fatiguing occupations (dressmakers, milliners, etc.) and also not
resting during pregnancy, had children with an average weight of
3,130 grammes, a slight but significant difference, in view of
the fact that the women of the first group were large and robust,
while those of the second group were of slight and elegant build.
Again, comparing groups of women who rested during pregnancy, it
was found that the women accustomed to fatiguing work had
children with an average weight of 3,319 grammes, while those
accustomed to less fatiguing work had children with an average
weight of 3,318 grammes. The difference between repose and
non-repose is thus considerable, while it also enables robust
women exercising a fatiguing occupation to catch up, though not
to surpass, the frailer women exercising a less fatiguing
occupation. We see, too, that even in the comparatively
unfatiguing occupations of milliners, etc., rest during pregnancy
still remains important, and cannot safely be dispensed with.
"Society," Letourneux concludes, "must guarantee rest to women
not well off during a part of pregnancy. It will be repaid the
cost of doing so by the increased vigor of the children thus
produced" (Letourneux, _De l'Influence de la Profession de la
Mere sur le Poids de l'Enfant_, These de Paris, 1897).

Dr. Dweira-Bernson (_Revue Pratique d'Obstetrique et de
Pediatrie_, 1903, p. 370), compared four groups of pregnant women
(servants with light work, servants with heavy work, farm girls,
dressmakers) who rested for three months before confinement with
four groups similarly composed who took no rest before
confinement. In every group he found that the difference in the
average weight of the child was markedly in favor of the women
who rested, and it was notable that the greatest difference was
found in the case of the farm girls who were probably the most
robust and also the hardest worked.

The usual time of gestation ranges between 274 and 280 days (or
280 to 290 days from the last menstrual period), and occasionally
a few days longer, though there is dispute as to the length of
the extreme limit, which some authorities would extend to 300
days, or even to 320 days (Pinard, in Richet's _Dictionnaire de
Physiologie_, vol. vii, pp. 150-162; Taylor, _Medical
Jurisprudence_, fifth edition, pp. 44, 98 et seq.; L.M. Allen,
"Prolonged Gestation," _American Journal Obstetrics_, April,
1907). It is possible, as Mueller suggested in 1898 in a These de
Nancy, that civilization tends to shorten the period of
gestation, and that in earlier ages it was longer than it is now.
Such a tendency to premature birth under the exciting nervous
influences of civilization would thus correspond, as Bouchacourt
has pointed out (_La Grossesse_, p. 113), to the similar effect
of domestication in animals. The robust countrywoman becomes
transformed into the more graceful, but also more fragile, town
woman who needs a degree of care and hygiene which the
countrywoman with her more resistant nervous system can to some
extent dispense with, although even she, as we see, suffers in
the person of her child, and probably in her own person, from the
effects of work during pregnancy. The serious nature of this
civilized tendency to premature birth--of which lack of rest in
pregnancy is, however, only one of several important causes--is
shown by the fact that Seropian (_Frequence Comparee des Causes
de l'Accouchement Premature_, These de Paris, 1907) found that
about one-third of French births (32.28 per cent.) are to a
greater or less extent premature. Pregnancy is not a morbid
condition; on the contrary, a pregnant woman is at the climax of
her most normal physiological life, but owing to the tension thus
involved she is specially liable to suffer from any slight shock
or strain.

It must be remarked that the increased tendency to premature
birth, while in part it may be due to general tendencies of
civilization, is also in part due to very definite and
preventable causes. Syphilis, alcoholism, and attempts to produce
abortion are among the not uncommon causes of premature birth
(see, e.g., G.F. McCleary, "The Influence of Antenatal Conditions
on Infantile Mortality," _British Medical Journal_, Aug. 13,
1904).

Premature birth ought to be avoided, because the child born too
early is insufficiently equipped for the task before him.
Astengo, dealing with nearly 19,000 cases at the Lariboisiere
Hospital in Paris and the Maternite, found, that reckoning from
the date of the last menstruation, there is a direct relation
between the weight of the infant at birth and the length of the
pregnancy. The longer the pregnancy, the finer the child
(Astengo, _Rapport du Poids des Enfants a la Duree de la
Grossesse_, These de Paris, 1905).

The frequency of premature birth is probably as great in England
as in France. Ballantyne states (_Manual of Antenatal Pathology;
The Foetus_, p. 456) that for practical purposes the frequency
of premature labors in maternity hospitals may be put at 20 per
cent., but that if all infants weighing less than 3,000 grammes
are to be regarded as premature, it rises to 41.5 per cent. That
premature birth is increasing in England seems to be indicated by
the fact that during the past twenty-five years there has been a
steady rise in the mortality rate from premature birth. McCleary,
who discusses this point and considers the increase real,
concludes that "it would appear that there has been a diminution
in the quality as well as in the quantity of our output of
babies" (see also a discussion, introduced by Dawson Williams, on
"Physical Deterioration," _British Medical Journal_, Oct. 14,
1905).

