THE BIRTH-RATE

New Zealand Mail, Issue 1617, 25 February 1903, Page 21

THE BIRTH-RATE

mortality among married WOMEN. OPINIONS OF MEDICAL MEN. On the important question of the declining birth-rate, to which pointed inference was made in a Leaflet issued the other day from tho Rcgistrai-Geiieial s office, and on the allied question of che fitness of colonial women for maternity, which was raised by a correspondent in our columns, it was thought advisable to obtain the opinions of some expenenced medical men. do that end a “Times” representative made a numbci of calls, and found several gentlemen willing to state the results cf their observation and experience. Dr Alexander said:—“l do not really consider colonial women aie less fitted for cnild-bearing than women at Home are. Physically they are quite as strong in every way as the English women are. In fact, I should say they are stronger. I should think the lov. - est class of women at Home would be very unhealthy. As to the middle and upper classes, I should think colonial women should he equally as strong. As general rule, all classes here have attendance by medical men, whereas at Home very often some classes have merely to trust to midwives. They are therefore more likely to have better results here. “Statistics show that the number of fatal cases here is very much the same, perhaps less, than at Home. Since the introduction of antiseptic treatment, the death-rate at Home has been very much reduced-, especially in the lying-in hospitals. In these hospitals now tho death-rate is a mere fraction, much less than it is in general practice. The state of affairs has been totally reversed by this treatment. Previously it was so high that they were almost going to close the hospitals. Since then it has sunk to practically nothing. The same answer applies to cases of serious illness and disablement. There is nob much disablement following confinement in the colonies.

“I think that the declining birthrate is undoubtedly due to preventive means —artificial or otherwise —being employed. I don’t think it is at all due to physical unfitness.” Dr J. M. Mason, Chief Health Officer, in the course of an interview, said: —“With regard to the statement made by your correspondent, which seems to indicate that he believes that parturition in New Zealand is attended by more dangers than in the Old Country, I think that facts will not bear him out. New Zealand women are just as capable of bearing healthy children, and with as little danger to themselves, as' their sisters in the Old World. Ono reason, doubtless. for your correspondent’s impression arises from the fact that in many cases only births that have been attended with untoward circumstances are brought prominently before the layman’s notice. In the great majority of oases the function of labour is not attended by any unusual symptoms. “Illness or disablement (consequent upon labour are not more common here than in the Old Country. Where such illness does result, the cause is very, much the same as obtains in Great Britain, namely, want of sufficient care during the two or three months immediately following the confinement. “With respect to the larger question of the declining birth-rate, this, from an economical and public health point of view, is most important. Unfortunately, there can be no question as to the accuracy of statistics, As to the cause, there can also be no question whatever. Physical unfitness plays a very small part. It is to premeditated interference with the course of nature that, we must look for an answer to the question. It has been suggested that legislation might in some measure meet the case, but the difficulties in this direction seem to me almost insuperable. The Sale of Preventives Bill, which was introduced last session, would certainly have made it difficult for the travelling pedlar of such wares to prosecute his work, but certainly no legislative interference could influence the cause to which the declining birthrate is mainly attributable. There are many difficulties in dealing with this question. As lias been pointed out, by one of your correspondents, the doctrine of Malthus as at present interpreted is far different from that which was preached by Malthus himself. Jiis contention w.as that as .foodstuffs increased in numerical ratio while population increased in geometrical rafio, there must scon come a time when great difficulty in the procuration cf food must eventuate. - While some of his statements are undoubtedly fairly accurate, it has to be borne in limit that his conception of the food producing world was very much more limits! than what exists at the present, time. In any case, lie did not counsel an interference with natural laws other than by abstinence and continence. It is readily admitted by all that the standard of living has greatly increase:.! during the past fifty years, and although wages have been raised also.. there would seem to be just as great difficulty in making ends meet. Wherever child labour is capable of being used and made remunerative, it has been found that larger families result.”

