When women had limited control of their fertility, pregnancy was an almost inevitable consequence of regular sexual intercourse. Knowledge and availability of contraception was limited or non-existent until the 20th century. Some couples used condoms in the first half of the 20th century. After the contraceptive pill was legalised in 1961 women could better control their fertility on their own.
At first, women relied on intuition and physical changes to recognise pregnancy. Midwives or doctors provided confirmation through physical examinations and later urine tests. Home pregnancy tests were available from the early 1980s. These gave women an opportunity to absorb the news in private if they wished.
Trust in God
Early Pākehā women settlers with religious faith often placed themselves in God’s hands when it came to pregnancy and childbirth. Writing to her mother about 1856, missionary wife Jane Buttle said: ‘I had begun to think I should have no more [children] but I find I am mistaken. Well we must not murmur. We are in the Lord’s hands, he gives life and he will give strength.’1 Jane died in 1857 – possibly during childbirth.
Single mothers suffered social condemnation. Working women often had to leave jobs or faced dismissal if they became pregnant. Legal protection and unpaid parental leave were provided to mothers in 1980 and to fathers in 1987. Paid parental leave was available from 2002.
Care of pregnant women
Until the early 20th century antenatal (before birth) care was a private affair – women looked after themselves with the aid of family and friends.
Confirmation of pregnancy was often greeted with pleasure and sometimes with resignation. In 1845 mother-of-six Jessie Campbell wrote, ‘I regret to tell you that I expect to be confined again in November. I trust this will be the last occasion for I am heartily sick of the business.’2
State antenatal care was first provided in 1918 as a way of reducing maternal deaths from preventable illnesses. Early clinics were mainly run at public maternity hospitals. Nurses gave women advice, and conducted basic medical examinations like blood pressure checks and urine tests. Women’s diet and exercise were regarded as important.
The Plunket Society, general practitioners (GPs) and independent midwives also provided care. In 1990 midwifery became an autonomous profession in New Zealand, Since the late 20th century most ante-natal, birthing and post-birth care has been provided by midwives.
Medical technology increased the monitoring of pregnant women throughout the 20th century. More complex urine and blood tests checked for a range of maternal disorders. X-rays, amniocentesis (checking the fluid around the baby in the womb) and ultrasound scans were used to monitor foetal development and detect abnormalities.
By the late 20th century doctors could do genetic tests on embryos in the womb. If serious abnormalities were detected, parents had to decide whether to continue with the pregnancy. Later, embryos created by fertility treatments could be tested before implantation in the woman’s womb (preimplantation genetic diagnosis – PGD). This testing also became available where parents had a family history of genetic abnormalities.
Technology reduced the mystery and risk of childbearing. Parents could see their baby as a foetus and discover its gender. Scans became ‘first photos’ – in the 21st century they were available in digital, email-friendly form. Some commentators claimed that access to technology encouraged public perception that pregnancy and birth were medical events rather than a natural process.
In the 19th century women usually learned about pregnancy and birth from their mothers and female relations. Later they supplemented this by reading books and attending antenatal classes.
The first specific books were published in the early 20th century. These concentrated on baby care. Maternal care during pregnancy was included from about the 1920s. Early books did not pay much attention to the process of giving birth. By the 1950s they contained this information.
New Zealand’s first antenatal classes were held in 1948. They were run by Parents Centre founder Helen Brew and (separately) Plunket. Men and women attended Parents Centre classes together, while Plunket ran separate groups for men and women until the 1960s. By the early 21st century a wide range of classes existed, run by independent midwives, religious organisations and non-profit community groups.