It need scarcely be pointed out that not only is immaturity a
cause of deterioration in the infants that survive, but that it
alone serves enormously to decrease the number of infants that
are able to survive. Thus G. Newman states (loc. cit.) that in
most large English urban districts immaturity is the chief cause
of infant mortality, furnishing about 30 per cent. of the infant
deaths; even in London (Islington) Alfred Harris (_British
Medical Journal_, Dec. 14, 1907) finds that it is responsible for
nearly 17 per cent. of the infantile deaths. It is estimated by
Newman that about half of the mothers of infants dying of
immaturity suffer from marked ill-health and poor physique; they
are not, therefore, fitted to be mothers.

Rest during pregnancy is a very powerful agent in preventing
premature birth. Thus Dr. Sarraute-Lourie has compared 1,550
pregnant women at the Asile Michelet who rested before
confinement with 1,550 women confined at the Hopital Lariboisiere
who had enjoyed no such period of rest. She found that the
average duration of pregnancy was at least twenty days shorter in
the latter group (Mme. Sarraute-Lourie, _De l'Influence du Repos
sur la Duree de la Gestation_, These de Paris, 1899).

Leyboff has insisted on the absolute necessity of rest during
pregnancy, as well for the sake of the woman herself as the
burden she carries, and shows the evil results which follow when
rest is neglected. Railway traveling, horse-riding, bicycling,
and sea-voyages are also, Leyboff believes, liable to be
injurious to the course of pregnancy. Leyboff recognizes the
difficulties which procreating women are placed under by present
industrial conditions, and concludes that "it is urgently
necessary to prevent women, by law, from working during the last
three months of pregnancy; that in every district there should be
a maternity fund; that during this enforced rest a woman should
receive the same salary as during work." He adds that the
children of unmarried mothers should be cared for by the State,
that there should be an eight-hours' day for all workers, and
that no children under sixteen should be allowed to work (E.
Leyboff, _L'Hygiene de la Grossesse_, These de Paris, 1905).

Perruc states that at least two months' rest before confinement
should be made compulsory, and that during this period the woman
should receive an indemnity regulated by the State. He is of
opinion that it should take the form of compulsory assurance, to
which the worker, the employer, and the State alike contributed
(Perruc, _Assistance aux Femmes Enceintes_, These de Paris,
1905).

It is probable that during the earlier months of pregnancy, work,
if not excessively heavy and exhausting, has little or no bad
effect; thus Bacchimont (_Documents pour servir a l'Histoire de
la Puericulture Intra-uterine_, These de Paris, 1898) found that,
while there was a great gain in the weight of children of mothers
who had rested for three months, there was no corresponding gain
in the children of those mothers who had rested for longer
periods. It is during the last three months that freedom, repose,
the cessation of the obligatory routine of employment become
necessary. This is the opinion of Pinard, the chief authority on
this matter. Many, however, fearing that economic and industrial
conditions render so long a period of rest too difficult of
practical attainment, are, with Clappier and G. Newman, content
to demand two months as a minimum; Salvat only asks for one
month's rest before confinement, the woman, whether married or
not, receiving a pecuniary indemnity during this period, with
medical care and drugs free. Ballantyne (_Manual of Antenatal
Pathology: The Foetus_, p. 475), as well as Niven, also asks only
for one month's compulsory rest during pregnancy, with indemnity.
Arthur Helme, however, taking a more comprehensive view of all
the factors involved, concludes in a valuable paper on "The
Unborn Child: Its Care and Its Rights" (_British Medical
Journal_, Aug. 24, 1907), "The important thing would be to
prohibit pregnant women from going to work at all, and it is as
important from the standpoint of the child that this prohibition
should include the early as the late months of pregnancy."

In England little progress has yet been made as regards this
question of rest during pregnancy, even as regards the education
of public opinion. Sir William Sinclair, Professor of Obstetrics
at the Victoria University of Manchester, has published (1907) _A
Plea for Establishing Municipal Maternity Homes_. Ballantyne, a
great British authority on the embryology of the child, has
published a "Plea for a Pre-Maternity Hospital" (_British Medical
Journal_, April 6, 1901), has since given an important lecture on
the subject (_British Medical Journal_, Jan. 11, 1908), and has
further discussed the matter in his _Manual of Ante-Natal
Pathology: The Foetus_ (Ch. XXVII); he is, however, more
interested in the establishment of hospitals for the diseases of
pregnancy than in the wider and more fundamental question of rest
for all pregnant women. In England there are, indeed, a few
institutions which receive unmarried women, with a record of good
conduct, who are pregnant for the first time, for, as
Bouchacourt remarks, ancient British prejudices are opposed to
any mercy being shown to women who are recidivists in committing
the crime of conception.

