Dr Sally Pairman
"The story of the New Zealand College of Midwives 1986-2010... a positive story of amazing change for women and midwives."
When Dr Sally Pairman returned from the United Kingdom as a newly-trained midwife and joined a professional association, she would not have believed that, a quarter of a century later, she would be writing its history. Pairman has "always been involved, in one way or another" in the New Zealand College of Midwives. She helped found the College as an independent body (previously, midwives belonged to a special section of the Nurses‘ Association). She has been a board member, an education consultant and held the role of president from 1993 to 1997. But, perhaps most significantly, Pairman was a stalwart champion of the law change that enabled the autonomous practice of midwifery, thus safeguarding the existence of the profession - and the College - in New Zealand.
Serving as a kind of repository of institutional memory, and inspired by pioneering midwifery advocate Joan Donley OBE, "who was always telling us to write things down". Women's Business: The story of the New Zealand College of Midwives 1986-2010 was coauthored with current College Chief Executive Karen Guilliland. It charts a journey, says Pairman, replete with "successes, frustrations and some great stories." In doing so, it revels something of the College's legacy - as fundamentally shaping the relationships among women, midwives and the health system in New Zealand.
"The College can take huge credit for driving change in the midwifery system. Throughout that entire period, when laws were being rewritten, new educational programmes developed, referral guidelines established and midwives were starting out as independent businesswomen, the College was the only real constant." And in supporting the rise of midwifery, the College has succeeded in refocusing pregnancy as normal, healthy life event rather than a medical issue, Pairman says. Today, some 90 per cent of women have midwives as their lead maternity carer, appreciating the holistic and continuous care they receive throughout their pregnancy and birth. Other countries - including Canada, Japan, Australia and Indonesia - are increasingly looking towards New Zealand's model of midwifery "because it's cheap and sustainable in a wide range of communities and provides great outcomes for mothers and babies."
"Yet still", she says, "the way some midwives are victimised in the media when things go wrong suggests a latent distrust of woman-managed health care." "Midwives are autonomous, but they are not alone. They work closely with others throughout the medical system. Yet, if the worst happens and a baby dies - and we have to understand that we will never achieve nil perinatal mortality - there is still a tendency to isolate and blame midwives." "The College has worked hard to ensure the processes are in place to prevent midwives becoming exposed in this way. But it's clear that helping the public understand the role and limitations of midwifery is important to women continuing to feel that this is a safe profession to enter."
"Despite this", says Pairman, "the book is primarily a celebration. It involved finding and analysing historical documents over more than 25 years, such as minutes of meetings, letters, newsletters, government documents, written case studies and many reminiscences. It is a positive story of amazing change for women and midwives."