Elizabeth was born in 1946 in the South Island of New Zealand and undertook her nursing training in the 1960s. Elizabeth and her husband have three children. Elizabeth worked in a variety of nursing roles until taking up a position as a Plunket nurse in 1988. She is currently a practicing Plunket nurse in the South Island.
…I do like to write down what the mother actually says to me, in her words. I like to do that. That is about… a lot more about development and less about eating and food. That is definitely a spin over from my own experience...
Vignette 24 Ronda (40)
Ronda was born in 1964 in New Plymouth. Although originally starting a Bachelors of Science degree, the birth of her first child meant a break from study. After her first three children, Ronda felt the need to return to study and with the support of her husband, Ronda started studying for her Bachelor of Midwifery. Following completion of her training, Ronda has worked in a variety of midwifery roles and has had two more children. Ronda
currently works as a midwife in Auckland.
…if the Plunket nurse has come on the Monday and weighed the baby there is absolutely no need for the baby to be weighed again or sometimes the mother’s just like “I forgot to mention this with her”, so you still carry on with things like that. But generally it’s more focus on the mother after that…
I see it that once you give the ownership of the book to the caregiver you can see the light turn on in them and “oh yes, can I write in this?” And you say “of course, it’s your book, it’s your child’s book and what you write in there is so that you can look back with them on what they were doing” (Rachel, 49)629
When Nicholas’ mum received his Plunket book in hospital, she also received an accompanying book called ‘Thriving Under Five’. This book provided further information on child raising for Nicholas’ mum and remained in the bookshelf next to the Plunket book. Nicholas’ mum also referred to other child care books to help her find information about child care including books by Christopher Green,630 Penelope Leach,631 and Miriam Stoppard.632 Along with these practical guides, Nicholas’ mum also subscribed to and read the Little Treasures parenting magazine, published by a disposable diaper company. The World Wide Web was also accessible for
Nicholas’ mum and she frequently sought information on the internet with regards to parenting.
Despite Nicholas’ Plunket nurses offering considerable individual support and care to Nicholas’ mum, Nicholas’ Plunket book itself still does not at any point recognize the knowledge or experience Nicholas’ mum has in caring for Nicholas. The book encourages the mother to ‘be patient’, to ‘seek help’, to ‘eat and sleep well’, and to ‘share feelings’.633 Nowhere does the book provide written
affirmation that the mother herself holds any knowledge of value. The assumption is that the mother knows nothing of children or babies. The
629 Interview with Rachel, 8 November 2004, paragraph 87
630 C. Green, Babies! A Parent's Guide to Surviving (and Enjoying) Baby's First Year (East
Roseville: NSW: Simon & Schuster, 1999).
631 P. Leach, Baby and Child (London: M. Joseph, 1988).
632 M. Stoppard, Complete Baby and Child Care (London: Dorling Kindersley, 1995). 633 Plunket book PB JC1, 1998
Vignette 25 Rachel (49)
Rachel was born in 1956 in England and arrived in New Zealand three years later with her parents and three siblings. She had a varied childhood living in a number of remote and island regions. Rachel initially trained as a dental therapist. She is married with two daughters and currently works as a Plunket nurse in Auckland.
I just really felt like I fell into Plunket with a lot of life experiences. I’d had postnatal depression with both my girls. So I guess that gave me insight. I hadn’t felt myself that parenting was easy, still don’t through the life challenges or the life span. Yeah, so I just really loved it right from the start. And really felt that I could give something back to women.
organisation continues to hold the conviction that medical knowledge is paramount in the care of children.
The period from Nicholas’ birth through to 2008 when this thesis was completed, was a period of relative stability in New Zealand. Unemployment was very low and economically, New Zealand was holding its own in international markets with the formation of several large global companies based in New Zealand such as Fonterra, now the largest dairy products export company in the world.634 In terms of the social context for families, paid parental leave was in the process of being introduced and from 2002, New Zealand mothers were eligible for 12 weeks paid parental leave.635 This was increased to 13 weeks in 2004,636 and to 14 weeks in 2006.637 Many mothers were now working or intended to return to work after the birth of their child. Children, however, were likely to spend longer in the family home due to governmental policies around student support,638 and house prices were high and continuing to rise making it less likely for young families to own their own home. In terms of well child care, services were provided for all parents by either the Plunket Society or other well child providers – often Maori or Pacific Island health services – for example Te Ha o Te Oranga in Northland and Tuariki Healthcare in South Auckland.639 ‘By Maori for Maori’ initiatives saw uptake of the provision of well child care by Maori and Pacific providers for their own people increase and parents were able to choose who would be
providing well child care to their child and when they wished to cease the service.640
634 Fonterra, About Us, 2008, Available:
http://www.fonterra.com/wps/wcm/connect/fonterracom/fonterra.com/our+business/fonterra+at+a +glance/about+us/key+facts, 2 April 2008.
