Studies in the psychology of sex, volume VI. Sex in Relation to Society by Havelock Ellis. - HTML preview

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freedom, repose,

the cessation of the obligatory routine of

employment become

necessary. This is the opinion of Pinard, the chief

authority on

this matter. Many, however, fearing that economic

and industrial

conditions render so long a period of rest too

difficult of

practical attainment, are, with Clappier and G.

Newman, content

to demand two months as a minimum; Salvat only asks

for one

month's rest before confinement, the woman, whether

married or

not, receiving a pecuniary indemnity during this

period, with

medical care and drugs free. Ballantyne (_Manual of

Antenatal

Pathology: The Foetus_, p. 475), as well as Niven,

also asks only

for one month's compulsory rest during pregnancy,

with indemnity.

Arthur Helme, however, taking a more comprehensive

view of all

the factors involved, concludes in a valuable paper

on "The

Unborn Child: Its Care and Its Rights" (_British

Medical

Journal_, Aug. 24, 1907), "The important thing would be to

prohibit pregnant women from going to work at all,

and it is as

important from the standpoint of the child that this

prohibition

should include the early as the late months of

pregnancy."

In England little progress has yet been made as

regards this

question of rest during pregnancy, even as regards

the education

of public opinion. Sir William Sinclair, Professor

of Obstetrics

at the Victoria University of Manchester, has

published (1907) _A

Plea for Establishing Municipal Maternity Homes_.

Ballantyne, a

great British authority on the embryology of the

child, has

published a "Plea for a Pre-Maternity Hospital"

(_British Medical

Journal_, April 6, 1901), has since given an

important lecture on

the subject (_British Medical Journal_, Jan. 11,

1908), and has

further discussed the matter in his _Manual of Ante-

Natal

Pathology: The Foetus_ (Ch. XXVII); he is, however,

more

interested in the establishment of hospitals for the

diseases of

pregnancy than in the wider and more fundamental

question of rest

for all pregnant women. In England there are,

indeed, a few

institutions which receive unmarried women, with a

record of good

conduct, who are pregnant for the first time, for,

as

Bouchacourt remarks, ancient British prejudices are

opposed to

any mercy being shown to women who are recidivists

in committing

the crime of conception.

At present, indeed, it is only in France that the

urgent need of

rest during the latter months of pregnancy has been

clearly

realized, and any serious and official attempts made

to provide

for it. In an interesting Paris thesis (_De la

Puériculture avant

le Naissance_, 1907) Clappier has brought together

much

information bearing on the efforts now being made to

deal

practically with this question. There are many

_Asiles_ in Paris

for pregnant women. One of the best is the Asile

Michelet,

founded in 1893 by the Assistance Publique de Paris.

This is a

sanatorium for pregnant women who have reached a

period of seven

and a half months. It is nominally restricted to the

admission of

French women who have been domiciled for a year in

Paris, but, in

practice, it appears that women from all parts of

France are

received. They are employed in light and occasional

work for the

institution, being paid for this work, and are also

occupied in

making clothes for the expected baby. Married and

unmarried women

are admitted alike, all women being equal from the

point of view

of motherhood, and indeed the majority of the women

who come to

the Asile Michelet are unmarried, some being girls

who have even

trudged on foot from Brittany and other remote parts

of France,

to seek concealment from their friends in the

hospitable

seclusion of these refuges in the great city. It is

not the least

advantage of these institutions that they shield

unmarried

mothers and their offspring from the manifold evils

to which they

are exposed, and thus tend to decrease crime and

suffering. In

addition to the maternity refuges, there are

institutions in

France for assisting with help and advice those

pregnant women

who prefer to remain at home, but are thus enabled

to avoid the

necessity for undue domestic labor.

