The Cost of Coffins
He only is free who can control himself.
EPICTETUS.
The imposition of motherhood upon a married woman in absolute
despite of her health and of the interests of the children is none
the less an iniquity because it has at present the approval of
Church and State.
SALEEBY: _Woman and Womanhood_.
Why do poor slum mothers buy more coffins than do the same number of
rich women?
The incredulous may answer this question by asserting that they don’t,
but as a matter of fact they do. The Registrar-General’s Report for
1911 shows that of every thousand births in the upper and middle
classes, 76·4 babies die, while of a thousand births in the homes of
unskilled workmen (this would be the class of the “poor” mothers) 152·5
babies die.
So that it is clear that if each member of this poorest class of
mothers had exactly the same number of babies as each mother of the
rich class, she would have to purchase about two coffins for every
coffin bought by those whose babies are not so prone to die.
There is, however, another fact which completes the proof of my first
sentence. The upper and middle classes do not have so many children per
family as do the poorest class. To a thousand married people in the
upper and middle classes there were born in 1911 119 babies, but to
the poor mothers--the wives of the unskilled workmen--there were born
213. So that in addition to buying twice as many coffins per thousand
children born, these poor mothers have nearly twice as many coffins
again, owing to the fact that nearly twice as many children are born to
them.
I wonder if poor women have ever asked themselves if they can afford
coffins at this rate?
Of course the coffins of these poor little babies are very small, and
do not require very much wood to make them. But let us think in what
other ways they cost: To the mother they cost not only all the little
the baby had eaten, and used in the way of clothes before its death,
but all the wastage of her own vitality while she was bearing it; she
could not work so well, at any rate towards the end of the time.
Home duties had to be somewhat neglected; the older children had to
go to school dirtier and less cared for; the husband had less comfort
and fewer smiles; every one in the family was poorer, not only in
material things and in the work that might make material things, but in
happiness and buoyancy.
It needs no imagination to realize, when you have once grasped these
facts, that poor people are much less able to spare the cost of a
doomed baby than are the better class people. Then why do they so often
indulge in this tragic luxury? Chiefly through lack of knowledge,
through ignorance, particularly on the part of the mother.
Often ignorance is blind and unaware that it is ignorance, stupidly
blundering through life; but this is not always the mother’s attitude.
She may, indeed she often does, passionately desire knowledge and seek
for it wherever she thinks she may find it in her restricted circle.
Too tragically often she is baffled in her search.
Some years before the war, when I was lecturing at a Northern
University, a little incident opened my eyes to this fact. I was young
and had not encountered this aspect of life before, and it burnt itself
into my consciousness as one of the most vivid impressions of my life.
It was this:--
One of my students was a woman who was hoping to qualify as a medical
doctor, and she was having tea with me and chatting about the events of
the day. As part of her training she had been assisting the doctor in
dealing with out-patients at a hospital, and a woman had brought in a
miserable little baby, which wailed all the time and which the mother
explained wouldn’t put on any flesh or grow into a nice, healthy baby
whatever she did with it.
The mother, with tears in her eyes, made an intensely earnest appeal
to the doctor to tell her what was to her unaccountably wrong with the
infant.
She was a fine strapping woman, and thought her babies ought to be
large and healthy. She said this was her third or fourth, and the
others had all died when they were very little.
This happened more than seven years ago. Thank God our racial attitude
has changed since then.
The doctor put her off with some soothing platitudes, but the woman
driven to despair said: “I believe there’s something wrong with my
man. If there’s something wrong with my man I won’t have babies no
more--it’s just cruel to see them miserable like this and have them
dying one after the other. Won’t you, for God’s sake, tell me whether
there’s anything wrong with my man or not?” This appeal was met by the
assurance that there was nothing wrong, and she should go on having
babies and do her duty by her husband.
My medical woman student said that it was glaringly obvious that the
baby was syphilitic.
I asked her why she did not immediately tell the mother the truth. She
shrugged her shoulders and said: “I’ve got my exam. to pass; if I did a
thing like that Dr. ---- would stop me going to the hospital. I can’t
afford to take risks like that. Why, he might not only stop me, but it
would do the other women students a lot of harm too.”
This was before the war, and England was less enlightened, less eager
for medical women’s assistance than the war has made her, and it was
then a fight for a girl to get a footing in the hospitals for the wide
experience she needed for a general practice.
I vowed to myself that I would never forget that mother, and that some
day I would batter at the brazen gates of knowledge on her behalf.
Here was a mother with a glimmering of the truth, seeking passionately
for knowledge from the one person she had a right to turn to for this
knowledge, and she was put off with lies, encouraged again to bear the
cost of a hopelessly doomed birth; to risk the agonies of child-birth,
to bring into the world a creature who for a short spell would be
tormented and then would cost her a coffin.
By refusing his scientific advice, that doctor in reality sent that
woman, whose desire to know was stirred, to the gossip of the slum
alley and the street corner. There she would get a blurred and
inaccurate, if not actually harmful, idea of what he should have been
able to tell her in a clean, simple language based on scientific fact.
When this is put down on paper, I feel as though it would be ridiculous
to begin to point out the monstrous cruelty and the monstrous folly of
such an action as that doctor’s. Yet such action was not isolated, it
did not depend on one man’s warped conceptions of loyalty to another
unknown man, “the husband.” Since the war a public realization of the
racial destructiveness of such diseases has been increased and the
woman and her husband would to-day be more likely to receive medical
treatment.
But even to-day if a mother is truly told that there is “something
wrong with her man,” would she also certainly be told how in wise
and healthy fashion she can herself supplement what his criminal
negligence neglected? If a husband is careless and callous a woman
must save herself and the community from the waste and the misery of
irretrievably doomed births.
She will indeed be an exceptionally lucky woman if she to-day finds
in public hospitals doctors to whom she could turn for knowledge
how _best_ to control conception, though such knowledge is not only
essential to her private well-being, but essential to her in the
fulfilment of her duties as a citizen.
This little incident is but one illustration of many aspects of the
subject. It is not only _disease_ which necessitates restraint on
parenthood. No healthy woman can bear a long series of infants in rapid
succession without loss both to them and to herself. This is discussed
in my _Wise Parenthood_.
Any one who thinks will see clearly that no civilized country, not
even the richest in the world, can afford babies’ coffins. Though they
are smaller than grown-up people’s they are more costly, for they are
waste and nothing but waste. A grown-up individual, man or woman, has,
we hope at any rate, given some return to the community in work or in
ideas for all that his life has cost. But the infant’s death is sheer
unmitigated waste.
If all the mothers who realize this and who feel their need for the
best help that science can give them, would insist and persist in
their enquiries for a knowledge of the most reliable results of modern
science, they would in the end succeed in getting them. There is enough
knowledge now in the world for the race to transform itself in a couple
of generations.