At present, indeed, it is only in France that the urgent need of
rest during the latter months of pregnancy has been clearly
realized, and any serious and official attempts made to provide
for it. In an interesting Paris thesis (_De la Puericulture avant
le Naissance_, 1907) Clappier has brought together much
information bearing on the efforts now being made to deal
practically with this question. There are many _Asiles_ in Paris
for pregnant women. One of the best is the Asile Michelet,
founded in 1893 by the Assistance Publique de Paris. This is a
sanatorium for pregnant women who have reached a period of seven
and a half months. It is nominally restricted to the admission of
French women who have been domiciled for a year in Paris, but, in
practice, it appears that women from all parts of France are
received. They are employed in light and occasional work for the
institution, being paid for this work, and are also occupied in
making clothes for the expected baby. Married and unmarried women
are admitted alike, all women being equal from the point of view
of motherhood, and indeed the majority of the women who come to
the Asile Michelet are unmarried, some being girls who have even
trudged on foot from Brittany and other remote parts of France,
to seek concealment from their friends in the hospitable
seclusion of these refuges in the great city. It is not the least
advantage of these institutions that they shield unmarried
mothers and their offspring from the manifold evils to which they
are exposed, and thus tend to decrease crime and suffering. In
addition to the maternity refuges, there are institutions in
France for assisting with help and advice those pregnant women
who prefer to remain at home, but are thus enabled to avoid the
necessity for undue domestic labor.

There ought to be no manner of doubt that when, as is the case
to-day in our own and some other supposedly civilized countries,
motherhood outside marriage is accounted as almost a crime, there
is the very greatest need for adequate provision for unmarried
women who are about to become mothers, enabling them to receive
shelter and care in secrecy, and to preserve their self-respect
and social position. This is necessary not only in the interests
of humanity and public economy, but also, as is too often
forgotten, in the interests of morality, for it is certain that
by the neglect to furnish adequate provision of this nature women
are driven to infanticide and prostitution. In earlier, more
humane days, the general provision for the secret reception and
care of illegitimate infants was undoubtedly most beneficial. The
suppression of the mediaeval method, which in France took place
gradually between 1833 and 1862, led to a great increase in
infanticide and abortion, and was a direct encouragement to crime
and immorality. In 1887 the Conseil General of the Seine sought
to replace the prevailing neglect of this matter by the adoption
of more enlightened ideas and founded a _bureau secret
d'admission_ for pregnant women. Since then both the abandonment
of infants and infanticide have greatly diminished, though they
are increasing in those parts of France which possess no
facilities of this kind. It is widely held that the State should
unify the arrangements for assuring secret maternity, and should,
in its own interests, undertake the expense. In 1904 French law
ensured the protection of unmarried mothers by guaranteeing their
secret, but it failed to organize the general establishment of
secret maternities, and has left to doctors the pioneering part
in this great and humane public work (A. Maillard-Brune,
_Refuges, Maternites, Bureaux d'Admission Secrets, comme Moyens
Preservatives des Infanticide_, These de Paris, 1908). It is not
among the least benefits of the falling birth rate that it has
helped to stimulate this beneficent movement.

The development of an industrial system which subordinates the human body
and the human soul to the thirst for gold, has, for a time, dismissed from
social consideration the interests of the race and even of the individual,
but it must be remembered that this has not been always and everywhere so.
Although in some parts of the world the women of savage peoples work up to
the time of confinement, it must be remarked that the conditions of work
in savage life do not resemble the strenuous and continuous labor of
modern factories. In many parts of the world, however, women are not
allowed to work hard during pregnancy and every consideration is shown to
them. This is so, for instance, among the Pueblo Indians, and among the
Indians of Mexico. Similar care is taken in the Carolines and the Gilbert
Islands and in many other regions all over the world. In some places,
women are secluded during pregnancy, and in others are compelled to
observe many more or less excellent rules. It is true that the assigned
cause for these rules is frequently the fear of evil spirits, but they
nevertheless often preserve a hygienic value. In many parts of the world
the discovery of pregnancy is the sign for a festival of more or less
ritual character, and much good advice is given to the expectant mother.
The modern Musselmans are careful to guard the health of their women when
pregnant, and so are the Chinese.[6] Even in Europe, in the thirteenth
century, as Clappier notes, industrial corporations sometimes had regard
to this matter, and would not allow women to work during pregnancy. In
Iceland, where much of the primitive life of Scandinavian Europe is still
preserved, great precautions are taken with pregnant women. They must lead
a quiet life, avoid tight garments, be moderate in eating and drinking,
take no alcohol, be safeguarded from all shocks, while their husbands and
all others who surround them must treat them with consideration, save them
from worry and always bear with them patiently.[7]

It is necessary to emphasize this point because we have to realize that
the modern movement for surrounding the pregnant woman with tenderness and
care, so far from being the mere outcome of civilized softness and
degeneracy, is, in all probability, the return on a higher plane to the
sane practice of those races which laid the foundations of human
greatness.

