Covering the history of the Plunket Society from 1907 to the present day, this book is organized around three dominant themes that contribute both to international historiography and to the social history of New Zealand. These themes are the mixed economy of welfare, maternal and infant health, and motherhood and parenting. Discussed in detail is how these three strands form an important contribution to New Zealand’s social history. In particular, the public role of women as welfare providers, maternal and child health provision, and parenting roles and practices are examined. An in-depth study of the voluntary welfare system, this book will be of interest to welfare historians, women’s studies historians, social historians of medicine, and government policy makers.
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About the Author
Linda Bryder is a professor of history at the University of Auckland. She is the author of Below the Magic Mountain: The Social History of Tuberculosis in Twentieth-Century Britain and A Healthy Country: Essays on the Social History of Medicine in New Zealand. She is on the editorial board of a number of international health and history journals including Hygeia Internationalis and is a council member of the New Zealand Historical Association.
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A Voice for Mothers
The Plunket Society and Infant Welfare 1907â"2000
By Linda Bryder
Auckland University PressCopyright © 2003 Linda Bryder
All rights reserved.
Founding the Society for Promoting the Health of Women and Children
Politicians and doctors define the problem
New Zealand had the lowest recorded infant mortality in the world at the beginning of the twentieth century, but this did not appear to be a cause of self-congratulation. John Findlay, Attorney-General and leader of the Legislative Council from 1906 to 1911, explained in 1907 that, although the infant death rate was lower in New Zealand than elsewhere, it was not declining. In 1904 it was 71 per 1000 births; in 1897 it had been 72. At the same time the fertility rate was declining, which gave rise to 'reflection and anxiety', according to New Zealand's Governor, Lord Ranfurly. These matters were publicly discussed in the early part of the century because of prevailing concerns – not confined to New Zealand – about 'national efficiency'. New Zealand saw itself as part of the great British Empire and Anglo-Saxon race: population issues were viewed in terms of imperial strength. In a 1904 memorandum on infant life preservation, Premier Richard John Seddon declared, 'Babies are our best immigrants', echoing the conclusion of a recent report on declining birth rates in New South Wales. Given their geographical position, these young British colonies were particularly worried about a potential influx of Asians. For Seddon, 'In the younger colonies of the Empire population is essential and if increased from British stock the self-governing colonies will still further strengthen and buttress our great Empire. In British interests it is clearly undesirable that the colonies should be populated by the inferior surplus of people of older and alien countries.' Immigration policies were restricted accordingly but there were also attempts to build up the local white population to fill the spaces.
The origins of the infant welfare movement in Britain have been traced to the South African War of 1899–1902, in which it was discovered that up to a third of the recruits were unfit for military training owing to physical defects. There was a public outcry and army records were said to show that there had been deterioration in health during the previous 50 years (i.e. coinciding with a period of urbanisation). This resulted in the setting up of the Inter-departmental Committee on Physical Deterioration, which reported in 1904. In the event no deterioration was found, but it did reveal extensive ill health among the poorer sectors of society. The report focused in particular on infants and children, the next generation of fighters and workers. It was shown that the death rate among infants had not declined as had general death rates over the previous half-century. The infant welfare movement in Britain was launched as a result of a concern for national efficiency, especially in the light of declining British military and economic power compared with Germany, the United States and Japan. Nor was Britain alone in this concern. As Alisa Klaus has written, Fascists and Fabians alike advocated public programmes to protect maternal and child life and to encourage child-bearing for the sake of national strength.
In New Zealand, political interest in the high infant death rates is evident in the debates surrounding a 1904 bill to set up maternity hospitals for poor but respectable working-class wives and as training schools for mid-wives. Although the focus was maternity services, it was infant rather than maternal health that was the central concern. Introducing the bill into Parliament, Seddon stated that the 'deaths at maternity are alarming', and went on to point out that during the period 1894–1903, there had been 20,487 deaths among children aged five and under, and 15,767 under the age of one year. He added that he was still awaiting information about the deaths of mothers. Introducing the bill into the Legislative Council, Attorney-General Albert Pitt explained that the aim of registering and training midwives was to reduce infant deaths. He repeated Seddon's statistics on infant mortality and added that 'in addition, no doubt many of the mothers died in childbirth'.
