PART II.--THE UNDERLYING CAUSES OF ABORTION IN NEW ZEALAND.

As seen by the Committee, the reasons which lead to a resort to abortion may be set out under the following broad headings:--

(1) Economic and domestic hardship.

(2) Fear of labour and its sequelae.

(3) Pregnancy in the unmarried.

(4) Changes in social outlook.

(5) Ignorance of effective methods of contraception and of the dangers of abortion.

(6) Influence of advertising.

(1) ECONOMIC AND DOMESTIC HARDSHIP.

(_a_) _Poverty._--Cases arise where the parents are on the bread-line and have no means of supporting a child, but the Committee is of opinion that such extreme poverty is rare in New Zealand.

More common are the cases in which income is sufficient for a small family but a larger one would constitute hardship, or, alternatively, in which income is sufficient to support several small children but not to provide education, &c., in later life. The view, formerly widely accepted, that membership of a large family is in itself a valuable contribution to education and to the training of responsible citizens, appears to be at a discount, and many parents now consider that advantages which can be _given_ to a child as a result of family limitation outweigh the natural advantages of a large family in which the children develop initiative through companionship.

(_b_) _Housing._--This constitutes an acute problem in crowded city areas. In many cases houses which are past repair and already condemned form the only shelter for a growing family. Ordinary domestic and hygienic conveniences are often lacking. Where a family is able to pay for better accommodation, difficulties frequently arise owing to the unwillingness of landlords to accept tenants with children, and, as the demand for houses exceeds the supply, landlords are able to pick and choose. The lack also of suitable cottages on farms for married couples with children probably has a considerable influence on the limitation or avoidance of families and leads to a premium being placed on childlessness because married couples without "encumbrances" can more easily obtain employment. This is an aspect of the problem that should receive earnest consideration.

(_c_) _Domestic._--Lack of help in the home even by those who can afford it is a factor of very great importance. This applies especially to country life, where a woman's whole physical energy is taken up by attention to domestic matters and often also to farm-work, to the detriment of family life. The following is an account given to one witness by a farmer's wife, describing an average day's work:--

"Rise 4.30, have cup of tea--wife to shed, set machines, hubby to bring cows--start milking 5 a.m., hard going to 8 o'clock; wife returns house to get breakfast, also see to children and cut lunches for them to take to school. Hubby feeds calves, fowls, and ducks, then breakfast. Load milk on express, harness horse, away to factory mile away--get whey return. Now 9 o'clock, wife has machines down and washes, hubby hose down shed. Drive whey down to paddocks and feed 40 pigs, returns, unharness horse, wash cart down, yoke team to plough, disk, &c. Wife to start housework about 10 o'clock, dinner at 12.30 to be ready, or taken down to paddocks (if harvesting 3 or 4 men are working). Usual times fencing, repairing sheds, fixing yards, besides other farm duties till 3.30--afternoon tea--children given something to eat on returning from school. Husband and wife to sheds again 4 till 7. Hubby washes machines, feeds calves, &c., wife in meantime has returned house, washed children and put to bed before sitting down to her tea at 8 o'clock--by time washed up is 9 o'clock--too tired to do anything else but crawl into bed."

The lack of adequate playing-areas, kindergartens, and other means of employing the time of the pre-school child outside the home is a matter that was brought before the notice of the Committee as another of the domestic difficulties. This is one of the factors preventing that amount of leisure which is necessary for the well-being of the mother.

(_d_) _Cost of Confinement._--This was stressed particularly by country witnesses. Where a woman is beyond the reach of medical attendance and has to travel a considerable distance to hospital this adds materially to the cost of the confinement. To some women even moderate hospital and medical fees are prohibitive, and the problem is rendered more difficult still by the necessity for providing extra help in the home or on the farm during the wife's absence. It was, however, rightly pointed out by one witness that the fees paid to an abortionist and the economic waste due to subsequent ill health would in many cases more than pay the expenses of an ordinary confinement.

(2) FEAR OF LABOUR AND ITS SEQUELAE.

This was referred to by several witnesses, some of who cited cases from their own experience. An erroneous idea seems to be prevalent among certain sections of the laity that the total abolition of pain during labour is possible for every patient. The fear that such relief will be withheld has been suggested as a cause for women seeking the abortionist. It would seem, however, that, with the increasing knowledge of methods of pain-relief in labour, more extensive ante-natal and post-natal care, and the cultivation of a more normal psychological outlook among pregnant women, the fear complex will in future assume progressively less importance. The Committee believes that increasing attention is being paid to these aspects by the medical profession.