There ought to be no manner of doubt that when, as

is the case

to-day in our own and some other supposedly

civilized countries,

motherhood outside marriage is accounted as almost a

crime, there

is the very greatest need for adequate provision for

unmarried

women who are about to become mothers, enabling them

to receive

shelter and care in secrecy, and to preserve their

self-respect

and social position. This is necessary not only in

the interests

of humanity and public economy, but also, as is too

often

forgotten, in the interests of morality, for it is

certain that

by the neglect to furnish adequate provision of this

nature women

are driven to infanticide and prostitution. In

earlier, more

humane days, the general provision for the secret

reception and

care of illegitimate infants was undoubtedly most

beneficial. The

suppression of the mediæval method, which in France

took place

gradually between 1833 and 1862, led to a great

increase in

infanticide and abortion, and was a direct

encouragement to crime

and immorality. In 1887 the Conseil Général of the

Seine sought

to replace the prevailing neglect of this matter by

the adoption

of more enlightened ideas and founded a _bureau

secret

d'admission_ for pregnant women. Since then both the

abandonment

of infants and infanticide have greatly diminished,

though they

are increasing in those parts of France which

possess no

facilities of this kind. It is widely held that the

State should

unify the arrangements for assuring secret

maternity, and should,

in its own interests, undertake the expense. In 1904

French law

ensured the protection of unmarried mothers by

guaranteeing their

secret, but it failed to organize the general

establishment of

secret maternities, and has left to doctors the

pioneering part

in this great and humane public work (A. Maillard-

Brune,

_Refuges, Maternités, Bureaux d'Admission Secrets,

comme Moyens

Préservatives des Infanticide_, Thèse de Paris,

1908). It is not

among the least benefits of the falling birth rate

that it has

helped to stimulate this beneficent movement.

The development of an industrial system which

subordinates the human body

and the human soul to the thirst for gold, has, for a

time, dismissed from

social consideration the interests of the race and even of the individual,

but it must be remembered that this has not been always and everywhere so.

Although in some parts of the world the women of savage peoples work up to

the time of confinement, it must be remarked that the

conditions of work

in savage life do not resemble the strenuous and

continuous labor of

modern factories. In many parts of the world, however, women are not

allowed to work hard during pregnancy and every

consideration is shown to

them. This is so, for instance, among the Pueblo

Indians, and among the

Indians of Mexico. Similar care is taken in the

Carolines and the Gilbert

Islands and in many other regions all over the world. In some places,

women are secluded during pregnancy, and in others are compelled to

observe many more or less excellent rules. It is true

that the assigned

cause for these rules is frequently the fear of evil

spirits, but they

nevertheless often preserve a hygienic value. In many

parts of the world

the discovery of pregnancy is the sign for a festival of more or less

ritual character, and much good advice is given to the expectant mother.

The modern Musselmans are careful to guard the health of their women when

pregnant, and so are the Chinese.[6] Even in Europe, in the thirteenth

century, as Clappier notes, industrial corporations

sometimes had regard

to this matter, and would not allow women to work during pregnancy. In

Iceland, where much of the primitive life of

Scandinavian Europe is still

preserved, great precautions are taken with pregnant

women. They must lead

a quiet life, avoid tight garments, be moderate in

eating and drinking,

take no alcohol, be safeguarded from all shocks, while their husbands and

all others who surround them must treat them with

consideration, save them

from worry and always bear with them patiently.[7]

It is necessary to emphasize this point because we have to realize that

the modern movement for surrounding the pregnant woman with tenderness and

care, so far from being the mere outcome of civilized

softness and

degeneracy, is, in all probability, the return on a

higher plane to the

sane practice of those races which laid the foundations of human

greatness.

While rest is the cardinal virtue imposed on a woman

during the later

months of pregnancy, there are other points in her

regimen that are far

from unimportant in their bearing on the fate of the

child. One of these

is the question of the mother's use of alcohol.

Undoubtedly alcohol has

been a cause of much fanaticism. But the declamatory

extravagance of

anti-alcoholists must not blind us to the fact that the evils of alcohol

are real. On the reproductive process especially, on the mammary glands,

and on the child, alcohol has an arresting and

degenerative influence

without any compensatory advantages. It has been proved by experiments on

animals and observations on the human subject that

alcohol taken by the

pregnant woman passes freely from the maternal

circulation to the foetal

circulation. Féré has further shown that, by injecting alcohol and

aldehydes into hen's eggs during incubation, it is

possible to cause

arrest of development and malformation in the chick.[8]

The woman who is

bearing her child in her womb or suckling it at her

breast would do well

to remember that the alcohol which may be harmless to

herself is little

better than poison to the immature being who derives

nourishment from her

blood. She should confine herself to the very lightest of alcoholic

beverages in very moderate amounts and would do better still to abandon

these entirely and drink milk instead. She is now the

sole source of the

child's life and she cannot be too scrupulous in

creating around it an

atmosphere of purity and health. No after-influence can ever compensate

for mistakes made at this time.[9]