In 1908 Seddon's successor as Prime Minister, Sir Joseph Ward, addressed a meeting presided over by the Governor of New Zealand, Lord Plunket, to set up a voluntary society to protect infant life in Auckland. Ward declared that he knew of no matter more urgent. Putting aside sentimentalism, and approaching it from a 'mercenary point of view', he calculated that 'every human being in the Dominion was valued at about £250'. A few months earlier a member of the Legislative Council voiced similar sentiments when supporting an amendment to the Infant Life Protection Act: 'The real reason for our solicitude is not murdered babes. It is that population, which is decreasing, is indispensable to national safety and national progress. We must have soldiers and workers, or our prosperity will be imperilled and our industry will decay.' In a health promotion poster issued in 1909, the newly appointed Chief Health Officer, Dr Thomas Valintine, devoted a section to 'Assets versus Liabilities', placing the value to the country of each healthy young adult at over £300, and each 'unhealthy wastrel and dependent [sic] who has to be kept by the public' as a 'grave liability'. A government poster succinctly summarised the belief during the First World War, using a military image, 'The Race marches forward on the feet of Little Children'. Warfare had provided a major impetusfor the infant welfare movement in Britain. In New Zealand, too, records of army recruits in the First World War showed up poor health. The Army Medical Board had rejected 31 per cent of those examined; many more 'unfits' reached England. The publicity surrounding this gave added impetus, and political respectability, to the infant welfare movement.
These concerns must be viewed in the context of contemporary attitudes which regarded the environment and 'the laws of Nature' (or becoming 'more sensible, normal and healthy in our habits') as more important than heredity. Some commentators followed the teachings of late nineteenth-century social Darwinism that nature should be allowed to take its course in wiping out the less fit members of the society, and that social policy should not pander to the survival of the weak but rather should prevent them from propagating. Marsden MP Frank Mander, for example, put forward the eugenist view that 'consumptives and imbeciles and weaklings, who cannot possibly rear healthy children, should not be allowed to marry'. He believed the proposed free maternity homes were not a good thing, because they might lead to 'propagating a lot of criminal children, who would be better out of the world altogether'. This, however, appears to have been a minority view. Environmentalism was much more to the fore among 'progressive' thinkers of the early twentieth century.
One of these was London-trained Dr William Collins – a new member of the Legislative Council, Seddon's physician and a friend of Dr James Mason, first Chief Health Officer of New Zealand from 1900 to 1909. Collins argued that children were born 'full of possibilities for good health or ill health and for good or evil', and that it was the state's responsibility to ensure that they did not grow up to become inmates of general or mental hospitals. He believed that, although all instincts of 'criminal stock' could not be eradicated in one generation, it was possible to change the mental condition of the child through the environment, and so lessen the hereditary taint. This was a view shared by the doctor who was to become the leader and figurehead of the infant welfare movement in early twentieth-century New Zealand, Dr Frederic Truby King, then Medical Superintendent of Seacliff Mental Asylum.
What aspects of the environment required modifying? In his 1907 annual report, Mason analysed the 1811 infant deaths during the past year. Of these, 861 were due to 'diarrhoea, enteritis and marasmus', which, he claimed, 'often spells nothing more than bad feeding'. In Mason's view 'bad feeding' was caused by ignorance, 'want of care' and the quality of the milk supply. The solution was knowledge, 'love' and a clean milk supply. There was nothing original in this analysis. Any New Zealander with an interest in the subject would be aware of a recent book by the English medical officer, Dr George Newman, Infant Mortality. A Social Problem, published in 1906. Indeed, Collins and Findlay cited Newman's book during the parliamentary debates.
Although child-rearing may have been perceived as a women's sphere and previously a private affair, the early twentieth-century concern for the future of the race and empire elevated it to a matter of national importance, discussed at length by the country's leaders who, as fathers themselves, claimed to have a special grasp of the issue. For example, Liberal MP for Christchurch city, Thomas Taylor, stated in 1904, 'Most members of the House – with the exception of one or two bachelors (and bachelors have no right to be counted at all) – most men out of their own experience will have seen how the average mother, a woman of education, well trained and well cared for, lacks education in regard to one of the most important, if not the most important, of her duties in life, when for the first time she handles her own offspring, in the most clumsy manner – does not know quite which is the head end and which is the foot end of the baby.' During the 1907 discussions on infant life protection in the Legislative Council, 56-year-old prominent Auckland citizen, Seymour George, stated modestly, 'I am speaking, I may say, with some little knowledge. I have a large family myself, and my children are all grown-up young men and young women, and they are very healthy people.' He proceeded to claim that deaths were caused 'through ignorance'. His own children were brought up on milk and had nothing to eat or drink but milk until they were over twelve months of age. Sixty-two-year-old George Jones pointed out that he was the father of ten children, nine of whom were living 'and in that respect I can put myself in competition with the Hon. Mr George'. He mocked George's self-proclaimed expertise in child-rearing: 'Here we have a gentleman in Chamber who can rock the cradle, fill the bottle, mix the food, and make a fortune all at once'. The New Zealand Observer also picked up on George's 'touching exposition of the subject before the Legislative Council' which 'mark[ed] him out as an authority on "baby" topics'. Yet Jones too went on to expand on the 'teachings of medical science' in child-rearing.