As to the bearing of this matter on the subject of abortion, several witnesses, among whom were two obstetricians of wide experience, expressed the opinion that, while fear of pregnancy and labour is rare, fear of infection following abortion is a factor the recognition of which is becoming more general.

The Committee is of opinion that fear of labour is not a major factor, and this opinion is supported by many witnesses.

Ill health was alleged as a cause in a few instances, but it would appear that, in spite of the ambiguous state of the law, no genuine ease of ill health need resort to abortion by clandestine methods. This is referred to in greater detail elsewhere.

(3) PREGNANCY IN THE UNMARRIED.

While this constitutes only a small part of the general problem of abortion, it is, nevertheless, a matter of great importance, and one which merits the closest study. Undoubtedly the general attitude towards the unmarried mother to-day is kinder and more tolerant than was formerly the case, but the fact remains that the single girl who determines to face the world with her child may find herself subject to unreasonable and unnecessary cruelty and injustice. Excellent work in assisting the single mother is done by various religious and charitable organizations, and where a girl is driven to the abortionist this is more likely to be due to fear of social ostracism than to lack of ways and means of caring for the child.

Several witnesses mentioned ignorance of matters relating to sex as being frequently responsible for pregnancy in the unmarried. This is undoubtedly the case, and the responsibility of parents, guardians, and teachers in this matter is evident. The evil influence of drinking on young people was also stressed, medical and social workers being well aware of the importance of this factor. Alcohol consumption need not be excessive to undermine self-control and dull the moral sense.

(4) CHANGES IN THE SOCIAL OUTLOOK.

The Committee believes that, in the altered social outlook, particularly towards the rearing of large families, lies a very important cause for the present situation. This aspect of the matter is intimately interwoven with the economic considerations already set forth, but extends far beyond them.

The point of view of what we believe to be a very large body of women is illustrated by the following evidence, which is but one of many similar expressions of opinion heard by the Committee. This witness, speaking on behalf of a group with incomes of L300 to L400 per annum, stated:--

"On present incomes, not more than two or three children at the outside can be given educational and economic opportunities. It may be said that it is quite possible to mitigate to a quite tolerable degree the strain put upon the parents by the provision of (1) adequate wages for husbands, and (2) a system of domestic help for wives. With regard to (1) it is not probable within our lifetime that everybody will be guaranteed an income adequate to the needs of a family of, say, three children--'needs' as viewed by educated parents. The most sympathetic administration would have its hands full for many a year coping with the problem of helping those thousands of our people who have been just on or very near the bread-line. Those worst off hitherto need help first. A man earning between three and four hundred a year should not claim Government help to breed children, when there are such numbers of people living on a much lower wage. But it must be perfectly clear to each member of the Commission who figures the matter out that a salary of less than L400 will not enable more than two children to be given such chance of development as every parent reasonably desires. It is pertinent to ask here what is the average number of children in the families of the British middle class--which is mainly the stratum from which our legislators, rulers, and magistrates have been drawn. Do such people breed freely? Self-respecting parents prefer to do without such Government help as family allowances; but knowing the cost of training a child they claim the rights first, to decide how many children they will breed, and, secondly, to live themselves normally satisfied married lives. Few women, moreover, of average intelligence are to-day content to be breeding-machines, and their husbands support them in that attitude. With regard to domestic help, even were this, or nursing schools, or both, provided by the State, the responsibility for her children's well-being would be still all-absorbing, at least during the first four years of each one's growth. Students of child psychology are insistent that the pre-school period is the most important in the life of the individual and requires the most skilful attention. Natural affection is not enough; it must be wedded to care for the child's mind. Now, willy-nilly, modern life itself takes such toll of nervous energy that there are few educated women today who go through all the child-bearing period and have sufficient nerve force to welcome each child that may 'come along' and rear it happily. Yet without adequate nervous energy in the mother what family can develop into healthy and well-balanced useful citizens? It necessarily follows that the output of children will be limited if the parents are to do their part adequately. Quantity, the mass production of the past, must give way to quality. That involves birth-control. How is it to be achieved?"

