Chapter 2

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 individualdevelopment 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 coitusduring 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.

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 withdisastrous 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 economicconditions 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.

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 economicconditions 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, andtwo 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 areas 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 wet-nurse industryflourishes so greatly that nearly all the children are brought up by hand, it has been found that the percentage of rejected conscripts is nearly double that for France generally. Corresponding results have been found by Friedjung in a large German athletic association. Among 155 members, 65 per cent. were found on inquiry to have been breast-fed as infants (for an average of six months); but among the best athletes the percentage of breast-fed rose to 72 per cent. (for an average period of nine or ten months), while for the group of 56 who stood lowest in athletic power the percentage of breast-fed fell to 57 (for an average of only three months).The advantages for an infant of being suckled by its mother are greater than can be accounted for by the mere fact of being suckled rather than hand-fed. This has been shown by Vitrey (De la Mortalité Infantile, Thèse de Lyon, 1907), who found from the statistics of the Hôtel-Dieu at Lyons, that infants suckled by their mothers have a mortality of only 12 per cent., but if suckled by strangers, the mortality rises to 33 per cent. It may be added that, while suckling is essential to the complete well-being of the child, it is highly desirable for the sake of the mother's health also. (Some important statistics are summarized in a paper on "Infantile Mortality" inBritish Medical Journal, Nov. 2, 1907), while the various aspects of suckling have been thoroughly discussed by Bollinger, "Ueber Säuglings-Sterblichkeit und die Erbliche functionelle Atrophie der menschlichen Milchdrüse" (Correspondenzblatt Deutschen Gesellschaft Anthropologie, Oct., 1899).It appears that in Sweden, in the middle of the eighteenth century, it was a punishable offense for a woman to give her baby the bottle when she was able to suckle it. In recent years Prof. Anton von Menger, of Vienna, has argued (in hisBurgerliche Recht und die Besitzlosen Klassen) that the future generation has the right to make this claim, and he proposes that every mother shall be legally bound to suckle her child unless her inability to do so has been certified by a physician. E. A. Schroeder (Das Recht in der Geschlechtlichen Ordnung, 1893, p. 346) also argued that a mother should be legally bound to suckle her infant for at least nine months, unless solid grounds could be shown to the contrary, and this demand, which seems reasonable and natural, since it is a mother's privilege as well as her duty to suckle her infant when able to do so, has been insistently made by others also. It has been supported from the legal side by Weinberg (Mutterschutz, Sept., 1907). In France the Loi Roussel forbids a woman to act as a wet-nurse until her child is seven months old, and this has had an excellent effect in lowering infantile mortality (A. Allée,Puériculture et la Loi Roussel, Thèse de Paris, 1908). In some parts of Germany manufacturers are compelled to set up a suckling-room in the factory, where mothers can give the breast to the child in the intervals of work. Thecontrol and upkeep of these rooms, with provision of doctors and nurses, is undertaken by the municipality (Sexual-Probleme, Sept., 1908, p. 573).

The advantages for an infant of being suckled by its mother are greater than can be accounted for by the mere fact of being suckled rather than hand-fed. This has been shown by Vitrey (De la Mortalité Infantile, Thèse de Lyon, 1907), who found from the statistics of the Hôtel-Dieu at Lyons, that infants suckled by their mothers have a mortality of only 12 per cent., but if suckled by strangers, the mortality rises to 33 per cent. It may be added that, while suckling is essential to the complete well-being of the child, it is highly desirable for the sake of the mother's health also. (Some important statistics are summarized in a paper on "Infantile Mortality" inBritish Medical Journal, Nov. 2, 1907), while the various aspects of suckling have been thoroughly discussed by Bollinger, "Ueber Säuglings-Sterblichkeit und die Erbliche functionelle Atrophie der menschlichen Milchdrüse" (Correspondenzblatt Deutschen Gesellschaft Anthropologie, Oct., 1899).

