Story: Women’s health
Page 2 – Māori women’s health, pre-colonial times to 1940s
Health before European contact
Māori health in the pre-European period can be only broadly sketched, due to a lack of information. In the late 18th century the Māori population was about 90,000–100,000. Estimates of the birth rate suggest that each woman had an average of about five births. The rate of maternal mortality (death during or as a result of childbirth) is unknown, but it, combined with the burden of childbearing, may have meant that women did not live as long as men.
Māori were free of many of the infectious diseases Europeans suffered from. Heart disease and cancer, both diseases of older age, were probably uncommon. Skin diseases (such as scabies), arthritis and rheumatism were present, and dental problems were a serious threat to health.
Can’t go, won’t go
While some hospitals refused to admit Māori, many Māori refused to go to hospital. Hospitals were where you went to die, where you were cut up after death, where a baby’s iho (umbilical cord) and whenua (placenta) were not treated with respect.
Health after European contact
Since European colonisation, the health of Māori women has been notably worse than that of New Zealand women generally.
From the mid-19th century infectious disease, loss of resources and, to a much lesser extent, wars caused the Māori population to more than halve. At its lowest, in 1891, Māori numbered barely 42,000.
During these years of catastrophic population loss, more adult women than men died. One result was fewer women than men in the Māori population: in 1857–58, for example, there were 130 men for every 100 women. (Although the ratio changed, women continued to be outnumbered until the mid-20th century.)
In addition to killing people, infectious disease limited births. The result of syphilis and gonorrhoea for Māori women was a high level of infertility – around 35% had no children in the 1850s. In a culture that favoured high fertility, and valued children and women’s childbearing capacity, this, combined with the high death rate at the time, was a disaster.
Death in childbirth
The importance of women within Māori society was vividly expressed by the traditional proverb: mate i te tamaiti he aurukōwhao; mate i te wahine he takerehāia. (The death of a child may be overcome, but the death of a woman is a calamity.)
Maternal deaths and birth rates
Rates of maternal mortality in 19th- and early 20th-century Māori communities are unknown, as the first figures were not collected until 1920. In that year nearly 23 Māori women died for every 1,000 live births. (The rate amongst Pākehā women was 6.5 per 1,000 live births.) This figure, high as it is, was probably an underestimate: Māori deaths were not reliably reported until after the Second World War.
Increasing immunity and a high birth rate saw the Māori population recover. The number of children per 100 women rose from 87 in the mid-19th century to 127 in 1901. By 1945, the population reached 115,646.
Māori women’s access to medical help was limited by a number of factors:
- the loss of tohunga and traditional medical knowledge through population decline
- the scarcity of hospitals and doctors in the rural areas where most Māori lived
- the refusal of some hospitals to admit Māori
- the reluctance of some doctors to treat Māori
- Māori women’s reluctance to be examined by male doctors (almost invariably Pākehā).