The Rise and Fall of National Women’s Hospital: A History by Linda Bryder (review)

Hospital histories are not easy to write—each has its own personality that over time can shift due to changes in the political and social context and the hospital’s internal dynamics. The National Women’s Hospital (NWH) took in its first patients in 1946, had its own facility in 1964, and closed in 2004. For a major hospital, its life span was quite short. In the years leading up to the creation of the NWH, most women in New Zealand were delivered by midwives at home or in what were called St Helens hospitals (heavily subsidized compared to public hospitals). Under the new Labour government in the late 1930s, the decision was made that women in delivery should have access to both a nurse and a physician within a hospital setting. Women’s organizations were supportive of the shift, as were many women, seeing in a hospital birth access to pain relief and a longer stay after the birth before going home.

Linda Bryder argues that the NWH was unlike most hospitals in the early years. Its teaching was focused on postgraduate students, it had university status and thus was not controlled by the state, and it had an international reputation in research. Much of the latter focused on developing methods to save premature newborns and before birth, for example, giving an Rh-negative fetus time to grow through an intrauterine blood transfusion of Rh-negative blood. In addition, NWH kept up to date in infertility research and methods to overcome it such as AID and IVF. In looking at all these issues, Bryder is essentially introducing the reader to the history of technology in childbirth.

While research brought international fame to the hospital, the daily running of it was left largely to the midwives and nurses. Here Bryder excels in tracking the power each had. For example, in the 1950s, a nursing shortage caused NWH to consider hiring male nurses, something that the country’s Nurses and Midwives Registration Board (NMRB) rejected and the NWH consequently had to accept.

As with any institution, the NWH had to deal with changes from outside. Between 1964 and the 1980s many women were questioning the way childbirth in a hospital was managed, what Bryder sees as part of “rising consumerism” (p. 169) of the larger society. In the 1970s onward the controversial issues of contraception, sterilization, and abortion challenged both practitioners and patients, and Bryder is adamant that the conflicts that ensued were not simplistic conflicts between doctors versus women. Doctors were not of one view on any of the challenges, but then neither were women. Here Bryder shows us how almost any aspect of birthing could be contested.

Chapter 10, “Feminists, Midwives and National Women’s Hospital,” is central to the narrative. It addresses the Cartwright Report on the research done in NWH on cervical cancer that led to a “scandal” that weakened the reputation of the hospital. For Bryder, the feminists who “exposed” the problem were “radical” (p. 190) with “little room for compromise or negotiation” (p. 191) in their view of how delivery of babies should be handled—by midwives and at home. It is unclear, however, how this group garnered the power that they seemed to have in successfully confronting the NWH. While the Labour government elected in 1984 sympathized with the women’s movement, surely not all women in it were what Bryder sees as radical.

The hospital had difficulty overcoming the Cartwright Report and the debates over birthing norms, but the context of the 1980s and 1990s faced NWH with too many changes: the increase in numbers of women coming to the hospital due to the closure of another hospital nearby, the lack of midwives at the hospital to cope with the rise in patients, the lack of finances to maintain good care, the end of the Postgraduate School as...