It appears that in Sweden, in the middle of the eighteenth century, it was a punishable offense for a woman to give her baby the bottle when she was able to suckle it. In recent years Prof. Anton von Menger, of Vienna, has argued (in hisBurgerliche Recht und die Besitzlosen Klassen) that the future generation has the right to make this claim, and he proposes that every mother shall be legally bound to suckle her child unless her inability to do so has been certified by a physician. E. A. Schroeder (Das Recht in der Geschlechtlichen Ordnung, 1893, p. 346) also argued that a mother should be legally bound to suckle her infant for at least nine months, unless solid grounds could be shown to the contrary, and this demand, which seems reasonable and natural, since it is a mother's privilege as well as her duty to suckle her infant when able to do so, has been insistently made by others also. It has been supported from the legal side by Weinberg (Mutterschutz, Sept., 1907). In France the Loi Roussel forbids a woman to act as a wet-nurse until her child is seven months old, and this has had an excellent effect in lowering infantile mortality (A. Allée,Puériculture et la Loi Roussel, Thèse de Paris, 1908). In some parts of Germany manufacturers are compelled to set up a suckling-room in the factory, where mothers can give the breast to the child in the intervals of work. Thecontrol and upkeep of these rooms, with provision of doctors and nurses, is undertaken by the municipality (Sexual-Probleme, Sept., 1908, p. 573).

As things are to-day in modern industrial countries the righting of these wrongs cannot be left to Nature, that is, to the ignorant and untrained impulses of persons who live in a whirl of artificial life where the voice of instinct is drowned. The mother, we are accustomed to think, may be trusted to see to the welfare of her child, and it is unnecessary, or even "immoral," to come to her assistance. Yet there are few things, I think, more pathetic than the sight of a young Lancashire mother who works in the mills, when she has to stay at home to nurse her sick child. She is used to rise before day-break to go to the mill; she has scarcely seen her child by the light of the sun, she knows nothing of its necessities, the hands that are so skilful to catch the loom cannot soothe the child. The mother gazes down at it in vague, awkward, speechless misery. It is not a sight one can ever forget.

It is France that is taking the lead in the initiation of the scientific and practical movements for the care of the young child before and after birth, and it is in France that we may find the germs of nearly all the methods now becoming adopted for arresting infantile mortality. The village system of Villiers-le-Duc, near Dijon in the Côte d'Or, has proved a germ of this fruitful kind. Here every pregnant woman not able to secure the right conditions for her own life and that of the child she is bearing, is able to claim the assistance of the village authorities; she is entitled, without payment, to the attendance of a doctor and midwife and to one franc a day during her confinement. The measures adopted in this village have practically abolished both maternal and infantile mortality. A few years ago Dr. Samson Moore, the medical officer of health for Huddersfield, heard of this village, and Mr. Benjamin Broadbent, the Mayor of Huddersfield, visited Villiers-le-Duc. It was resolved to initiate in Huddersfield a movement for combating infant mortality. Henceforth arose what is known as the Huddersfield scheme, a scheme which has been fruitful in splendid results. The pointsof the Huddersfield scheme are: (1) compulsory notification of births within forty-eight hours; (2) the appointment of lady assistant medical officers of help to visit the home, inquire, advise, and assist; (3) the organized aid of voluntary lady workers in subordination to the municipal part of the scheme; (4) appeal to the medical officer of help when the baby, not being under medical care, fails to thrive. The infantile mortality of Huddersfield has been very greatly reduced by this scheme.[16]

