reaching ahead through them in order to affect, if possible, generation
after generation of people yet unborn--this is a kind of immortality
snatched from death and a satisfaction, though composed entirely of
hope, that parents prize. Strong-souled people feel that their
personalities are worth perpetuating, especially in conjunction with
their beloveds'! In proportion to their love of life, to the strength of
their joy and the clarity of vision of even better things, people find
one lifetime all too short to fulfill the expanding urges within them.
In their children they see human beings who may carry on their work, or
at any rate transmit their traits to grandchildren and
great-grandchildren.
Just at present people who have found life good, the ideal parents, feel
the need of entrusting the future to people like themselves, the
desperate need to keep power from falling into the hands of morbid
madmen who, under the pretext of enlarging life, precipitate horrible
wars precisely because they themselves, starved, oppressed, or
humiliated from the cradle, have never found life good. Yes, our
children can make all the difference between a life full of hope for the
future of the race and one of pessimism and despair. It is this sense of
children as carrying something of ourselves, our tempers, our hopes,
into the future which is at the bottom of what we call the eugenic
urge--the desire, that is, to beget good stock and pass on only the best
in us.
About the obvious pleasures that children bring, the fascination of
seeing their characters unfold, the happiness of festivals like
Thanksgiving, Christmas, and Easter, which without children lose half
their charm, it is not necessary to speak.
For our purposes, however, the point is that there are literally dozens
of reasons why nearly all of us want children. The problem is when to
have them and in what numbers. For modern man likes to know what he is
about in this world and to direct and control his destiny in the light
of other knowledge and experience.
The time for the first baby is a question of readiness on the parents'
part. Are they ready physically, psychologically, economically? These
are not, of course, three separate ways of being ready; they are
interdependent ways, but they offer suitable heads under which to
discuss the subject.
Economic readiness is of utmost importance. Insecurity of employment,
insufficient means to provide the mother and baby with medical
supervision and good food, or looming debts are in themselves sufficient
to prevent prospective parents from attaining the other kinds of
readiness--physical and psychological. On the other hand, young people
with steady incomes should not postpone having children merely because
those incomes are not high. Three can live almost as cheaply as two,
especially in the child's first years. It is the expense of
hospitalization and doctor's care, during pregnancy and throughout the
first year or two following the birth, that sometimes threatens to
unbalance the family budget. This additional expense must be provided
for. It need not be great--a matter of a few hundred dollars, often less
in various parts of the country. The doctor's fee for pre-natal care and
delivery will correspond roughly, unless he is a senior specialist of
great reputation (by no means a necessity for healthy people), to the
expense for hospitalization. The latter can frequently be obtained for a
hundred dollars or less--though rarely, if ever, in a big city--making
the total cost of getting the baby about two hundred dollars. In many
parts of the country hospital schemes, into which you make a monthly or
yearly payment, make it possible to get two weeks' hospitalization for
mother and baby, with semi-private room, use of delivery room, and
nursing care, for about ten dollars. This effects an obvious saving, and
has done a great deal to bring children within the reach of all. During
the first year or so the mother needs to be quite free to call on her
doctor for service or advice whenever she wishes. Sometimes the doctor
will be glad to arrange a flat charge for a year's attention, say a
hundred dollars, or more or less, depending on the family income. Such
an arrangement often does the parents a great deal of good, putting
their minds at rest, for they feel they can call on the doctor in all
reasonable emergencies, ask him all necessary questions, expect periodic
visits to their baby, and receive all necessary vaccinations and
immunizations for a fee they can afford. The sum may be paid in monthly
or quarterly installments.
Money for the child may be saved out of monthly earnings. This
well-known phenomenon is called saving for children. Very often the
parents of the married couple are glad to help them with the extra
expense involved in having their first child. I do not mean by
loans--for it is not good for young people to be in debt, even to loving
creditors--but by actually undertaking to pay the hospital and the
physician. If people are ready for a baby in all other ways and only
money keeps them from parenthood, the prospective grandparents often
feel it their duty to help in this way. Dr. Josephine Hemenway Kenyon,
director of the Health and Happiness Club of _Good Housekeeping_, has
often made the wise suggestion that fathers give, in addition to any
other wedding present, a $500 or $1000 bond, called "The Baby Bond," to
be kept to meet the expenses of bringing the first baby into the world
and protecting its first year of life. This idea appealed so strongly to
some parents that Dr. Kenyon went even further, suggesting that young
parents who can afford it take out a ten-year endowment policy of $1000
for their thirteen-year-old children, to be available when these
children are twenty-three, if needed, to help them start their own
families.