635 "Parental Leave and Employment Protection (Paid Parental Leave) Amendment Act 2002,"
(New Zealand: 2002), vol.
636 "Parental Leave and Employment Protection Amendment Act 2004," (New Zealand: 2004),
vol.
637 "Parental Leave and Employment Protection (Paid Parental Leave for Self-Employed Persons)
Amendment Act 2006," (New Zealand: 2006), vol.
638 S. Hillcoat-Nalletamby and A. Dharmalingam, "Midlife Parental Support for Adult Children in
New Zealand," Journal of Sociology 39.3 (2003).
639 Ministry of Health, Well Child Service Specification 2002 (Wellington: Ministry of Health,
2002).
Conclusion
The Plunket book came into being as a result of professional development in nursing practice in the early 1920s. Initially a small book consisting of a weight chart, a small space for the nurse to write directives, and a small amount of printed information for the mother, the book has developed over time into a resource that the mother can use both as a guide and as a record of her child’s growth and development. The book now contains numerous pages of
information, a selection of weight charts, space for the mother to write and record information about her child, and age dictated forms for nurses, lead maternity carers and doctors to complete.
Early books contained strict instructions for mothers to follow as they cared for their infants; the approach was prescriptive. There were particular emphases on weight and feeding (including meticulous recipes for milk and food preparation, and strict timetables). Early books reflected the strict routines advocated for by Truby King and others around the world as a means of reducing infant mortality rates. By the early to mid 1950s, changes in the attitude and approach of the Plunket Society and Plunket nurses were starting to occur. Formal recognition of the importance of milestones as a measure of development rather than solely weight was included in the books. Directives became increasingly conciliatory and descriptive. By the 1960s there is evidence of the use of anticipatory guidance in the books and by the 1970s, the book finally advocates the
importance of love, protection and psychological development of the child in a manner similar to that seen as early as the 1950s in the United States. Significant changes occurred when publication of the book shifted from the Plunket Society to the Department of Health in the early 1980s. The new book contained a vast proportion of the information a Plunket nurse would normally have sat down and written in the book for a mother, now she was simply required to tick some boxes. However, the increased information was seen as valuable by participants in this study and the book continues to follow a similar format to the 1980s book in 2008.
Despite a clear biomedical framework of practice, signs of resistance by nurses to medical practitioners and governing bodies were present in the books. This was initially evident when nurses continued to offer prescriptions for treatment in the books after being ordered not to, and was latterly evident in a refusal to use the prescribed checklists in the new Department of Health books. Some mothers also offered resistance, writing in books when this was not expected. Mothers are now encouraged to write their own notes in the book. Despite these changes, Plunket books still do not recognise the knowledge and expertise potentially held by the mother herself. The belief remains that motherhood must be directed by a medical or nursing professional.
A chronological reflection on the book offers an understanding of how and why the book has developed in relation to societal change. Presenting real life examples of children’s books however, brings to life the experiences of mothers as they have cared for their children over time and provides an emotional context to our understanding of the book. The emotional context also offers possible understandings of why the book is kept and handed on from generation to generation. The real life examples in this chapter are recognisable as common experiences of motherhood. There is a resonance in each example that a mother may feel in relation to her own experiences. This resonance acknowledges the joy, the difficulties, the struggles and the rewards of motherhood, offering each mother an enhanced understanding of her own role as mother, particularly in relation to the continuity of motherhood across time. The book as a feature of motherhood in New Zealand provides the mother with affirmation of her role as mother. It is partially the content of the book and partially what the book represents that makes it important to the individual. The next chapter of this thesis examines the role of the Plunket book in the identify formation of the mother in New Zealand.