The Huddersfield scheme may be said to be the origin of the English Notification of Births Act, which came into operation in 1908. This Act represents, in England, the national inauguration of a scheme for the betterment of the race, the ultimate results of which it is impossible to foresee. When this Act comes into universal action every baby of the land will be entitled—legally and not by individual caprice or philanthropic condescension—to medical attention from the day of birth, and every mother will have at hand the counsel of an educated woman in touch with the municipal authorities. There could be no greater triumph for medical science, for national efficiency, and the cause of humanity generally. Even on the lower financial plane, it is easy to see that an enormous saving of public and private money will thus be effected. The Act is adoptive, and not compulsory. This was a wise precaution, for an Act of this kind cannot be effectual unless it is carried out thoroughly by the community adopting it, and it will not be adopted until a community has clearly realized its advantages and the methods of attaining them.An important adjunct of this organization is the School for Mothers. Such schools, which are now beginning to spring up everywhere, may be said to have their origins in theConsultations de Nourrissons(with their offshoot theGoutte de Lait), established by Professor Budin in 1892, which have spread all over France and been widely influential for good. At theConsultationsinfants are examined and weighed weekly, and the mothers advised and encouraged to suckle their children. TheGouttesare practically milk dispensaries where infants for whom breast-feeding is impossible are fed with milk under medical supervision. Schools for Mothers represent an enlargement of the same scheme, covering a variety of subjects which it is necessary for a mother to know. Some of the first of these schools were established at Bonn, at the Bavarian town of Weissenberg, and in Ghent. At some of theSchools for Mothers, and notably at Ghent (described by Mrs. Bertrand Russell in theNineteenth Century, 1906), the important step has been taken of giving training to young girls from fourteen to eighteen; they receive instruction in infant anatomy and physiology, in the preparation of sterilized milk, in weighing children, in taking temperatures and making charts, in managing crêches, and after two years are able to earn a salary. In various parts of England, schools for young mothers and girls on these lines are now being established, first in London, under the auspices of Dr. F. J. Sykes, Medical Officer of Health for St. Pancreas (see,e.g.,A School For Mothers, 1908, describing an establishment of this kind at Somers Town, with a preface by Sir Thomas Barlow; an account of recent attempts to improve the care of infants in London will also be found in theLancet, Sept. 26, 1908). It may be added that some English municipalities have established depôts for supplying mothers cheaply with good milk. Such depôts are, however, likely to be more mischievous than beneficial if they promote the substitution of hand-feeding for suckling. They should never be established except in connection with Schools for Mothers, where an educational influence may be exerted, and no mother should be supplied with milk unless she presents a medical certificate showing that she is unable to nourish her child (Byers, "Medical Women and Public Health Questions,"British Medical Journal, Oct. 6, 1906). It is noteworthy that in England the local authorities will shortly be empowered by law to establish Schools for Mothers.The great benefits produced by these institutions in France, both in diminishing the infant mortality and in promoting the education of mothers and their pride and interest in their children, have been set forth in two Paris theses by G. Chaignon (Organisation des Consultations de Nourrissons à la Campagne, 1908), and Alcide Alexandre (Consultation de Nourrissons et Goutte de Lait d'Arques, 1908).The movement is now spreading throughout Europe, and an International Union has been formed, including all the institutions specially founded for the protection of child life and the promotion of puericulture. The permanent committee is in Brussels, and a Congress of Infant Protection (Goutte de Lait) is held every two years.

An important adjunct of this organization is the School for Mothers. Such schools, which are now beginning to spring up everywhere, may be said to have their origins in theConsultations de Nourrissons(with their offshoot theGoutte de Lait), established by Professor Budin in 1892, which have spread all over France and been widely influential for good. At theConsultationsinfants are examined and weighed weekly, and the mothers advised and encouraged to suckle their children. TheGouttesare practically milk dispensaries where infants for whom breast-feeding is impossible are fed with milk under medical supervision. Schools for Mothers represent an enlargement of the same scheme, covering a variety of subjects which it is necessary for a mother to know. Some of the first of these schools were established at Bonn, at the Bavarian town of Weissenberg, and in Ghent. At some of theSchools for Mothers, and notably at Ghent (described by Mrs. Bertrand Russell in theNineteenth Century, 1906), the important step has been taken of giving training to young girls from fourteen to eighteen; they receive instruction in infant anatomy and physiology, in the preparation of sterilized milk, in weighing children, in taking temperatures and making charts, in managing crêches, and after two years are able to earn a salary. In various parts of England, schools for young mothers and girls on these lines are now being established, first in London, under the auspices of Dr. F. J. Sykes, Medical Officer of Health for St. Pancreas (see,e.g.,A School For Mothers, 1908, describing an establishment of this kind at Somers Town, with a preface by Sir Thomas Barlow; an account of recent attempts to improve the care of infants in London will also be found in theLancet, Sept. 26, 1908). It may be added that some English municipalities have established depôts for supplying mothers cheaply with good milk. Such depôts are, however, likely to be more mischievous than beneficial if they promote the substitution of hand-feeding for suckling. They should never be established except in connection with Schools for Mothers, where an educational influence may be exerted, and no mother should be supplied with milk unless she presents a medical certificate showing that she is unable to nourish her child (Byers, "Medical Women and Public Health Questions,"British Medical Journal, Oct. 6, 1906). It is noteworthy that in England the local authorities will shortly be empowered by law to establish Schools for Mothers.