While rest is the cardinal virtue imposed on a woman during the later
months of pregnancy, there are other points in her regimen that are far
from unimportant in their bearing on the fate of the child. One of these
is the question of the mother's use of alcohol. Undoubtedly alcohol has
been a cause of much fanaticism. But the declamatory extravagance of
anti-alcoholists must not blind us to the fact that the evils of alcohol
are real. On the reproductive process especially, on the mammary glands,
and on the child, alcohol has an arresting and degenerative influence
without any compensatory advantages. It has been proved by experiments on
animals and observations on the human subject that alcohol taken by the
pregnant woman passes freely from the maternal circulation to the foetal
circulation. Fere has further shown that, by injecting alcohol and
aldehydes into hen's eggs during incubation, it is possible to cause
arrest of development and malformation in the chick.[8] The woman who is
bearing her child in her womb or suckling it at her breast would do well
to remember that the alcohol which may be harmless to herself is little
better than poison to the immature being who derives nourishment from her
blood. She should confine herself to the very lightest of alcoholic
beverages in very moderate amounts and would do better still to abandon
these entirely and drink milk instead. She is now the sole source of the
child's life and she cannot be too scrupulous in creating around it an
atmosphere of purity and health. No after-influence can ever compensate
for mistakes made at this time.[9]

What is true of alcohol is equally true of other potent drugs and poisons,
which should all be avoided so far as possible during pregnancy because of
the harmful influence they may directly exert on the embryo. Hygiene is
better than drugs, and care should be exercised in diet, which should by
no means be excessive. It is a mistake to suppose that the pregnant woman
needs considerably more food than usual, and there is much reason to
believe not only that a rich meat diet tends to cause sterility but that
it is also unfavorable to the development of the child in the womb.[10]

How far, if at all, it is often asked, should sexual intercourse be
continued after fecundation has been clearly ascertained? This has not
always been found an easy question to answer, for in the human couple many
considerations combine to complicate the answer. Even the Catholic
theologians have not been entirely in agreement on this point. Clement of
Alexandria said that when the seed had been sown the field must be left
till harvest. But it may be concluded that, as a rule, the Church was
inclined to regard intercourse during pregnancy as at most a venial sin,
provided there was no danger of abortion. Augustine, Gregory the Great,
Aquinas, Dens, for instance, seem to be of this mind; for a few, indeed,
it is no sin at all.[11] Among animals the rule is simple and uniform; as
soon as the female is impregnated at the period of oestrus she absolutely
rejects all advance of the male until, after birth and lactation are over,
another period of oestrus occurs. Among savages the tendency is less
uniform, and sexual abstinence, when it occurs during pregnancy, tends to
become less a natural instinct than a ritual observance, or a custom now
chiefly supported by superstitions. Among many primitive peoples
abstinence during the whole of pregnancy is enjoined because it is
believed that the semen would kill the foetus.[12]

The Talmud is unfavorable to coitus during pregnancy, and the
Koran prohibits it during the whole of the period, as well as
during suckling. Among the Hindus, on the other hand, intercourse
is continued up to the last fortnight of pregnancy, and it is
even believed that the injected semen helps to nourish the embryo
(W.D. Sutherland, "Ueber das Alltagsleben und die Volksmedizin
unter den Bauern Britischostindiens," _Muenchener Medizinische
Wochenschrift_, Nos. 12 and 13, 1906). The great Indian physician
Susruta, however, was opposed to coitus during pregnancy, and the
Chinese are emphatically on the same side.