The question of the right age for parenthood is naturally of importance.
But it depends on many factors, chief among which, after the economic
problem has been disposed of, are physical and psychological health.
Some time between twenty-three and twenty-eight seems to me to be a
satisfactory time for a woman to bear her first baby; but any time up to
thirty-five presents no difficulty, provided the physical and mental
conditions are healthy and propitious. Plenty of women of forty and over
have been known to go through first and subsequent pregnancies
successfully, but there is no reason for postponing children to this age
except failure to find the right mate earlier in life. People who have
their first child when over thirty-five are themselves over fifty when
the child goes through adolescence--an age which may make it difficult
to help the child meet its crucial problems in the tone of one good
friend to another. If you cannot have your children before thirty-five,
you must make every effort to remain young enough for spiritual
companionship with them. The best age for parenthood is to be
determined, not in terms of years, but of physical and psychological
health and happiness.
In marriage psychological health and happiness are largely dependent on
love. It is of the utmost importance that every child should be a love
child, in the best sense of the term. Love is a splendor that eludes
definition, but it is characterized by an inexhaustible desire for the
beloved's company and a steadily burning fire of enthusiasm and
admiration. So-called disillusion in love comes from the failure of
these emotions. Young lovers, through plenty of courting and
companionship, should try to make sure of the lasting quality of their
love. This is sometimes impossible, however, and for this reason and
others I think it is just as well for married people to wait a year or
even two before having their first child. In the happiest marriages
there are many adjustments, unforeseen before the wedding, to be made.
And it may very well be that only in the continued intimacy of marriage
can the strength of love be tested. Only there can love gutter out or
prove itself stronger than death--so much stronger indeed, that, as it
deepens and widens in fullness and power, it turns of its own accord
directly toward the creation of more life.
* * * * *
In other words, the best time to have children is when the lovers, sure
of themselves and of each other, feel an imperious need to stamp the
gold of life with each other's images. I feel no hesitancy in urging
married couples to take a year or so to make sure of their love, if only
for the children's sake. Economic conditions being adequate, there is no
reason to suppose that real lovers will put off having children until
it is too late to obtain the best eugenic results. To paraphrase the
poet, we may say that those who restrain their desire for children do so
because their desire is weak enough to be restrained. Such people will
probably not make good parents. True lovers will beget children after a
year or two, nor will they mind making a few so-called sacrifices, as of
parties and new automobiles, for the sake of having children. They
recognize the distinction between entertainment and joy. Man may be a
laughing animal, but he is more essentially a creative animal. His
deepest pleasures are simply the by-products of his activity. In
building a home around a family of children both men and women often
find the deepest of all possible pleasures. And when it is in this
spirit of vital affection that the child is begotten, we get, as the
eugenists say, a vital fertilization. The chances are that children so
begotten will themselves be capable of strong, sound, deep-seated
feelings. As Dr. Kugelmass says in _Growing Superior Children_, "The
degree of emotional devotion of one parent to another is reflected
dominantly in the transmission of the more vital elements in the
constitution of the progeny."
To the question of physical readiness for childbirth I come last, but
not because it is of least importance. Without physical health the
parents cannot expect to beget healthy children, nor indeed can they, in
many cases, manage even to bear them. As everyone knows, women afflicted
with tuberculosis, heart disease, and kidney changes should probably
refrain from bearing children. But this is a matter for the doctor to
decide. Such people, if their troubles are not severe, may safely bear
at least one child, sometimes two. They should put themselves in the
hands of a good physician and rely implicitly on his findings and
advice. Sufferers from venereal diseases should not attempt to beget
children till they have been given a clean bill of health. Nor should
children be begotten when the body is weakened by temporary disease or
during the stage of debilitating after-effects. For disease and fatigue
affect sex cells unfavorably. So do mental strain, depression and
overexcitement. Unhealthy physical and mental states in the parents lead
to debilitated or deficient offspring. They open the way to the
operation of undesirable hereditary factors which generations of
self-controlled parents have been driving into the background and
attenuating to the point of disappearance. It is possible for the
father, too, to weaken his vitality by excessive sexual activity. In
fine, the best time for conception to take place is when the lovers'
sense of well-being, physical as well as mental, is at its fullest.
Full-bodied passion, which we may think of as a kind of crisis of love
and health, will give us offspring to be proud of. One thing we cannot
plan, however, is the sex of the child to come. Nor should we, in
general, wish to. It was the limited sphere of feminine activities that
once tended to make girls a debit, boys a credit. Nowadays girls have
just as many opportunities of becoming interesting human beings as have
boys. It is a favorite theory of my husband's that they may, and often
do, become more interesting, because they can do not only everything
that boys can do but one thing more--they can bear children, a
humanizing experience of the greatest possible value.