The great benefits produced by these institutions in France, both in diminishing the infant mortality and in promoting the education of mothers and their pride and interest in their children, have been set forth in two Paris theses by G. Chaignon (Organisation des Consultations de Nourrissons à la Campagne, 1908), and Alcide Alexandre (Consultation de Nourrissons et Goutte de Lait d'Arques, 1908).

The movement is now spreading throughout Europe, and an International Union has been formed, including all the institutions specially founded for the protection of child life and the promotion of puericulture. The permanent committee is in Brussels, and a Congress of Infant Protection (Goutte de Lait) is held every two years.

It will be seen that all the movements now being set in action for the improvement of the race through the child and the child's mother, recognize the intimacy of the relation between the mother and her child and are designed to aid her, even if necessary by the exercise of some pressure, in performing her natural functions in relation to her child. To the theoretical philanthropist, eager to reform the world on paper, nothing seemssimpler than to cure the present evils of child-rearing by setting up State nurseries which are at once to relieve mothers of everything connected with the production of the men of the future beyond the pleasure—if such it happens to be—of conceiving them and the trouble of bearing them, and at the same time to rear them up independently of the home, in a wholesome, economical, and scientific manner.[17]Nothing seems simpler, but from the fundamental psychological standpoint nothing is falser. The idea of a State which is outside the community is but a survival in another form of that antiquated notion which compelled Louis XIV to declare "L'Etat c'est moi!" A State which admits that the individuals composing it are incompetent to perform their own most sacred and intimate functions, and takes upon itself to perform them instead, attempts a task which would be undesirable, even if it were possible of achievement. It must always be remembered that a State which proposes to relieve its constituent members of their natural functions and responsibilities attempts something quite different from the State which seeks to aid its members to fulfil their own biological and social functions more adequately. A State which enables its mothers to rest when they are child-bearing is engaged in a reasonable task; a State which takes over its mothers' children is reducing philanthropy to absurdity. It is easy to realize this if we consider the inevitable course of circumstances under a system of "State-nurseries." The child would be removed from its natural mother at the earliest age, but some one has to perform the mother's duties; the substitute must therefore be properly trained for such duties; and in exercising them under favorable circumstances a maternal relationship is developed between the child and the "mother," who doubtless possesses natural maternal instincts but has no naturalmaternal bond to the child she is mothering. Such a relationship tends to become on both sides practically and emotionally the real relationship. We very often have opportunity of seeing how unsatisfactory such a relationship becomes. The artificial mother is deprived of a child she had begun to feel her own; the child's emotional relationships are upset, split and distorted; the real mother has the bitterness of feeling that for her child she is not the real mother. Would it not have been much better for all if the State had encouraged the vast army of women it had trained for the position of mothering other women's children, to have, instead, children of their own? The women who are incapable of mothering their own children could then be trained to refrain from bearing them.

Ellen Key (in herCentury of the Child, and elsewhere) has advocated for all young women a year of compulsory "service," analogous to the compulsory military service imposed in most countries on young men. During this period the girl would be trained in rational housekeeping, in the principles of hygiene, in the care of the sick, and especially in the care of infants and all that concerns the physical and psychic development of children. The principle of this proposal has since been widely accepted. Marie von Schmid (in herMutterdienst, 1907) goes so far as to advocate a general training of young women in such duties, carried on in a kind of enlarged and improved midwifery school. The service would last a year, and the young woman would then be for three years in the reserves, and liable to be called up for duty. There is certainly much to be said for such a proposal, considerably more than is to be said for compulsory military service. For while it is very doubtful whether a man will ever be called on to fight, most women are liable to be called on to exercise household duties or to look after children, whether for themselves or for other people.

