Bridget Lynch has been a midwife and midwifery activist for almost 40 years. She is a Past President of the International Confederation of Midwives, a Past-President of the Association of Ontario Midwives and a founding Board Member of the Canadian Association of Midwives. Bridget was an Assistant Professor in the Midwifery Education Program at McMaster University, and over her 35-year clinical career she was the Head of the Division of Midwifery at three Toronto hospitals. During her 9 years on the Board of the ICM, Bridget was invited to speak at conferences and meet with midwives in over 35 countries. Meeting and working with the sisterhood of midwives all over the world has been the greatest privilege of her life.
One way to understand key developments in midwifery is to look at the career of former ICM President, Bridget Lynch. This midwife educator from Toronto, Canada was the president of ICM from 2008 to 2011. During her term, there were significant advances for the ICM, including the development of global standards in education and regulation, the first ICM congress in Africa and the launch of the first State of the World’s Midwifery Report (SoWMy). It was also during her term that the UN health agencies (H4) identified the midwifery workforce as key to improving maternal and newborn health, as well as the need for 350,000 more midwives globally.
As part of our centennial celebration, and our efforts to document the history of midwifery, we sat down with Bridget to explore how the profession evolved over her presidency and how her career contributed to the ICM we know today.
Bridget’s motivation to pursue midwifery came from her own childbirth experience in Canada in the early 1970s.
“I had a baby in hospital, and they took her to the nursery after she was born — healthy mom, healthy baby and I was just beside myself that they took her away” says Bridget. “When my husband came in the next day, I told him, ‘If I ever have a baby again. I’m having it at home. I saw that as the only way I would be able to keep my baby with me. It was this experience that made me realise that women and families should be the primary decision-makers in where and how we give birth. I set out to get involved, not just for myself, but for my daughter and all future generations, and it became my lifelong passion.”
In 1994, Bridget became one of the first regulated midwives in Canada, advocating alongside many others for greater recognition of midwives and midwifery in her province and across the country. The International Confederation of Midwives (ICM) played a key role in this advocacy effort. “The achievement of the regulation of an autonomous midwifery profession in Ontario and other provinces in Canada was supported by our memberships in the ICM,” says Bridget. “It helped convince the provincial governments of the legitimacy of the profession.”
In 1999, Bridget, now President of the Association of Ontario Midwives, attended the ICM Council Meeting in the Philippines where she was one of several Canadian midwives representing midwifery associations in their respective provinces. She recognised it was time to establish a stronger, more unified midwifery profession in Canada, and when she returned from the Congress, she started working towards this goal.
“At that time, the Canadian Confederation of Midwives was a loosely organized group where the presidents of each of the provincial associations met to discuss issues in common,” says Bridget. “Based on my experience at the ICM Manilla Council Meeting, This proposal was agreed and at the next ICM Council Meeting in Vienna in 2002, instead of provincial associations, Canada was represented by the Canadian Association of Midwives and Bridget sat as a Council representative. At that time, she was also the first Canadian elected as an Americas Regional representative to the ICM Board.
This is just one example from Bridget’s career where she advocated for improved collaboration amongst midwives.
After serving as the ICM Regional Representative for North America and the Caribbean, she was elected ICM Deputy Director. During her term, ICM rewrote the Constitution, and the role of an elected Director and Deputy Director was changed to an elected President and Vice-President. As part of that process, Bridget, together with the Board, spearheaded a new governance model where ICM’s Council (consisting of two representatives from each member association) would determine the strategic directions for the ICM Triennial Plan. This was in contrast to the previous system wherein Council was presented with priorities and recommendations largely pre-determined by the Board.
“We created an opportunity for Council (member associations) to determine the strategic priorities for the organisation by allowing them the time to discuss and prioritise issues during the Council Meeting,” says Bridget.
