CAUSE FOR ALARM

Hawke's Bay Herald-Tribune, Issue 74, 14 April 1937, Page 9

CAUSE FOR ALARM

Dominion's High Death Rate from Abortion STEPS T0WARDS REMEDY New Zealand lias oue of the highest death, rates from abortion in the world and all the evidenco indicates that it is exceedingly frequent, aecording to the Commitee of Enquiry which. was set up by the Government to consider various aspects of the prdblem. The committee made an exhaustive survey and in a long repOrt summarises its findinga and conclusiona as follows: — "The committee is convinced that the indnction of abortion is exceedingly common in New Zealand, and that it has defiuitely increased in recent years. It has"been estimated that at least one pregnancy in every five ends in abortion; in other words that some 6000 abortions occur in New ZealanU every year. Of these, it is believod that 4000, at % conservative estimate, are criminally induced either through the agency of criminal abortiOnists or b'y self-induction, either of which is equally dangerous.- It is clear that death from septic abortion occurs almost entirely in such cases. Such deaths have greatly. increased in recent years, and now constitute one-quarter of the total maternal m'ortality; m some urban districts it ' amounts to nearly half of the total maternal mortality. New Zealand has, according to comparative international statistics, one of the highest dcath-rates from abortion in the "world. Thei committee, after talong' evidence from witnesses representirig all sections of the community, has formed the conclusion that the main causes for this resort to abortion axe; — • (1)( Economic' and d.omestie hardship;' (2) Changes in social and moral outlook; (3) Pregnancy ' amongst the unmarried; and (4) In a im&ll proportion of caees, fears of childbirth. , Possible Bexnedies. " Consideration has been given to the possible remedying of these causes;-— (a) In so far as economic hardship is the primary factor cortain recom- . mendations have been made regarding iinancial, domestic and obstetrical help by the State. (b) To Iessen any fear of childbirth 1 where this exists, it has been recommended that_ the public should be informed that New Zealand now has a very low death-rate in actual childbirth and that relief of pain in labour is iargely used. At the same timo the committee has advocated that further qfforlp in th'e direction of pain :eliof should be explored \ .(c) For dealing with the problem of the unmarried mother, the committee considers that the attack must be along the lines of more careful education of the young in matters of sex, prohibition of the advertisement and sale ot contraceptives* to the young, and a more tolerant attitiide on the part ot society towards these girls and their. Children. ; (d) The committee believes, however, tha^ the most important cause of all is a change in the outlook q£ women which expresses itself in a demand of the right to limit — or avpjd— the family, coupled with a widespread halfknowledge and use of bifth-control methods — often ineffective. These fajling, the temptation to abortion follows. Means of ContcoL ■'The . committee. can see only two directions in which abortion resulting from these tendencies can be controlled — • ' (1) By the direction of birth-control knowledge through more responsible channels, where, while the methods would be more reliable, the responsibilities and privileges of motherhood, the advisability of self-discipline in certain directions, and' other. aspects of the matter would be discussed.. (2) To appeal to the womanhood of N ew .Zealand, in so- far ,as selfish and unworthy motives have entered into 6ur family life, to consider the grave' physical and moral dangers, not to speak of the dangers of race suicide which are involved. • ' Prohibition of Advertisements. . , " The prohibition of the promisCuoua advertisement. of contraceptives, and of their sale to the young; the licensing of the importation of certain types of contraceptives. _ the rCstriction of the sale oi distribution of contraceptives to practising chemists, doctors, hospitals, and clinics; the prohibition of the advertisement, or of the sale, ex- . oept on medical prescription, of certain drugs and appliances which might be used for abortion purposes; these measures are recommended. The specific legislation of theropeutic abortion (by doctors for health reasons) as a safeguurd to doctors was fully examined but is not recommended. The committee is satisfied that. the present interpretafcion of the -law is such that, where the reaBons for the operation are valid, the doctor runa no rjsk of prosecution. The risks of an alteratioo in the law are great. "Legislation of abortion for social and economic reasons was also put forward. The cominittea has discussed the matter, and strongly condemns any countenancing of this measnre. Though it may be conceded that legalised performance of the operation by doctors in hospitals might reduce the incidenca of surr.eptitious abortion and deaths from septic abortion, we do not accept this as any justification of a procedure which is associated with grave moral and physical dangers • ' With regard to sterilisation, the committee adopts the same view as towards the specific legalisation of therapeutic abortion. It is believed that,- where the reasons for the operation are in accord with generaliyaccepted medical opinion, there is no bar J:o its performance. We see, however, tendencies in the direction of | extending this operation far beyond the 1 bounds of this aecepted medical