[1]

It is not, of course, always literally true that each parent supplies exactly half the heredity, for, as we see among animals generally, the offspring may sometimes approach more nearly to one parent, sometimes to the other, while among plants, as De Vries and others have shown, the heredity may be still more unequally divided.

[2]

It should scarcely be necessary to say that to assert that motherhood is a woman's supreme function is by no means to assert that her activities should be confined to the home. That is an opinion which may now be regarded as almost extinct even among those who most glorify the function of woman as mother. As Friedrich Naumann and others have very truly pointed out, a woman is not adequately equipped to fulfil her functions as mother and trainer of children unless she has lived in the world and exercised a vocation.

[3]

"Were the capacities of the brain and the heart equal in the sexes," Lily Braun (Die Frauenfrage, page 207) well says, "the entry of women into public life would be of no value to humanity, and would even lead to a still wilder competition. Only the recognition that the entire nature of woman is different from that of man, that it signifies a new vivifying principle in human life, makes the women's movement, in spite of the misconception of its enemies and its friends, a social revolution" (see also Havelock Ellis,Man and Woman, fourth edition, 1904, especially Ch. XVIII).

[4]

The word "puericulture" was invented by Dr. Caron in 1866 to signify the culture of children after birth. It was Pinard, the distinguished French obstetrician, who, in 1895, gave it a larger and truer significance by applying it to include the culture of children before birth. It is now defined as "the science which has for its end the search for the knowledge relative to the reproduction, the preservation, and the amelioration of the human race" (Péchin,La Puériculture avant la Naissance, Thèse de Paris, 1908).

[5]

InLa Grossesse(pp. 450et seq.) Bouchacourt has discussed the problems of puericulture at some length.

[6]

The importance of antenatal puericulture was fully recognized in China a thousand years ago. Thus Madame Cheng wrote at that time concerning the education of the child: "Even before birth his education may begin; and, therefore, the prospective mother of old, when lying down, lay straight; when sitting down, sat upright; and when standing, stood erect. She would not taste strange flavors, nor have anything to do with spiritualism; if her food were not cut straight she would not eat it, and if her mat were not set straight, she would not sit upon it. She would not look at any objectionable sight, nor listen to any objectionable sound, nor utter any rude word, nor handle any impure thing. At night she studied some canonical work, by day she occupied herself with ceremonies and music. Therefore, her sons were upright and eminent for their talents and virtues; such was the result of antenatal training" (H. A. Giles, "Woman in Chinese Literature,"Nineteenth Century, Nov., 1904).

[7]

Max Bartels, "Isländischer Brauch," etc.,Zeitschrift für Ethnologie, 1900, p. 65. A summary of the customs of various peoples in regard to pregnancy is given by Ploss and Bartels,Das Weib, Sect. XXIX.

[8]

On the influence of alcohol during pregnancy on the embryo, see,e.g., G. Newman,Infant Mortality, pp. 72-77. W. C. Sullivan (Alcoholism, 1906, Ch. XI), summarizes the evidence showing that alcohol is a factor in human degeneration.

[9]

There is even reason to believe that the alcoholism of the mother's father may impair her ability as a mother. Bunge (Die Zunehmende Unfähigkeit der Frauen ihre Kinder zu Stillen, fifth edition, 1907), from an investigation extending over 2,000 families, finds that chronic alcoholic poisoning in the father is the chief cause of the daughter's inability to suckle, this inability not usually being recovered in subsequent generations. Bunge has, however, been opposed by Dr. Agnes Bluhm, "Die Stillungsnot,"Zeitschrift für Soziale Medizin, 1908 (fully summarized by herself inSexual-Probleme, Jan., 1909).

[10]

See,e.g., T. Arthur Helme, "The Unborn Child,"British Medical Journal, Aug. 24, 1907. Nutrition should, of course, be adequate. Noel Paton has shown (Lancet, July 4, 1903) that defective nutrition of the pregnant woman diminishes the weight of the offspring.

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