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“To be mothers were women created and to be fathers men.”—Sayings of Manu.

I have spoken in the last chapter of the changes that came in the thoughts and attention of women in the first few months of the war. We saw how war spoke with a more powerful voice, and the women who had been snatching at power felt the quickening of a quite new spirit of humbleness. That uplifting was the great opportunity. Women discovered something stronger and more important than themselves.

Our inquiry now is this: What has happened since then? what fresh conditions is war developing or likely to develop? And first it is well to note the strange power of war to stir us into action. Two years ago it would have seemed impossible to feed the hungry and clothe the ragged and to turn all the wasters and slackers into vigorous heroes. Now these things have been done; and much that in peace time seemed a far-off possibility has become a present fact.

War has a terribly effective way of dealing not only with men but with their problems. And one result is that a quite new interest is being taken in motherhood and child welfare.

England can no longer afford to be wasteful of the lives of her citizens. She has been wasteful in the past, and her new mood of caring must be made a conviction and a purpose.

As a result of this world war there has been and will continue to be an immense sacrifice of men, much in excess of any wars in the past history of nations, and it is evident that every belligerent country must lose from her best male stock; and it is not only the physically fittest, but the mentally and morally fittest, that are sacrificed.

For years to come the birth rates will be lowered throughout the greater part of Europe. In our own land the situation is one that must give fear. Our death rate has been very high in numbers and in quality, while at the same time our birth rate has been the lowest on record. Even the civilian death rate has risen; and, worst and most menacing of all, the infantile mortality rate has risen two per thousand above the average of the last two years.

Put these grave facts together, and, with even a fraction of realisation of their meaning, it becomes clear that we have to face a wastage of life unparalleled in the annals of our race. What are we going to do?

Now, I am not one who believes in the advantage, or even in the possibility of any forced excess in procreative activity. Numbers are of less importance to a nation than the moral, mental, and physical superiority of its men. The wholesale waste of these qualities in war is just what must be of such enormous menace to the future. The nation that does nothing to meet this and to ensure as far as possible the superiority of the next generation of her children will gain nothing even from victory, for it will mean only defeat in the future.

The issues of life and death have by the lurid war-light been forced upon our attention. And again I ask, What are we going to do?

The answer is plain. This terrible loss of life and of the forces of life abroad in war must be made good by a more intelligent and efficient care of the young lives at home. This we must do, and we must do it quickly. It is possible for a nation by such increased care of the rising generation of its children to compensate itself for the loss of lives during the war within a comparatively short period after the close of war. Indeed, if we have the will, as we possess the means, we can make it true that because of the war there will be more people—yes, and healthier and happier—in this land of ours in ten or fifteen years’ time than if the war had never happened.

This is what we can do. Shall we do it? The answer is with women. We can, within limits, do almost what we please. There has come to us a great opportunity, and out of the gates of death itself we may snatch life.

Much waits to be done, not only in the actual saving of infantile life, but further, by providing effective and prompt remedies to all bad conditions of living, so that the health and the mental capacity and moral character of the children dependent upon these conditions, or related to them, may be raised and maintained at a right standard of efficiency. Then we have to realise that more even than this is needed, and that all our efforts will fail of their full effect unless we go further back than the child, and the problem of the mother be frankly faced. The question of infantile mortality and child welfare is really the question of motherhood. And there is now no ultimate need of the State greater, more imperative, than this of securing a more enlightened motherhood.

This need is the reason for my book. I know that the days of war are not a time suitable either for the writing or reading of long books. Yet I offer no apology, so convinced I am of the urgency of this matter of saving motherhood that I had to write.

The object of my book is twofold. First, to put forward a fresh plea for assigning that high value to motherhood in practice which at present it receives only in words. This would ensure at once right conditions for all mothers and all children; it would also serve better than anything else to do away with many age-old mistakes, misunderstandings and disorder. In the second place (or rather in connection with all that is said), I wish to set forth what seem to me to be the chief causes that hitherto have hindered motherhood and bound my sex from the full enjoyment of life; and to suggest that the reason of this bondage is not, as is so often stated, the aggressive selfishness of men, but is due much more to women’s own actions, to their absurdly wrong education and entire misunderstanding of the sexual life; a misunderstanding which has decided the direction in which they believed the freedom they have been so ardently, yet wastefully seeking, was to be found.

