CUSTOMS AT BIRTH
It has already been shown that the decay of the Fijian race is due, not
to a low birth-rate, but to an excessive mortality among infants. The
mean annual birth-rate for the ten years 1881-1891 was 38.48. This
compares very favourably with the mean annual rates of European
countries, which vary from 42.8 in Hungry to 25.9 in France. In England
the rate is 35.3.
The excessive mortality among Fijian infants makes it necessary to
examine very closely the practices of the native midwives at the risk of
wearying the reader with somewhat technical details.
Native midwives are generally the ordinary medical practitioners, and
are termed _Vu-ni-kalou_ (skilled in spirit-lore), or _Yalewa vuku_
(wise woman), though that term belongs more properly to the wives of the
hereditary _matai sau_ (canoe-wrights and carpenters). These women keep
their craft secret, and as a consequence it often becomes family
property, being handed down from mother to daughter. The natives assert,
however, that so far from the craft being regarded as hereditary, any
person who thinks she has discovered a new remedy is at liberty to
follow the business when so inclined. This opens a wide field to
quackery, of which any woman with more cunning or self-assertion than
her neighbours can avail herself for the sake of credit or of gain.
[Pageheader: MIDWIVES]
None but a few of the female relations of a lying-in woman are admitted
to the house when she is in labour, the mixed attendance customary in
Tonga on such occasions not being tolerated. When the labour pains begin
the woman assumes a squatting posture, but during the throes of
childbirth she lies back in the arms of two friends sitting behind her,
who support her shoulders while the midwife stations herself in front.
From a physiological point of view this is a disadvantageous position,
but it appears to be adopted by chance rather than design, it being a
natural posture for a people who both sleep and sit on a matted floor.
The midwife makes a digital examination for the purpose of ascertaining
the presentation, which is generally normal. The membranes are not
tampered with, and nothing else is done until after the natural birth of
the child. Then the midwife clears its mouth of mucus with her fingers
or with her lips. Midwives differ on the point of the moment at which
the umbilical cord should be severed. Some of them seem to know that the
cord pulsates, but they do not understand the reason, for the Fijians
know nothing of the circulation of the blood. They generally wait until
the child breathes or cries out. If it emits no cry the general practice
is to compress the cord between the finger and thumb, and to squeeze the
blood onward towards the child. Sometimes they rattle a bunch of _kitu_
(gourds) near its ear in the hope of awakening it. Neither artificial
respiration nor a dash of cold water is ever resorted to, though cold
water is used in Tonga in extreme cases, and the natives mention cases
in which children must have perished through the neglect of this
precaution. The cord is then measured from the navel to the knee, and
cut square across with a mussel-shell, or a bamboo knife. Now-a-days
scissors are sometimes used. It is never severed by biting as is done by
some natural races, nor is it ever tied or knotted. Native opinions vary
as to whether bleeding occurs in consequence of the cord not being tied.
The midwives deny that it does, but some women declare that it is a good
thing for the "bad blood" to drain out of the cord. Severance of the
umbilical cord without ligature is not so unsafe as might appear, for
the experience of obstetricians goes to show that there is less risk of
haemorrhage when the cord is left long, though, of course, bleeding is
more likely to occur from a clean transverse cut than from an oblique
cut, or a laceration. After division the foetal end is wrapped in a
shred of bark-cloth, and coiled down on the abdomen. The blood that
oozes from it is absorbed by the cloth, which is changed occasionally.
As soon as the child cries and the cord has been severed an attendant
washes it in cold water. A drink of cold water is given to the mother
with the view of stimulating the uterus to contract and expel the
afterbirth. Retention of the placenta is the one contingency dreaded by
native women, but the midwives say that it is as rare as it is
dangerous. Among the inland tribes the midwives often introduce the hand
to extract the placenta, but among the coast people they believe it to
be an experiment which is better left alone. In cases where the drink of
cold water fails in its intended effect, herbal infusions are
administered, and poultices are sometimes applied externally, but the
safe expedient of compressing the uterus by placing the hand on the
abdomen is unknown to Fijian midwives--a surprising fact in a nation of
masseuses. It seems clear that Fijian mothers sometimes die from
retained placenta, and that the blame is laid at the door of the midwife
if she has ventured upon any manual interference. One woman stated that
some of her friends went through life in dread of pregnancy through the
popular fear of retained placenta.
