A New Thinker On Childbirth

Sydney Morning Herald

Monday March 12, 2007

Hannah Dahlen and Nicky Leap

PAMELA HAYES

1935-2007

AS AN inner-city midwife and educator, Pam Hayes witnessed just about every possible combination of birth, life and death. She saw that women were being sold short by euphemisms and platitudes surrounding sex and childbirth, and she set about changing the rules of engagement.

Open-minded and unshockable, Hayes travelled all over Australia during the still-repressed 1970s taking education programs, workshops and seminars to midwives. Her lectures about sexuality and health included references to erections and orgasms at a time when this was still considered quite outrageous.

Long before Australia accepted the values of multiculturalism, she was impressing upon her students that sexual norms and experiences might legitimately be very different for migrant groups or for those living alternative lifestyles. She was even reported once to a hospital matron for showing midwifery students a Canadian film in which a couple engaged in a frank, to-camera discussion of their love life, including the woman's sexual response.

In an interview two years ago for a professional journal, Hayes said she had been "trying to challenge the sphere of midwives' knowledge, to develop an understanding of a couple's sexuality as part of the midwifery curriculum".

If doctors were allowed to teach and discuss such issues, she reasoned, so should midwives, who cared for women at a vulnerable time.

"I remember ... thinking midwives were badly done by compared with doctors and nurses," she recalled, "just as I thought women were badly done by compared with men."

Hayes, who helped cement the identity of midwifery as a profession distinct from nursing, has died after a short illness, aged 71.

Following her mother and grandmother into midwifery, Hayes trained at Sydney's Royal Prince Alfred Hospital in 1953, and then worked in Hobart and back in Sydney before travelling to New York in 1960. She spent a year at St Luke's in Manhattan and 18 months as a nurse and midwife on a small island off British Columbia, half of which was an Indian reservation.

Returning to Sydney, she joined The Women's Hospital - known as Crown Street - where she stayed for 20 years, leaving the labour ward in 1969 to become the midwifery educator.

Hayes was pivotal in setting up the organisation that would later become the Australian College of Midwives. In 1975, after travelling to Lausanne to the International Confederation of Midwives conference, she met Margaret Peters, a midwife from Melbourne, and Jenny Cooling from South Australia.

The three organised for their states to become confederation members - facilitated by a visit to Australia by the British midwifery luminaries Margaret Myles and Marjorie Bayes.

The germ of a single national organisation was initiated in 1978 and - with all the exuberance of a fledgling organisation and virtually no capital - the group decided on a financial structure, including a scholarship fund and an ambitious and successful bid to host the 1984 congress of the international body. The Australian College of Midwives was born in 1983.

Hayes was head of the midwifery school at Crown Street from 1975 until its closure in 1983.

The biggest source of regret in her career stemmed from the Crown Street years and allegations years later that young, single women who gave birth at the hospital had been treated inhumanely and coerced into relinquishing their infants for adoption.

An inquiry in the late 1990s into adoption practices of three decades earlier caused Hayes deep distress, but she was never defensive and acknowledged that the actions of the past had, with hindsight, been clearly wrong. In particular, she recognised that not allowing the young women to see their babies had been damaging, but she insisted the doctors and midwives of the 1960s and '70s had genuinely believed this would assist the mothers' psychological recovery.

Hayes worked at Royal Prince Alfred as a clinical nurse educator in midwifery until 1991, leading the development of the NSW Midwives Association. "We ran it from our bedrooms, boots of cars," she recalled, until she orchestrated the purchase of the Ultimo premises that remain its home.

Hayes was also a historian. In addition to overseeing the association's collection of a salutary array of birthing instruments, she had a superb grasp of the fraught debates between doctors, nurses and midwives, dating back to the 1890s, which centred on midwives' separate identity from nursing.

The midwives continued to call themselves such, gradually winning public acceptance of the term. The battle still rages over name badges and employment awards, although the change in 2004 of the NSW Nurses Act to the Nurses and Midwives Act was an important symbolic victory.

The 2005 introduction of NSW's first bachelor of midwifery course, at the University of Technology, Sydney, was another testament to the energy of Hayes and colleagues of her generation.

In 1990, Hayes received a Medal of the Order of Australia for her services to child-bearing women and midwifery. This was a fitting tribute to one who truly has "midwifed" Australian midwifery through to its coming of age.

Hayes leaves a wonderful legacy. Hers was a life well lived and she chose to live most of it for midwifery. She is survived by her brother, Don Hayes, and his family.