3. The cost of medical attention has increased. All demand more of the doctors now than they did in the last generation. The doctors are able to do more than they formerly could, and particularly for his children, every man wants the best that he can possibly afford. Hence medical attendance for a child is constantly becoming more costly, because more frequent; and further, the amount of money which parents spend on medical attendance for their children usually increases with any increase in their income.
4. The cost of domestic labor is greater. Most kinds of domestic service have more than doubled in price within the memory of relatively young people. Moreover, it is gradually being realized that a high standard is desirable in selecting a nurse for children. As a fact, a children's nurse ought to have much greater qualifications than the nurse whose duty is to care for sick adults. If a mother is obliged to delegate part of the work of bringing up her children to some other woman, she is beginning to recognize that this substitute mother should have superior ability; and the teachers of subconscious psychology have emphasized the importance of giving a child only the best possible intellectual surroundings. Ignorant nursemaids are unwillingly tolerated, and as the number of competent assistants for mothers is very small, the cost is correspondingly high. An increase in the number of persons trained for such work is to be anticipated, but it is likely that the demand for them will grow even more rapidly; hence there is no reason to expect that competent domestic help will become any less costly than it is now.
5. The standards of education have risen steadily. There is perhaps no other feature which has tended more to limit families. Conscientious parents have often determined to have no more children than they could afford to educate in the best possible way. This meant at least a college education, and frequently has led to one and two-child families. It is a motive of birth control which calls for condemnation. The old idea of valuable mental discipline for all kinds of mental work to be gained from protracted difficult formal education is now rejected by educational psychologists, but its prevalence in the popular mind serves to make "higher education" still something of a fetish, from which marvelous results, not capable of precise comprehension, are anticipated. We do not disparage the value of a college education, in saying that parents should not attach such importance to it as to lead them to limit their family to the number to whom they can give 20 years of education without pecuniary compensation.
The effect of these various factors in the increasing cost of children is to decrease fecundity not so much on the basis of income of parents, as on the basis of their standards. The prudent, conscientious parent is therefore the one most affected, and the reduction in births is greatest in that class, where eugenics is most loth to see it.
The remedy appears to be a change in public opinion which will result in a truer idea of values. Some readjustments in family budgets are called for, which will discriminate more clearly between expenditure that is worth while, and that which is not. Without depriving his children of the best medical attention and education, one may eliminate those invidious sources of expense which benefit neither the children nor anyone else,—overdressing, for instance. A simplification of life would not only enable superior people to have larger families, but would often be an advantage to the children already born.
On the other hand, the fact that higher standards in a population lead to fewer children suggests a valuable means of reducing the birth-rate of the inferior. Raise their low standards of living and they will reduce their own fertility voluntarily (the birth control movement furnishing them with the possibility). All educational work in the slums therefore is likely to have a valuable though indirect eugenic outcome. The poor foreign-speaking areas in large cities, where immigrants live huddled together in squalor, should be broken up. As these people are given new ideas of comfort, and as their children are educated in American ways of living, there is every reason to expect a decline in their birth-rate, similar to that which has taken place among the native-born during the past generation.
This elevation of standards in the lower classes will be accomplished without any particular exertion from eugenists; there are many agencies at work in this field, although they rarely realize the result of their work which we have just pointed out.
But to effect a discriminating change in the standards of the more intelligent and better educated classes calls for a real effort on the part of all those who have the welfare of society at heart. The difficulties are great enough and the obstacles are evident enough; it is more encouraging to look at the other side, and to see evidences that the public is awakening. The events of every month show that the ideals of eugenics are filtering through the public mind more rapidly than some of us, a decade ago, felt justified in expecting. There is a growing recognition of the danger of bad breeding; a growing recognition in some quarters at least of the need for more children from the superior part of the population; a growing outcry against the excessive standards of luxury that are making children themselves luxuries. The number of those who call themselves eugenists, or who are in sympathy with the aims of eugenics, is increasing every year, as is evidenced by the growth of such an organization as the American Genetic Association. Legislators show an eager desire to pass measures that as they (too often wrongly) believe will have a eugenic result. Most colleges and universities are teaching the principles of heredity, and a great many of them add definite instruction in the principles of eugenics. Although the ultimate aim of eugenics—to raise the level of the whole human race—is perhaps as great an undertaking as the human mind can conceive, the American nation shows distinct signs of a willingness to grapple with it. And this book will have failed in its purpose, if it has not convinced the reader that means are available for attacking the problem at many points, and that immediate progress is not a mere dream.
One of the first necessary steps is a change in educational methods to give greater emphasis to parenthood. And this change, it is a great pleasure to be able to say, is being made in many places. The public schools are gradually beginning to teach mothercraft, under various guises, in many cities and the School of Practical Arts, Columbia Univ., gives a course in the "Physical Care of the Infant." Public and private institutions are beginning to recognize, what has long been ignored, that parenthood is one of the functions of men and women, toward which their education should be directed. Every such step will tend, we believe, to increase the birth-rate among the superior classes of the community; every such step is therefore, indirectly if not directly, a gain for eugenics; for, as we have emphasized time and again, a change in public opinion, to recognize parenthood as a beautiful and desirable thing, is one of the first desiderata of the eugenics program.
The introduction of domestic science and its rapid spread are very gratifying, yet there are serious shortcomings, as rather too vigorously set forth by A. E. Hamilton: