The fact that many persons consult physicians for a cure for sterility, and go to great trouble and expense to further the bearing of children, and the fact many childless couples adopt children rather than to have a childless home, are evidence of the fact that there is no danger of the parental instinct dying out. It is the experience of physicians generally that the patients who desire information regarding scientific contraceptive methods are usually those who already have as many children as they can well take care of, and not those who wish to escape parenthood in toto.
We are constantly reminded that the size of the average family is much smaller than it was a hundred years ago—but still the race is rapidly increasing, owing to the decreased death-rate resulting from a better knowledge of hygiene and medicine. Moreover, it is positively asserted that the "old time large family" frequently had one father but several mothers—the husband marrying several times in order to replace with a new life the old wife who had broken down and died from overwork and excessive childbearing.
It is claimed that in Holland, in which Birth Control is recognized by law, and where it is legally sanctioned and even encouraged among those who are not able to support large families, statistics show that the population is increasing more rapidly than before, owing to the decreased mortality of infants and young children arising from the better care of those who are born.
Dr. Robinson says on this point: "Here we have a whole country, Holland, in which the prevention of conception is legally sanctioned, in which the use of preventives is practically universal—and is this country dying out? On the contrary, it is increasing more rapidly than before, because we have this remarkable and gratifying phenomenon to bear in mind, that wherever the birth-rate goes down, the death rate goes down pari passu, or even to a still greater degree. This can be proven by statistics from almost every country in the world. For instance, in 1910 the birth-rate in Holland was 32, and the mortality 18; in 1912 the birth-rate fell to 28, but then the mortality rate fell still lower, namely to 12, so we see an actual gain in population, instead of a loss. And the physical constitution of the people has been improving * * *. And in New Zealand, where the sale of contraceptives is practically free, the birth rate is now 20, and the mortality rate is 10. Does that look like race suicide? On the contrary, there is a steady increase at the rate of ten per cent, while sickness and death of children, with their attendant economic and emotional waste, are reduced to a minimum."
Not only are the children of small families as a rule better cared for, from economic reasons easy to discern, but it is also a fact that the health of the mothers is far better, and consequently the health of the children when born is better than the average. One has but to look around him upon the families who boast of having had eight, ten, and twelve children born to them, to see what a frightful average percentage of deaths of infants and young children is present, and which brings down the number of the survivors.
Dr. Alice Hamilton, in "The Bulletin of the American Academy of Medicine," for May, 1910, reports that she has investigated the families of 1,600 wage workers, and found the following death rate per 1,000 birth among them, viz.:
| Families of 4 children and less | 118 deaths per 1,000 births |
| Families of 6 children | 267 deaths per 1,000 births |
| Families of 7 children | 280 deaths per 1,000 births |
| Families of 8 children | 291 deaths per 1,000 births |
| Families of 9 children or more | 303 deaths per 1,000 births |
Dr. Hamilton sums up her investigation as follows:
"Our study of the poorer working class shows that child mortality increases proportionately as the number of children increase, until we have a death rate in families of 8 children and over which is two and a half times as great as that in families of 4 children and over."