What is true of alcohol is equally true of other potent drugs and poisons,

which should all be avoided so far as possible during

pregnancy because of

the harmful influence they may directly exert on the

embryo. Hygiene is

better than drugs, and care should be exercised in diet, which should by

no means be excessive. It is a mistake to suppose that the pregnant woman

needs considerably more food than usual, and there is

much reason to

believe not only that a rich meat diet tends to cause

sterility but that

it is also unfavorable to the development of the child in the womb.[10]

How far, if at all, it is often asked, should sexual

intercourse be

continued after fecundation has been clearly

ascertained? This has not

always been found an easy question to answer, for in the human couple many

considerations combine to complicate the answer. Even

the Catholic

theologians have not been entirely in agreement on this point. Clement of

Alexandria said that when the seed had been sown the

field must be left

till harvest. But it may be concluded that, as a rule, the Church was

inclined to regard intercourse during pregnancy as at

most a venial sin,

provided there was no danger of abortion. Augustine,

Gregory the Great,

Aquinas, Dens, for instance, seem to be of this mind;

for a few, indeed,

it is no sin at all.[11] Among animals the rule is

simple and uniform; as

soon as the female is impregnated at the period of

oestrus she absolutely

rejects all advance of the male until, after birth and lactation are over,

another period of oestrus occurs. Among savages the

tendency is less

uniform, and sexual abstinence, when it occurs during

pregnancy, tends to

become less a natural instinct than a ritual observance, or a custom now

chiefly supported by superstitions. Among many primitive peoples

abstinence during the whole of pregnancy is enjoined

because it is

believed that the semen would kill the foetus.[12]

The Talmud is unfavorable to coitus during

pregnancy, and the

Koran prohibits it during the whole of the period,

as well as

during suckling. Among the Hindus, on the other

hand, intercourse

is continued up to the last fortnight of pregnancy,

and it is

even believed that the injected semen helps to

nourish the embryo

(W.D. Sutherland, "Ueber das Alltagsleben und die Volksmedizin

unter den Bauern Britischostindiens," _Münchener

Medizinische

Wochenschrift_, Nos. 12 and 13, 1906). The great

Indian physician

Susruta, however, was opposed to coitus during

pregnancy, and the

Chinese are emphatically on the same side.

As men have emerged from barbarism in the direction of civilization, the

animal instinct of refusal after impregnation has been completely lost in

women, while at the same time both sexes tend to become indifferent to

those ritual restraints which at an earlier period were almost as binding

as instinct. Sexual intercourse thus came to be

practiced after

impregnation, much the same as before, as part of

ordinary "marital

rights," though sometimes there has remained a faint suspicion, reflected

in the hesitating attitude of the Catholic Church

already alluded to, that

such intercourse may be a sinful indulgence. Morality

is, however, called

in to fortify this indulgence. If the husband is shut

out from marital

intercourse at this time, it is argued, he will seek

extra-marital

intercourse, as indeed in some parts of the world it is recognized that he

legitimately may; therefore the interests of the wife, anxious to retain

her husband's fidelity, and the interests of Christian morality, anxious

to uphold the institution of monogamy, combine to permit the continuation

of coitus during pregnancy. The custom has been

furthered by the fact

that, in civilized women at all events, coitus during

pregnancy is usually

not less agreeable than at other times and by some women is felt indeed to

be even more agreeable.[13] There is also the further

consideration, for

those couples who have sought to prevent conception,

that now intercourse

may be enjoyed with impunity. From a higher point of

view such intercourse

may also be justified, for if, as all the finer

moralists of the sexual

impulse now believe, love has its value not only in so far as it induces

procreation but also in so far as it aids individual

development and the

mutual good and harmony of the united couple, it becomes morally right

during pregnancy.

From an early period, however, great authorities have

declared themselves

in opposition to the custom of practicing coitus during pregnancy. At the

end of the first century, Soranus, the first of great

gynæcologists,

stated, in his treatise on the diseases of women, that sexual intercourse

is injurious throughout pregnancy, because of the

movement imparted to the

uterus, and especially injurious during the latter

months. For more than

sixteen hundred years the question, having fallen into the hands of the

theologians, seems to have been neglected on the medical side until in

1721 a distinguished French obstetrician, Mauriceau,

stated that no

pregnant woman should have intercourse during the last two months and that

no woman subject to miscarriage should have intercourse at all during

pregnancy. For more than a century, however, Mauriceau remained a pioneer

with few or no followers. It would be inconvenient, the opinion went, even

if it were necessary, to forbid intercourse during

pregnancy.[14]