The problem was perceived to be ignorance of 'the laws of nature', which could be remedied through the teaching of scientific principles. The most 'natural' form of infant feeding was of course breastfeeding and this was strongly promoted by early twentieth-century environmentalists. Medical studies conducted in Europe since the 1880s had shown that breast milk was a protective factor against infantile diarrhoea, the major cause of infant deaths. In his 1906–7 annual report, Mason cited the Health Officer for Liverpool, England, who had calculated that the rate of deaths for breastfed infants was 20 per 1000 from infantile diarrhoea, while among those fed on artificial foods and cow's milk it was a staggering 440 per 1000.
Breastfeeding did not just prevent deaths in infancy. Truby King had a particular interest in psychiatry, not only as medical superintendent of a mental asylum, but also as lecturer in mental diseases at Otago University and member of the Psychological Association. He argued that breastfeeding 'formed the best means of prophylaxis against the infantile cerebropathies', by which he was referring to the development of 'idiots, imbeciles and epileptics'. He cited Professor Ernesto Lugaro who, in his 1909 text Modern Problems in Psychiatry, argued that these conditions might be the result of lesions in the brain following infantile cerebral disease. King included breastfeeding among the factors tending to 'reduce the supplies of populations in asylums, hospitals, benevolent institutions, goals and slums' and to contribute to 'a very remarkable improvement ... in the physical, mental and moral condition of the whole community'.
Although it is not known how many women breastfed in early twentieth-century New Zealand, many expressed the view that the number was declining. At least one MP believed that the 'great bulk of the mothers' did not breastfeed. Dr Collins estimated in 1907 that about 80 per cent did not 'suckle' their infants. The trend was perceived as a public issue. In 1904 Legislative Council member William Beehan commented on the disinclination of many present-day mothers to 'suckle their young', which was the greatest cause of infant mortality. Collins explained that many women objected to breastfeeding, no matter how much the doctor urged it. Seymour George claimed they objected that it 'put their figures out of shape' and that it was inconvenient.
Other medical authorities commented on the trend. Writing on infant diarrhoea in his annual report for 1906–7, Christchurch sanitary inspector, R. J. McKenzie, claimed that 'the most grave responsibility rests on the mothers who, from carelessness, ignorance, or selfishness, do not feed their children at the breast'. He thought that the absence of breastfeeding was understandable (though perhaps not justifiable) in the manufacturing districts in England, where women were largely employed in factories, but that the neglect was 'less excusable' in New Zealand where few mothers were wage-earners. Dr Joseph Frengley, Assistant Chief Health Officer, claimed it was the 'so-called upper classes, Society women, ... Social parasites' who did not breastfeed. In his view, 'the working women, the true mothers, the women with the breasts', had no trouble. He was satisfied that it was a mistake 'from the natural point of view' to keep alive babies who could not be suckled by their mothers: 'If we only bred from the mothers who can suckle their babies we should soon have proper motherhood'. At the inaugural meeting of the Auckland Society for the Protection of Infant Life in 1908 Dr Arthur Marsack stated that 'Any woman who could nurse her child, and would not, took the risk of being morally guilty of homicide by omission'.
According to these observers, this failure to breastfeed was compounded by their ignorance of 'the rudimentary art of preparing food for their offspring'. Thomas Kelly complained that 'the great bulk of mothers gave condensed milk or starchy food to infants under twelve months, which it was very well known infants could not digest'. Attorney-General John Findlay claimed there was no excuse for 'dietetic disease', the major cause of infant death, since the methods of child-rearing were no longer 'haphazard, but have been reduced, as any well-instructed book will tell you, to an exact science'. He asserted that any 'long-experienced physician' could speak of the 'appalling' ignorance of many 'well-intentioned' mothers. Seymour George lamented that young wives did not even know how to cook dinner for their husbands yet were responsible for infant health: 'The result is that many children die in the early stages of life'. He claimed it was 'the duty of the State' to teach young girls housewifery, so that 'their husbands and families should not suffer from food badly cooked – a matter that is often the beginning of disease in people'.
Excerpted from A Voice for Mothers by Linda Bryder. Copyright © 2003 Linda Bryder. Excerpted by permission of Auckland University Press.
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Table of Contents
Chapter 1: Founding the Society for Promoting the Health of Women and Children,
Chapter 2: A Professional Organisation,
Chapter 3: Plunket Becomes a Household Word: the Interwar Years,
Chapter 4: Complementary or Competing Services: Plunket and the Medical Profession in the Interwar Period,
Chapter 5: Helen Deem and Paediatrics, 1939–56,
Chapter 6: Plunket and the Government, 1939–60,
Chapter 7: Neil Begg and Social Paediatrics, 1960–78,
Chapter 8: Community Paediatrics, 1980s and 1990s,
Chapter 9: Plunket Nursing Services in the Late Twentieth Century,
Chapter 10: A Women's Society? Plunket's Changing Image from the 1970s,