Legislation to control Midwifery continued throughout the second half of the 20th century with regular updates and amendments to The Health Act of 1911. These changes included who the midwife must inform of her intention to commence private practice; the situations when a midwife must consult a medical practitioner; what drugs the midwife could and could not administer; the contents of her midwifery bag; and the paperwork the midwife was required to complete. The growth of general hospital services began with the establishment of small hospitals specifically for the impoverished and developed into the large publicly-funded institutions which began to dominate the provision of health care.

Sedation of the patient during labour was routine in most maternity hospitals from the 1920s onward, and the ‘twilight sleep’ method along with chloroform were used in the institutions.

From the 1930s most women in Australia gave birth in hospital; women still received midwifery care from midwives, although the care administered was ordered and directed by doctors.

Midwives now had to train in hospitals and most training expected them to be nurses first.

Henny Ligtermoet

With the increasing number of women birthing within the institutions the number of midwives offering midwifery care at home reduced dramatically and by the 1950s it was almost non-existent. This was the case when Henny Ligtermoet arrived in Australian in 1951 with her husband and two children.(1) Henny planned to have more children and wanted to birth them at home as she had done with her first two children in her home county, Holland. This plan proved to be difficult and led to a lifelong passion and fight for midwife-attended homebirth in Australia.(2) Henny was told by her GP that homebirth was illegal in Australia and it was only after she telephoned the Public Health Department that she was informed that homebirth was not illegal. Nevertheless, during the phone call she was advised that she should not have a homebirth as it was ‘highly dangerous’. It took Henny three years to find a midwife.(3) According to an interview undertaken by Carol Thorogood in 19994, Henny stated that once she found one midwife— a midwife who attended the Italian women living in WA who wanted a homebirth— she found there was a small underground homebirth movement. However, midwives could be found only by word of mouth, as the medical profession considered the practice of homebirth dangerous. Henny said that until the 1970s many babies were recorded in the official documentation as ‘baby born before arrival’; therefore, the name of the attending doctor or midwife was not recorded.(5)

Henny dedicated the rest of her life to birth activism, the fight for women’s right to choose to birth at home with a midwife and to promote what she termed ‘natural childbirth’. She founded the Midwifery Contact Centre in 1956, based in East Fremantle, Australia’s first organised homebirth group.(6) The Midwifery Contact Centre’s aim was to act as the go-between for women seeking midwives to attend their homebirths.

(1) Ligtermoet, Henny. 1999b. “My Thoughts in the Mid 1950s,” in Ligtermoet, Henny (1921‐1999), State Library of Western Australia.

(2) Ligtermoet, Henny. 1999a. “Correspondence, Documents and Submissions by Henny Ligtermoet,” in Ligtermoet, Henny(1921‐1999), State Library of Western Australia.

(3) Ligtermoet, “My Thoughts in the Mid 1950s.”

(4) Thorogood, “Politics and the Professions: Homebirth in Western Australia.”

(5) Ligtermoet, “My Thoughts in the Mid 1950s.”

(6) Ligtermoet, “Correspondence, Documents and Submissions by Henny Ligtermoet.”

Profiles

Rhodanthe Lipsett © Gary Schaefer

Rhodanthe with Nicky Leap & Gill Hall

Rhodanthe Lipsett OAM {Canberra, ACT, 1922-2019}

Rhodanthe Lipsett was born in South Australia and spent her early years on a fruit orchard at Cadell on the Murray River. She received her secondary education at the Presbyterian Girls’ College in Adelaide.

Rhodanthe began her career as a nurse at the Adelaide Children’s Hospital, before gaining postgraduate experience at the Royal Adelaide Hospital. Having developed a strong love for working with mothers and their babies she began her life as a midwife in 1947 in Broken Hill District Hospital. Rhodanthe then further expanded her qualifications by gaining her Infant Welfare Certificate from Tresillian in Sydney. Rhodanthe then travelled to England where she spent the next two years gaining further experience in maternal and child health.

In 1951, on her return to Australia, Rhodanthe moved to Canberra to work at Canberra Hospital, later moving into community care at Maternal and Baby Health Centres and visiting rural mothers and their newborn babies. Following her marriage to her husband John, there was a break in her career while she cared for their own three children. In 1971, Rhodanthe returned to the profession she loved. Joining the staff of the Queen Elizabeth II Family Centre in Canberra where she spent the next 18 years providing professional support and practical information for mothers and teaching parenting skills. By this time Rhodanthe was also teaching health care professionals both in the community and at the QE II.

Specialising in infant and maternal health, Rhodanthe was awarded a Medal in the Order of Australia in 1992 for her services to Australian women and their families. In 1996, she was made a Fellow of the Australian College of Midwives in recognition of her work for the profession. Following retirement, Rhodanthe remained an active member of the College, and was enthusiastically involved in furthering the welfare of mothers and their babies.

Rhodanthe published her first book No one right way in 2004, a handbook for parents coping with the first three months of their baby’s life. This was revised and updated in the 2012 book Baby care: Nurturing your baby, your way a book to help parents understand the needs of their baby, with reassuring advise about the many ways to meet those needs. She says that the first six weeks are the most difficult for new mothers, and it is important to assist, encourage and inspire them so that they experience more ‘up times’ than ‘down times’.

“If they can experience less anxiety and more confidence in the early weeks, I believe it can set the pattern for the months and years ahead.”

Royalties from sales of the book go to the Rhodanthe Lipsett Fund to support the education of Aboriginal and Torres Strait Islander midwives.

In 2006, the Australian College of Midwives created the ‘Rhodanthe Lipsett Award’ worth $1000 in recognition of her work.

In early 2009 the Australian College of Midwives established the Aboriginal and Torres Strait Islander Midwives Scholarship Fund. In September 2009 at the ACM National Conference held in Adelaide the then President of the College, Professor Pat Brodie, presented an award of recognition to Rhodanthe and announced that the Fund would, from that day forward, be known as the Rhodanthe Lipsett Indigenous Midwifery Fund.

In 2012, at age 90, Rhodanthe was awarded an honorary doctorate by the University of Canberra for a lifetime of services to baby and maternal health.

Rhodanthe passed away in January 2019, 4 days shy of her 97th birthday.

For more information, visit indigenousmidwives.org.au

Resources

Dahlen, H., Homer, C., Leap, N., & Tracy, S. (2011). Women and Birth 24, 105-111. doi:10.1016/j.wombi.2010.09.002

Abstract A review of key historical texts that mentioned perineal care was undertaken from the time of Soranus (98—138 A.D.) to modern times as part of a PhD into perineal care. Historically, perineal protection and comfort were key priorities for midwives, most of whom traditionally practised under a social model of care.

With the advent of the Man-Midwife in the seventeenth and eighteenth century, the perineum became pathologised and eventually a site for routine surgical intervention — most notably seen in the widespread use of episiotomy.

There were several key factors that led to the development of a surgical rather than a social model in perineal care. These factors included a move from upright to supine birth positions, the preparation of the perineum as a surgical site through perineal shaving and elaborate aseptic procedures; and the distancing of the woman from her support people, and most notably from her own perineum.

In the last 30 years, in much of the developed world, there has been a reemergence of care aimed at preserving and protecting the perineum. A dichotomy now exists with a dominant surgical model competing with the re-emerging social model of perineal care.

Historical perspectives on perineal care can help us gain useful insights into past practices that could be beneficial for childbearing women today. These perspectives also inform future practice and research into perineal care, whilst making us cautious about political influences that could lead to harmful trends in clinical practice.