opinion. For this reason, we do not recommend any alteration in the present position. Public Responslbility. "The failure to obtain the conviction of "the criminal abortionist, even in cases where the guilt seems beyond all doubt,»has been discussed as a matter of serious concern, and the committee can only bring. befote the public its responsibility, as represented by members of juries, for the vir^ial .encouragement of this evil pxaetice, Finally, the committee, while fully conscious of its inability to place before you a complete and certain solution of this grave problem, or one which will satisfy all shades of opinion, believes that a definite service will have been done through this investigation if full publicity i3 given to the facts of the sitilation as here revealed, and if the .public cOnscience is awakened to the fact that,"although. State aid and legal prohibitions may do something to remove causes and to deter crime, the iiitimate issue rests with the attitudo and action of the people themselves." "TJnprinclpied Doctors'" "It is' perfectly clear that the real monaco is the instrumentally produced abortion, either self-induced by the person herSelf, or the reBult of an illegal operation performed by some outside person," the committee considers. "These abortionists include a ■ few unprincipled doctors and chemists, a few women with varying degrees of nu^sing experience training, and a number of unskilled persons. . Grave concern has been occasioned by tho realisation of the frequency of septic abortion, the most significant indication of which is the number of women who lose their lives as. the result -of this complication," the report states, and adds 'that, "the evidenee offered to the committee by -medical witnesses indicated conclusively that sepsis, and death from sepsis- particularly, is almost entirely due to illegal instrumental' interference." Underlylng . Causes. The committee sets out broadly the followiug undexlying , causes cf abortion in New Zealand — economic and domestic hardship; fear of labour and, its sequelae; pregnaucy in* the unmarried; changes in social outlook; ignorance of effective methods of contraception, and of the dangers ,of abortion; influence of advertising. The opinion is expressed that While cases arise where. the parents are on the brepdline and iiave no means of supporting a child, such extreme poverty is rare in New Zealand. ♦'More common are the cases in which income is suf ficient for a small family but a, larger one would constitute hardship, or, alternatively, in which income is suf ficient to suppart several small children, but not to provide education, etc., ih later life. Housing 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 aro often lacking. 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 leada to a premium being placed on childlessness because married couples without ' ' oncumbrances " can more easily obtain employment. Lack of help in the home even by those who can afford it is a factor of very great importance. 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. Cost of confinement was emphasised particularly by country witnesses. "It was, however, rightly pointed out by one witness that the fees paid to an aboftionist and the economic waste due to subsequent illhealth would in many cases more than pay the expenses of an ordinary confinement." 1

Influence 61 Dxinkiag. The committee voices the opinion that fear of labour is not a major factor in the problem.' . The report emphasises the importance of pregnancy in the unmarried and "the evil influence of drinking on young people ... alcohol consumption need not be excessive to undermine self-control and dull the moral sense." The committee believes that in the altered social outlook, particularly towards the rearing of large families^ lies a very important cause of the present situation, and makes special mention of an attitude of "pitying superiority ' ' towards the woman with many children, which appears to be tho current fashion, of the influence on some women of comparison with less burdened neighbours and of the modern desire for pleasure and freedom. There is also ref erence to the eff ect of ihe fear of war, "which acts as a. powerfui deterrent from child-bearing. " ' 'Beprehensible Practlce. " Dealing with the influence cf advertising the report states; "A reprehensible practice is that of certain socailed 'mail order chemists,' who send out price-lists of contraceptives and abortifacients indiscriminately through the post. lu some cases these advertisements were shown to be of a definitely misleading- and ' fraudulent character.' ' In its general Teport on the control of abortion ariiong the unmarried the committee states t|iat it is convinced that there should be a determined e'ffort to suppress the indiscriminate sale of contraceptives.