A Doctor's Journal
Boom in Babies
By MILES HOWARD
in the study of society) were few. Now some are to be found in a paper by Ronald Freedman and his colleagues in the Scientific American for April.
Until quite lately in the history of mankind, population growth was controlled by the three factors of birth, migration and death. Now—in the States at any rate—migration is a minor fac- tor, and the death-rate has fallen to a low and stable level. The birth-rate is what matters. Over the past seventy years or so, the use of various contraceptive measures has begun to show its effects on the 'graph' of population in most of the Western nations. During the years of the Great Depression, the US birth-rate dropped to the lowest level it has ever reached; it was pre- dicted that the population would no longer expand and might even decline. The prophets did not foresee the 'baby boom' after the war and the steep rise in total number that went with it. Control of conception (by whatever means) does not necessarily mean that families are always small—in times of prosperity, when parents feel confident about their own and the country's future, the number of children will rise.
The team whose survey is summarised here set out to find how couples felt about family plan- ning, how widely it is practised and how the sub- groups, among those who were studied, differed in their practice. Some 2,700 white women be- tween eighteen and thirty-nine were interviewed at length, and data were sought on pregnancies, methods of contraception and plans for the future. The 'sample' was so chosen as to be a reasonably representative cross-section of the seventeen million white married couples in this age-group in 1955. A complete record of the re- quired data was obtained from 91 per.cent. of the sample, and this is taken to show that family planning is now accepted as a topic that can be discussed and inquired about in a matter-of-fact way : indeed (if refusal to answer be taken as an index) it is regarded as a much less 'personal' matter than income. Contraception, in this sur- vey, was defined as 'any measure of limitation of the family, except sterilisation.'
The first, and perhaps most important, con-
elusion from the survey is that the principles of regulation of number and of spacing of children were accepted by every section of the population.
Less than per cent. of the women indicated unqualified disapproval of limitation. Of the couples classed as `fecund'—those who know themselves to be fertile-83 per cent. had adqpted some kind of contraception and another 7 per cent. intended to do so after having the number of children they wanted. No significant difference in the practice of contraception between metro- polis, small town and country. Some 12 per cent. of all the pregnancies, in the women interviewed, were described as 'accidental'; an unwanted pregnancy was more likely to occur in a large family than in a small one. Apropos of this, the authors comment that an unplanned conception does not always mean that the child is unwanted : unluckily, what it does mean, often enough, is that the parents compensate for their latent resent- ment of the new arrival by an anxious over- Protectiveness. I have little doubt that the unex- pected conception, while a couple are employing a contraceptive method, is much more likely to be the result of carelessness or ignorance on the part of the users than failure of the method itself : the causes of failure, in short, are to be sought in the individual rather than in the tech- nique. One such cause is the emotional 'block' that exists in many women in relation to any device or method for the prevention of preg- nancy; even though it has all been discussed, and they seem to have accepted the idea, the drive towards conception is so strong that it pro- vokes an unwitting misuse of the method. An exploratory survey, of the kind I have outlined above, could be made even more valuable if it were supplemented by an inquiry into the atti- tudes of present-day women towards pregnancy and its prevention, and the maternal role—not only explicit 'opinions,' but emotional orienta- tion, as shown by behaviour and life-pattern. Has the young woman of today begun to repudiate her function as a wife and mother? If so, is she obliged to deny or suppress a primary biological need?
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