Midwifery Practice & Pioneers

Accounts of First people’s health prior to colonisation are limited and vary widely, but some knowledge has been kept of traditional, culturally safe birthing practices

The arrival of the First Fleet in 1788 saw some 220 women among the 1350 souls onboard 11 ships: 187 convict women, and 33 sailors wives. Some 18 births took place during the voyage, the last being a son born to Sergeant Major Thomas Whittle on January 26, 1788 as the fleet sailed into Sydney Cove. But the arrival of European colonists would have devastating health effects on the First Peoples.

The practice of convict women assisting birthing women during the voyage to Australia continued on subsequent convict voyages and in the colonies.

The Aboriginal Protection Policy saw the enforced separation of Aboriginal people onto missions and reserves, with devastating cultural and health effects

Colonial women often relied on a neighbour to assist at childbirth. Commonly, one of these helpful neighbours would eventually become more experienced and skilled, and become recognised as ‘the midwife’ in the community. They were often known simply as ‘Granny’.

By the 1880s midwives working within their communities were able to earn a living from attending births. The majority of women still gave birth at home; however, the lying-in house or private maternity hospital of the midwife was another option. During this period nursing began to evolve as an occupation, and the medical profession gained power and influence within the State and the community. Nursing and medicine gained increased control over midwifery, and legislation placed restrictions on midwives’ practice.

Independent midwifery was in serious decline by the early to mid-20th century. The establishment of publicly funded maternity hospitals, the medicalisation of birth and medical dominance within the hospitals, led to the state and medical control of the training and regulation of midwives. Once women began to birth in hospital, the specialisation of obstetrics completed the medical dominance of birth.

Assimilation policies in Australia determined how Aboriginal and Torres Strait Islander people should have the same rights and privileges and responsibilities as other non-Indigenous Australians, and be made essentially indistinguishable from non-Aboriginal Australians. The health of Indigenous people continued to suffer under this policy, as cultural and social welfare continued to be neglected.

From the 1930s most women in Australia gave birth in hospital; women still received care from midwives, although the care administered was ordered and directed by doctors. Midwives now had to train in hospitals, and most training expected them to be nurses first.

Community controlled services were, and still are, vital for Aboriginal and Torres Strait Islander people to be able to participate in decisions and have overall control over all aspects of an organisation that serves them.

By the mid-1970s consumer and political pressure for birthing alternatives began to mount in Australia. An international move towards a model that recognised the definition of a midwife and a philosophy of practice that was ‘with woman’ resulted in renewed interest in educating midwives without the need for a nursing qualification.