Culture, Medicine, and Psychiatry

, Volume 42, Issue 2, pp 278–294 | Cite as

The Making of Informed Choice in Midwifery: A Feminist Experiment in Care

  • Margaret E. MacDonaldEmail author
Original Paper


This paper is about the clinical principle of informed choice—the hallmark feature of the midwifery model of care in Ontario, Canada. Drawing on ethnographic history interviews with midwives, I trace the origins of the idea of informed choice to its roots in the social movement of midwifery in North America in the late 1960s and 1970s. At that time informed choice was not the distinctive feature of midwifery but was deeply embedded what I call midwifery’s feminist experiment in care. But as midwifery in Ontario transitioned from a social movement to a full profession within the formal health care system, informed choice was strategically foregrounded in order to make the midwifery model of care legible and acceptable to a skeptical medical profession, conservative law makers, and a mainstream clientele. As mainstream biomedicine now takes up the rhetoric of patient empowerment and informed choice, this paper is at once a nuanced history of the making of the concept and also a critique of the ascendant ‘regime of choice’ in contemporary health care, inspired by the reflections of the midwives in my study for whom choice is impossible without care.


Informed choice Midwifery Midwifery in Canada Anthropology of reproduction 



I would like to thank the midwives and clients who have contributed their time and interest to my research on midwifery and health consumption over the years. I am also very grateful to a number of colleagues and academic interlocuters with whom I have had the pleasure to share and discuss this work at various stages of refinement, including Janet Childerhose, Christa Craven, Megan Davies, Todd Foglesong, Pamela Klassen, Ana Ning, and Natasha Pravaz. This paper has also benefited from the constructive comments of two anonymous reviewers. This work was supported by a York University Research Release Award in 2013–2014.

Complaince with Ethical Standards

Conflict of interest

The Author declares that he/she has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of AnthropologyYork UniversityTorontoCanada

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