Crown Street Hospital, founded in 1893, was to become Sydney’s largest women’s hospital with over 6000 births recorded each year by the early 1960s. It was the centre for major research into pre-eclampsia for which it gained international acclaim in the 1950s, and Dr William McBride from the hospital was credited with discovering the link between thalidomide and birth defects in 1961. But just as significantly as its contributions to medicine was the fact that it impacted on the lives of many Sydney women over its ninety-year history, priding itself on caring for the most impoverished and marginalised women in society and the sickest babies; it was, Godden tells us, ‘a hospital with a heart’. From the time of the 1930s Depression its declared policy was never to turn a woman away, and despite staff shortages and overcrowded wards, with births occurring in corridors, it kept that promise.
This is a commissioned history and as such Godden strove to be comprehensive in telling its story, including management, building construction, finance and staffing issues. These details of the hospital’s institutional history make for less compelling reading (appearing in short sections under subtitles such as ‘Buildings,’ ‘Renovations,’ ‘Administration’ and ‘Board’), and the lack of footnotes detracts from its academic usefulness. Nevertheless, there is much here to keep the reader engaged.
Godden deftly captures the culture of the hospital. We learn how Sydney’s immigrants in the period after the Second World War (particularly Greek, Italian and Maltese women) came from cultures that encouraged the expression of pain and tended to shout loudly during birth, scaring some of the other first-time mothers; epidurals apparently sorted this. Some of the accounts are of pain, suffering and death, sometimes of harsh treatment by staff (this is no romantic history of the hospital), but often of kindness, gentleness and understanding. Godden rightly keeps the midwives in the foreground, not surprisingly given her background in nursing history, and she devotes a whole chapter to Edna Shaw, matron from 1937 to 1952, whom she describes as a nursing icon in the Florence Nightingale tradition.
Marginalised patients who ended up at Crown Street included ‘social outcasts due …to their sexually transmitted diseases (STDs), septic (infected) abortions, and unwelcome pregnancies’ (p.102). Possibly the most interesting side to the hospital was its catering to unmarried mothers (also called ‘waiting patients’) and adoption. Godden discusses this along the way, for instance in a short section entitled ‘The Social Outcasts’ on pp. 102–3, where we learn among other things that unmarried mothers were used in teaching (the hospital was a teaching hospital linked to the University of Sydney), and in the chapter on Shaw and her kindness to unmarried mothers. Godden then devotes a chapter to this, covering the period 1952–73. This chapter draws on a parliamentary inquiry and the narratives that emerged during the inquiry of ‘cruel and misguided treatment’. Yet Godden also acknowledges that personal reflections, like other sources, could be fallible and selective, with memories being influenced by public narratives and responses to current concerns (not least compensation issues). She also cautions that these stories might not be representative. One account which stretches credulity was that of a three-day labour, which resulted from an unnamed professor allowing midwives ‘to push my baby back up the birth canal’ so they could go to the hospital ball (p. 272).
The chapter on measures taken at the hospital to address pre-eclampsia and eclampsia, which affected one in every 300–500 pregnant women in the 1940s, makes for fascinating reading. Antenatal care and a strict diet were the solution to this common and serious medical issue, and the hospital secured the services of the police to help persuade women with worsening pre-eclampsia to be admitted to hospital. The use of police, one doctor pointed out, presumably caused immense fear in migrant women who had lived under Nazi or Communist dictatorships. The harsh treatment extended to the antenatal ward: ‘Our lockers were checked each night after visiting to make sure no food was being smuggled in’. The results of the campaign, overseen by medical superintendent Reginald Hamlin and matron Edna Shaw around 1950, were apparently ‘so astounding that initially many refused to believe it’. Godden cites British obstetrics professor W.I.C. Morris who said that ‘Crown Street Hospital had “shown the world the way” in the most important advance in obstetrics this century’ (p. 159).
The chapter on thalidomide is of course of much wider interest than this hospital’s history. Godden contextualises the tragedy in the light of the post-war innocence relating to drugs and their possible teratogenic effects. She tells how, with his exposure of thalidomide in 1961, McBride became Sydney’s favourite obstetrician, winning honours which included the Order of Australia, as well as a prestigious French prize from the Institut de la Vie in 1971, with which he set up a research institute, Foundation 41. She explains how later, in 1993, he was struck off the medical register for medical fraud relating to experimental results about Debendox, but was conditionally reinstated five years later; she does not go into detail, but the section is intriguingly sub-titled ‘Hubris or a Tall Poppy?’
Finally, mothers’ voices permeate this fascinating social history. For instance one mother who recounted her experience arrived in 1948 following the closure of a private hospital she had booked into. She was shaved, enema-ed, and wheeled into the labour ward, a huge room with beds of screaming women, separated by curtains and with students checking them. After the birth she was wheeled into a corridor for a day or two until a bed in a ward became available. She only had contact with her baby at feeding times, she was in bed for nine days, home on the tenth, ‘with infant dressed by staff in his best outfit’. This would not be the treatment of choice for modern mothers but this mother concluded, ‘It was a magnificent hospital staffed by saints, truly’ (pp. 115–66), a gentle reminder that we should not judge the past.
