Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Midwifery in New Zealand 1904-1971

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Midwifery in New Zealand 1904-1971

Article excerpt

INTRODUCTION

New Zealand midwifery became a regulated profession with the passing of The Midwives Act 1904. This article explores the changes that took place in New Zealand in the period following that Act until midwives lost their right to be responsible for the care of childbearing women without medical oversight with the passing of the Nurses Act 1971. In 1900 midwives were usually married women who had borne children themselves, and worked in the community. By 1971 midwives were mostly single women, and were almost invisible among the nursing dominated workforce (Stojanovic 2003).

I would argue that three interdependent and synergistic factors, medicalisation, hospitalisation and nursification created an environment that dramatically changed both the midwifery profession and the New Zealand maternity service. The Midwives Act 1904 established midwifery training schools and the registration of midwives, and a state midwifery service (Cooper 1998). The Act also put midwifery under the direct control of medicine and began the introduction of nursing culture into midwifery by creating the nurse-midwife. With the 'cause and effect' cycle of the three synergistic and catalytic factors, medicalisation, hospitalisation and nursification, came a series of clinical and political changes that culminated in the passing of the Nurses Act 1971 with its resultant loss of autonomy for midwives.1

MATERNITY IN THE 1900S

A Wellington gynaecologist/obstetrician, Dr Kenneth Pacey (in Manson and Manson) describes maternity care in the early twentieth century:

The vast majority of women had their babies in their own homes. Since many of these were humble in the extreme, the environment left much to be desired.Yet here were dealt with the major complications of obstetrics. Some of the graver emergencies were sent to the general hospital, but others such as the high forcep deliveries, the breech deliveries, were coped with on the spot.

(Manson & Manson 1960: 40)

In 1900 the maternity service in New Zealand was provided mostly by lay midwives, some who had received tuition from other midwives or doctors. There were a small number of midwives who had some training in maternity from overseas hospitals and some who 'took in' women into their homes for birth (Manson & Manson 1960: 50). In urban areas there were private 'lying-in' hospitals owned by doctors or midwives, and these midwives often had no formal training. They were called by various names - 'lay midwife', 'traditional midwife', 'handywoman', and sometimes, 'the monthly nurse' - although the latter term can also be applied to women who visited the home and took over the care of the household for a month following the birth (Donley 1986). Widows often provided midwifery services as it was a way of earning some money, or at least payment 'in kind' (De Vore 1997: 44-57). By 1900 the numbers of midwives in New Zealand who had done some form of training were beginning to increase but there was no training school available in New Zealand (Donley 1986).

It became apparent that the European populations' birth rate was dropping in both Australia and New Zealand. This was highlighted in the findings of the New South Wales Royal Commission in 1904 (Donley 1986). Improving maternity care was seen as a method of reducing the high infant mortality rate thus increasing the numbers of live adults to help maintain a majority balance for New Zealand's European population (Donley 1986). A law regulating the practice of midwifery and providing for the education and registration of midwives was perceived as a method of achieving this improvement. This law, the Midwives Act 1904, was passed through the combined efforts of civil servants Grace Neill and Dr. Duncan McGregor, and the Premier of New Zealand, Richard John Seddon (Manson & Manson 1960). Grace Neill was a Scottish woman, a widow, who had joined the Department of Labour as the first woman inspector of factories. …

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