use the various perinatal services.

This year, the Coalition for Midwifery is coordinated by The Movement for Autonomy in Childbirth.