As men have emerged from barbarism in the direction of civilization, the
animal instinct of refusal after impregnation has been completely lost in
women, while at the same time both sexes tend to become indifferent to
those ritual restraints which at an earlier period were almost as binding
as instinct. Sexual intercourse thus came to be practiced after
impregnation, much the same as before, as part of ordinary "marital
rights," though sometimes there has remained a faint suspicion, reflected
in the hesitating attitude of the Catholic Church already alluded to, that
such intercourse may be a sinful indulgence. Morality is, however, called
in to fortify this indulgence. If the husband is shut out from marital
intercourse at this time, it is argued, he will seek extra-marital
intercourse, as indeed in some parts of the world it is recognized that he
legitimately may; therefore the interests of the wife, anxious to retain
her husband's fidelity, and the interests of Christian morality, anxious
to uphold the institution of monogamy, combine to permit the continuation
of coitus during pregnancy. The custom has been furthered by the fact
that, in civilized women at all events, coitus during pregnancy is usually
not less agreeable than at other times and by some women is felt indeed to
be even more agreeable.[13] There is also the further consideration, for
those couples who have sought to prevent conception, that now intercourse
may be enjoyed with impunity. From a higher point of view such intercourse
may also be justified, for if, as all the finer moralists of the sexual
impulse now believe, love has its value not only in so far as it induces
procreation but also in so far as it aids individual development and the
mutual good and harmony of the united couple, it becomes morally right
during pregnancy.

From an early period, however, great authorities have declared themselves
in opposition to the custom of practicing coitus during pregnancy. At the
end of the first century, Soranus, the first of great gynaecologists,
stated, in his treatise on the diseases of women, that sexual intercourse
is injurious throughout pregnancy, because of the movement imparted to the
uterus, and especially injurious during the latter months. For more than
sixteen hundred years the question, having fallen into the hands of the
theologians, seems to have been neglected on the medical side until in
1721 a distinguished French obstetrician, Mauriceau, stated that no
pregnant woman should have intercourse during the last two months and that
no woman subject to miscarriage should have intercourse at all during
pregnancy. For more than a century, however, Mauriceau remained a pioneer
with few or no followers. It would be inconvenient, the opinion went, even
if it were necessary, to forbid intercourse during pregnancy.[14]

During recent years, nevertheless, there has been an increasingly strong
tendency among obstetricians to speak decisively concerning intercourse
during pregnancy, either by condemning it altogether or by enjoining great
prudence. It is highly probable that, in accordance with the classical
experiments of Dareste on chicken embryos, shocks and disturbances to the
human embryo may also produce injurious effects on growth. The disturbance
due to coitus in the early stages of pregnancy may thus tend to produce
malformation. When such conditions are found in the children of perfectly
healthy, vigorous, and generally temperate parents who have indulged
recklessly in coitus during the early stages of pregnancy it is possible
that such coitus has acted on the embryo in the same way as shocks and
intoxications are known to act on the embryo of lower organisms. However
this may be, it is quite certain that in predisposed women, coitus during
pregnancy causes premature birth; it sometimes happens that labor pains
begin a few minutes after the act.[15] The natural instinct of animals
refuses to allow intercourse during pregnancy; the ritual observance of
primitive peoples very frequently points in the same direction; the voice
of medical science, so far as it speaks at all, is beginning to utter the
same warning, and before long will probably be in a position to do so on
the basis of more solid and coherent evidence.

Pinard, the greatest of authorities on puericulture, asserts that
there must be complete cessation of sexual intercourse during the
whole of pregnancy, and in his consulting room at the Clinique
Baudelocque he has placed a large placard with an "Important
Notice" to this effect. Fere was strongly of opinion that sexual
relations during pregnancy, especially when recklessly carried
out, play an important part in the causation of nervous troubles
in children who are of sound heredity and otherwise free from all
morbid infection during gestation and development; he recorded in
detail a case which he considered conclusive ("L'Influence de
l'Incontinence Sexuelle pendant la Gestation sur la Descendance,"
_Archives de Neurologie_, April, 1905). Bouchacourt discusses the
subject fully (_La Grossesse_, pp. 177-214), and thinks that
sexual intercourse during pregnancy should be avoided as much as
possible. Fuerbringer (Senator and Kaminer, _Health and Disease in
Relation to Marriage_, vol. i, p. 226) recommends abstinence from
the sixth or seventh month, and throughout the whole of pregnancy
where there is any tendency to miscarriage, while in all cases
much care and gentleness should be exercised.

The whole subject has been investigated in a Paris Thesis by H.
Brenot (_De L'Influence de la Copulation pendant la Grossesse_,
1903); he concludes that sexual relations are dangerous
throughout pregnancy, frequently provoking premature confinement
or abortion, and that they are more dangerous in primiparae than
in multiparae.