The occasional retention of portions of the membranes appears to puzzle
Fijian midwives. They lay particular stress upon the impropriety of
removing such fragments--_ai kumbekumbe_ (cleavings), they call
them--even when they have been extruded spontaneously, but, on the
contrary, are careful to tie them down _in loco_ under a bandage of
bark-cloth, trusting the rest to nature. They admit, however, that women
to whom this happens are usually feverish for some time, and they
evidently think the situation dangerous.
[Pageheader: FORTITUDE OF FIJIAN MOTHERS]
After the conclusion of the third stage of labour some midwives of the
inland tribes introduce the hand as far as the _bai ni yate_ (_lit._,
fence of the liver) or the _tuvu ni ngone_ (foetal source, _i.e.
Fornix vaginae_), and, bending the fingers, clear out all the clots they
can find. Others adopt the better practice of raising the mother to a
sitting posture to facilitate their discharge by gravitation.
An infusion called _wai-ni-lutu-vata_ (medicine for simultaneous birth)
is sometimes taken during the later months of pregnancy, to induce an
easy labour and the descent of the placenta at the proper moment.
Among the hill tribes of Vitilevu labour seems to be more easy and
expeditious than on the coast, and yet, notwithstanding their less
varied experience, the midwives of those tribes enjoy a higher
reputation for skill, and also follow more orthodox methods than their
sisters among the more enlightened tribes. Both, however, display the
same ignorance of the rudiments of physiology, and are as empirical in
their midwifery as in their treatment of ordinary sickness.
The infant mortality is attributed by many Europeans to the hard work
done by the women during pregnancy, and immediately after childbirth.
The native belief is that a woman should do no heavy work up to the time
of quickening, but that thenceforward the more she works the easier will
her confinement be. Though this maxim is universal, the practice during
pregnancy varies with the individual and the locality. Among the hill
tribes women leave their house as early as the day after their
confinement; they generally do so about the fifth day. Cases are
recorded in which a woman has gone out in the morning in an advanced
stage of pregnancy, and has returned in the evening with a load of
firewood on her back and a new-born child in her arms. But at Mbau, and
among the higher classes generally, women are kept to the house for a
full month, and among the high chiefs the _bongi ndrau_ (hundred days)
are observed, the mother abstaining from all but purely domestic
occupations for that period.
Accidents of childbirth seem to be rare with Fijian women. All the
midwives that have been questioned agree that mal-presentations are
uncommon, and that only one case of an arm-presentation had occurred
within their experience. When abnormal presentations do occur they are
regarded as being the fruit of an adulterous connection, and when the
child dies, as it invariably does, the death is put down to this cause
instead of to want of skill on the part of the midwife. The Vital
Statistics put the still births at 6 per cent., and in a few provinces
at 10 per cent., but it has been ascertained that many of these
represent cases of foetal death before delivery.
In western Vitilevu, the centre of belief in witchcraft, confinements
used to take place out of doors. A temporary hut is run up near the
yam-garden, often at a considerable distance from the village, and the
pregnant woman takes up her quarters there for the event. No preparation
is made beyond taking a rough creel, padded with dried grass, for the
reception of the new-born infant. The people use neither mat nor
bark-cloth for the purpose, being loath to destroy it afterwards, and
saying, "How will you get rid of the blood with which it will be
stained?" The hut, too, is floored only with grass. As a rule there is
no midwife, and the woman does all that is necessary for herself. The
key to these primitive customs is the belief in witchcraft. The most
effective tools of the wizard are the excretae of the intended victim. If
the woman was attended during her confinement a grass-blade, stained
with blood, might be secreted by a malicious person, and used to compass
her death. She uses no mats because mats are too precious to be wantonly
burned, and every mat she had used would be a weapon in the hands of her
enemies. So she brings her child into the world unaided, and burns the
hut and all it contains before she sets out for the village. Now, mark
how superstition works for sanitation. Whereas the child of the coast is
brought into the world in a stuffy hut, and swaddled in dirty
bark-cloth, reeking with impurities, the inland baby and its mother are
guarded against infection by a law of cleanliness more rigid than any
that the Mosaic code enjoined.
