Curtin University Perth Western Australia, School of Nursing, Midwifery and Paramedicine, Australia; Charles Darwin University, College of Nursing and Midwifery, Australia.
Curtin University Perth Western Australia, School of Media, Creative Arts and Social Inquiry (MCASI), Australia.
Women Birth. 2022 Sep;35(5):e409-e420. doi: 10.1016/j.wombi.2021.10.009. Epub 2021 Nov 1.
To date there is has been very little research into midwifery in Western Australia (WA), therefore this paper addresses a significant gap in the literature. The aim of this paper was to gain insight into the history of midwifery in WA.
Since the beginning of recorded history midwives have assisted women in childbirth. Midwifery is recognised as one of the oldest professions; midwives are mentioned in ancient Hindu texts, featured on Egyptian papyrus and in The Bible. Up until the seventeenth century childbirth was the responsibility of midwives, but the gradual emergence of barber-surgeons, then man-midwives and obstetricians heralded a shift from women-led and community-supported birth to a patriarchal and medical model. Throughout the twentieth century childbirth practices in the Western World have continued to change, leading to a move from midwifery-led care at home to doctor-led care in the hospital.
The first non-Indigenous Australian midwives were not formally trained; they came on ships bringing convicts to Australia and are described as 'accidental' midwives, as assistance in childbirth came from whoever was available at the time. This period was followed by what was called the 'Aunt Rubina' period where older married women helped younger women in childbirth. Throughout the early 1800s untrained or 'lay' midwifery care continued alongside the more formally trained midwives who had arrived with the colonists. From the early 20th century, when birth moved into the hospital, midwives in WA have been incorporated into the hierarchy of the professions with obstetrics as the lead profession and midwifery considered a speciality of nursing. The role of the midwife has been subordinated, initially controlled by medicine and then incorporated into the institutions and nursing. The increase in legislative and training requirements for midwives throughout Australia and the move from home to the hospital, gradually led to the decrease in autonomous midwives working within the community, impacting women's choice of birth attendant and place of birth.
The historical suppression of midwifery in Australia has impacted the understanding of the role of the midwife in the contemporary setting. Understanding the development and evolution of the midwifery profession in Australia can help future directions of the profession.
迄今为止，西澳大利亚（WA）的助产士研究很少，因此本文填补了文献中的一个重要空白。本文的目的是深入了解 WA 助产士的历史。
从有记录的历史开始，助产士就一直在协助妇女分娩。助产士被认为是最古老的职业之一；在古印度教经文中提到了助产士，在古埃及纸莎草和《圣经》中也有记载。直到 17 世纪，分娩都是助产士的责任，但随着理发师-外科医生、男助产士和产科医生的逐渐出现，分娩从以女性为主导、以社区为支撑的模式转变为以父权制和医学模式为主导。整个 20 世纪，西方世界的分娩实践不断变化，导致从以助产士为主导的家庭分娩转向以医生为主导的医院分娩。
第一批非土著澳大利亚助产士未经正式培训；他们随船而来，船上载有罪犯前往澳大利亚，被称为“意外”助产士，因为分娩时谁有空谁就会提供帮助。接下来是所谓的“鲁比娜阿姨”时期，那时年长的已婚妇女帮助年轻妇女分娩。在整个 19 世纪初，未经培训或“非专业”的助产士护理与随殖民者而来的更正式的助产士护理并存。从 20 世纪初，分娩进入医院时，WA 的助产士就已经融入了专业人士的等级制度中，产科成为主导专业，而助产士则被视为护理的一个专业。助产士的角色被降级，最初受医学控制，然后被纳入医疗机构和护理中。随着澳大利亚对助产士的立法和培训要求的增加，以及从家庭到医院的转变，逐渐导致在社区中工作的自主助产士数量减少，这影响了妇女对分娩护理人员和分娩地点的选择。
澳大利亚对助产士的历史压制，影响了当代对助产士角色的理解。了解澳大利亚助产士职业的发展和演变，可以帮助确定该职业的未来方向。