During recent years, nevertheless, there has been an

increasingly strong

tendency among obstetricians to speak decisively

concerning intercourse

during pregnancy, either by condemning it altogether or by enjoining great

prudence. It is highly probable that, in accordance with the classical

experiments of Dareste on chicken embryos, shocks and

disturbances to the

human embryo may also produce injurious effects on

growth. The disturbance

due to coitus in the early stages of pregnancy may thus tend to produce

malformation. When such conditions are found in the

children of perfectly

healthy, vigorous, and generally temperate parents who have indulged

recklessly in coitus during the early stages of

pregnancy it is possible

that such coitus has acted on the embryo in the same way as shocks and

intoxications are known to act on the embryo of lower

organisms. However

this may be, it is quite certain that in predisposed

women, coitus during

pregnancy causes premature birth; it sometimes happens that labor pains

begin a few minutes after the act.[15] The natural

instinct of animals

refuses to allow intercourse during pregnancy; the

ritual observance of

primitive peoples very frequently points in the same

direction; the voice

of medical science, so far as it speaks at all, is

beginning to utter the

same warning, and before long will probably be in a

position to do so on

the basis of more solid and coherent evidence.

Pinard, the greatest of authorities on puericulture,

asserts that

there must be complete cessation of sexual

intercourse during the

whole of pregnancy, and in his consulting room at

the Clinique

Baudelocque he has placed a large placard with an

"Important

Notice" to this effect. Féré was strongly of opinion that sexual

relations during pregnancy, especially when

recklessly carried

out, play an important part in the causation of

nervous troubles

in children who are of sound heredity and otherwise

free from all

morbid infection during gestation and development;

he recorded in

detail a case which he considered conclusive

("L'Influence de

l'Incontinence Sexuelle pendant la Gestation sur la

Descendance,"

_Archives de Neurologie_, April, 1905). Bouchacourt

discusses the

subject fully (_La Grossesse_, pp. 177-214), and

thinks that

sexual intercourse during pregnancy should be

avoided as much as

possible. Fürbringer (Senator and Kaminer, _Health

and Disease in

Relation to Marriage_, vol. i, p. 226) recommends

abstinence from

the sixth or seventh month, and throughout the whole

of pregnancy

where there is any tendency to miscarriage, while in

all cases

much care and gentleness should be exercised.

The whole subject has been investigated in a Paris

Thesis by H.

Brénot (_De L'Influence de la Copulation pendant la

Grossesse_,

1903); he concludes that sexual relations are

dangerous

throughout pregnancy, frequently provoking premature

confinement

or abortion, and that they are more dangerous in

primiparæ than

in multiparæ.

Nearly everything that has been said of the hygiene of pregnancy, and the

need for rest, applies also to the period immediately

following the birth

of the child. Rest and hygiene on the mother's part

continue to be

necessary alike in her own interests and in the child's.

This need has

indeed been more generally and more practically

recognized than the need

for rest during pregnancy. The laws of several countries make compulsory a

period of rest from employment after confinement, and in some countries

they seek to provide for the remuneration of the mother during this

enforced rest. In no country, indeed, is the principle carried out so

thoroughly and for so long a period as is desirable. But it is the right

principle, and embodies the germ which, in the future, will be developed.

There can be little doubt that whatever are the matters, and they are

certainly many, which may be safely left to the

discretion of the

individual, the care of the mother and her child is not among them. That

is a matter which, more than any other, concerns the

community as a whole,

and the community cannot afford to be slack in asserting its authority

over it. The State needs healthy men and women, and by any negligence in

attending to this need it inflicts serious charges of

all sorts upon

itself, and at the same time dangerously impairs its

efficiency in the

world. Nations have begun to recognize the desirability of education, but

they have scarcely yet begun to realize that the

nationalization of health

is even more important than the nationalization of

education. If it were

necessary to choose between the task of getting children educated and the

task of getting them well-born and healthy it would be better to abandon

education. There have been many great peoples who never dreamed of

national systems of education; there has been no great people without the

art of producing healthy and vigorous children.

