Natural Childbirth in Canada and the World

Whitney Wood

Anticipating a “long-awaited” fourth pregnancy in the spring of 1948, twenty-seven-year-old Karen Birch from rural Alberta wrote to Grantly Dick-Read (1890-1959), the British doctor who had emerged as a leading figure in the burgeoning natural childbirth movement. Offering praise for Dick-Read’s influential book, Childbirth Without Fear (1944), Birch asked the doctor “to take on a patient 6,000 miles away”, and expressed her desire to know more about the method and how to achieve a “successful” natural delivery. While Dick-Read responded that Birch was, unfortunately, “just outside [his] limit for attending women in labour!”, the doctor and expectant mother embarked on a correspondence lasting approximately eighteen months. Birch never met Dick-Read, and most would not consider her to be his patient. Nevertheless, she, like other Canadians who took the time to write to Dick-Read, was an active participant in the broader campaign for natural childbirth, one of the first organized efforts to contest the medicalization of childbirth, a process that had gone largely unquestioned since the late-19^th century.

Historians have examined the impact of Dick-Read’s theories – ideas that came to be synonymous with “natural childbirth” before the global emergence of the Lamaze method in the late 1950s – in Great Britain and the United States, but his teachings, and natural childbirth writ large, have received little attention in the Canadian context. As a SSHRC postdoctoral fellow at the University of London, my work aims to correct this imbalance. In my current project, A New Way to Birth? Natural Childbirth in Canada and the World, 1930-2000, I  follow in the steps of historians including Karen Flynn, Laurence Monnais, David Wright, and Sasha Mullaly, and seek to trace the transnational spread of medical ideas and practices – in this case, as they relate to the international natural childbirth movement.

To this end, as a relatively “new” international historian, I was happy to be invited to McMaster to attend the “Undiplomatic History: Rethinking Canada and the World” workshop hosted by the L.R. Wilson Institute for Canadian History in April 2017. Here, I realized the importance for Canada in the world scholars of incorporating lenses of analysis that, while relatively new to the Canadian historiography, have been a mainstay of transnational, global, and international history for some time. Looking at the history of natural birth, I suggest, provides a valuable example of how ideas, people, and practices spread across transnational networks. An examination of the natural childbirth movement demonstrates that Canada existed as one of many spokes in a broader culture of transnational medicine throughout the postwar decades.

The Canadian natural childbirth movement was shaped, first and foremost, by migration. The international movement of both expectant mothers and the physicians who treated them fuelled the spread of Dick-Read’s theories and the practice of Childbirth Without Fear techniques. Canadians from across the country expressed enthusiasm for the Dick-Read method. This suggests that natural childbirth theories had the power to cross deep-seated Canadian regional, cultural, and linguistic divides, but a closer look at the letters between Canadians and Dick-Read – a remarkable series of correspondence housed at the Wellcome Library for the History of Medicine – demonstrates that many expectant mothers (and fathers) who sought information on the method had recently moved to Canada (often from the United Kingdom) as part of the postwar immigration boom. Some noted that they had first encountered Dick-Read’s theories prior to emigrating, and sought the doctor’s help and guidance in securing a physician amenable to the method at a time when they felt “very much” like “strangers in a strange land.”

Canadian medical practitioners were similarly affected by postwar immigration trends, as well as a broader social and political context that saw the introduction of universal healthcare – and, as a result, an increased demand for foreign-trained physicians –  in a number of western countries. Again, and as David Wright, Sasha Mullally, and Mary Colleen Cordukes have suggested, the “Canadian-British nexus” was particularly significant in terms of medical migration  Physicians regularly sought out foreign credentials in postgraduate specialties including obstetrics, and, at the same time, many practitioners who were born, raised, and trained abroad emigrated to Canada and took up obstetric practice. Foreign-trained physicians, like Dalhousie University Professor of Obstetrics Dr. H.B. Atlee, who undertook extensive postgraduate work in the UK during the interwar period, were leading figures in the Canadian natural childbirth movement. Atlee, for example, became interested in Dick-Read’s ideas in the 1940s, a decade before they attracted widespread attention from the Canadian popular press. Dick-Read, in turn, was aware of an interested in Atlee’s work, and considered the Nova Scotia obstetrician a leader in the field, commenting to one Waterloo, ON mother in a 1959 letter that he wished she “could go a little further east to Halifax and have your baby under the care of Dr. Atlee.”

Natural childbirth found supporters like Atlee within the mainstream medical establishment, but the majority of Canadian physicians upheld the status quo (that is, medicalized, anaesthetized birth) and resented lay incursions into medical decision-making processes. The early natural childbirth movement, then, was largely driven by the efforts of lay Canadian mothers, fathers, and parents-to-be who sought to “spread the natural childbirth gospel.” Karen Birch, for example, told Dick-Read of her efforts to “preach” the method with what she described as “missionary fervor” to friends, relatives, doctors, and nurses. The method enjoyed growing coverage in the Canadian press over the course of the 1950s, and this rising popularity culminated in an extensive North American lecture tour by Dick-Read, including stops in Toronto, Montreal, and Ottawa, in 1958. Press coverage regularly emphasized the international attributes of Childbirth Without Fear, highlighting Dick-Read’s British background, observation of “foreign” births, and practice at a South African maternity hospital. At a more basic level, Dick-Read’s natural childbirth theories relied heavily on the idealization and romanticization of so-called “primitive” births, and, after his arrival in South Africa in the 1950s, descriptions of births he observed during an extensive “tour of central Africa.”

Throughout the 1940s and 1950s, “natural childbirth” was a term that was synonymous with the Read method. Grantly Dick-Read found a captive international audience during the postwar years in those who were interested in a new way to birth. In turn, Canadian women and men interested in alternative techniques took the time to write to Dick-Read. By doing so, Canadians demonstrated their engagement with an international medical movement that was itself fuelled by the international migration and communication of both parents-to-be and the physicians who treated them. Alongside these patterns of immigration and emigration, medical ideas flowed across national borders, shaping and sustaining a transnational culture of natural childbirth.

Whitney Wood is a SSHRC postdoctoral fellow in the Department of History, Classics, and Archaeology at Birkbeck, University of London, where her current project is a study of natural childbirth ideologies in Canada from the 1930s to the late-20th century. Her research interests include the histories of the body, childbirth, pain, and anaesthesia, and her first book, Birth Pangs: Maternity, Medicine, and Feminine Delicacy in English Canada, 1867-1940, is under contract with McGill-Queen’s University Press.

[1] In accordance with archival restrictions, all names are pseudonyms.

Cover Image: Antenatal Class Photograph, The National Childbirth Trust, c. 1960, SA/NCT/B/1/2/1/3/7, Wellcome Images