Nearly everything that has been said of the hygiene of pregnancy, and the
need for rest, applies also to the period immediately following the birth
of the child. Rest and hygiene on the mother's part continue to be
necessary alike in her own interests and in the child's. This need has
indeed been more generally and more practically recognized than the need
for rest during pregnancy. The laws of several countries make compulsory a
period of rest from employment after confinement, and in some countries
they seek to provide for the remuneration of the mother during this
enforced rest. In no country, indeed, is the principle carried out so
thoroughly and for so long a period as is desirable. But it is the right
principle, and embodies the germ which, in the future, will be developed.
There can be little doubt that whatever are the matters, and they are
certainly many, which may be safely left to the discretion of the
individual, the care of the mother and her child is not among them. That
is a matter which, more than any other, concerns the community as a whole,
and the community cannot afford to be slack in asserting its authority
over it. The State needs healthy men and women, and by any negligence in
attending to this need it inflicts serious charges of all sorts upon
itself, and at the same time dangerously impairs its efficiency in the
world. Nations have begun to recognize the desirability of education, but
they have scarcely yet begun to realize that the nationalization of health
is even more important than the nationalization of education. If it were
necessary to choose between the task of getting children educated and the
task of getting them well-born and healthy it would be better to abandon
education. There have been many great peoples who never dreamed of
national systems of education; there has been no great people without the
art of producing healthy and vigorous children.

This matter becomes of peculiar importance in great industrial states like
England, the United States, and Germany, because in such states a tacit
conspiracy tends to grow up to subordinate national ends to individual
ends, and practically to work for the deterioration of the race. In
England, for instance, this tendency has become peculiarly well marked
with disastrous results. The interest of the employed woman tends to
become one with that of her employer; between them they combine to crush
the interests of the child who represents the race, and to defeat the laws
made in the interests of the race which are those of the community as a
whole. The employed woman wishes to earn as much wages as she can and with
as little interruption as she can; in gratifying that wish she is, at the
same time, acting in the interests of the employer, who carefully avoids
thwarting her.

This impulse on the employed woman's part is by no means always and
entirely the result of poverty, and would not, therefore, be removed by
raising her wages. Long before marriage, when little more than a child,
she has usually gone out to work, and work has become a second nature. She
has mastered her work, she enjoys a certain position and what to her are
high wages; she is among her friends and companions; the noise and bustle
and excitement of the work-room or the factory have become an agreeable
stimulant which she can no longer do without. On the other hand, her home
means nothing to her; she only returns there to sleep, leaving it next
morning at day-break or earlier; she is ignorant even of the simplest
domestic arts; she moves about in her own home like a strange and awkward
child. The mere act of marriage cannot change this state of things;
however willing she may be at marriage to become a domesticated wife, she
is destitute alike of the inclination or the skill for domesticity. Even
in spite of herself she is driven back to the work-shop, to the one place
where she feels really at home.

In Germany women are not allowed to work for four weeks after
confinement, nor during the following two weeks except by medical
certificate. The obligatory insurance against disease which
covers women at confinement assures them an indemnity at this
time equivalent to a large part of their wages. Married and
unmarried mothers benefit alike. The Austrian law is founded on
the same model. This measure has led to a very great decrease in
infantile mortality, and, therefore, a great increase in health
among those who survive. It is, however, regarded as very
inadequate, and there is a movement in Germany for extending the
time, for applying the system to a larger number of women, and
for making it still more definitely compulsory.

In Switzerland it has been illegal since 1877 for any woman to be
received into a factory after confinement, unless she has rested
in all for eight weeks, six weeks at least of this period being
after confinement. Since 1898 Swiss working women have been
protected by law from exercising hard work during pregnancy, and
from various other influences likely to be injurious. But this
law is evaded in practice, because it provides no compensatory
indemnity for the woman. An attempt, in 1899, to amend the law by
providing for such indemnity was rejected by the people.

In Belgium and Holland there are laws against women working
immediately after confinement, but no indemnity is provided, so
that employers and employed combine to evade the law. In France
there is no such law, although its necessity has often been
emphatically asserted (see, e.g., Salvat, _La Depopulation de la
France_, These de Lyon, 1903).

In England it is illegal to employ a woman "knowingly" in a
work-shop within four weeks of the birth of her child, but no
provision is made by the law for the compensation of the woman
who is thus required to sacrifice herself to the interests of the
State. The woman evades the law in tacit collusion with her
employers, who can always avoid "knowing" that a birth has taken
place, and so escape all responsibility for the mother's
employment. Thus the factory inspectors are unable to take
action, and the law becomes a dead letter; in 1906 only one
prosecution for this offense could be brought into court. By the
insertion of this "knowingly" a premium is placed on ignorance.
The unwisdom of thus beforehand placing a premium on ignorance
has always been more or less clearly recognized by the framers of
legal codes even as far back as the days of the Ten Commandments
and the laws of Hamurabi. It is the business of the Court, of
those who administer the law, to make allowance for ignorance
where such allowance is fairly called for; it is not for the
law-maker to make smooth the path of the law-breaker. There are
evidently law-makers nowadays so scrupulous, or so simple-minded,
that they would be prepared to exact that no pickpocket should be
prosecuted if he was able to declare on oath that he had no
"knowledge" that the purse he had taken belonged to the person he
extracted it from.

