“The Time of Natures Trial”- Childbirth in New Zealand

Every day, there are around 168 new babies born in New Zealand. 2020 is the International Year of the Midwife and to acknowledge the hard work and dedication that midwives demonstrate in their work, I thought it would be nice to delve into and share a snippet of the history of midwifery in New Zealand.

Image: Staff Photographer, Auckland Weekly News. At A New Zealand State Maternity Hospital, 23 August 1928, Auckland Libraries Heritage Collections AWNS-19280823-50-1.


Nineteenth Century 

In the nineteenth century, Māori birthing practices differed greatly from those of the newly arriving Europeans. Alison Clarke explores these differences in her book “Born to a Changing World: Childbirth in Nineteenth Century New Zealand”. She writes that many Māori women would give birth outside, with the assistance of another person if it was her first child, but often alone if it was not her first birth. If the woman was from a chiefly family, her labour and birth would take place in a whare kōhanga, or nest house, which was a specifically built, temporary shelter. Births took place outdoors and away from the kāinga because the process of childbirth was a highly tapu experience and being away from everyday activities kept the tapu separate. The book discusses how childbirth did vary from iwi to iwi and that the information we now have largely draws on European sources such as doctors and anthropologists. There are also accounts of Māori seeking help from tohunga and also European doctors or midwives for more difficult births.

After the 1907 Tohunga Suppression Act, Māori had to rely more heavily on European assistance for difficult childbirths. Relying on European assistance posed a risk to the strict cultural elements associated with Māori birthing practices such as being required by doctors to deliver babies indoors, not being able to follow through with tapu-removing bathing rituals and also the loss of agency around decisions made during the process.

European experiences of birth in the nineteenth century were often arduous and vastly different to those of Māori. In the early years, the female European population in New Zealand was still quite low and women would often travel great lengths to assist their fellow European sisters. One such woman was Catherine Leigh who had arrived from Britain in 1822 with her husband who was a Methodist missionary.  Alison Clarke proposes that Catherine may have been the first formally trained midwife in New Zealand because the “Matron of the London Lying-in Hospital, had kindly admitted Mrs. Leigh to attend at the Hospital, to receive instructions in Midwifery during several weeks”. In 1823 Marianne Williams arrived in New Zealand, bringing with her formal Midwifery training and experience from Britain. Despite both Catherine and Marianne undertaking specific Midwifery training to prepare for missionary work, this was uncommon, as most midwives learned their skills on the job and from other women.  Given the geographic isolation that most European settlers faced in New Zealand, births were often attended by family members and neighbours throughout the nineteenth century.

Image: Unknown, Hannah and Ann Grigg of Whitford, 1897, Auckland Libraries Heritage Collections Footprints 00896

Home to hospital, and back again 

In 1904, the Midwives Act was passed. Advocated for by Grace Neill (the same woman who advocated for the Nurses Registration Act of 1901 as discussed in this blog post), the Act intended “to provide for the Better Training of Midwives, and to regulate the Practice of Midwifery.” This meant that women had to complete a twelve-month course (or 6 months if they were already a registered nurse), deliver a certain number of babies, pay a fee and pass an examination in order to become registered.  The Act also set a precedent for state run maternity hospitals, restricted un-registered nurses from practicing and allowed women with sufficient on-the-job experience to be entitled to register.

The first half of the twentieth century saw private and state maternity hospitals flourish. The likes of Mrs Pee’s nursing home ‘Waimarino’ which was open from 1905 to 1921 was an option for women who lived rurally and who were unable to travel.

Image: S. Collins & Son, 'Mrs Pee's Nursing Home', Otahuhu, ca 1910, Auckland Libraries Heritage Collections Footprints 03786.

At the same time, the government ramped up its contribution to maternity care by opening the first St Helens Hospital. Named after the birthplace of Premier Richard Seddon, St Helens Hospitals were established to provide subsidized healthcare to low income women in an attempt to rectify the falling birth rate and high infant mortality rates. They were also set up as a direct response to the 1904 Act.

Image: F.W. Young, State Babies: A good batch at the St Helens Maternity Home, Auckland, NZ, July 1909,  Auckland Libraries Heritage Collections AWNS-19090729-4-5.

Image: Herman John Schmidt, Nurses From St Helens Hospitals, c1918, Auckland Libraries Heritage Collections 31-WP820

The St Helens Hospital on Rintoul Street in Newtown, Wellington opened on May 29th 1905 and was, in fact, the first state-run maternity hospital in the world. On June 14th 1906, the Auckland St Helens Maternity Hospital opened in Pitt Street. The Auckland star had this to say about the hospital:

                “Another important work to be undertaken at these hospitals is the training of nurses for maternity cases. At present no such certificates can be got in the colony, and nurses have had to go to Australia to qualify. Pupil nurses will pay a fee of £10 for six months' training, and £20 for 12 months. These maternity hospitals will be the first in New Zealand to issue certificates for that special branch of nursing. Another function of the hospital is to teach mothers how to properly feed and look after a young child... Another maternity hospital is to be established in Christchurch. It may be mentioned also that only married patients were admitted.” 