Should you wish to know what are your chances of having twins, I must
remind you that the tendency to give birth to them is an inherited
trait, especially through the father. Twins are much more likely to be
girls than boys, and to be born later rather than earlier in the
mother's married life. Thus it is three times more likely that a woman
of thirty-eight will give birth to twins than that a woman of
twenty-four will do so. Should you fear that the unpredictable
appearance of twins will unbalance your baby budget, you can, for a
moderate sum, insure yourself against this chance with many of the
larger insurance companies. The insurance must be taken out before the
existence of twins in the uterus can be diagnosed--that is, in the first
two or three months of gestation. One twin birth occurs to about 90
single births, one triple to about 8000, and one quadruple to about
650,000. In all medical literature only about 30 cases of quintuplets
have been recorded. Multiple births are not only rare, but the babies
are often so delicate that they are extremely difficult to rear. We can
be well pleased if our first pregnancy eventuates in a single healthy
baby of either sex.
All the reasons for wanting the first child apply in the case of the
second, and to them are added more. What was in the first instance
simply a hope and a vague if powerful urge has now grown into a
conscious desire, based on the self-knowledge and experience gained from
loving and looking after the first child. We have had a real taste of
the joys of home and family building, and now nothing short of economic
catastrophe is likely to stop us from building higher. I assume, of
course, that the mother did not encounter any severe difficulties in
giving birth to her first child. If she was in good medical hands, she
probably did not, though certain unusual formations of the pelvis may
have made her labor longer than usual. I do not say more painful,
because medical science has found ways of minimizing the pains of
childbirth. Even if it was found necessary to deliver the first child by
Caesarean operation, a woman in normal health can without danger bear at
least two children by this method. And at the very least a family should
include two children.
Quite apart from the parents' natural desire to go on expressing their
mutual love by building a full-voiced home on the foundations laid by
the first child, it soon becomes apparent that this first child, for the
sake of its own social and moral development, needs a little brother or
sister. It needs companionship. It needs to share its toys and its
parents. Otherwise it will tend to grow self-centered. By being too much
with grown-ups it may become moody and negative.
After the question, "Can you afford it?"--and I sincerely hope you
can--the next question facing the mother who wants a second child is,
"When can I bear it with the maximum amount of benefit to it, to my
first child, and to myself?" Clearly, if it is to be a playmate for the
first child, you will want to have it as soon as possible. But, in
fairness to both the mother and the child-to-be, there should elapse a
period of about two years between the birth of the first and the
conception of the second offspring. Less time than that will seldom
allow the mother, who put so much of her best blood and bone into
building and nursing the first baby, to recover fully her maximal
physical health and strength. All authorities are agreed on this point.
There may be exceptions, of course, and there are always mothers who, by
reason of having married late, perhaps, are anxious to have as many
babies as quickly as possible. But most women neither can nor will nor
should produce children in this fashion. There is too much risk of
weakening the mother's body and of begetting poor stock.
Later children may be spaced to suit the desires of the parents, a
recovery period of two years or more always being allowed the mother.
But will there be any later children? Dr. Ellsworth Huntington in his
contribution to this volume has told us that most of us who are not
shiftless and incompetent, on one hand, or wealthy and well-established,
on the other, belong to a group in which the average number of
children, including those who die young, is fewer than three. Dr.
Huntington rightly deplores this "rapid fall of the birthrate,
especially among intelligent, far sighted, industrious, progressive
people whose ideals of family life are high." The trouble with a family
of fewer than three is that it cannot be counted on to project very far
into the future those sound souls, that good biological inheritance,
which the parents flatter themselves are so definitely worth preserving.
A family of two or even three children will not, on the average, produce
two who, by becoming parents, may be thought of as replacing their
father and mother. Thus a family of fewer than four children may be said
to be dying out. This is a sorry state of things for those parents who,
as I said above, like to think of themselves as affecting the destinies
of the race by transmitting their best characteristics from generation
to generation.
When intelligent people are forced to limit their families to one or two
children by lack of money, it is a great pity. There is a great
abundance of good things in America, but we do not seem to be able to
get these things distributed in such a way as to do the most good. We
are all working for a better world, but are we working hard enough? I
sometimes think that we are not working so hard as we might, because our
stake in that better scheme of things is not large enough. If we dared
to have three or four children, with all the sacrifices implied, I
wonder whether this fact would not sharpen our scent on the trail of the
better America.
