The average number of procreative years of married life was 16.1, the age of fifty years being considered in this study as the end of the procreative period for the seventy-two women who were older than that. The average number of living children was 3.27 and of deceased children 1.2, making a total average of 4.47 children born to each family. Of the 464 women, 176, or three eighths, had had abortions or miscarriages, the total number of such interruptions of pregnancy being 324, or an average of 1.8 each for the women involved.
Of the 464 women, 192 knew of no contraceptive methods and therefore had used none. The remaining 272 women knew of one or more methods, more or less effectual, for the prevention of conception. Of the 192 women who were ignorant of the use of contraceptives, practically one half, or 104, had a history of abortions, with a total of 202 abortions, or an average of two apiece. In contrast with this, of the 272 women who knew of one or more contraceptives, only one fourth, or seventy-two, had undergone abortions, with a total of 122 abortions, or an average of only 1.6 apiece.
A further analysis of our tables shows an interesting and striking relationship between ignorance of methods for the prevention of conception and the number of children. Sixty-eight women had had three children each. Of these, twenty-six, or thirty-eight per cent., were ignorant of contraceptives. Twenty-eight women had had four children each. Of these fourteen, or fifty per cent., were ignorant of contraceptives. Fifty-five women had had five children each. Of these thirty were ignorant of contraceptives, or fifty-four per cent. Thirty-two women had had six children each. Of these twenty were ignorant of contraceptives, or sixty-two per cent. Forty women had had seven children each. Of these thirty-eight were ignorant of contraceptives, or ninety-five per cent. Twenty-one women had had eight children each. Of these twenty were ignorant of contraceptives, or ninety-five per cent. Forty-four women had had nine or more children each, and of these all were ignorant of contraceptive measures. Arranged in tabular form, these data would appear as follows:
| Number of Women | Number of Children | Number Ignorant of Contraceptives | Percentage |
|---|---|---|---|
| 68 | 3 | 26 | 38 |
| 28 | 4 | 14 | 50 |
| 55 | 5 | 30 | 54 |
| 32 | 6 | 20 | 62 |
| 40 | 7 | 38 | 95 |
| 21 | 8 | 20 | 95 |
| 44 | 9 to 17 | all | 100 |
It is sometimes stated by opponents of birth control that contraceptive methods are known by every married person and that the fault and immorality of having a large family of unprovided for dependents lies not in ignorance of contraceptives but rather in a lack of determination on the part of one or both parents to use preventive measures; in other words, that the failure to use contraceptives results from the inconvenience attending some methods and also from the influence of religious sentiment.
The above data, however, tend to show that ignorance of contraceptives not only is a great factor in the production of large families, but is also a great factor in increasing the number of abortions. From the fact that two thirds of these women knew absolutely no contraceptive method, while the methods used by many of the others were ineffectual or positively harmful, it is apparent that there is a definite opportunity for educating these women in methods of regulating conception. That there is need and demand for such education is voiced in unmistakable language by the multitude of poor who seek advice from all practising physicians.
MATERNAL MORTALITY
Prof. Theodate L. Smith, director of the Library Department, Child Study Institute, Clark University, investigated the records of the families of early graduates of Yale University (1701 to 1745) and of Harvard University (1658 to 1690); and found that of the wives of Harvard men, 37.3 per cent. died under the age of 45 years, while of the wives of Yale men, 40 per cent. died under 50 years. Prof. Smith also showed that there is a tendency for families very large in the first generation to die out in the third or fourth generation. One family of twenty children, by two wives, has living descendent by one son only, one daughter being untraceable. A family of ten brothers and sisters, only two of whom lived until 50, produced three surviving children, who in turn have produced one, and that a sickly specimen. Another family had fourteen in the first generation, eight in the second, six in the third and only two in the fourth.—Mary Alden Hopkins in Harper’s Weekly, June, 1915.
TUBERCULOSIS, CAUSE OF THE GREATEST NUMBER OF DEATHS OF WOMEN DURING THE CHILD-BEARING PERIOD
OBSTETRICS. A Text Book for the Use of Students and Practitioners. J. Whitridge Williams, Professor of Obstetrics, John Hopkins University, Obstetrician-in-Chief to the John Hopkins Hospital, Gynaecologist to the Union Protestant Infirmary, Baltimore, Md. D. Appleton & Co. 1912.