Joan Donley was a midwife whose advocacy of home births and natural childbirth helped shape modern midwifery in New Zealand. She argued that women should have the right to reject medicalised maternity care, and helped establish several organisations which promoted natural childbirth and an extension of the rights of midwives. Donley regarded home birth as a ‘feminist and a political act’ by which women could reclaim their bodies from ‘the white, male-controlled obstetrics and gynaecology … specialty which is trying to gain a complete monopoly of childbirth in New Zealand’.1
Joan Elsa Carey was born in Regina, Saskatchewan, Canada, on 19 March 1916. She was the eldest of the three children of bank manager Edward Hunsdon Carey and Gladys Christine Stafford-Carey. Joan took up nursing because she could not afford to study to be a doctor. She trained at Saskatoon City Hospital, graduating as a registered nurse in 1938 and taking a position with the British Columbia Coast mission at Pender Harbour soon afterwards. Her work there focused on tuberculosis, logging injuries and childbirth.
Joan married fisherman Robert (Bob) Fuhland Donley (1914–1992) in Vancouver on 22 November 1941. She left nursing to start a family, giving birth to her first child in 1942 and her fifth and last in 1957. The couple initially operated a fishing boat out of Pender Harbour, with Joan becoming one of the first women in British Columbia licensed for hand-lining cod. In the mid-1940s they purchased 19 acres of uncleared land at Middle Point, Pender Harbour, where they operated a sawmill and a smokehouse. Life was hard and the marriage difficult, and at 39 Joan had a heart attack. She nursed herself back to health using natural remedies. Joan and Bob were active in seeking better roading, electricity and educational facilities for their district. In 1959 the couple shifted to a 10 acre property at Sechelt. In the early 1960s Joan edited the local newspaper, the Sechelt Peninsula Times, which provided an outlet for her causes and campaigns until she was fired for being too outspoken.
In 1964 the family decided to emigrate to New Zealand, motivated in part by fear of nuclear war and the growing influence of the United States in Canadian politics. They settled in Auckland and opened the Crescent Fish Mart in Grey Lynn in 1965. Joan left Bob late in 1969, and used family money from Canada to pay off the couple’s debts and purchase a home in Mount Albert. Joan decided to become a midwife to support herself and her youngest son, the other children having left home. She undertook the six-month maternity training at National Women’s Hospital in 1970 and completed her midwifery training at St Helen’s Hospital in 1972, aged 56. She then worked as a midwife for two years at Waitākere Hospital.
In 1974 an older midwife, Vera Ellis Crowther, persuaded Joan and Carolyn Young to leave the hospital environment and take over from her as domiciliary (home-birth) midwives. Women had been offered the choice of a free hospital birth or a midwife-assisted home birth since the late 1930s, but almost all women chose the hospital option. In 1970 there were just 87 home births in the whole country (0.13 per cent of all births). The Nurses Act 1971 made it illegal for a midwife to provide maternity care unless a medical practitioner took responsibility for the woman during childbirth. Some doctors continued to support home births attended by midwives, and in 1974 Joan and Carolyn were among the few domiciliary midwives practising in Auckland. Their practice ranged from Albany to Papatoetoe. Joan’s first home birth was that of her granddaughter, Mandy, in 1974.
Joan Donley attended approximately 750 births over the course of her 21-year career as a home-birth midwife. She noted in 1986 that calls for assistance ‘come in clusters – frequently around the full or new moon and when it’s dark and stormy. … It’s something to do with electromagnetic forces.’2 She used herbal teas, acupuncture, massage and warm baths to help women give birth without medical intervention, and formed lasting friendships with many of the mothers. It was not a lucrative career, with the Health Department paying only $180 per birth in 1986. But Joan was not in it for the money; for her it was a crusade deeply embedded in her political and philosophical beliefs related to socialism and feminism.
Joan’s social activism found various outlets. She was active in the Citizens Association for Racial Equality and the New Zealand Peace Council by the late 1960s, and in the early 1970s she grew interested in communist China. She served as secretary of the New Zealand China Friendship Society, for which she ran a seminar in Auckland in 1974, and was involved in three tours of China. Joan led a 1975 tour to survey the women’s liberation movement in China, which she considered relevant to the women’s movement in New Zealand. She noted, ‘the struggle for socialism is basic. Without that, women’s liberation is merely a dream.’3 She supported the New Zealand Communist Party as the only organisation correctly applying the principles of Chinese communism and encouraged other women to follow her lead.
