These letters give an intimate picture of the difficulties, the
troubles, often the miseries, sometimes the agonies, that afflict many
millions of our people, as a consequence of normal functions of their
lives. An unwise reticence has prevented the public mind from realising
that maternity, among the poorer classes, presents a whole series of
urgent social problems. These letters give the facts. It is the first
time, I believe, that the facts have been stated, not by medical men or
social students, but by the sufferers themselves, in their own words.
The Women’s Co-operative Guild, unresting in their efforts for the
improvement of the conditions of working women, have rendered a most
useful service in eliciting these letters and in making them public.
It is necessary to take action to solve the problems that here stand
revealed, first for the elementary reason that a nation ought not to
tolerate widespread suffering among its members, if there are measures
by which that suffering can be obviated without indirectly causing
worse. “Woman,” says Kant, “is an end in herself, and not merely a
means to an end.” Apart from all question of social advantage, her
claim for help for her own sake, when she needs help to meet the
difficulties special to herself, is as valid as any other claim--as the
claim of the sick man, for his own sake, to be cured, as the claim of
the child, for his own sake, to be protected and to be taught.
Action is necessary also because, for the lack of it, the nation is
weakened. Numbers are of importance. In the competition and conflict of
civilisations it is the mass of the nations that tells. Again and again
in history a lofty and brilliant civilisation embodied in a small State
has been borne under by the weight of a larger State of a lower type.
The ideas for which Britain stands can only prevail so long as they
are backed by a sufficient mass of numbers. It is not enough to make
our civilisation good. It must also be made strong; and for strength,
numbers are not indeed enough without other elements, but they are none
the less essential. Under existing conditions we waste, before birth
and in infancy, a large part of our possible population.
How quickly some social evils will yield to treatment is seen in the
fact that in ten years the campaign against infant mortality has
reduced the death-rate among infants under one year of age by nearly
a third. But it is still very excessive. It is not race or climate or
the irreducible minimum of physical defect which accounts for a large
part at least of the present infant death-rate. In the same towns,
among people of the same stock, twice, sometimes three times, as many
infants, in proportion to the number born, will die in the wards where
the poorer classes live as die in the wards where the well-to-do
live. The excess is mainly due to ignorance, to malnutrition, to all
the noxious influences that go with poverty. Not nature, but social
conditions, are to blame for the evil. Therefore it is remediable.
The time is past when a shallow application of the doctrine of
evolution led people to acquiesce in a high infant death-rate. It was
thought that it meant merely the killing off of the weak, leading to
the survival of the fittest, and that the process, cruel in its method,
was beneficent in its end. There are few now who do not see that the
high death-rate is due, in large measure, to a bad environment; and
that by keeping a bad environment you produce unfitness. You partly
remedy the evil, it is true, by destroying a large number of lives
which have been made unfit to survive; but you leave, as a clog on the
community, numbers of others not killed but weakened. The conditions
that kill also maim.
The theory, too, is passing away that the country is over-full and that
the danger to be feared is not a lack of population but its excess.
Because many districts are overcrowded, it does not follow that these
islands as a whole are over-populated. So long as food supplies can be
relied upon from oversea, it is difficult to set limits to the numbers
that, under sound social conditions, this country can maintain.
The conclusion is clear that it is the duty of the community, so far as
it can, to relieve motherhood of its burdens, to spread the knowledge
of mothercraft that is so often lacking, to make medical aid available
when it is needed, to watch over the health of the infant. And since
this is the duty of the community, it is also the duty of the State.
The infant cannot, indeed, be saved by the State. It can only be saved
by the mother. But the mother can be helped and can be taught by the
State.
The local health authorities have large powers, and some already are
eager to use them. As President of the Local Government Board I was
able to submit to them a comprehensive scheme of assistance to mothers
in pregnancy, in confinement, and in the care of the infants, and to
offer, to such as chose to adopt it, a Treasury grant of one-half of
the modest expenditure involved. The need at the moment is to create
among the local councillors and their electors a body of opinion
which will secure the adoption of this scheme and its administration
on effective lines. Because I believe it will conduce to that end, I
commend this book the more readily.