[Pageheader: PRACTICES OF THE GILBERT ISLANDS]
As the Gilbert Islanders are credited with being excessively prolific,
and are said to be the only race in the South Seas that would increase
if artificial means were not used to prevent the population exceeding
the capacity of the islands, it will be well to compare their methods of
midwifery as described by Tearabugu, a professional midwife. On her
island--Tamana--much attention is paid to pregnant women. They do no
work during the first two months of pregnancy. At the seventh month they
are anointed with oil; about the eighth their limbs are given passive
exercise, and they go to a separate house to be shampooed by expert
masseuses, in order to train their muscles to bear the labour pains. The
umbilical cord is measured to the middle of the child's forehead, and
cut, but not tied. The placenta is extracted by hand if it does not come
away naturally. In cases of mal-presentation the midwives know how to
give assistance. The mother does no work during suckling, and, if it is
necessary to wean the child prematurely, a substitute for the mother's
milk is found in a butter made from the fresh fruit of the pandanus. The
midwives are reputed to be exceptionally clever, and the labours easy
and safe. Tearabugu could not remember a single case which had
terminated fatally for the mother. She said that four or five children
are considered enough, and any above that number are not allowed to come
to maturity. All the women practise abortion because they are so
prolific. If they did not they would have from ten to twenty children
apiece. But neither medicine nor instruments are used. The common method
is to pound the abdomen with a billet of wood, and this is not fatal to
the mother. Now, however, the practice is being abandoned, because the
missionaries have persuaded the people that it is dangerous.
Lactation
The Fijian child begins life with a dose of medicine. As soon as it has
been washed in cold water a little of the juice of the candle-nut-tree
(_Aleurites triloba_) is put into its mouth to make it vomit. Then a
ripe cocoanut, or in some places a plantain, is roasted and chewed into
a pulp, which is dropped into a cocoanut-shell cup. A piece of
bark-cloth, shaped like a nipple, is dipped into this, and given to the
child to suck. The mother's first milk, being considered unwholesome,
is drawn off, and for the first day, or, in the case of a chief's child,
for the first three days, the baby is put to the breasts of a wet nurse,
if its rank is sufficient to command her services. The wet nurse is
strictly forbidden to bathe or fish in salt water, and there must not be
too great a disparity of age between her own and her foster child. When
the mother's breasts are full, her child is given to her to suckle, but
now, as in the old days, the children of chiefs are suckled by more than
one woman. In Tonga the mother suckles her child as soon as the milk
comes.
In one respect only have the ancient customs relating to suckling
children begun to break down; the missionaries have tried to discourage
the employment of a wet nurse, probably because her own child is likely
to suffer from neglect.
Among the common people it has always been the custom for two girls from
the wife's and two from the husband's family to feed and tend the new
mother, unless her rank is too lowly to entitle her to the services of
more than one. The two grandmothers of the child, if living, also help
to tend the mother. But at the tenth day they all leave her to the care
of her husband. This custom fits into the waning practice of concubitous
marriage, (_q. v._ ante), for if the husband and wife belong to
different islands the wife's relations are unable to contribute their
services to her support. During the first ten days the mother is
confined to a vegetable diet. She is forbidden to eat what the native
call _ka ndamu_ (red things, _i.e._ fish, crabs, pork, or broths made
therefrom), and is fed upon taro or bread-fruit puddings (_vakalolo_),
yams, taro, or spinach. At the end of ten days she goes about her
house-work, and if she cannot command the services of her relations to
enable her to lay up for the _bongi ndrau_ (hundred days), she resumes
all her ordinary outdoor work except sea-fishing, for, as the natives
say, "there is _dambe_ in the sea, and if the mother wets her leg above
the calf in salt water, her milk will be spoiled."
[Illustration: Women Fishing with the Seine.]
[Pageheader: REMARKABLE CASE]
It is perhaps owing to their hard work and low diet that Fijian mothers
so often suffer from a deficiency of breast milk, and that so many
children die from _matha na mena suthu_ (drying up of the milk) and
_londo i suthu_ (privation of milk), _i.e._ from the death, absence, or
neglect of the mother. When the mother's milk fails her breasts are
oiled and steamed and painted with turmeric, and are kept warm by
bandages of bark-cloth, while she eats spinach, _mba vakoro_ (a mixture
of spinach with shell-fish), and drinks fish soup and spinach water.
Kava, which was absolutely forbidden to women of the last generation, is
now drunk by both pregnant and nursing women under the belief that it
induces easy labour and promotes a flow of milk when all other means
fail. But if the flow of milk is re-established, the more nutritious
diet is at once discontinued, for quantity is all that is aimed at.