Lord Bacon said that those who have children have given hostages to
fortune. But I am inclined to think that those who have made large and
important bargains with chance are just those who will move heaven and
earth to guard against mischance. One aspect of the better America,
proposed by the American Eugenic Society, will perhaps be the adoption
of a sliding-wage scale, characterized by a rise in pay upon marriage
and with the arrival of each successive child.
That thoughtful people of our time, whether rich or not, will soon
return to having families as large as our grandparents' is extremely
unlikely. To bear ten or fifteen children would probably kill most
modern women or so completely wear them out that the remnant of their
lives would not be worth living. And families of this size would
similarly exhaust even unusually large pocket-books, leaving most
fathers insolvent. Though it is probably true, as economists say, that
our land and its resources, if more equitably distributed and
scientifically exploited, are capable of supporting many more millions
of Americans than at present, there seems to be no good reason for
stepping up the modern middle-class family beyond four or five children.
The reader will notice that I have been going on the assumption that
people can have children, and fine specimens at that, to order--when and
as they please. This is to a large extent true. The key to the mystery
is the doctor. Modern medical schools and modern law have entrusted into
his hands not only the physical but the mental well-being of his
patients. The tight interlocking of the body and spirit has been
everywhere recognized, and the impossibility, in many illnesses, of
healing one without treating the other. Positive well-being in the body,
so important for the begetting of strong children, is practically
inconceivable apart from positive happiness in the mind.
Thus it has become a prime tenet of eugenics that babies must not be
conceived under conditions of excessive mental worry or strain. Children
begotten in deprivation or the fear that they are going to lower the
whole family's standard of living to a painful pinch are not going to
have much chance, even while in the womb, to turn out fit and strong.
Judicious limitation of birth for reasons of health, the _whole_ health
of the parents, in behalf of the best possible grade of offspring has
therefore become a routine part of the physician's service to his
patients. Every married couple should put themselves in the hands of a
physician whom they respect and admire, making him an indispensable
third partner to their family planning. This crucial role of the doctor
in eugenics is one of the few really deeply encouraging signs of our
times.
_The Woman Asks the Doctor_, by Dr. Emil Novak of Johns Hopkins, gives
some idea of the role the modern physician may play in helping parents
plan the vigorous citizenry of the future. When the married lovers are
ready to have their children, it is naturally with the woman that the
doctor is most concerned, correcting structural or functional deviations
or mild organic disease before the pregnancy has advanced too far,
seeing to it that the glandular mechanisms do their important work, that
nutritional intake is sufficient, that digestion is kept successfully
functioning, that metabolic processes are raised to more than ordinary
efficiency, and that the body is kept free from all toxins and
infections. After the birth of the child the doctor will not only look
after the child but also see to it that the mother suffers no adverse
after-effects and is restored to her maximal health and efficiency as
soon as possible, ready to bear her next healthy baby when the time
shall come.
Should a baby be conceived unexpectedly, the doctor is often the best
person to help the parents handle the untoward situation. He can give
the mother's physical condition that special attention which it will
probably need if she has borne another child quite recently. If the
objection to the child arises from economic or psychologic
unpreparedness, there is no one better fitted, possibly, than the modern
physician for changing negative fear to positive desire. By the force of
his own enthusiasm for new life, by his vision of the modern family, by
a skillful combination of his common sense and psychiatric training, and
by his ability to arrange fees within the range of his worried clients,
he can usually turn the unplanned conception into a happy accident.
It is often to the physician, too, that the father must look for
practical guidance and encouragement in those unforeseeable cases when
the mother perishes in connection with childbirth. It is he who is in
the best position to prevent the father from unconsciously attaching
blame to the unoffending child and harboring an undefined resentment
which may adversely affect both lives. The doctor can help the bereaved
father to cling to his dream of family life, can assist him in building
a happy home for his motherless child or children, or can advise him on
problems which may arise out of finding a new mother for them.
Another important function of the physician is to give aid to couples
who have difficulty in begetting children. The question of sterility
comes up frequently in our time, especially among cultivated and
intellectual people. Persistent failure to conceive we term _absolute_
sterility; persistent failure to carry pregnancy to a successful end, we
call _relative_ sterility. The latter is an obstetric problem and can
usually be dealt with successfully. So can the former in about forty
percent of the cases. We must remember the rule formulated by Matthews
Duncan, that the marriage of persons between twenty and thirty cannot be
regarded as sterile until at least four years of normal, happy sexual
intercourse have elapsed. I have known half a dozen instances in which a
child was born after five, six, ten, and, in one case, fifteen years of
complete failure to conceive. In these cases no special efforts were
made by the couple to bring about conception.