In 2008, at the ICM Council Meeting in Glasgow, Scotland, the Council implemented this new process and prioritised strengthening midwifery education, regulation and member associations. Bridget had this to say about the significance of the direction set at the 2008 Council meeting:
“The mandate we were given was a golden opportunity for the ICM to be proactive and take the lead to develop globally recognised education and regulation standards. At the time, governments in low-resource countries were attempting to strengthen midwifery, but in the absence of global standards, each country was essentially on their own and developing wildly different education programs with varying scopes of practice. We also realised that education, regulation and the professional association are all inter-connected ‘pillars’ — if any one of them is weak, the entire profession is weak. We needed to find a way to strengthen them all”
Tasked with this new mandate from Council, Bridget secured funding from the Swedish government to create two task forces: one, led by Joyce Thompson and Judith Fullerton, to develop global standards for midwifery education and the other, led by Sally Pairman and Loise Silverton, to develop global standards for regulation. The Education and Regulation Task forces included midwifery experts from around the world, and to ensure global recognition and endorsement for this work, they consulted with UNFPA, the World Health Organization (WHO), the International Federation of Gynecology and Obstetrics (FIGO) and the International Pediatric Association (IPA). Both sets of global standards were published in 2011 and would become the first global standards in education and regulation for any healthcare profession in the world.
For Bridget, points of pride in her career have largely come from efforts to prioritise representation and inclusivity and engage more voices from more countries in ICM’s global work.
“One of the things I’m proudest of is the networking of midwives in education, regulation and strengthening professional associations that happened during those three years,” says Bridget. “I remember at one point realising that there were over 100 midwifery leaders from Africa, South America, the Caribbean, Asia, Europe and North America fully engaged and involved with this work. That’s what was most important for me as ICM President — to recognize and engage these midwifery leaders directly to determine the future of the profession. In order to keep the ICM strong, it must be relevant in the lives of midwives everywhere.”
In addition to ICM’s work on education, regulation and association-strengthening, Bridget conceptualised one of the most successful ICM campaigns to date: The Road to Durban – an initiative to promote the 2011 Triennial Congress in Durban, South Africa. During the months leading up to the Congress midwives from various regions were expressing concerns about the safety of traveling to South Africa, resulting in a growing concern that attendance would be low.
To address this, Bridget and the Board decided to leverage May 5th, International Day of the Midwife (IDM), which fell two months before the Durban Congress, to promote the Congress and the concerns of midwives in Africa. The Road to Durban campaign, encouraged midwifery associations around the world to organise 5 km walks on IDM in cities and towns across their countries to highlight the devastating maternal and infant mortality rates in Africa, and the need for more midwives as a response to the issue.
“The campaign was so exciting — dozens of countries participated, with thousands of midwives and their supporters and many press events,” says Bridget. “We had midwives walking in the high Arctic in Canada as well as in small South Sea islands. Not only did we create a focus on the needless deaths in childbirth across Africa, I had so many people tell me afterwards that it was because of that walk they decided to go to the ICM Congress in Durban – which ended up being a tremendous success with one of the highest attendance rates ever!.”
The Road to Durban campaign was more than a career highlight for Bridget – it was another opportunity to leverage the strength of the global midwifery community towards awareness-building for the profession and increased investment in midwives and midwifery.
The 2011 Congress was also the first Congress to invite global partners to chair panels, meet midwives from around the world and learn about the issues impacting midwives and the communities they serve. An unforgettable moment for Bridget was the launch of the first State of the World’s Midwifery Report (2011), and the reaction to that report from key ICM partners.
“The editor of The Lancet stood at the podium, and after he announced The Lancet would be publishing its first ever series on Midwifery, he added, ‘attending this Congress has been life changing – I wish I had been born a midwife!’”
“It was a proud moment”, says Bridget. “All I could think was ‘we did it! All of us working together – look at what we are able to achieve! Look at these amazing midwives, sisters and friends. How blessed I have been to work with you all!’”
As ICM closes out its centennial anniversary, Bridget is optimistic for the future of the organisation, and for midwives and midwifery.
“My hope is that midwifery will become a fully autonomous profession everywhere in the world, with robust education and regulatory programmes and effective professional associations; a profession that attracts people of the highest calibre dedicated to promoting and protecting reproductive and newborn health and reproductive human rights,” says Bridget. “The ICM must continue to lead the way in representing the profession in the global arena, taking the lead as experts in caring for the human dyad from the community through to the tertiary setting, while continuing to support evolving education. regulatory and association needs.”