Ross Howie: Safe childbirth central goal

Opinion

Dennis Bonham "is best remembered for his part in what became known as 'the unfortunate experiment at National Women's Hospital'." So said the obituary published in the Weekend Herald of May 14 (link below). Who could differ with the conclusions of what was so authoritatively billed as the "last word"?

Well, many people; I for one. Professor Bonham had his critics (me among them at times), but he did more good for the health of New Zealanders than any of them, indeed possibly more than any other single individual in the past 50 years. He deserves far more recognition for this than he ever got in his lifetime. Who else in the health field in his time had his range of achievements?

He worked tirelessly and well to make childbirth in New Zealand safer than it had ever been. This was his central goal in a remarkable combination of research, education and action.

The success of the effort is a matter of record. Childbirth not only became safer for mothers as a result of his work on maternal mortality, but baby deaths in New Zealand fell by nearly 80 per cent between 1950 and 1990 (perinatal mortality figures respectively 34.6 and 7.4 per 1000 births by the definition of the time). This is probably the greatest - if least recognised and appreciated - advance in public health in this country during that time. It meant a saving of more than 1500 babies a year.

Of course this was the result of the combined efforts of all involved, but it would not have happened without the energy and leadership of Dennis Bonham and his predecessor Harvey Carey. Most of the improvement was seen in Professor Bonham's years.

He encouraged, as few before him, a wide collaboration of all involved in the field of childbirth. A reflection of this was his founding of the Perinatal Society of New Zealand just 25 years ago. The results of his efforts in saving babies owed much to the kind of co-operative approach that he fostered.

He gave notable support to research by others in his department, much of which gained international recognition. One of the projects was said by many to be the greatest world advance in the field in its time.

He played a large part in setting up the Auckland School of Medicine as chairman of its establishment committee. He showed in this, as in other activities, great energy, effectiveness, and a readiness to innovate.

For one working in New Zealand, he had an unusual international outlook. He trained and encouraged obstetricians for the Pacific Islands and Southeast Asia. In this and in work as a consultant for the World Health Organisation his influence extended far beyond this country.

Paradoxically, given the views of some feminists, he probably did more than any other head of department in the medical school to encourage women into his specialty. And much more.

He had a bad press, but did not deserve the opprobrium he faced. It seems to be a law of public health almost as much as of physics that for every action there is an equal and opposite reaction. The history of maternity services, and of immunisation, are examples. Happily the opposite reaction is not quite equal, or we would still be in the Dark Ages - but that risk is worryingly ever there. Ask some mothers who have lost babies in recent years.

There is something very wrong with the priorities of a society that is not prepared to give credit where it is so patently due. Dennis Bonham deserves our most grateful thanks. One day, when the country wakes out of the stupor of political correctness it has been in for the past 20 years, I am confident he will get them.

* Ross Howie worked as a paediatrician with Dennis Bonham for 25 years, and with others - notably Sir Graham Liggins - in research on preventing respiratory disorders in babies born prematurely.