out on a limb: the personal mandate to practise midwifery by midwives of the domiciliary midwives

281 Pages·2008·1.08 MB·English

OUT ON A LIMB: THE PERSONAL MANDATE TO PRACTISE MIDWIFERY BY
MIDWIVES OF THE DOMICILIARY MIDWIVES SOCIETY OF NEW ZEALAND
(INCORPORATED), 1974-1986.

by
Maggie Banks

A thesis submitted to Victoria University of Wellington
in fulfilment of the requirements for the degree of
Doctor of Philosophy
in Midwifery

© Maggie Banks 2007
Copyright and all other intellectual property rights of this thesis belong to Maggie Banks.

You may not reproduce all or any part of this thesis without her prior permission except for the
following:

• Short extracts for the purposes of review, research or quotation in your own writing,
provided that you properly reference her authorship, and/or
• A copy for your own personal use.
Abstract

As an archival and oral herstory of domiciliary midwifery in New Zealand during 1974-
1986 this research makes an original and significant contribution to midwifery knowledge
both nationally and internationally. It explored the herstories of the Domiciliary Midwives
Society (Incorporated) and eight of its midwives to reveal the exercising of the personal
mandate to practise within the full scope of midwifery in the community during a time
when all but a handful of midwives worked in the hierarchical and institutional structures
of hospitals.

The significant findings of this study included a new ‘with-woman’ process for positioning
midwifery research, and gathering, analysing and expressing evidence. This process
engages and embeds the philosophical underpinnings, process and method of home birth
midwifery practice into the research process with the intention of breaking down barriers
between these two midwifery activities. Further, this study evidenced the role midwifery
played in medicine’s (and nursing’s) colonisation of midwifery in reframing the midwife’s
identity as a nurse, imposing obstetric nursing standards of practice and diminishing the
full scope of the midwife’s practice as a discipline separate from, and independent to
nursing. Amongst considerations of this colonising process are the investigation of
domiciliary midwifery undertaken by midwives of the New Zealand Nurses Association
(NZNA) and Midwives and Obstetrical Nurses Special Interest Section (MSIS) of NZNA
and the subsequent ‘Policy Statement on Home Confinement’ authored by MSIS in 1980.
Thus, this thesis elaborates a dissenting view on the oppression of midwives by medicine
in that midwifery created and exercised mechanisms to both ensure a 100% hospitalisation
of childbirth during the study period and limitation of the domiciliary midwifery service.

It is hoped that this study will provide a pathway for midwives to move fluidly between the
practices of both research and midwifery, as well as ensuring that domiciliary midwifery
herstory in New Zealand becomes secured.

i
Thank you to the support people

During physiological birth no one can do the work for the woman but many can support
her to do so. Similarly, this thesis is the result of over five years of my work but I have
been well supported along the way by the following people.

Thank you to those who assisted me to access archival material - Barbara Brown, previous
Maternity Manager for the Ministry of Health, who made Ministry of Health files available
to me in Hamilton and Lynda Stopforth, New Zealand Nurses Organisation librarian, who
helped me find archival documents and facilitated my access to these. I thank Joan Donley
for her generosity in allowing access to her personal papers at her home in 2001 and
Glenda Stimpson for her diligent guardianship of, and generous access to Auckland
Midwives Special Interest Section files before their permanent lodgement in the Auckland
Medical Library.
My thanks go to the midwives of the Domiciliary Midwives Society (Incorporated) who
supported my study and particularly Carolyn Young, Joan Donley, Bronwen Pelvin, Sian
Burgess, Gillian Wastell, Anne Sharplin, Jenny Johnston and Sue Lennox for participating
in the study so openly and willingly.
I particularly thank Margi Martin for voicing her belief that a university is a place in which
one can stand and argue one’s own reality – a belief without which I could not have
sustained my PhD candidature. I am indebted to Rose McEldowney and Maralyn Foureur,
my supervisors, for both the support I received to ‘just do it’ and their rapid and wise
responses to the times when I needed help.
Many describe the PhD journey as a lonely one. I have not found it so. I have been
surrounded, sustained and grounded by my family. Thank you, Pandie, Hannah and Sam.
Gabriel and Tobin – you have been very patient about Nannie finishing the ‘thesist’. And
last, but absolutely not the least – thank you Tony for your sustained ability to respond
with interest to the “listen to this, Tone!” that you have been subjected to over the last five
years.
ii
Dedication

This thesis is dedicated to the women of home birth - consumers and home birth midwives
- and to their, and our, families who provide the essential support.
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Abbreviations
AGM Annual General Meeting
BoH Board of Health
CSU Combined State Unions
DGoH Director-General of Health
DHO District Health Office
DM domiciliary midwife
DMS Domiciliary Midwives Society (Incorporated)
DMSRC Domiciliary Midwives Standards Review Committee
DoH Department of Health
DoN Director of Nursing with the Department of Health
DTI Department of Trade and Industry
FoL New Zealand Federation of Labour
GP General Practitioner
HBA Home Birth Asociation
HBSG Home Birth Support Group
LSCS Lower segment Caesarean section
MOH Medical Officer of Health
MoH Minister of Health
MP Member of Parliament
MSB Maternity Services Benefit
MSC Maternity Services Committee
MSIS Midwives and Obstetric Nurses Special Interest Section
NCNZ Nursing Council of New Zealand
NHSC National Health Statistics Centre