Dr E. Rawson does not think the proportion of serious and ratal cases of confinement or of disablement after confinement is unduly large. Asked what he thought was the cause cf tlie declining birth rate, lie said: “The cause is that people arc getting more civilised, and with civilisation goes a disinclination to carry the great burden cf a large family, with its responsibilities and anxieties. Tho remedy is to make tho cost of living cheaper, so as to give persons a chance of living as they want to live nowadays. Generaliv-speak-ing, it is the careless and improvident who have largo families. Of course, there are those who think ‘Blessed is he that hath his quiver full,’ and the fuller tho better; but people are now loss inclined than before to undertake tlie responsibilities cf large families, feeling as they do that they must educate and bring them up better than in the past. There was a time when, especially to farmers, large families meant more

hands to do tho work. Now it means more mouths to eat. In all civilised countries tho birth rate is declining, from the disinclination to have large families. Whilst having families, women are poor companions to their husbands, and have to give up a large portion of their lives to bearing and bringing up children. They are not real companions to their husbands, nor are they able to join in social life. They have to put themselves out of tho world to a large extent and to become simply nurses to their children, if tho nursing is to be done properly. My own impression is that the declining birth rate will continue increasing in degree. There is a steady desire not to have large families. The -inclination is nob to have no children at -all, but not to have too many. There is no sign of newly-married women not wanting to have children, bat there are evidences of women who have children already not wanting more. I think the tendency is for people to limit their families to two or three, but there is certainly no disinclination to having any children at all. As to the remedy, I don’t see any. There is the question: Is it better to have two or three children well brought up and well educated or to have a dozen dragged up ? Naturally, as people become more enlightened and women more free they will prefer the two or three well-brought-up children. So as far as remedy goes, there is none.” “With regard to the fitness of colonial women to bear children, I think they are less fitted than English women. They have not the physique of English women, and are much more “highly strung,” and so are physically unfitted. Whether this is due to the climate or to the colonial way of living is another matter, but J should say the colonial life in some measure renders them less fit physically for motherhood. They come to maturity sooner and become old sooner. As a rule a large family drags them down, whereas English women are bright and buxom at the age when colonial women are withering.”

SOME VALUABLE STATISTICS. Dr Chappie, when seen by a “Times” representative, was found to be well posted up in the subject, and readily replied to the various questions. “Are colonial women, in your experience, in any way physically unfitted for motherhood P” “In my opinion New Zealand women a re of finer physique and better health tliau almost any in the world. By a process of natural selection our colony was first peopled by picked men and women. Only sturdy, healthy adventurous spirits isolated themselves from British environment and tradition, ana sought and found a wild new home, which they have made to blossom as the rose. Colonisers have always been of this type, and physique, health and love of liberty have been tiieir inheritance. New Zealanders are a conspicuous example. .Healthy, well-de-veloped women not only bear good stock, but they escape the dangers of maternity and our own women run less risk than any in the world. Of 10,000 females born in the healthy disti,cts of England, 7864 enter the child-bearing period of life (fifteen years), in Nevi South Wales and Victoria 8054, and m New Zealand 8687, i.e., in our colony 823 more females reach the age of firteen than in England; while 6050 in England. 6399 in New South W ales and Victoria, and 7207 in New Zealand pass safely through this period, i.e., reach the affe of forty-five years. For the decade, 1885-1894, the maternal death rate in England was 5.3 per 1000 births; for 1896 it was 5. The average m New South Wales up to 1898 was nearly 7 per 1000 births, while in New Zealand for 1901 it was only 4.4. These deaths included many immediately following labour, but not necessarily due to it. Many delicate and diseased women bear children and die of their diseases in childbed. These swell official statistics, which are much higher than those chronicled by accoucheurs. In the vicinity of Wellington a doctor reported 2000 labours with one death, 453 of them in New Zealand with no deaths. Another doctor here reported 2844 cases with two deaths, another 1500 with three deaths, another 2589, in the early days prior to 1885, with ten deaths. I have collected published and private statistics of 13,603 cases in or near Wel-

