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•R•CO•D PERTH, WEDNESDAY, NOVEMBER 15, 1944.
NO. 3,154.
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ELLIOTT O ELLIOTT OPTICIANS Piccadilly Arcade Perth Tel. B7988
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bebunking the " Planned Tarenthond',,Ildvoeaev On what Scientific Evidence Does Birth-Spacing Rest? Disastrous Consequences for the Mother Youth aBetter Ally than "Spacing" e
In round numbers, then, it was found that infants born after an interval of but one year following a preceding birth faced a mortality which was one and a half times that met by infants born after intervals of two years or more. The lowest mortality for the entire first year of:life was enjoyed by in. (ants born four or more years after a previous childbirth. Dr. Woodbury s monograph is a scholarly study, largely objective; and it contains no suggestion whatever as By NICHOLAS J, EASTMAN, D.D. to what might be done to reduce infant mortality in the short-interval groups. But those interested in the furtherance of birth control were quick to see n remedy,
Birth control propagandists have sought to defend this shocking pray tic. on the ground that it assists parents to space their children intelligently. This article debunks that view by showing that "scientific" child spacing has disastrous consequences for the mother. Thus, on purely natural grounds, and apart from the immorality of the act, birth control is revealed as something' that should never exist.
In 1925 there appeared a monograph which has probably had more influence on the pattern of childbearing in the United States than any half-dozen other publications. Its title was " Casual Factors in In. fant Mortality; A Statistical Study Based on Investigations in Eight Cities." Its author was Robert Aforse Woodbury, Ph.D., then director of statistical. research in the Children's Bureau, U.S. Department of Labour. Dr. Woodbury's study is a meticulous analysis of the more important causal agents in infant mortality; and
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among other factors especial attention is given to the role played by the interval of time since the preceding birth. Mortality. After a careful survey of many as. pects of the problem the conclusion is reached that " the infants born after short intervals had a markedly high rate of mortality from all causes. Evidently some factor that is intimately connected with the short interval— perhaps through the influence of frequent births upon the mother' s health —affected adversely the chances of life of the infants who followed closely after preceding births." The specific infant mortality figures for the first year of life reported per 1000 were as follows: for those in whom the interval since the preceding birth was one year, 146.7 :for those in whom the interval wits two years, 98.6; for the three-yearinterval group, 86.6; and for those in whom the interval was four years and more, 84.9. The corresponding figures for neenatal deaths were: 51, . 2: 37.3 ;36.7, and 38.1. Stillbirth data followed a, similar trend.
Birth Control. Certainly, they, reasoned, if conception could be prevented in women during the first year or two after childbirth, the high mortality associated with the short interval could be prevented. And forthwith the Woodbury study became one of the corner-stones of the birth-mntrol movement and has temaincd so ever since. Upon it, indeed, is based the entire rationale, from a medical viewpoint, of so-called " child spacing," a term which has come to be a sort of euphemism for contraception in general. llforeover, information about this presumably high infant mortality associated with short-interval births has been given such wide circulation that it is frequently stressed in our lay periodicals, always with the implication that it is a generally accepted truth, almost one of the axioms of childbearing. For instance, in the September, 1943, issue of " Reader' s Digest," an article appeared entitled, " Questions on Childbirth ." It starts with the challenging querv: " How much do you know about the latest scientific findings as to childbirth?" Then follow a series of statements which the reader is supposed to check as "true" or " false." Accepted Facts. These comprise, in main, elementary and commonly accepted obstetric facts. Along with these, item No. 23 reads as follows: " Babies born at yearly intervals to a mother are as likely to live as if there were periods of several years between them." The answer is: " False. Where the interval between the birth of two babies is less than two years, the in-
fant mortality rate is one and a half times as high as if the children were spaced." A footnote states: "The :American Medical Association has verified the facts in this article." Here, then; again, are Dr. Woodbury' s figures, having reached ( after approval by the American Dledical A's soc•iation) the " Reader's Digest" with its millions of readers. Because of the wide influence which the Woodbury monograph has exerted, it would seem appropriate to review that portion of it which deals with the short-interval problem. This comprises an analysis of 8,196 births in Baltimore, all occurring between January 1 and - December 31, 1915, that is, 28 years ago. In view of the many life-saving advances which have been made both in pediatrics and obstretrics over this period, it would seem permissible to question whether conclusions drawn from births occurring in 1915 are valid today. conclusions. When all available data are analysed from the viewpoint of their statistical validity, it becomes clear that certain conclusions are significant beyond any question They seem clear-cut and inescapable: 1. Infants born from 12 to 14 months after a previous viable delivery ( that is, during the second year) have at least as low a still-birth and neo-natal mortality as do infants born after longer intervals. 2. The longer the interval between birth, the more likely the mother is to suffer from some form of hypertensive toxemia of pregnancy. The incidence of this complication is lowest when the interval is 12 to 24 months, significantly higher rwhen it is 24 to 48 months, and much higher when it exceeds four years. 3. In patients who have had a previous hypertensive toxemia of pregnancy, the likelihood of repetition becomes progressively greater as the in. terval becomes longer. 4. The incidence of the following conditions is no greater when the interval is 12 to 24 months than when it is longer: premature labour, anaemid, post-partum hemorrhage, and puerperal infection : nor are mothers in this brief-interval group less able to nurse their babies. The weight of the mature babies was approximately the same,regardless of the interval. Finallv, concerning the bearing of our findings on the practical issue Qf child spacing, the following question would seem permissible: In recommending child spacing for the health of mother and infant, hays (Continued on Page 4.)
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