Image: Auckland Star, June 6 1906

These hospitals were primarily run by midwives, with very little involvement from doctors unless they were called upon. The government operated a total of seven St Helens Hospitals, with the Auckland St Helens operating until 1990.  In 1925 the Nurses and Midwives Registration Act created some major changes. The act separated the two professions and created maternity nurses, who worked with doctors while midwives worked alone.

Image: Auckland Weekly News, Unveiling the first memorial erected to the memory of the late Mr. Seddon: Sir Joseph ward unveiling the memorial lamp presented by the employees of the Auckland railway workshops to the St Helens maternity hospital, July 30, 1906, Auckland Libraries Heritage Collections AWNS-19060809-4-1.

Image: Henry Winkelmann, Showing the exterior of St Helens Hopital, Pitt Street, Sep 1922, Auckland Libraries Heritage Collections 1-W450. 

Midwifery as a practice continued to evolve and refine. Well-known medical historian Linda Bryder discusses a major change that took place in the 1930s when the role of doctors involvement in birthing practices was raised. A 1937 Committee of Enquiry into Maternity Services reported did not favour the British midwife-led services and instead “endorsed doctor attendance for all births in hospital”. Bryder’s book The Rise and Fall of National Women’s Hospital: A History is a detailed resource that tracks the journey of midwifery from its beginnings through to the closure of the hospital. The discussions that took place in the 1930s set the tone for the development of a new maternity hospital. Dr Doris Gordon was instrumental in establishing the hospital. She was one of the first two women to graduate in medicine in New Zealand. Dr Gordon successfully fought for publicly funded maternity care for all women and in 1938 New Zealand became the first country in the Commonwealth to fund a 14-day hospital stay for women following a birth, as well as medical and midwifery costs.

Image: Francis Alton, Checking blood pressure, Auckland, ca 1946, Auckland Libraries Heritage Collections Footprints 02484.

From 1946, an iteration of the ‘National Women’s Hospital’ has operated at the site near Cornwall Park in Greenlane West. Until 1955, it was known as The Obstetrical and Gynecological Unit at Cornwall Hospital.  Construction of the new hospital began in 1958 and was opened on February 14 1964. It was 11 floors high and purpose built to provide a world-class facility for maternity care for the women of New Zealand. From 1957, midwives had to be registered nurses and were not able to deliver babies without a doctor present.

Image: New Zealand Herald, Auckland NW Hospital, 28 November 1961, Auckland Libraries Heritage Collections 1370-29-25-2. 

Midwifery in New Zealand has faced a long, often challenging journey pioneered mostly by the women working in the field. In 1978 the Homebirth Association was started in Auckland to challenge the medicalisation of childbirth. They operated under the slogan 'Women need midwives need women'- meaning that the attitudes toward birth needed to be centered around women and their experiences. The 1990s saw an official shift away from doctor-led birthing practices with the 1990 Nurses Amendment Act. This reintroduced autonomous midwifery which meant that midwives could once again be responsible for managing births without a doctor. Nowadays, there are countless options for how/where/when your birth may take place. As medicine and technology have advanced, midwives and midwifery training has been reevaluated and adjusted to remain as current as possible. Women have taken control of their birthing experience and can draw on the strength and knowledge of midwives that has been accumulated over centuries.

Image: Unknown, 'Home birth support', Manukau City Centre, 1983, Auckland Libraries Heritage Collections Footprints 02799.


Sources:

Alison Clarke, 'Born to a changing world: Childbirth in nineteenth-century New Zealand', 2012.

Allison Kirkman, 'Health practitioners - Nurses and midwives', Te Ara - the Encyclopedia of New Zealand, URL: http://www.TeAra.govt.nz/en/health-practitioners/page-3 (accessed 11 February 2020).

Auckland District Health Board, 'History of National Women's Hospital', URL: https://nationalwomenshealth.adhb.govt.nz/assets/Womens-health/Documents/Referrals-and-info/History-of-National-Women.pdf (accessed 11 February 2020).

Linda Bryder, 'The Rise and Fall of National Women's Hospital: A History', Auckland University Press, 2014.

Midwifery Council, '2020 International Year of the Midwife', URL: https://www.midwiferycouncil.health.nz/about-us/publications/2020-international-year-midwife (accessed 11 February 2020).

Ministry for Culture and Heritage, 'The world’s first state-run maternity hospital opens', URL: https://nzhistory.govt.nz/page/world%E2%80%99s-first-state-run-maternity-hospital-opens, updated 29-May-2018.

Sarah Marianne Williams, 'Williams, Marianne', Dictionary of New Zealand Biography, first published in 1990. Te Ara - the Encyclopedia of New Zealand, URL: https://teara.govt.nz/en/biographies/1w24/williams-marianne (accessed 5 February 2020).

Author: Samantha Waru, Graduate Heritage, Research and Archives. 

Comments

  1. Do you know of a midwife, Mrs Hannah (Emma) Green of Plymouth Road, New Plymouth in 1894 she delivered my Nana who was a twin.

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