Joan’s political views were directly relevant to her approach to the politics of childbirth. She viewed having a baby at home as a ‘feminist and a political act’ in which ‘women rebelled against the technological takeover of their bodies’ by male doctors and hospital nurses.4 She rejected the medicalisation of childbirth as ‘modern medical megalomania’, and demanded that women be free to choose to deliver their babies naturally and at home. She asked: ‘Whose body is it? Whose baby is it?’5 She encouraged mothers to be aware of the political issues. Joan was particularly critical of midwives who worked in hospitals, asserting that most New Zealand midwives had become a ‘nurse-midwife, a hybrid, a medically-oriented handmaiden, while the real midwife is an endangered species.’6
She opposed the government policy of regionalisation of maternity services in the 1970s and 1980s, which involved closing some small maternity hospitals and basing operative, resuscitation and neonatal technology in regional centres. She claimed that this policy was supported by multinational drug companies which made huge profits, and was a self-perpetuating system which guaranteed obstetricians and gynaecologists ‘a monopoly of clinical material’ – that is, women.7 She opposed immunisation for similar reasons, seeing it merely as a ‘lucrative enterprise promoted by the pharmaceutical empires’.8 She was supportive of the anti-vaccination campaigner Hilary Butler and the Immunisation Awareness Society she founded in 1988.
Joan played a central role in setting up a series of organisations to promote the interests of domiciliary midwives. In 1978 she formed the Auckland Home Birth Association, a lobby group for domiciliary midwives. She was a founding member of the New Zealand Domiciliary Midwives Society, established in 1981 and soon accepted as a bargaining body by the Department of Health. At a 1988 meeting of the Midwives and Obstetric Nurses Special Interest Section of the New Zealand Nurses’ Association, she argued that the section should be disbanded in favour of the formation of an independent College of Midwives to ensure the survival of midwifery as a profession. The New Zealand College of Midwives was founded the following year to represent all midwives, set professional standards and oversee midwife education. A 2010 history of the college credited Joan as its ‘official founder’; without her ‘amazing insight, conviction and energy’ it would never have come into existence.9
Joan also lobbied for professional recognition of midwives by the government and for direct entry into midwifery training (without the requirement to first train as a nurse). The Nurses Amendment Act 1990 gave midwives pay parity with doctors for attendance at childbirth and the right to practise independently. Tertiary institutions soon offered direct-entry midwifery courses. Donley had influenced this legislation by writing regularly to Health Minister Helen Clark, her local member of Parliament.
The 1980s was a decade of intense political campaigning for Joan. She published many articles and several books, notably Save the midwife (1986), a polemical history of New Zealand midwifery. She networked with radical and home-birth midwives in New Zealand as well as in Australia, Canada, the United States, the United Kingdom and Ireland. In 1984 she travelled to the United States and Canada. The next year she attended a National Homebirth Australia Conference in New South Wales. She corresponded with the International Confederation of Midwives, and with the UK-based Association of Radical Midwives. In 1990 she attended an Invitational Forum on Midwifery Education and Practice, in Toronto, Canada.
From the late 1980s Joan was active on the Auckland Women’s Health Council. She kept a watching brief over developments in midwifery education and practice into the 1990s, attending meetings, speaking at conferences and writing reports. She accumulated an extensive archive of offprints, reports and newspaper clippings. She continued to show an interest in all aspects of the health of women and children, with a particular interest in alternative medicine. Joan visited China again in 1992 to study the applicability of acupuncture and homeopathy to childbirth.
Joan’s contributions to the politics of childbirth were publicly recognised in various ways. She was made an OBE in 1990 for services to midwifery, and was awarded both the New Zealand 1990 Commemoration Medal and the New Zealand Suffrage Centennial Medal 1993. In 1997 she was awarded an honorary Master’s degree in midwifery from the Auckland Institute of Technology, and in 2001 the New Zealand College of Midwives established the Joan Donley Midwifery Research Collaboration as its research arm.
Joan Donley retired from midwifery in 1995 after she was injured in a car accident. In 1998 the College of Midwives reprinted Save the midwife as Birthrites: natural vs unnatural childbirth in New Zealand. Joan declared in a new introduction, ‘After 50 years of being “under the doctor” it is difficult for women to overcome their fear-based medical dependence and opt to regain control of their bodies and their births.’10 Joan maintained her feminist principles to the end. She died in Auckland on 4 December 2005 at the age of 89.