Maternity: Letters from Working-Women

by Unknown

The general effect upon women is the useless suffering inflicted upon them, and one of the chief causes of this is undoubtedly excessive childbearing. This evil is directly due to those semi-civilised notions which were touched upon above, and though, as we shall see when we deal with the decline of the birth-rate, nature is taking her own way of reacting against it, it still exists. We would draw attention to the conditions disclosed in such letters as [1], [20], [36], and [71]. In the first case we find a woman married at nineteen having 11 children and 2 miscarriages in 20 years, her husband’s wages being 20s. a week. In the second case there are 5 children and one miscarriage in 9 years; in the third 5 children and 5 miscarriages in 12½ years; and in the fourth 9 children and 1 miscarriage in 24 years. These cases have been taken more or less at random, and nothing could be more significant than the bare fact that out of 386 women who have written these letters, 348 have had 1,396 live children, 83 still-births, and 218 miscarriages. These figures speak for themselves: the mere physical strain of pregnancy and childbirth succeeding each other with scarcely an interval for ten or twenty years renders a healthy bodily and intellectual life impossible. And when the additional strain of insufficient means and incessant labour are added, the suffering which becomes the daily concomitant of life is unimaginable to those who are born in the more fortunate classes of society.

If any further evidence is wanted of the direct effect of such conditions upon the health of women, we would draw attention to the number of miscarriages and still-births. It is probable that not all the writers have included miscarriages; but even as it is the number of miscarriages is 15·4 per cent. of the live births, while the number of still-births is 5·9 per cent. Taken together, these figures show a pre-natal death-rate of 21·3 per 100 live births, as against a national infant death-rate of 10·9. According to some medical writers the frequency of abortions “is believed to be about 20 or 25 per cent. of all pregnancies”; while Dr. Amand Routh estimates that the number of deaths during pregnancy probably equals the number of deaths in the first year after birth. The following letters are a pathetic endorsement of the view that fatigue, strain, and domestic conditions are responsible for large numbers of miscarriages, and point to the urgent need of pre-natal care.

We have now come by a logical sequence from a consideration of the effect of the conditions of women’s lives upon themselves to the further effect upon the life and death of their offspring. We have, in fact, travelled the same road as, but in the opposite direction from, those who in the last ten years have conducted the campaign against Infant Mortality. It was about ten or twelve years ago that many people were suddenly horrified to learn that out of every 1,000 children born in England and Wales, about 150 died before they have lived twelve months. A vigorous campaign against Infant Mortality by means largely of what is called Infant Welfare work followed. Government departments and private persons and organisations have co-operated with such success that the death-rate of infants under one year of age per 1,000 births has fallen from 145 in 1904 to 109 in 1913. But the point which, for our present purpose, is most illuminating is to note the course which that campaign has pursued and is pursuing. It has become more and more clear that if you wish to guard the health of the infant, you must go back from it to the mother; it is the circumstances of the mother—her health, her knowledge, her education, and her habits—before the child is born no less than at the time of and after birth, that again and again determine whether the child is to have health or disease, to live or to die. In fact, from whatever point you regard the question, the words of the writer of letter [63] are true: We shall not get “a race in the future worthy of England until the nation wakes up to the needs of the mothers of that future race.”

Infant mortality in the first year of life is still appallingly high, and there is good reason for believing—though the fact cannot be absolutely proved—that this high rate is very largely due to the circumstances in which the great mass of working-class women are obliged to bear children. As is well known, it is in the first month after birth that the death-rate is highest, and it is this rate which reformers have been least successful in reducing. Now, if the causes of deaths of infants in the first four weeks of life are examined, an enormous proportion are due to “immaturity.” “It needs no argument,” says Dr. A. K. Chalmers, “to show that until we have a clearer conception of the causes which lead to death from immaturity, we cannot but fail to make any considerable impression on the volume of deaths which occur during this period of infant life.” But as a matter of fact there is high authority for debiting the greater number of these deaths from immaturity to the physical health and condition of the mother. “It is evident,” writes Sir George Newman, “that if infants die within a few days or hours of birth, or even if dying later show unmistakable signs of being unequal to the calls of bare physical existence, that there must be something more than external conditions or food or management which is working to their hurt. The explanation is clearly to be found in ante-natal conditions.” Dr. Noel Paton considers that the “malnutrition of the mother helps to explain the very high infant mortality among the very poor. The infant starts life at a low level, and readily succumbs to the hardships to which it is too often subjected.” Dr. Ashby writes: “My own experience in the out-patient room entirely confirms the opinion that nutrition of the mother has a very important bearing on the nutrition of the fœtus, and that the statement that the percentage of unhealthy births among the poor is small is not justified by facts. We constantly see fully developed infants a day or two old ... clearly ill-fitted, as the event proves, to withstand the conditions of external existence.... There is no question of syphilis; they are the children of poor mothers who have lived hard lives of wear and tear during pregnancy, are themselves badly nourished and weakly, and have felt the pinch of poverty, though often perhaps poverty of the secondary sort.”

