A Voice for Mothers: The Plunket Society and Infant Welfare, 1907-2000 (review)

This carefully researched volume is a valuable addition to scholarship in the field of infant welfare. It documents the twentieth-century history of the Royal New Zealand Society for the Health of Women and Children, better known as the Plunket Society. Linda Bryder is not a newcomer to this field: she has published previously on the work of the Plunket Society, and is well acquainted with the international context of infant welfare and historical analysis in the area. Sources for her work are the extensive Plunket archives, including an oral history collection; records from other infant welfare bodies; New Zealand health department files; various government reports; and a substantial body of secondary literature.

Having established her credentials as a Plunket baby and a Plunket mother, and acknowledging her "great respect for the women who fought so hard for the service and the nurses whom they employed," Bryder declares that she wants to avoid "sticking up for Plunket" (p. vii). Her purpose, rather, is "to place Plunket in the context of three broad themes: the relationship between the voluntary sector and the state in the provision of welfare, the development of paediatrics as a specialty and changing trends in infant health, and the relationship between health providers and their clients, the mothers" (p. xii). She achieves this in significant measure. She demonstrates the success of influential volunteer Plunket committees in maintaining state support for the society's privileged position as an infant welfare service provider, often in the face of bureaucratic opposition. She captures the committees' playing off of bureaucrats and professionals against each other, and their siding with whoever will support Plunket in maintaining sufficient independence to promote its views. And she does better than many others have done in illuminating the complexity, ambivalence, and changing nature of the relationship between infant welfare nurses and their clients.

However, I am not convinced that Bryder has entirely avoided "sticking up for Plunket." Nor has she provided a clear argument about what determines infant and child health. I expected to find a more rigorous critique of Plunket's approach to the problems—namely, infant mortality, and threats to the survival of young children—that it was established to address. She notes that "everywhere," at the beginning of the twentieth century, the infant welfare movement constructed the problem as maternal ignorance and the solution as the education of individuals about the "correct methods of child-rearing" (p. ix). Her own account of the state of infant health in New Zealand after almost a century of Plunket suggests challenges to this construction, and invites discussion about it, but nowhere does she pursue this directly.

Nor does Bryder scrutinize the effect, on the health of infants, of the culture and structure of the Plunket Society. She provides a vivid account of the turf wars between its governing committees, which comprised civic-minded "maternalist activists" without credentials in either health care or health policy, and the Plunket nurses, pediatricians, and health department staff. She illustrates the iconic status that the society achieved, and the ire and defensiveness raised by perceived attacks on its independence—but she seems reluctant to make judgments about the way this affected Plunket's capacity to further the health of New Zealand children. Perhaps, despite their insistence to the contrary, the Plunket "ladies" were not the equal of health professionals and bureaucrats, in matters of health policy (p. 169)? Perhaps advice-giving, no matter how well intentioned, is not the most effective way of promoting health?

Indeed, we learn little from A Voice for Mothers about the public health ideas and research that, since the 1970s, have influenced health departments and services and have demonstrated the extent to which the maintenance of health is socially determined and not amenable to action by individuals on the basis of advice. The descriptions of the work of Plunket nurses in chapter 9 clearly imply a broad...