So that we may understand our present failures better, I have attempted to seek causes and to suggest reasons. My inquiry reaches back before human parenthood and examines the parental instinct in its making; it shows the way and for what reason this instinct of caring for the young became fixed and stronger in the mother than in the father. It sets out from this beginning, and, after a short chapter on primitive motherhood, passes to the consideration of women and the home, marriage as it affects parenthood, the unmarried mother and sexual relationships outside of marriage, as well as other allied questions. It tries to offer a practical solution to some of the problems involved, in particular the problem of education and new ideals of conduct and sexual health for all girls. It recommends a revolution in our schools and methods of training; changes that must, as I believe, be made, unless we are prepared to accept as inevitable the decay of motherhood, as well as an increasing failure of happiness in marriage, with its resulting antagonism between sex and sex.

But to return to this present introductory chapter. I have upon my study table two documents. The one is that from which I have taken the quotation placed before this opening section of my book. It is the Annual Report for 1914,[2] of the Chief Medical Officer of the Board of Education. The second consists of two pamphlets on the Health of Munition Workers, treating of the Hours of Work and Employment of Women, both prepared by the command of Right Hon. D. Lloyd George, and published in connection with the important illustrated Report, which shows and explains all the numerous and different engineering operations on which women are now engaged in munition work. The object of the Report is to attract more women workers; but it is with the two pamphlets I am concerned. For the present, however, I shall leave them, returning to them later in order to show how closely they are connected with the other Report, which treats of infant mortality, child disease and neglect, and all the wastage of motherhood. It is on the shameful significance of the facts given in this Report that we must now fix our attention.

It would be difficult to find a more complete condemnation of motherhood. The Report is full of condemning facts. For, let us not disguise it from ourselves that, in spite of much that has been done, many efforts and real improvements, motherhood remains very evil; about the lives of little children lurk cruelties, disease, dirt, and neglect that ought not to be permitted.

Let me take one group of facts from this Report; facts that cry out to us all how urgently wrong things are. In the year 1914, 92,166 children died in England and Wales under one year of age. Think of the wanton wastage: in every thousand children born one hundred and five have died. Their number of the year’s toll of new lives reaches close up to the recorded deaths for the first fifteen months of war![3] And the evil does not end here, for the bad conditions which kill these babies act also in maiming and disabling, or at least in lowering the health standard, of many of the children who live, and thus add to the number of those who die in the early years of childhood, or survive only with enfeebled bodies and defective minds. And, further, no account is taken here of the lives that are lost before birth takes place: I mean the still births and abortions, the ante-natal deaths of which no record is kept. Our tendency is to assume that life begins at the birth, whereas the life of each child starts at the moment of its conception. Thus the birth rate is really the survival from the conception rate. And the destruction of life before birth from adverse ante-natal conditions is probably larger than the death rate in the first post-natal year.

You will see that the problem is sufficiently grave. And this unnecessary waste—for it is unnecessary—is going on every year, and will go on until we begin to feel it strongly enough to take action to prevent it. It can be prevented. The chief causes of infant mortality are briefly two—

(1) Poor physique of the mother or inheritable disease in one or other parent, causing premature births with weakened constitutions and congenital defects in the children.

(2) Ignorance of mothers in appropriate infant care and low standard of home life; bad feeding and insanitary conditions are accountable for the greater number of child deaths.

