120 years of the Midwives Act in England and Wales

By Fiona Gibb, Head of Education RCM on 31 July 2022 NHS MSWs - Maternity Support Workers NHS Unions Trade Unions Covid-19

31 July 2022 marks the 120 anniversary of the 1902 Midwives Act. The Act has been credited as the first formal recognition and development of professional midwifery. Of course, midwifery is one of the world’s oldest professions long practised before the creation of an act, but before 1902, midwifery care was usually provided by uneducated midwives or nurses that had practical experience or women who had given birth themselves and the experience of helping others.

The 1902 landmark led to the creation of the Central Midwives Board and regulated midwifery practice and formalised education in England and Wales, later followed by the 1915 Midwives Act (Scotland) and the 1918 Midwives Act (Ireland).

The creation of the Act was not without its challenges. There were concerns from the medical establishment that this may lead to the professional status and capacity of ill-qualified women and that formal recognition of midwifery education and regulation would give midwives medical status and competition for the ‘medical men.’ Interestingly, definitions of birth were discussed in the creation of the Act. There were disagreements about midwives attending ‘natural’ births but not ‘abnormal’ births and difficulties in agreeing on what was ‘natural.’  A topic that has continued to this day and is the focus of the recent Re:Birth project.

The 1902 Act secured the certificated protection of the title midwife and after its implementation in 1905, no woman could call themselves a midwife unless certified. Yes, the Act assumed that only a woman would act as a certified midwife which was eventually removed by the Sex Discrimination Act Order 1983 which allowed men to practice as midwives under certain conditions.  Although the 1902 Act established the legal standing of midwives alongside medical professionals, some historians argue that it was the later 1936 Midwives Act that secured the professional recognition of midwives and improved maternity services. The 1902 act aimed to protect the public rather than promoting the expertise of midwives, midwifery identity, and practice. Nevertheless, it should be acknowledged that the first 1902 Act paved the way for the future of Midwifery in the UK.

120 years later and the positive impact that midwives have had on improving global maternity care is well evidenced, however, we are facing new challenges with a shortage of midwives, overworked, and burnt out with substantial pressures on maternity services and education. On this important anniversary, let us remember the hurdles overcome to achieve the legal protection of the midwife title and celebrate the past generation of midwives that secured the education, regulation, and autonomous practice of midwifery. It is now our turn to uphold and advance the profession for the next generation of midwives and the families they care for.