Book Review

Janet McCalman's work provides us with an insight into the medicalised world of childbirth from the mid-nineteenth century to the present. Through the history of one women's hospital the changes in medical treatment of women's reproductive health is detailed. This hospital history is primarily a medical history, not a social, administrative or workers history; but the emphasis in this book provides valuable information on medical and nursing practice—information that is not available elsewhere. Documents detailing daily practice in hospitals are a rare find and it is even rarer still that these documents are used to write a work that is accessible to the scholar and interested citizen. McCalman makes excellent use of a very rich source of hospital documents that includes detailed and comprehensive case histories. The latter chapters on practice since the 1950s include extensive oral history evidence from both nursing staff and former patients. This extends the details of daily practice and provides an insight into the lives of both nurses and patients.	1
This book is not for the squeamish, at least not the chapters on the nineteenth century. Lengthy case histories of extended suffering provide us with a window from which to view many tragic cases. In the nineteenth century, before major use of anaesthetics, performance of a range of operations and drug treatment really did lead to a world of 'sex and suffering' for some women. Because it is a hospital history it is easy to come away with the impression that all childbirth in the nineteenth century was dangerous and required medical intervention. This was not the case as most births were routine and death resulted in a relatively small number of cases. In contrast to the myriad of births that occurred in homes, this history records numerous very difficult cases where medical and nursing knowledge and skills were often found wanting in the nineteenth century. The changing relationship between the patient and the hospital in the twentieth century is recorded in the change from all births being emergency admissions to the development of pre-natal care.	2
The rich sources that this history uses to great effect lead, in part, to a history guided by the views and deeds of the leading medical men who were so influential in the development of the Women's Hospital. The leading medical men frequently created the records and other staff, and indeed the patients themselves, have left us less documentation. This can mean that the history is written from the perspective of the leading medical men, presenting an aspect of heroic recovery and the brave medical men who battled to achieve this. This view is alleviated in chapter 13 where McCalman details nurses' work practices and views. Focused on the twentieth century, this chapter relies on detailed oral interviews and opens up the world of the nurse and the mother and the normal delivery. Chapter 9 also opens up the world of the nurse through use of the midwifery case book for the years 1920 to 1931 and provides a rare and beautifully written account of the depths of poverty in some Melbourne suburbs.	3
Most hospital histories are eulogistic. This one is not. A few provide insights for the interested reader and the scholar and this is one of these. The sources have largely dictated the direction of the history and it has emerged as a medical history. This is valuable as records of medical techniques and their use in hospitals are rare. At the same time there are insights into aspects of the administration of the hospital and the social milieu. Extensive and lengthy quotes, as well as plentiful illustrations, add to the knowledge conveyed in this book. The clear explanation of medical terms is also a bonus. McCalman has used the vehicle of a hospital history to detail the treatment changes in the nineteenth and twentieth centuries in a women's hospital and this provides a valuable work on medical practice.	4
University of Newcastle GLENDA STRACHAN

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