Without necessarily assenting to the sentiments expressed in the above quotation, the Committee considers that such opinions cannot but demand thoughtful consideration. Dread of large families or of close-interval pregnancies under modern conditions is undoubtedly a common reason for attempting to limit the family.

But having made all allowances for the more difficult circumstances of modern times, the more thoughtful consideration of some husbands for their wives and of some parents for their children, and a legitimate intention to maintain a higher standard of living, it seems clear that amongst a considerable section of the community the demand for the limitation of families has passed beyond these motives into regions of thoughtlessness and selfishness.

Furthermore, an attitude of pitying superiority towards the woman with many children appears to be a current fashion. Many witnesses expressed the opinion that a young and sensitive mother was frequently deterred from a further pregnancy, for which she would in other circumstances be quite prepared, or tempted to seek abortion, because of the fear of ridicule by current public opinion.

Still other women, it has been explained, are influenced by comparisons. Seeing their neighbours leading less burdensome and more pleasure-full lives, they decide to follow suit.

The modern desire for pleasure and freedom from responsibility has led many to lose sight of the ideal of the family as a service to the State and the unit of social life.

Unwillingness on the part of the wife to give up remunerative work is a factor that operates in certain cases; this may be due to the position of the wife as the support of an invalid husband and family, but in other cases the reason is obviously selfish.

While dealing with this question of social outlook, it will not be out of place to refer to an aspect which, though mentioned by only a few witnesses, is known to all social workers as a factor of increasing importance. This is the fear of war. It may take the form of (_a_) conscious visualization of the horrors of war, or (_b_) sub-conscious fear evidenced by excessive anxiety regarding the future. In either case it acts as a powerful deterrent from child-bearing, although it is doubtful whether those who are influenced by this fear would resort to abortion where contraception had failed.

Speaking of social conditions, some witnesses, under the impression that the average age at marriage was rising, attribute the increasing abortion-rate among the unmarried partly to this cause.

The actual fact is that the age at marriage has decreased of late years, but is still probably higher than would be the case if economic conditions were more favourable.

It is clear that, whether the motives be worthy or selfish, women of all classes are demanding the right to decide how many children they will have. Methods which depend on self-control are ruled out as impracticable. Contraceptives are largely used, and, judging by the marked decline in the birth-rate in recent years, are in many cases successful. In other cases, however, they are not so, and there is then frequently a resort to abortion.

(5) IGNORANCE OF EFFECTIVE METHODS OF CONTRACEPTION AND OF THE DANGERS OF ABORTION.

The public as a whole is ignorant of the physiology of reproduction. This results in attempts being made to prevent conception by methods which are doomed to failure at the outset. The use of defective methods owing to their comparative cheapness and the unnecessarily high cost of effective appliances are undoubtedly among the causes of such failure.

While it is not the function of this Committee to report upon the wider aspect of contraception, but to deal with it only in relation to the abortion problem, yet we would point out that the evidence given showed that, though contraception is widely practised, many of the methods used are unreliable and not founded upon physiological knowledge, and that when they fail abortion is resorted to. Abortion is a delayed, dangerous, and unsatisfactory form of birth-control. It was stressed by some witnesses that many women have no idea of the risks to life and health involved in the procuring of abortion, a medical witness mentioning, among other evils, the tendency to spontaneous abortion arising from damage to the generative organs sustained at an initial induced abortion. Other witnesses, on the contrary, maintained that these risks are well known to the majority of women, but that when faced with an unwanted pregnancy they are willing to incur any risk. Fuller reference to these dangers appears in another section of the report.

(6) INFLUENCE OF ADVERTISING.

The attention of the Committee was drawn to advertisements appearing in certain periodicals which, while openly advocating the use of various contraceptives, referred to restraint and self-control in deprecatory terms. Abortifacients were advertised in terms which, while equally offensive, were less obvious. Other advertisements set forth the contents of certain books on sex matters of a very undesirable nature. The language of these advertisements can only be described as obscene, and their possible effects on immature and inexperienced minds can well be imagined.

A reprehensible practice is that of certain so-called "mail order chemists," who send out price-lists of contraceptives and abortifacients indiscriminately through the post. In some cases these advertisements were shown to be of a definitely misleading and fraudulent character.