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NMRB Nurses and Midwives Registration Board
NSNZ Nurses Society of New Zealand
NZCOM New Zealand College of Midwives

NZMA New Zealand Medical Association
NZNA New Zealand Nurses Association
NZNO New Zealand Nurses Organisation
NZOGS New Zealand Obstetrical and Gynaecological Society
NZRNA New Zealand Registered Nurses’ Association
OSRC Obstetric Standards Review Committee
PMR Perinatal Mortality Rate
PN Principal Nurse (of a hospital)
PPHN Principal Public Health Nurse
PSA New Zealand Public Services Association
ToR Terms of Reference

v
List of players
BARKER, Dr R.A. Chairman, Maternity Services Committee of the Board of
Health.
BASSETT, Dr Michael Minister of Finance, July 1984 to December 1988.
BAZLEY, Margaret National President NZNA, 1972-1974.
Director, Division of Nursing, DoH, 1978-1984.
BIRBECK, Adele Domiciliary midwife, Dunedin.
BOYD, G.R. Assistant Director, Division of Clinical Services to Medical
Officer of Health, Christchurch.
BURGESS, Sian Domiciliary midwife, Auckland.
CAREY, Shona Executive Director, NZNA,1976 - February 1983.
National Secretary of Nurses Union, 1976- February 1983.
DONLEY, Joan Domiciliary midwife, Auckland.
ELLIS-CROWTHER, Vera Domiciliary midwife, Auckland.
FELL, Thelma Domiciliary midwife, Hamilton.
HELEM, Ursula Domiciliary midwife, Christchurch.
HOGAN, Irene Domiciliary midwife, Auckland.
JOHNSTON, Jenny Domiciliary midwife, Hamilton and Wellington.
KEMP, Henrietta Home Birth Association National Lobbying Coordinator and
National Newsletter Editor.
LAWTON, Maureen Supervisor, Wellington Women’s Hospital in 1969.
Charge tutor at St Helens Hospital, Wellington in 1977.
LENNOX, Sue Domiciliary midwife, Lower Hutt.
LIVINGSTONE, Allison Accountant for Auckland domiciliary midwives.
MALCOLM, Hon. A.G. Minister of Health, 1981-1984.
McGOWAN, Margaret Canterbury/West Coast MSIS Chairperson in 1978.
McLEAN, Lynne Domiciliary midwife, Wellington.
Secretary, Domiciliary Midwives Society of New Zealand,
1981- May 1983.
NICHOL, Jennie Senior Advisory Officer, Department of Health
NIGHTINGALE, Anne In charge of midwifery education St Helens Hospital,
Auckland, 1967-1972.
Auckland Branch President of NZNA, 1972.
Chairperson of Nursing Council of New Zealand, 1975-1984.
Principal Nurse of St Helens Hospital, Auckland, 1972-1990.
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PELVIN, Bronwen Domiciliary midwife, Nelson.
Secretary, Domiciliary Midwives Society (Incorporated),
June 1984 – c.1995.
PHILLIPS, Dr J.S. Director of Clinical Services, Department of Health,
Wellington.
Chairman, Medical Services Advisory Committee in 1980.
SAGE, Jennifer Domiciliary midwife, Wellington.
SALMONE, Beatrice Nursing academic.
SHARPLIN, Anne Domiciliary midwife, Thames and Bay of Plenty.
TEW, Margorie Epidemiologist.
VOADEN, Chris Domiciliary midwife, Nelson.
WASTELL, Gillian Domiciliary midwife, South Auckland.
Secretary, Domiciliary Midwives Society of New Zealand,
June 1983 – May 1984.
WILLIAMS, Gill Domiciliary midwife, Bay of Plenty.
YOUNG, Carolyn Domiciliary midwife, Auckland.

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Table of contents
Abstract........................................................................................................................... i
Thank you to the support people ................................................................................... ii
Dedication..................................................................................................................... iii
Abbreviations ............................................................................................................... iv
List of players ............................................................................................................... vi
Table of contents ........................................................................................................viii
List of tables ...............................................................................................................xiii
List of figures ............................................................................................................. xiv

CHAPTER 1: MEETING AND GREETING THE THESIS.......................................... 1
How is this thesis woven? ..................................................................................................... 4
What led me to this study? .................................................................................................... 8
Re-search intentions and questions ..................................................................................... 15
Why was this study necessary? ........................................................................................... 16
Overview of the thesis ......................................................................................................... 19

CHAPTER 2: A HOME BIRTH MIDWIFE’S PHILOSOPHICAL
UNDERPINNINGS, PROCESS AND RE-SEARCH METHOD ................................. 22

Part 1 - Philosophical Underpinnings.............................................................................. 23
The politics of naming difference........................................................................................ 23
Marginalisation and difference............................................................................................ 26
Control by law ......................................................................................................... 26
Financial control ...................................................................................................... 27
Control by politics ................................................................................................... 28
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