This matter becomes of peculiar importance in great

industrial states like

England, the United States, and Germany, because in such states a tacit

conspiracy tends to grow up to subordinate national ends to individual

ends, and practically to work for the deterioration of the race. In

England, for instance, this tendency has become

peculiarly well marked

with disastrous results. The interest of the employed

woman tends to

become one with that of her employer; between them they combine to crush

the interests of the child who represents the race, and to defeat the laws

made in the interests of the race which are those of the community as a

whole. The employed woman wishes to earn as much wages as she can and with

as little interruption as she can; in gratifying that

wish she is, at the

same time, acting in the interests of the employer, who carefully avoids

thwarting her.

This impulse on the employed woman's part is by no means always and

entirely the result of poverty, and would not,

therefore, be removed by

raising her wages. Long before marriage, when little

more than a child,

she has usually gone out to work, and work has become a second nature. She

has mastered her work, she enjoys a certain position and what to her are

high wages; she is among her friends and companions; the noise and bustle

and excitement of the work-room or the factory have

become an agreeable

stimulant which she can no longer do without. On the

other hand, her home

means nothing to her; she only returns there to sleep, leaving it next

morning at day-break or earlier; she is ignorant even of the simplest

domestic arts; she moves about in her own home like a

strange and awkward

child. The mere act of marriage cannot change this state of things;

however willing she may be at marriage to become a

domesticated wife, she

is destitute alike of the inclination or the skill for domesticity. Even

in spite of herself she is driven back to the work-shop, to the one place

where she feels really at home.

In Germany women are not allowed to work for four

weeks after

confinement, nor during the following two weeks

except by medical

certificate. The obligatory insurance against

disease which

covers women at confinement assures them an

indemnity at this

time equivalent to a large part of their wages.

Married and

unmarried mothers benefit alike. The Austrian law is

founded on

the same model. This measure has led to a very great

decrease in

infantile mortality, and, therefore, a great

increase in health

among those who survive. It is, however, regarded as

very

inadequate, and there is a movement in Germany for

extending the

time, for applying the system to a larger number of

women, and

for making it still more definitely compulsory.

In Switzerland it has been illegal since 1877 for

any woman to be

received into a factory after confinement, unless

she has rested

in all for eight weeks, six weeks at least of this

period being

after confinement. Since 1898 Swiss working women

have been

protected by law from exercising hard work during

pregnancy, and

from various other influences likely to be

injurious. But this

law is evaded in practice, because it provides no

compensatory

indemnity for the woman. An attempt, in 1899, to

amend the law by

providing for such indemnity was rejected by the

people.

In Belgium and Holland there are laws against women

working

immediately after confinement, but no indemnity is

provided, so

that employers and employed combine to evade the

law. In France

there is no such law, although its necessity has

often been

emphatically asserted (see, e.g., Salvat, _La

Dépopulation de la

France_, Thèse de Lyon, 1903).

In England it is illegal to employ a woman

"knowingly" in a

work-shop within four weeks of the birth of her

child, but no

provision is made by the law for the compensation of

the woman

who is thus required to sacrifice herself to the

interests of the

State. The woman evades the law in tacit collusion

with her

employers, who can always avoid "knowing" that a birth has taken

place, and so escape all responsibility for the

mother's

employment. Thus the factory inspectors are unable

to take

action, and the law becomes a dead letter; in 1906

only one

prosecution for this offense could be brought into

court. By the

insertion of this "knowingly" a premium is placed on ignorance.

The unwisdom of thus beforehand placing a premium on

ignorance

has always been more or less clearly recognized by

the framers of

legal codes even as far back as the days of the Ten

Commandments

and the laws of Hamurabi. It is the business of the

Court, of

those who administer the law, to make allowance for

ignorance

where such allowance is fairly called for; it is not

for the

law-maker to make smooth the path of the law-

breaker. There are

evidently law-makers nowadays so scrupulous, or so

simple-minded,

that they would be prepared to exact that no

pickpocket should be

prosecuted if he was able to declare on oath that he

had no

"knowledge" that the purse he had taken belonged to the person he

extracted it from.

The annual reports of the English factory inspectors

serve to

bring ridicule on this law, which looks so wisely

humane and yet

means nothing, but have so far been powerless to

effect any

change. These reports show, moreover, that the

difficulty is

increasing in magnitude. Thus Miss Martindale, a

factory

inspector, states that in all the towns she visits,

from a quiet

cathedral city to a large manufacturing town, the

employment of

married women is rapidly increasing; they have

worked in mills or

factories all their lives and are quite unaccustomed

to cooking,

housework and the rearing of children, so that after

marriage,

even when not compelled by poverty, they prefer to

go on working

as before. Miss Vines, another factory inspector,

repeats the

remark of a woman worker in a factory. "I do not

need to work,

but I do not like staying at home," while another woman said, "I

would rather be at work a hundred times than at

home. I get lost

at home" (_Annual Report Chief Inspector of

Factories and

Workshops for 1906_, pp. 325, etc.).