The annual reports of the English factory inspectors serve to
bring ridicule on this law, which looks so wisely humane and yet
means nothing, but have so far been powerless to effect any
change. These reports show, moreover, that the difficulty is
increasing in magnitude. Thus Miss Martindale, a factory
inspector, states that in all the towns she visits, from a quiet
cathedral city to a large manufacturing town, the employment of
married women is rapidly increasing; they have worked in mills or
factories all their lives and are quite unaccustomed to cooking,
housework and the rearing of children, so that after marriage,
even when not compelled by poverty, they prefer to go on working
as before. Miss Vines, another factory inspector, repeats the
remark of a woman worker in a factory. "I do not need to work,
but I do not like staying at home," while another woman said, "I
would rather be at work a hundred times than at home. I get lost
at home" (_Annual Report Chief Inspector of Factories and
Workshops for 1906_, pp. 325, etc.).

It may be added that not only is the English law enjoining four
weeks' rest on the mother after childbirth practically
inoperative, but the period itself is absurdly inadequate. As a
rest for the mother it is indeed sufficient, but the State is
still more interested in the child than in its mother, and the
child needs the mother's chief care for a much longer period than
four weeks. Helme advocates the State prohibition of women's work
for at least six months after confinement. Where nurseries are
attached to factories, enabling the mother to suckle her infant
in intervals of work, the period may doubtless be shortened.

It is important to remember that it is by no means only the women
in factories who are induced to work as usual during the whole
period of pregnancy, and to return to work immediately after the
brief rest of confinement. The Research Committee of the
Christian Social Union (London Branch) undertook, in 1905, an
inquiry into the employment of women after childbirth. Women in
factories and workshops were excluded from the inquiry which only
had reference to women engaged in household duties, in home
industries, and in casual work. It was found that the majority
carry on their employment right up to the time of confinement and
resume it from ten to fourteen days later. The infantile death
rate for the children of women engaged only in household duties
was greatly lower than that for the children of the other women,
while, as ever, the hand-fed infants had a vastly higher death
rate than the breast-fed infants (_British Medical Journal_, Oct.
24, 1908, p. 1297).

In the great French gun and armour-plate works at Creuzot (Saone
et Loire) the salaries of expectant mothers among the employees
are raised; arrangements are made for giving them proper advice
and medical attendance; they are not allowed to work after the
middle of pregnancy or to return to work after confinement
without a medical certificate of fitness. The results are said to
be excellent, not only on the health of the mothers, but in the
diminution of premature births, the decrease of infantile deaths,
and the general prevalence of breast-feeding. It would probably
be hopeless to expect many employers in Anglo-Saxon lands to
adopt this policy. They are too "practical," they know how small
is the money-value of human lives. With us it is necessary for
the State to intervene.

There can be no doubt that, on the whole, modern civilized
communities are beginning to realize that under the social and
economic conditions now tending more and more to prevail, they
must in their own interests insure that the mother's best energy
and vitality are devoted to the child, both before and after its
birth. They are also realizing that they cannot carry out their
duty in this respect unless they make adequate provision for the
mothers who are thus compelled to renounce their employment in
order to devote themselves to their children. We here reach a
point at which Individualism is at one with Socialism. The
individualist cannot fail to see that it is at all cost necessary
to remove social conditions which crush out all individuality;
the Socialist cannot fail to see that a society which neglects to
introduce order at this central and vital point, the production
of the individual, must speedily perish.

It is involved in the proper fulfilment of a mother's relationship to her
infant child that, provided she is healthy, she should suckle it. Of
recent years this question has become a matter of serious gravity. In the
middle of the eighteenth century, when the upper-class women of France had
grown disinclined to suckle their own children, Rousseau raised so loud
and eloquent a protest that it became once more the fashion for a woman to
fulfil her natural duties. At the present time, when the same evil is
found once more, and in a far more serious form, for now it is not the
small upper-class but the great lower-class that is concerned, the
eloquence of a Rousseau would be powerless, for it is not fashion so much
as convenience, and especially an intractable economic factor, that is
chiefly concerned. Not the least urgent reason for putting women, and
especially mothers, upon a sounder economic basis, is the necessity of
enabling them to suckle their children.

