- 1885 Melbourne Lying-In Hospital training extended to six-months
- 1888 Melbourne Lying-In Hospital training extended to twelve-months
- 1893 Sydney Benevolent Asylum has an outbreak of puerperal sepsis, resulting in the death of 8 women and closure of the hospital. It relocates to Paddington as the Hospital for Women, and the Royal Hospital for Women from 1905
Lying in homes & private hospitals
By the 1880s midwives working within their communities were able to earn a living from attending births. Throughout the nineteenth and early twentieth centuries in Australia, the majority of women still gave birth at home; however, the lying-in house was another option for some women. The lying-in house had become popular in the eighteenth century in Britain, where its aim was to provide poor women with somewhere to go to birth, and then stay for a period of time following the birth to regain their strength. Increasingly, towards the end of the nineteenth century some Australian midwives began to offer this service. Rather than just attending women at their own home home, midwives would also provide midwifery care to women in their own residence and ‘private maternity hospitals’.
A new type of midwife
During this period nursing began to evolve as an occupation, and the medical profession gained power and influence within the State and the community, and there was a push for the registration of nurses and midwives. These events, and changes in the socio-political environment, led to the absorption of midwifery into nursing and the associated subordination to medicine. Nursing and medicine gained increased control over midwifery, and led to legislation which placed restrictions on midwives’ practice. This in turn led to the loss of autonomous midwifery practice, and ultimately their distinct role as a separate to nursing.
The subordination of midwifery was achieved as the Australian midwife did not have a strong foundation and had very little professional credibility, unlike British and European midwives. The majority of midwives in Australia at the end of the nineteenth century were still working-class and all were women. This class and gender divide between medicine on the one hand, and nursing and midwifery on the other, is of particular importance to the ease in which the subordination of midwifery was achieved. Medicine’s acceptance of hospital based midwives provides shows that the early struggle between medicine and midwifery was not about the midwives’ competence, but due to their status as independent practitioners. Medicine was opposed to any move to make midwifery an independent profession as they wanted to prevent the independent midwives from improving their status and standing in the community.
The only way that medicine could control midwifery was through nursing. The move to incorporate midwifery into another female dominated occupation – nursing – ensured that the working-class female midwives would continue to be excluded from medicine, as midwifery was now being defined as part of medicine under the new speciality of ‘obstetrics’. If midwifery became a branch of, or was included in nursing, then it too would fall under the control of medicine. To be able to control midwives, medicine also had to control who could train and practice as a midwife. Consequently, medicine encouraged the training of midwives, albeit with a minimal amount of training and skills. This training was enough to enable them to provide care within the medically controlled and supervised institution, but not enough to enable them to provide the full scope of midwifery practice, thereby discouraging them from entering into autonomous independent practice.
The working-class community midwives were seen as a hindrance to the new nurses and were excluded from many training schools due to their social class and age: they did not fit the new image of the new trained nurse-midwife. The introduction of medically-run, midwifery training schools created a new type of midwife who specialised in hospital-based midwifery, and was familiar with the medical model of care. This contributed to the divide between hospital-trained midwives and the independent community midwife.