It may be added that not only is the English law

enjoining four

weeks' rest on the mother after childbirth

practically

inoperative, but the period itself is absurdly

inadequate. As a

rest for the mother it is indeed sufficient, but the

State is

still more interested in the child than in its

mother, and the

child needs the mother's chief care for a much

longer period than

four weeks. Helme advocates the State prohibition of

women's work

for at least six months after confinement. Where

nurseries are

attached to factories, enabling the mother to suckle

her infant

in intervals of work, the period may doubtless be

shortened.

It is important to remember that it is by no means

only the women

in factories who are induced to work as usual during

the whole

period of pregnancy, and to return to work

immediately after the

brief rest of confinement. The Research Committee of

the

Christian Social Union (London Branch) undertook, in

1905, an

inquiry into the employment of women after

childbirth. Women in

factories and workshops were excluded from the

inquiry which only

had reference to women engaged in household duties,

in home

industries, and in casual work. It was found that

the majority

carry on their employment right up to the time of

confinement and

resume it from ten to fourteen days later. The

infantile death

rate for the children of women engaged only in

household duties

was greatly lower than that for the children of the

other women,

while, as ever, the hand-fed infants had a vastly

higher death

rate than the breast-fed infants (_British Medical

Journal_, Oct.

24, 1908, p. 1297).

In the great French gun and armour-plate works at

Creuzot (Saône

et Loire) the salaries of expectant mothers among

the employees

are raised; arrangements are made for giving them

proper advice

and medical attendance; they are not allowed to work

after the

middle of pregnancy or to return to work after

confinement

without a medical certificate of fitness. The

results are said to

be excellent, not only on the health of the mothers,

but in the

diminution of premature births, the decrease of

infantile deaths,

and the general prevalence of breast-feeding. It

would probably

be hopeless to expect many employers in Anglo-Saxon

lands to

adopt this policy. They are too "practical," they know how small

is the money-value of human lives. With us it is

necessary for

the State to intervene.

There can be no doubt that, on the whole, modern

civilized

communities are beginning to realize that under the

social and

economic conditions now tending more and more to

prevail, they

must in their own interests insure that the mother's

best energy

and vitality are devoted to the child, both before

and after its

birth. They are also realizing that they cannot

carry out their

duty in this respect unless they make adequate

provision for the

mothers who are thus compelled to renounce their

employment in

order to devote themselves to their children. We

here reach a

point at which Individualism is at one with

Socialism. The

individualist cannot fail to see that it is at all

cost necessary

to remove social conditions which crush out all

individuality;

the Socialist cannot fail to see that a society

which neglects to

introduce order at this central and vital point, the

production

of the individual, must speedily perish.

It is involved in the proper fulfilment of a mother's

relationship to her

infant child that, provided she is healthy, she should suckle it. Of

recent years this question has become a matter of

serious gravity. In the

middle of the eighteenth century, when the upper-class women of France had

grown disinclined to suckle their own children, Rousseau raised so loud

and eloquent a protest that it became once more the

fashion for a woman to

fulfil her natural duties. At the present time, when the same evil is

found once more, and in a far more serious form, for now it is not the

small upper-class but the great lower-class that is

concerned, the

eloquence of a Rousseau would be powerless, for it is

not fashion so much

as convenience, and especially an intractable economic factor, that is

chiefly concerned. Not the least urgent reason for

putting women, and

especially mothers, upon a sounder economic basis, is

the necessity of

enabling them to suckle their children.

No woman is sound, healthy, and complete unless she

possesses

breasts that are beautiful enough to hold the

promise of being

functional when the time for their exercise arrives,

and nipples

that can give suck. The gravity of this question to-

day is shown

by the frequency with which women are lacking in

this essential

element of womanhood, and the young man of to-day,

it has been

said, often in taking a wife, "actually marries but part of a

woman, the other part being exhibited in the

chemist's shop

window, in the shape of a glass feeding-bottle."