No woman is sound, healthy, and complete unless she possesses
breasts that are beautiful enough to hold the promise of being
functional when the time for their exercise arrives, and nipples
that can give suck. The gravity of this question to-day is shown
by the frequency with which women are lacking in this essential
element of womanhood, and the young man of to-day, it has been
said, often in taking a wife, "actually marries but part of a
woman, the other part being exhibited in the chemist's shop
window, in the shape of a glass feeding-bottle." Blacker found
among a thousand patients from the maternity department of
University College Hospital that thirty-nine had never suckled at
all, seven hundred and forty-seven had suckled all their
children, and two hundred and fourteen had suckled only some.
The chief reason given for not suckling was absence or
insufficiency of milk; other reasons being inability or
disinclination to suckle, and refusal of the child to take the
breast (Blacker, _Medical Chronicle_, Feb., 1900). These results
among the London poor are certainly very much better than could
be found in many manufacturing towns where women work after
marriage. In the other large countries of Europe equally
unsatisfactory results are found. In Paris Madame Dluska has
shown that of 209 women who came for their confinement to the
Clinique Baudelocque, only 74 suckled their children; of the 135
who did not suckle, 35 were prevented by pathological causes or
absence of milk, 100 by the necessities of their work. Even those
who suckled could seldom continue more than seven months on
account of the physiological strain of work (Dluska,
_Contribution a l'Etude de l'Allaitement Maternel_, These de
Paris, 1894). Many statistics have been gathered in the German
countries. Thus Wiedow (_Centralblatt fuer Gynaekologie_, No. 29,
1895) found that of 525 women at the Freiburg Maternity only half
could suckle thoroughly during the first two weeks; imperfect
nipples were noted in 49 cases, and it was found that the
development of the nipple bore a direct relation to the value of
the breast as a secretory organ. At Munich Escherich and Bueller
found that nearly 60 per cent. of women of the lower class were
unable to suckle their children, and at Stuttgart three-quarters
of the child-bearing women were in this condition.

The reasons why children should be suckled at their mothers' breasts are
larger than some may be inclined to believe. In the first place the
psychological reason is one of no mean importance. The breast with its
exquisitely sensitive nipple, vibrating in harmony with the sexual organs,
furnishes the normal mechanism by which maternal love is developed. No
doubt the woman who never suckles her child may love it, but such love is
liable to remain defective on the fundamental and instinctive side. In
some women, indeed, whom we may hesitate to call abnormal, maternal love
fails to awaken at all until brought into action through this mechanism by
the act of suckling.

A more generally recognized and certainly fundamental reason for suckling
the child is that the milk of the mother, provided she is reasonably
healthy, is the infant's only ideally fit food. There are some people
whose confidence in science leads them to believe that it is possible to
manufacture foods that are as good or better than mother's milk; they
fancy that the milk which is best for the calf is equally best for so
different an animal as the baby. These are delusions. The infant's best
food is that elaborated in his own mother's body. All other foods are more
or less possible substitutes, which require trouble to prepare properly
and are, moreover, exposed to various risks from which the mother's milk
is free.

A further reason, especially among the poor, against the use of any
artificial foods is that it accustoms those around the child to try
experiments with its feeding and to fancy that any kind of food they eat
themselves may be good for the infant. It thus happens that bread and
potatoes, brandy and gin, are thrust into infants' mouths. With the infant
that is given the breast it is easier to make plain that, except by the
doctor's orders, nothing else must be given.

An additional reason why the mother should suckle her child is the close
and frequent association with the child thus involved. Not only is the
child better cared for in all respects, but the mother is not deprived of
the discipline of such care, and is also enabled from the outset to learn
and to understand the child's nature.

The inability to suckle acquires great significance if we realize
that it is associated, probably in a large measure as a direct
cause, with infantile mortality. The mortality of
artificially-fed infants during the first year of life is seldom
less than double that of the breast-fed, sometimes it is as much
as three times that of the breast-fed, or even more; thus at
Derby 51.7 per cent. of hand-fed infants die under the age of
twelve months, but only 8.6 per cent. of breast-fed infants.
Those who survive are by no means free from suffering. At the end
of the first year they are found to weigh about 25 per cent. less
than the breast-fed, and to be much shorter; they are more liable
to tuberculosis and rickets, with all the evil results that flow
from these diseases; and there is some reason to believe that the
development of their teeth is injuriously affected. The
degenerate character of the artificially-fed is well indicated by
the fact that of 40,000 children who were brought for treatment
to the Children's Hospital in Munich, 86 per cent. had been
brought up by hand, and the few who had been suckled had usually
only had the breast for a short time. The evil influence persists
even up to adult life. In some parts of France where the
wet-nurse industry flourishes so greatly that nearly all the
children are brought up by hand, it has been found that the
percentage of rejected conscripts is nearly double that for
France generally. Corresponding results have been found by
Friedjung in a large German athletic association. Among 155
members, 65 per cent. were found on inquiry to have been
breast-fed as infants (for an average of six months); but among
the best athletes the percentage of breast-fed rose to 72 per
cent. (for an average period of nine or ten months), while for