In New Zealand The Midwives Act of 1904 established state control of midwives and provided for the establishment of state maternity hospitals both to ensure the better training of midwives and to address concerns about the health of childbearing women.

These hospitals were named St Helens and the first of these hospitals was opened in Wellington in 1905 followed by Dunedin in the same year and Auckland in 1906. Further hospitals were opened in Christchurch, Gisborne, Wanganui and Invercargill over the next 10 years.

The purpose of the St Helens Hospitals was to provide training facilities for midwives and subsidized care for married working class women. Initially they were managed and run by midwives but by the 1930's the situation had changed and the medical profession had gained access and eventual control.

Although midwives were autonomous in the community as independent practitioners the role was altered in the hospital environment where midwives became subordinated to the medical profession.

Despite the establishment of state maternity hospitals, admission to hospital for childbirth was only to occur gradually over the next 25 years. In 1920 about 35% of Pakeha women delivered in hospital. By 1938 the overall percentage of hospital births was 87%. Maori women ,in contrast ,were slow to break from their traditional practices and in 1938 only 18% delivered in hospitals.

The 1920's and 30's were to witness bizarre medical interventions under the pretext of lowering the high maternal mortality rate. Twilight sleep was one of the more infamous of these experiments whereby labouring women were rendered near comatose by drugs in order to safeguard mother and baby. Needless to say such interventions had little effect on mortality figures and only the advent of antibiotics, blood transfusion facilities and ecbolic agents in the 1940's began to impact favourably on these outcomes.

During this period midwives in New Zealand became peripheral to the politics of childbirth. The use of drugs to control pain meant increased hospitalisation and a change in the scale and type of hospitals as well. Small midwife-run maternity hospitals progressively closed in the post war period and political power shifted from the Department of Health to the Medical profession.

This trend continued so that by the 1970's childbirth services in New Zealand were almost entirely provided by hospitals and firmly under the control of the medical profession. The Nurses' Act of 1971 entrenched this position by preventing autonomous midwifery practice. If a woman wanted to have a midwife provide care for them during labour this was possible but only if primary responsibility was maintained by a doctor.

During the 1970's a new feminist ideal emerged with women seeking to regain control of their own bodies. This coincided with a movement by the public and greater nursing workforce questioning the acceptability of many of the doctrinaire medical practices of the day. A stronger ,more focused, midwifery profession began to assert itself and to redefine the values of maternity care. Although challenged by the medical establishment: notably by the Dennis Bonham led National Womens' Hospital the midwifery movement created a momentum of its own.
The Nurses Amendment Act of 1990 introduced by the then Minister of Health Helen Clark enabled a registered midwife to undertake responsibility for the care of women throughout pregnancy and childbirth, without being supervised by a medical practitioner.

The Act also made provision for direct-entry midwifery education. The net effect of the Act was to greatly expand the choice for women in relation to childbirth. Although the medical profession did not publicly oppose the principle of autonomy and it was thought that a team approach would ultimately benefit women it was evident by the mid 1990's that with a ballooning maternity budget and the development of the LMC system co-operation between doctor and midwife was effectively curtailed. Today only a small vestige of the once strong GP Obstetrician workforce still exists.

Childbirth care in New Zealand has turned full circle with Midwifery now newly established as the mainstream system of care. It is unlikely with the mass exodus of GPs from Obstetrics that the Medical model of care could return in its former state but it is hoped the hard fought improvements in maternity care are upheld by the midwifery profession.

Biography of Kate Sheppard

Kate Malcolm Sheppard (1847-1934) was one of the pioneers of the womens' movement in New Zealand. She championed the cause of the right of women to vote and was an advocate of women and children in this country.

She is our inspiration, we admire her knowledge, strength and compassion.

We chose her as our emblem because she represented a single minded voice that was prepared to challenge the status quo. In our own lesser way we continue that tradition by daring to bring about change by breaking down barriers between midwives and the community.

Kate Sheppard is recognized as the key figure in the suffrage movement in New Zealand - the first country in the world to grant universal adult suffrage to men and women equally.

Born Catherine Wilson Malcolm in Liverpool in 1847 she arrived in New Zealand with her recently widowed mother together with her sister in 1868. The family settled in Christchurch and in 1871 Kate married Christchurch merchant Walter Sheppard. Kate Sheppard became involved in the temperance movement early in her life. This link shaped her early thinking helping to forge the two themes of temperance and womens suffrage into a cohesive movement. She was elected president of the Womens Christian Temperance Union in 1887.

While acknowledging that womens' suffrage and prohibition were seen as tools of moral reform, Kate Sheppard also shared views more compatible with 20th century feminism. She was a strong champion of womens' rights and argued for womens' rights during divorce, equal rights to the guardianship of children, the advantages of contraception and the rights of women to participation in an active lifestyle. With Kate Sheppard at its head the WCTU campaigned vigorously for the right of women to vote. This was achieved by a combination of lobbying politicians, raising public awareness by newspapers and political meetings and organizing petitions which were presented to parliament.

This eventually culminated in the passage of the Electoral Act of 1893-granting universal suffrage to all New Zealanders. This victory for New Zealand women would precede similar success in Britain (1918) and the US (1920) by decades.

Having succeeded in obtaining the right of women to exercise their right to vote the next step was mobilizing NZ women for the election which occurred 8 weeks later. At the 1893 election it is estimated that 65% of all eligible women voted.

Kate Sheppard, as a result of her success in NZ became a world figure for the international womens' movement and toured America and Britain speaking to women to inspire their own suffrage movements. In 1896 Kate Sheppard was elected president of the National Council of women but ill-health forced her to limit her activity over the next decade.

She continued to write and publish regularly and effectively became an elder stateswomen of the cause in the early years of the new century.

Kate's only child Douglas died in 1910 and her husband died in1915. In 1925 at the age of 78 she re-married to William Lovell-Smith. She died in 1934 at the age of 87. In her obituary in the Christchurch Times on 16th July 1934 it was written: "A great woman has gone, whose name will remain an inspiration to the daughters of New Zealand while our history endures."

In 1991 women were granted the right to stand for Parliament and in 1934 just before her death Kate Sheppard had the satisfaction of seeing the first woman MP enter Parliament.

The poet Jessie MacKay - a contemporary of Kate Sheppard described her as: "the woman whose life and personality made the deepest mark upon New Zealand history."