We find the infantile death rate is much higher in urban communities than it is in rural England. It is well to give a table to show this—

	Annual Rates per 1000 living	Annual Rates per 1000 births
	Birth Rate.	Death Rate.	Diarrhœa and Enteritis (under two years).	Infant Mortality Rate.
England and Wales	23.8	13.7	20.4	105
97 great towns (including London)	25.0	15.0	26.1	114
145 smaller towns	23.9	13.1	19.8	104
England and Wales less the 242 towns	22.2	12.4	12.6	93
London	24.3	14.4	27.6	104

Consider the reason for this difference in the death rates—114 deaths per 1000 in the great towns, 104 in the smaller towns, and 93 in the country districts. Does not this prove that children are killed by the conditions into which they are born. It is obvious that urbanisation, with all that it means of unhealthy living, with factory work and the employment of women, exerts a profound effect on the lives and health of little children.

A portion of infant and child mortality represents, I well know, the removal from life of diseased children who ought never to have been born, and would not have been born under different sexual conditions, for this, above all, is a question of instructed motherhood. I am not forgetting this side of the problem. But these children, doomed to death from the time they are conceived, represent a fraction only of our infant mortality. The vast majority of babies are born healthy; it is we who kill them. Though the fact of the falling birth rate is being shouted aloud with an ever-increasing fear and insistence, the plain, simple fact is neglected; it is absurd to go on having more babies if we can’t first care enough to keep alive the babies that we have. There are still too many births for our civilisation to look after; we are still unfit to be trusted with a rising birth rate.[4]

Let us consider now how our neglect acts on the children who fight through the first years of infancy. I can take a few facts only chosen almost at hazard from the mass of similar evidence in the Educational Report. In London, out of 294,000 children medically examined, 101,000 or nearly half, were found to be in need of treatment. In England and Wales 391,352 children of school age were medically attended. A summary of the returns shows a wide prevalence of verminous uncleanness, the percentage being 18.1 per cent. for the heads and 11.8 per cent. for the bodies of the children. Again the figures show unclean conditions to be most prevalent in the towns, in some instances the percentage rising as high as thirty unclean children out of each hundred children examined. I ask you to think what this implies.

The nutrition of the children is equally bad, the different counties varying in percentage between five and twenty. Stockton-on-Tees has the unenviable distinction of standing the highest—thirty out of each hundred of its children showing signs of malnutrition. The same Report shows the fatal prevalence among the children of rickets, eye disease, discharging ears, and diseases of the throat and nose.[5] The proportion of defective teeth is higher than any malady and often exceeds seventy and eighty per cent. of the school entrants.

We should note that insufficient or unsuitable food is the chief cause of malnutrition and illness in children, and investigations seem to show that wrong feeding is the more prevalent. Thus Dr. Gould, writing of the children he examined in Bolton, says, “it is obvious that defective nutrition is due to dietetic ignorance on the parents’ part or to parental neglect.” Dr. Macdonald of Northampton, reporting on 448 cases examined in 1914, corroborates this view, stating in the course of his report of adenoidal children, “Many are suffering, not from insufficiency of food (that, I think, far from common in Northampton), but from bad food and badly prepared food.” Again, Dr. Orr of Shrewsbury writes, “The subject of unsuitable food is a very important one. The women of the working classes often show a surprising ignorance of the proper methods of cooking for family requirements, a want of knowledge of the value and suitability of food stuffs, and too often a general incompetence respecting household management.”[6] I may add as corroboration an instance from my own knowledge; one that would be comic, if it were not so piteous. A party of poor workings girls were invited to a meal; they were asked what they would like to have to eat. They answered, “Bread and pickles,” and added, “Pickles are so sustaining!”

Who can doubt the greatness of the evil that is going on? I could add many more facts at least equally impressive with the few that I have given, all witnessing to weakness in the constitution of our children, to disease and dirt, and every other painful result of ignorance and neglect. And does not all this speak of unfit motherhood; of women ill-trained as women and incapacitated for their supreme duty? There is failure somewhere. We have to find out where that failure is.

For I wish to make it very clear that I am not blaming the individual mother. What I do blame are the conditions of our civilisation that have called her into being. I have before me the admirable but infinitely distressing book, Maternity: Letters from Working Women. They are the outcome of an inquiry into the condition of working-class motherhood made by the Women’s Co-operative Guild. Nothing that I can say, or that any other writer could say, can have the reality and the bitter vividness of these letters written by the women themselves. I am able to quote only scattered sentences taken from a few letters just as they come and without special selection.