lington with a mortality of twenty, oi about 1.5 per 10U0 births, Jhe Alexandra Home lias had about 500 births with no maternal deaths. The statement of the ‘Times’ correspondent proves only this —that deaths under those distressing circumstances loom large in the mind, and -as first births are about twice as fatal as subsequent ones, the blighting effect on young homes is all tiie more conspicuous and fastens on the memory. All the dangers of maternity do not equal the dangers to which men arc exposed in their daily labour to provide the bread and butter. On the other hand, the maternal risks in nearing children and tho paternal vsks mj feeding them do not equal the risks co life of tnosc who incur no such responsibility, for we hare statistics to prove ‘that the length of life to the enjoyment of which *a married person may look forward is greater than that of tho unmarried, both female and male, at the same age.’ ” _ “Is tho proportion of serious ana fatal crises of confinement unduly great or of disablement following confinement P’ “No, I think not. Antiseptics and anaesthetics have, greatly reduced the obstetric mortality and the severity of tfie ordeal through which women have to pass. Of the disablement following confinement it is difficult to form an estimate. A. doctor of a very large women’s hospital in England reported that CO per cent, cf the ailments from which inmates suffered were due to confin omen t: ti iese would be mostly Sarah Gamp cases, and the obstetric sequelae vary inversely with the care and skill bestowed.” “What do you think is the cause of tho declining birth rate ?” “The immediate or primary cause is prudential prevention on the part of married people. The remote or secondary cause —that is, the motive for prevention —is twofold—first, a desire for luxury, ease and social status, ana second, the pressure and stress of i'fe from increasing competition, increased cost of living and the greater demands made upon parents by the claims of children for education, dress, amusement and social competition. The social capillarity that attracts one social stratum to the next above is very strong in the colonies. Tho first remedy appears to me to be to lessen the burdens of life by legislative means; the second, to educate tiie people to a, simpler and moro wholesome social ;iro, and against the vico cf oliganthropy; the third, to control the fertility of the unfit; and the fourth, to promote the immigration of selected, medically examined and certified tillers of the soil from older lands.” A SCIENTIFIC EXPLANATION. Mr Thomas "Watson writes:—l should like space to refer briefly to tho subject matter of the recent leaflet by our Registrar-General dealing with the colony’s birth rate. Therein it is contended that the remarkable decrease in the number of births is due to voluntary limitation. I believo that our people are no more open to that charge, probably less, than those of any other section of the Empire, and there is no evidence to support the contrary assumption.

Witli such a temperate climate and unequalled social and economic conditions, the assumption that our people compare unfavourably in this respect is, in the absence of direct proof, illogical and unjust. In Canada, where natural conditions would appear to be less favourable, tiie birth rate is abo've the average, while in Iceland, where the surroundings are decidedly unfavourable, the births are abnormally high, families of twenty and over being quite common. In a return of Icelandic births, now before me, it is shown that nearly one in a hundred births are triplets. ' I have already, in the “New Zealand Times,” put forward another theory in connection with this subject, and my only object in writing now is to point out the faulty basis upon which the Registrar relies. Why are the births in Auckland as numerous as in any portion of the Australasian colonies, while in Dunedin they are much less? The figures for 1901 of the four centres are: —Births per 1000 of the population — Auckland and suburbs, 30.00; Wellsrgton, 26.35; Christchurch, 24.12; Dunedin, 22.04; and these are about the usual proportions year by year. In 1899 the rate for Dunedin was 20.82, which is below that ever recorded by any community in any part of the world. Since 1880 the rate has fallen at Dunedin'by nearly 50 per cent., and it is the same in the country districts of Otago. The Registrar was wise, therefore, in using the qualifying remark that the to prove that the cities were the sinners had not been quite' successful. It is a well-known fact that births are relatively moro numerous in the -country than in the large cities, and so the Registrar gets us no forrader” in the matter. I repeat my formerly expressed belief that we must look to t-lio atmosphere for the cause. The Austral atmosphere is deficient in quality, as compared with that of the northern half of our globe, owing to excessive humidity (in suspension mainly), as proved by the barometric readings, the cause being the greater

ocean or evaporating surface. Hus deficiency of air means lees ox 3 gem us vital constituent. The effect caimo-. be other than most potent. I may be wrong, but there is just a suspicion mat tho chest capacity of tho New Zealand born is decreasing, doubtless due to tins cause. Flat chests and round shun.dels are becoming almost the rule and when it is remembered that, these young people are the offspring cf parents wno were physically above the average (for tho old lands sent us cf their best) it is all the more notable. I have been assrured by those who spent years at Klondike that’the New Zealanders them succumbed more quickly to the rigours of tho northern whiter than did those from Australia, especially Queensland and Western Australia. The apparently low death rate in. New Zealand might appear to be opposed to the atmospheric theory and births; but is our death rate really low? Statistically it is so, because our population on the average is of necessity much younger than that of older countries, bat the average age at death shows New Zealand in an unfavourable light. That average is only about thirty-three years. Considering that our population, is not contained in large cities, the average is extremely loir. The experience of the Now Zealand Friendly Societies, too, is most unfavourable, as shown by the Government officer’s reports, and the position grows worse year by year. The “experience” of these societies is immensely above the “expectation,” which is based upon the English “experience.” I refrain from quoting figures, which, by tho way, are ail eye-opener; but it is evident that early action must be taken by most of the lodges in the colony to place their fends upon a sound basis, otherwise the Government will have to step in. Note. —All q:distances in nature belong—so tho scientists tell us—to 0110 or other of two classes, of which iron and bismuth are tho types. Oxygen is para-magnetic, bismuth dia-magnetio, so that life in the Austral zone, with its deficiency of atmosphere, is composed of less iron, and consequently less magnetism than the life of tho northern regions'.