Wide-ranging history raises questions

THE RISE AND FALL OF NATIONAL WOMEN'S HOSPITAL: A HISTORY<br><b>Linda Bryder</b><br><i>Auckland...
THE RISE AND FALL OF NATIONAL WOMEN'S HOSPITAL: A HISTORY<br><b>Linda Bryder</b><br><i>Auckland University Press</i>
Historian Prof Linda Bryder uses the life of National Women's Hospital as a lens to view the history of reproductive health services in this book.

She says the rise and fall of the NWH as a stand-alone unit - which had its beginnings in 1946 and was a purpose-built hospital from 1964 until 2004 - reflected broader social, political and medical trends.

Bryder challenges any notion women were passive victims of the medical profession, arguing that while over time what women wanted changed, women's voices were ''ever-present and comprise an important part of the hospital's narrative and that of New Zealand's maternity services''.

This history is the one Bryder originally set out to write, with $345,000 from the Marsden Fund, before she became sidetracked into writing her highly controversial history of the ''unfortunate experiment'' at the hospital.

In it she claimed the 1988 inquiry by then Judge Silvia Cartwright got it wrong when it found Assoc Prof Herb Green had been conducting an experiment from 1966 by withholding conventional treatment from women who had carcinoma in situ (CIS) of the cervix.

Bryder implied the inquiry was somehow hijacked by a feminist agenda; there was no experiment and Green was not out of step with his contemporaries.

I mention this because I did not agree with Bryder's stance and concurred with those who felt she was confused or even closed-minded to information which did not support her view.

It makes it difficult to read this book without wondering how selective and accurate she has been this time in her use of material.

I suspect some of those who might have contributed to informed debate on her conclusions this time may avoid this book because they feel so strongly about her ''unfortunate experiment'' views (which get another airing in this book).

The history covers a wide range of topics including changing attitudes to childbirth, in vitro fertilisation and artificial insemination, sterilisation, abortion, and the hospital's varied

and internationally lauded research before it was rocked by the Cartwright inquiry and later the Helen Cull investigation into the practice of chest tapping premature babies to clear secretions.

In the section on abortion, I note Bryder suggests rape is grounds for an abortion in New Zealand. It isn't, although it can be taken into account by certifying consultants.

Her reference to the Cull report emphasises the actions staff took once the link between brain lesions and the chest tapping was suspected, but chooses to ignore or gloss over findings over the lack of consent, the fact staff were using this technique in a more excessive way than other hospitals and

that the supervision of nurses involved was informal and inconsistent. I would have liked to know more about how, over time, women patients felt about the emphasis on research at the hospital. In the early days, how much were they kept in the loop?

Did women come to ''distrust the medical profession as guardians of health'' as Bryder suggests, or did they just want to be better informed and more involved with decision-making around their health?

The section detailing the setting up and early days of the hospital is fascinating, including the involvement of the redoubtable Dr Doris Gordon (a graduate of the Otago medical school).

She was against state control of midwifery and, ironically, was also not happy about the emphasis on scientific research.

Were she still alive, it would be interesting to know how she felt about the way her ''baby'' developed.

Elspeth McLean is a columnist and former ODT health reporter.

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