Midwives, Women and the State: (De)Constructing Midwives and Pregnant Women in Ontario, Canada
Bibliographic record
Abstract
Abstract.Ontario'sMidwifery Actcame into effect on January 1, 1994, at a time of radical health care restructuring, marked by hospital closures and staffing cuts. In addition, feminist backlash was rampant in the popular media. Given these conditions, some have suggested that midwifery legislation was implemented because it aligned with the government's cost-cutting initiatives, while others have suggested that the government was responding to the dissatisfaction with obstetric practice outlined by a well-organized lobby. While these factors were no doubt important in the passing of the legislation, I offer a more critical reading of the policy texts, suggesting that the legislation and its enabling regulations problematize not only costs or client satisfaction but also the knowledge of midwives and the women they serve. In framing the issue as one of public safety, the policy ensemble introduced a new form of birthing expert—the expert midwife—reimposing a hierarchical relationship in the birthing process, serving to reify medical science and to objectify birthing women. In so doing, the legislation potentially silences claims for both professional and reproductive autonomy. Résumé.LaLoi sur les sages-femmesde l'Ontario est entrée en vigueur le premier janvier 1994 au cours d'une période houleuse dans le domaine de la santé qui fut marquée par des fermetures d'hôpitaux et des réductions de la main-d'œuvre. De plus, à cette époque, les médias populaires avaient clairement adopté une position antiféministe. Étant donné cette conjoncture, on proposa dans quelques articles que cette loi fut adoptée parce qu'elle cadrait bien avec les priorités gouvernementales de coupures budgétaires, tandis que d'autres insistèrent que le gouvernement ne faisait que réagir au mécontentement à l'endroit de la pratique obstétricale exprimé par un groupe d'intérêts puissant. Ces facteurs ont sans doute joué un rôle important dans l'adoption de la loi, mais je propose, en contrepartie, une interprétation plus critique des textes de politiques publiques. J'avance que la loi et sa réglementation soulignent une problématique qui va au delà des coûts et de la satisfaction de la clientèle, englobant aussi le savoir des sages-femmes et celui de leurs clientes. En formulant le débat en termes de sécurité publique, la législation a instauré une nouvelle forme d'expertise – l'experte sage-femme – qui réimpose une hiérarchie professionnelle dans le domaine de l'accouchement, ce qui a pour effet de solidifier la position de la médecine traditionnelle et d'objectiver les femmes. Ce faisant, la loi risque de négliger les revendications d'autonomie des professionnelles et des partisanes de l'accouchement naturel.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.019 | 0.007 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".