(1) Mother Injured in Girlhood

“Through being left without a mother when a baby—father was a very large farmer and girls were expected to do men’s work—I, at the age of sixteen, lifted weights that deformed the pelvis bones, therefore making confinement a very difficult case. I have five fine healthy girls, but the boys have all had to have the skull-bones taken away to get them past the pelvis. … I wish more could be done to train growing girls to be more careful.”

(2) A Wage-Earning Mother

“I myself had some very hard times, as I had to go out to work in the mill. I was a weaver and we had a lot of lifting to do. My first baby was born before its time, from me lifting my piece off the loom onto my shoulder. … If I had been able to take care of myself I should not have had to suffer as I did for seven weeks before the baby was born, and for three months after, and then there was the baby suffering as well, as he was a weak little thing for a long time, and cost pounds that could have been saved had I been able to stay at home and look after myself.”

(3) A Mother’s Injury To Her Daughters

“I am very pleased to say that, having one of the best of husbands, I suffered nothing during pregnancy, only ailments of my own caused through my mother having to work in the brickyard during her pregnancy with me. That, I am sorry to say, is the cause of my own and my sister’s illness … and that thing will go on until women give up hard work during pregnancy.”

(4) Worked too Hard as a Girl

“My third child was born nine years after the second. … She lived six hours, and was convulsed from birth. The doctor’s opinion was that I had worked too hard as a girl lifting heavy weights, therefore weakening the whole system.”

(5) The Results of Poverty

“I think a great deal of suffering is caused to the mother and child during pregnancy by lack of nourishment and rest, combined with bad housing arrangements. The majority of working women before marriage have been used to standing a great deal at their work, bringing about much suffering which does not tell seriously until after marriage, particularly during pregnancy. … I believe that bad housing arrangements have a very bad effect on mothers during pregnancy. I know of streets of houses where there are large factories built, taking the whole of the daylight away from the kitchen, where the woman spends the best part of her life. On the top of this you get the continual grinding of machinery. The mother wonders what she has to live for; if there is another baby coming she hopes it will be dead when it is born. The result is she begins to take drugs. … All this tells on the woman, physically and mentally; can you wonder at women turning to drink?”

(6) Another Case of Poverty and Overwork

“The first part of my life I spent in a screw factory from six in the morning till five at night, and after tea used to do my washing and cleaning. I only left two weeks and three weeks before my first children were born. After that I took in lodgers and washing, and always worked up till an hour or so before baby was born. The results were that three of my girls suffer with their insides. None are able to have a baby. One dear boy was born ruptured on account of my previous hard work.”

(7) The Evil of Sexual Ignorance

“Judging from my own experience, a fair amount of knowledge at the commencement of pregnancy would do a lot of good. One may have a good mother who would be willing to give information, but to people like myself your mother is the last person you would talk to about yourself or your state. … I have learnt the most useful things since my children grew up. The idea that you impress the child all through with your habits and ways, or that its health is to a great extent hindered or helped by your own well-being, was quite unknown to me.”

(8) Another Case

“When I was married, I had to leave my own town to go out into the world, as it were, and when I had to have my first baby, I knew absolutely nothing, not even how they were born. I had many a time thought how cruel (not wilfully, perhaps) my mother was not to tell me all about the subject when I left home. … When my baby was born I had been in my labour for thirty-six hours, and did not know what was the matter with me. … It was only a seven-months baby, and I feel quite sure if I had been told anything about pregnancy it would not have happened. I carried a heavy piece of oilcloth, which brought on labour. … I knew very little about feeding children, when they cried I gave them the breast. If I had known then what I know now my children would have been living. I was ignorant, and had to suffer severely for it, for it nearly cost me my life, and also those of my children. I very often ponder over this part of my life. I must not say anything about my mother now, because she is dead, but I cannot help thinking what might have been if she had told me.”

(9) Healthy Motherhood, Given as a Contrast

“Although I have had eight children and one miscarriage, I am afraid my experience would not help you in the least, as I am supposed to be one of those women who can stand anything. During my pregnancy, I have always been able to do my own work.

