The slow increase in the population of primitive peoples, which is also to be noticed wherever the conditions of life have not been influenced by European settlers and missionaries, is chiefly due to the want of proper midwifery, and no less to the frequent practice of abortion. The opinion is often met with, particularly in older writings, that among primitive people childbirth is extremely easy. But more extended knowledge has shown how dangerous childbirth is for the primitive mother also. Though childbirth is a natural physiological process, it does not always pass off quite without danger, no less under natural conditions than among highly civilised peoples. Primitive people know full well that the hour of childbirth is the hardest time in a woman's life, but not all have progressed far enough in the knowledge of physiology to be able to render efficient assistance to the woman in labour. Some people leave her, incredible as it may seem to us, without any assistance, either through indifference to life or through a superstitious fear of the mystery of life. Such cases are, however, very rare exceptions. Sometimes means are used for furthering the birth that are not only inefficacious, but actually injurious. Often, however, delivery is actually furthered by the assistance given. Internal manipulation is seldom resorted to, and operations are still more rare. R. W. Felkin's report about the operation of Cæsarian section among the negroes in Uganda seems to be unique. Ploss and Bartels have compiled a great deal of information about childbirth among primitive people. We add here some examples from the later literature.

Feticide occurs most likely among all primitive peoples to a larger or lesser degree, and injures them accordingly. The reasons are the same as with us: inability to support a large number of children or aversion to the worries of child-rearing. Unmarried girls procure abortion usually because the child might be a hindrance to a future marriage, particularly when the father of the expected child jilts the mother. Still pre-marital births are not always considered a disgrace among primitive people. The abortives resorted to are generally inefficacious, though some native peoples have discovered really effective remedies. Külz (p. 18) says quite rightly, "It is to be assumed that woman everywhere, even in a low state of civilisation, has her attention directed to the occurrence of involuntary premature birth by often recurring effective causes. Such external causes are not very remote from the mechanically and medically produced abortions. We only need to think of the fact that among all primitive peoples the chief work in the fields falls to the women, and that it is just heavy labour that has the tendency to interrupt pregnancy. It required only some little thought to discover this frequently observed coincidence and to learn from the involuntary interruption of pregnancy how to produce it voluntarily.... In the same way the production of abortions by poisons can easily be derived from a rational application of chance remedies producing corresponding involuntary effects.... Just as primitive man discovered many medicinal plants by repeatedly partaking of them, so he also found out the specific use of some of these for feticide. This could happen the more readily as among abortive remedies in use there were many that in a way served him as food and condiment, such as nutmeg, or the papaia kernels, or others that he used at the same time for poisoning fish, or others, again, like the aperient Cajanus indicus, which in moderate doses acts medicinally, in large doses, however, as an abortive."

The use of poisons and mechanical feticide not only brings about limitation of offspring, but often results in the death of the mother. Where they are very prevalent they contribute greatly to the scarcity of women, with all its attendant biological disadvantages. The contact of primitive people with Europeans generally increases the frequency of abortions. This is due partly to the desire for hiding the results of sexual intercourse with strangers, partly to the incitement to loose living which the acquaintance with European culture sometimes brings about.

How defective the state of midwifery is among primitive people is shown by many accounts in newer works of ethnology. Thus the missionary Endle writes (p. 41): "The native tribes of Assam and Burma have no special midwives. Every old woman may perform the duties of a midwife, and she does it without payment. There is no information about the treatment of the woman during parturition. The navel cord is generally cut off with a bamboo knife. The Katshári do not perform this with one cut, but make five cuts in the case of a boy and seven for a girl. The mother is considered unclean for several weeks after her confinement. This is also the case among many races of Southern and Eastern Asia, and in other parts of the world. Isolation even before the confinement sometimes occurs, and is due to the belief that women in this state are unclean."

Among the savage tribes of Formosa the birth of a child passes off so lightly that the lying-in woman is able to go on with her work on the following day. She only avoids heavy labour in the field for a month. After the birth certain superstitious ceremonies, according to old customs, are performed, such as driving away the devil, etc. Among many tribes twins are held to be a misfortune, and the second child is therefore killed. This also occurs frequently in other places (W. Müller, p. 230).

Among the Igorots of Bontoc (Philippines) the woman works in the field almost to the hour of her confinement. There are no festivities or ceremonies connected with the birth. The father of the child, if he is the husband of the woman, is present, as is also the woman's mother, but no one else. The parturient woman bends her body strongly forward, holding firmly on to the beam of the house, or she takes up an animal-like position, so that hands and feet are on the ground. Medicines and baths are not resorted to for hastening the labour pains, but the people present massage the abdomen of the labouring woman. About ten days after the birth her body is washed with warm water. There is no special diet, but the mother refrains from field work for two or three months. If twins are born, it is believed to be due to an evil spirit who has had connection with the woman whilst she was asleep. No blame is attached to the mother, but the quieter of the children (and when both children are quiet, the longer one) is buried alive near the house immediately after birth. Abortion is practised by married women as well as by single girls, if for some reason the child is not wanted. The mother warns her unmarried daughter against abortion, telling her that a girl who produces abortion will not get a faithful husband, but will become the common partner of several men. The fœtus is driven off in the second month of pregnancy by hot baths and massage. Abortion is not considered a disgrace (Jenks).

Among the Kayan of Borneo there are everywhere older women who serve as midwives. One of them is called in good time to the pregnant woman. She examines her abdomen from time to time, and pretends to be able to give the child the right position. She hangs some magical remedies about the living room, and applies various remedies externally. The pregnant woman follows her usual occupation until the labour pains commence. Then the midwife and other old relatives or friends assist her. The husband may also remain in the room, but he is prevented by a screen from seeing the parturient woman, who gets hold tightly of a cloth hung over or in front of her. The pains are generally of short duration, rarely lasting more than two or three hours. In order to prevent the rising of the child, the women bind a cloth tightly round the abdomen of the parturient woman, and two of them press firmly on the womb on either side. After the delivery of the child the navel cord is cut with a bamboo knife. If the after-birth does not follow soon, the women become anxious; two of them lift up the patient, and if that has no result, the navel cord is fastened to an axe in order to prevent it from re-entering the body, and presumably also to hasten the delivery of the after-birth. Internal manipulations are not resorted to. The after-birth is buried. If the child is born with a caul, the caul is dried, pounded into powder, and used in later years as medicine for the child. If the labour pains are exceptionally severe or long-lasting, or if an accident happens, the news travels rapidly. Everybody is overcome by fear, as the death of a parturient woman is particularly dreaded. The men and the boys take flight. If death actually ensues, most of the men remain in hiding for some time, and the corpse is quickly buried by old men and women who are least afraid of death.

The pregnant women of the Punan of Borneo continue with their usual work until the arrival of labour pains, and they resume it immediately after the confinement. To assist delivery the body is tightly bound above the womb. Nothing further is known about special help (Hose and McDougall, II., pp. 154, 185).

The Papua women are said to give birth easily, as a rule, but difficult deliveries and fatal cases do occur exceptionally. The custom exists in various places for the mother to throw the after-birth into the river or the sea after confinement (Williamson, p. 178; Seligmann, p. 85). Of the Mafulu Williamson says that when the after-birth is thrown into the river the mother gives the new-born child some water to drink. If the child partakes of it, it is considered a good omen; otherwise the child is believed not to be viable and is drowned. Williamson thinks that the purpose of this custom is to enable the mother to choose whether she wishes to keep the child alive or not. It also may happen that a childless woman accompanies the mother to the river and there adopts the child. Wilful abortion also occurs very often, not only in single girls, but also in married women, who thus keep their families small.