Towards the professionalisation of New Zealand midwifery, 1840-1921 : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Midwifery at Massey University
This thesis examines the reasons behind the move to formalise New Zealand European midwifery care in 1904 and the impact this had on midwifery practice. 'The Midwives Act, 1904' concentrated on providing a training system for midwives, hence traditional midwives found their duties circumscribed by their lack of knowledge and training. While women were seen as the appropriate case managers for women during parturition, the Midwifery Act set in place regulations that required advanced knowledge and set standards of practice. The setting up of a nation-wide structure at St Helens Hospitals1 St Helens hospitals does not have an apostrophe. for the training of midwives reinforced the role of the trained midwife, who in some instances was also a trained nurse, and began the move towards the hospitalisation of maternity patients which came to fruition around 1938. The contention of this thesis is that the Midwifery Act contributed to the development of professional standards of midwifery practice leading to a more professionalised midwifery service in place of that which had, until 1904, been unstructured and informal. Through the inclusion of scientific developments into the syllabus of instruction the Midwifery Act gave formal direction to the training, examination and practices of midwives. Finally, it brought to the fore the trained midwife and single woman who replaced the traditional married midwife. The developments and changes in midwifery that occurred following the 1904 Midwifery Act had their beginnings well in advance of the Act. Maternal and infant mortality and morbidity rates had become a concern in England during the 1860s. As early as 1867 maternity lying-in hospitals were beginning to develop protective mechanisms to prevent infection. In New Zealand an unstructured midwifery service comprised mainly of traditional midwives developed from 1840. Stringent use of antisepsis and advanced, professional, midwifery knowledge did not influence these midwives' practices until 1904 when the Midwives Act was implemented leading to the demise of the traditional midwife.