No better comment upon, or illustration of, these opinions of experts could be found than the facts contained in these letters. You can read in them the little details of existence which made the writers “mothers who have lived hard lives of wear and tear during pregnancy,” and watching those details you can see how the everyday working of the machine, which we call industry and society, leads to suffering, and wastes and destroys human life as soon as it is born. The results which can already be shown of care in the pre-natal period, bear out the contention that the suffering and loss of life which exists is unnecessary. The Women’s Municipal League in Boston, U.S.A., has had 1,512 women in five years (1910–1914) under its care. Amongst these women there have been no miscarriages in the last three and a half years; there were 60 cases of threatened eclampsia in the first year, there were only 2 in the last year; and the total number of infant deaths under one month was 2 per cent., while Boston’s rate was 4·3 per cent. The Johns Hopkins Hospital, U.S.A., obtained similar results, and in the Glasgow Maternity hospital more exact methods have reduced the infant mortality and morbidity.

If the problems raised by these letters throw light upon the terrible waste of women’s health and infant life, they no less certainly throw light upon another phenomenon of modern society—the decline of the birth-rate.

One of the most remarkable and important signs of change in the habits and aspirations of society, has been the sudden decline in the birth-rate which, noticeable in many countries, began in this country about forty years ago, and has continued steadily down to the present time. In every locality and class the number of children born yearly to married women is declining, but the fall is not the same everywhere; in the industrial population it is greater among the better-class and better-paid workers, and it is distinctly greatest among textile workers where wages are comparatively high and a large proportion of women work in factories. Now, it is absolutely certain that this decline is mainly due to the deliberate limitation of the family. There is, of course, a wide divergence of opinion as to the result of this conscious check upon the growth of population; some regard it as the clearest solution of the inextricable tangle in which the industrial system has enmeshed humanity, others see in it the suicide of a nation and the doom of a race. But people are so anxious to dispute about the good and evil of its effect that they often fail to see that for society itself the important good and evil lie in the conditions which cause the phenomenon. For the State it may be vital to know the result of men and women refusing to give her citizens; but it is still more vital for her to recognize the conditions within her which are leading men and women to this refusal.

These letters give the skeletons of individuals’ lives, and individual thoughts and feelings; but in those facts and thoughts and feelings one can see clearly the general mould of life and the sweep of the current of general opinion which is among the working classes, resulting in the refusal to have children. There is a kind of strike against large families, and it is not, among the workers, a selfish strike. The motives of this strike are admirably given in the following words from Letter No. [71], the whole of which is very illuminating on this point: “All the beautiful in motherhood is very nice if one has plenty to bring up a family on, but what real mother is going to bring a life into the world to be pushed into the drudgery of the world at the earliest possible moment?...” The fact that the decline in the birth-rate is greatest among the better-paid wage-earners is often said to prove that a growing love of ease and luxury is causing a declining birth-rate. The words “ease and luxury” are grotesque when applied to the lives of manual wage-earners. The fact is that the industrial worker took the first seventy years of last century to learn that the conditions such as described in these letters make a human and a humane life impossible alike for the mother and children of large families. This consciousness has spread slowly and surely during the last forty years, and, as is natural, it has spread most amongst the more educated and intelligent workers and those whose wages have given them at least the opportunity of realising that there are other things in life besides poverty and work. The numbers of such men and women will continue to grow who refuse to have children except under two conditions. Those conditions are that society shall pay its debt to the manual worker in such a way that his children can be born into a home where there is something better than bare existence, and that the woman has the means and the leisure to live a life of her own without which she is unfit to give life to her children and to direct it during their most impressionable years.

It is impossible to leave this question without touching upon one point which crops up occasionally in these letters. Opinions may differ as to the good or evil of the general limitation of families, but there can only be agreement upon the evil which results from the use of drugs to procure abortion. There are many facts which go to prove that the habit of taking such drugs has spread to an alarming extent in many places among working women. Several of these letters confirm that conclusion. The practice is ruinous to the health of women, is more often than not useless for procuring the object desired, and probably accounts for the fact that many children are weakly and diseased from birth. But here again the cause of the evil lies in the conditions which produce it. Where maternity is only followed by an addition to the daily life of suffering, want, overwork, and poverty, people will continue to adopt even the most dangerous, uncertain, and disastrous methods of avoiding it.

This introduction has been mainly concerned with pointing out certain evils deeply seated in national life. These evils have their origin in social conditions, and they touch life at so many points that they must, if allowed to work unchecked, modify the whole future of the race and state. There is no sign that society, if left to itself, will secrete some antitoxin to purge its own blood. The industrial and capitalist system tends to become continually more industrial and capitalistic; the gulf between the rich and poor, the fortunate and the unfortunate widens; ideals become higher and broader while the means to satisfy them are narrowed in the possession of a narrow class; only discontent seems to rise while the birth-rate falls. Society cannot cure itself, and the last hope, therefore, is for the State to attempt a cure.