When the milk fails or the mother dies the child's chances of surviving
are slender indeed. Its grandmother will carry it from house to house
imploring nursing mothers to give it suck. With one accord they all
begin to make excuses. They have not milk enough for their own children;
there are many other women more able to than they. In Thakaundrove a
woman who is not nursing sometimes takes the place of the mother. She is
fed on spinach, and is oiled and tended like the real mother, and in
course of time, if the child continues to suck her breasts, the milk
comes, and the child is reared. There is a well-attested case--and it is
said to be by no means a solitary instance--in which the grandmother
suckled the children during the mother's frequent absences from home.
They were the children of her youngest daughter, and yet she contrived
to induce a flow of milk for each of the four children in succession. It
is not surprising that all the children died in infancy, for such milk
could have little nutritive value.
Statistics show that, even counting the children that are fortunate
enough to find a wet nurse to adopt them, in at least three cases out of
four the death of the mother means the death of the child also, and that
the mortality is only a shade lower in cases where the mother is
deficient in breast milk. The father's absence from home is also a fatal
condition, for the mother is then obliged to take her baby with her to
the plantation, where it is left under a tree while its mother works in
the sun. Among the Motu tribes in New Guinea a sort of creche is
improvised in the corner of the field; every nursing mother goes to work
with her child slung in a net bag. These bags are slung from the
branches of a tree, and are guarded by one of the women told off for the
duty in rotation. I remember coming suddenly upon one of these trees at
a turn in the path. Its dead branches bore a round dozen of this strange
fruit--fat brown babies fast asleep with their knees doubled up to their
chins and their flesh oozing from the meshes of the net bags. Near the
same village I saw a woman, who had probably lost her baby, doing her
maternal duty to a sucking-pig and a puppy.
The only substitute for milk known to the Fijians is _mba_ water, _i.e._
water in which the stalks of the taro (_Calladium esculentum_) have been
boiled. It contains a large proportion of glucose, a little starch, a
trace of albumen, some malic acid, a pinkish or pale violet colouring
matter intensified by acids, water and cellulose, but no tannic or
gallic acids. The microscope showed it to be free from oxalate of lime
or other raphides. In the uncooked stalks and leaves there is a highly
acrid oily matter, which, however, is completely dissipated by heat even
below 200 deg. Fahrenheit. _Mba_ is not unlike boiled beet stalks, and the
sweet and mucilaginous liquor must be a palatable and not unsatisfying
food for a child in ordinary health, though it is far from being as
nutritive as mother's milk. It is strange that the Fijians have never
thought of adding to it the strainings of grated cocoanuts which abound
in every village, though even so the food would still be deficient in
proteids.
In Tonga, on the other hand, children are generally reared safely by
hand upon a diet of cooked breadfruit made into a liquid with
cocoanut-milk. I have heard of one instance of a child that was reared
on sugar-cane. The Gilbert Islanders use a butter made of the fruit of
the pandanus made fresh every day, and they also give their children
young cocoanuts to suck through a hollow rush.
[Pageheader: INSANITARY HABITS]
Weaning
If all goes well the child is weaned when three or four of both the
upper and lower incisors appear. For a month or two before this the
mother has been in the habit of giving it a slushy mess of yam to
prepare it for solid food. While weaning it she gives it chewed yam or
taro in addition to _mba_, and there is something to be said both for
and against this practice. The saliva is rich in ptyalin, which does not
act upon proteids or fats, and is therefore not secreted in any
appreciable quantity during the first year of infant life. As the starch
that is so plentiful in yam and taro is insoluble, it must be converted
into something more digestible before it can be assimilated. The acid of
the gastric juice would retard this conversion, but the ptyalin of the
saliva, like the diastase of malt, has the property of converting
moistened starch, when kept at a warm and even temperature such as that
of the body, into dextrin and glucose, which are easily assimilated.
Thus, while the mother feeds her child upon a diet which it is not yet
prepared to deal with, she supplies from her own mouth the necessary
moisture, warmth and ptyalin for making it digestible. Without the
chewing the mashed yam would produce diarrhoea.
On the other hand, the human mouth is the hotbed of bacteria, which,
though innocuous to the adult, may well be hurtful to an infant. The
Fijian uses no toothbrush but his index finger, which is seldom as clean
as the mouth it is intended to cleanse. It is therefore possible that
the fermentative action that causes diarrhoea in children may be set
up by the chewing, and the germs of specific constitutional disease may
be sometimes introduced. Tuberculosis and leprosy, so far as our present
knowledge of them goes, appear likely to be transmissible in this way,
and the Fijians are largely affected by both tubercle and leprosy. Most
Fijian mothers are heavy smokers, and the residuum of tobacco may well
impart a poisonous property to the food.