Blacker found

among a thousand patients from the maternity

department of

University College Hospital that thirty-nine had

never suckled at

all, seven hundred and forty-seven had suckled all

their

children, and two hundred and fourteen had suckled

only some.

The chief reason given for not suckling was absence

or

insufficiency of milk; other reasons being inability

or

disinclination to suckle, and refusal of the child

to take the

breast (Blacker, _Medical Chronicle_, Feb., 1900).

These results

among the London poor are certainly very much better

than could

be found in many manufacturing towns where women

work after

marriage. In the other large countries of Europe

equally

unsatisfactory results are found. In Paris Madame

Dluska has

shown that of 209 women who came for their

confinement to the

Clinique Baudelocque, only 74 suckled their

children; of the 135

who did not suckle, 35 were prevented by

pathological causes or

absence of milk, 100 by the necessities of their

work. Even those

who suckled could seldom continue more than seven

months on

account of the physiological strain of work (Dluska,

_Contribution à l'Etude de l'Allaitement Maternel_,

Thèse de

Paris, 1894). Many statistics have been gathered in

the German

countries. Thus Wiedow (_Centralblatt für

Gynäkologie_, No. 29,

1895) found that of 525 women at the Freiburg

Maternity only half

could suckle thoroughly during the first two weeks;

imperfect

nipples were noted in 49 cases, and it was found

that the

development of the nipple bore a direct relation to

the value of

the breast as a secretory organ. At Munich Escherich

and Büller

found that nearly 60 per cent. of women of the lower

class were

unable to suckle their children, and at Stuttgart

three-quarters

of the child-bearing women were in this condition.

The reasons why children should be suckled at their

mothers' breasts are

larger than some may be inclined to believe. In the

first place the

psychological reason is one of no mean importance. The breast with its

exquisitely sensitive nipple, vibrating in harmony with the sexual organs,

furnishes the normal mechanism by which maternal love is developed. No

doubt the woman who never suckles her child may love it, but such love is

liable to remain defective on the fundamental and

instinctive side. In

some women, indeed, whom we may hesitate to call

abnormal, maternal love

fails to awaken at all until brought into action through this mechanism by

the act of suckling.

A more generally recognized and certainly fundamental

reason for suckling

the child is that the milk of the mother, provided she is reasonably

healthy, is the infant's only ideally fit food. There

are some people

whose confidence in science leads them to believe that it is possible to

manufacture foods that are as good or better than

mother's milk; they

fancy that the milk which is best for the calf is

equally best for so

different an animal as the baby. These are delusions.

The infant's best

food is that elaborated in his own mother's body. All

other foods are more

or less possible substitutes, which require trouble to prepare properly

and are, moreover, exposed to various risks from which the mother's milk

is free.

A further reason, especially among the poor, against the use of any

artificial foods is that it accustoms those around the child to try

experiments with its feeding and to fancy that any kind of food they eat

themselves may be good for the infant. It thus happens that bread and

potatoes, brandy and gin, are thrust into infants'

mouths. With the infant

that is given the breast it is easier to make plain

that, except by the

doctor's orders, nothing else must be given.

An additional reason why the mother should suckle her

child is the close

and frequent association with the child thus involved.

Not only is the

child better cared for in all respects, but the mother is not deprived of

the discipline of such care, and is also enabled from

the outset to learn

and to understand the child's nature.

The inability to suckle acquires great significance

if we realize

that it is associated, probably in a large measure

as a direct

cause, with infantile mortality. The mortality of

artificially-fed infants during the first year of

life is seldom

less than double that of the breast-fed, sometimes

it is as much

as three times that of the breast-fed, or even more;

thus at

Derby 51.7 per cent. of hand-fed infants die under

the age of

twelve months, but only 8.6 per cent. of breast-fed

infants.

Those who survive are by no means free from

suffering. At the end

of the first year they are found to weigh about 25

per cent. less

than the breast-fed, and to be much shorter; they

are more liable

to tuberculosis and rickets, with all the evil

results that flow

from these diseases; and there is some reason to

believe that the

development of their teeth is injuriously affected.

The

degenerate character of the artificially-fed is well

indicated by

the fact that of 40,000 children who were brought

for treatment

to the Children's Hospital in Munich, 86 per cent.

had been

brought up by hand, and the few who had been suckled

had usually

only had the breast for a short time. The evil

influence persists

even up to adult life. In some parts of France where

the