“With the boys labour has only lasted twenty minutes, girls a little longer. I have never needed a doctor’s help, and it has always been over before he came. … My idea is that everything depends on how a woman lives, and how healthy she was born. I had the advantage of never having to work before I was married and never have wanted for money, so when the struggle came I had a strong constitution to battle with it all.”

(10) Another Fortunate Case

“I must be one of the fortunate ones. I have always had fairly good health during pregnancy and good times at confinements and getting up. … I owe my good health to being well nourished and looked after by my mother when I was a growing girl. I think if all young girls of to-day are properly cared for, it will make all the difference to the mothers of the future, and save much suffering during pregnancy and after.”

I should like to quote further from these letters, which have filled me with a passion of protest and pity. But why should I go on bringing fresh arguments to prove what already is sufficiently clear?

Give but a moment’s attention to the facts that stand out in these eight summarised cases, and at once you will grasp what is wrong. These mothers have not been equal to their task of child-bearing; we have demanded from them too much. We have permitted the weakening of their constitutions from girlhood with unsuitable and too heavy work, and we have allowed them to grow up and marry sexually ignorant. What wonder that so many have failed in their supreme work of motherhood. The women bitterly feel this failure; many of them are convinced of the evils that have resulted to themselves and their children from their own overstrain through work and their ignorance of sexual hygiene and mother-craft.

Take now a few briefly summarised results of all these three hundred and forty-eight examined cases of motherhood. We find the following figures: Total number of live births, 1,396, 80 still-births and 218 miscarriages. These figures speak for themselves. It is probable all miscarriages are not given, but even those that are stated show a pre-natal death rate of 21.3 per 100 deaths. And we have no record of abortions, which, without doubt, are very numerous. According to some medical authorities the frequency of abortion “is believed to be about 20 to 25 per cent. of all pregnancies.” Consider the following facts: two of these women each had ten miscarriages; one woman had eight miscarriages and no living child, while a second woman, after suffering seven miscarriages, consoled her motherhood by adopting an orphan boy; another woman gave birth to five dead children; the record of still another woman is three still-births and four miscarriages. The last of these mothers writes: “I had to work very hard to do everything for my little family, and after that I never had any more children to live. I either miscarried or they were still-born.”

The post-natal deaths are also numerous. Of the three hundred and forty-eight mothers, eighty-six (or 24.7 per cent.) lost children in the first year of life. The total number of deaths rises to 122, or 8.7 per 100 live births, and it should be noted that 50 per cent., or one half of these deaths, occurred during the first month of infantile life or were due to wrong birth conditions when death was after the first month.

It seems useless to comment further upon these facts; the figures speak with sufficient clearness for themselves. I would ask you, however, to remember them; I would ask you to try to understand all that they mean of our deplorable neglect of motherhood.

For long we have been persistently assuming that the characteristics of the child at birth are genetic or hereditary and therefore can be but slightly affected by a favourable or an adverse nurture. This is a monstrous error. Very few indeed are the defects and the diseases that are inevitable and part of the birth-inheritance, rather they are traceable directly to malnutrition or poison in the mother, and by this means the fresh life is weakened or infected before it is born. So much the greater is the importance of ante-natal nurture. The child can be saved only through the mother. Inferior mothers must result in inferior children. And what we need now for the future maintenance and welfare of our race in adequate numbers and quality, is a speedy and practical recognition of the truth that nothing will avail us if we so educate, train, and work our women that as mothers they fail in their creative hour.

Let us now consider briefly how these matters stand in our land at the present time, and let us examine them in the light of these facts we have established of an over-burdened and, therefore, unfit motherhood. And the first thing we find is that the special conditions brought about by the Great War have greatly increased the problem we have to solve. I have already referred to the Report issued by the Health of Munition Workers Committee on “Employment of Women” and “Hours of Work.” They give summary accounts of the conditions of women’s labour and what is actually going on. I confess that what is stated has filled me with the gravest fears. I will give a few of the facts as they are set down.