Infant and maternal mortality in relation to size of family and rapidity of breeding : A study in human responsibility / [Clarice Margaret Burns].

  • Burns, C. Margaret (Clarice Margaret)
Date:
1942
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Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Infant and maternal mortality in relation to size of family and rapidity of breeding : A study in human responsibility / [Clarice Margaret Burns]. Source: Wellcome Collection.

    11/264 (page VII)
    0 DISCUSSION AND CONCLUSIONS. A study of the information contained in the following chapters renders it possible to give a fairly definite answer to several questions. What is the size of family with the lowest infant and child death- rates ? The answer to this depends on whether death-rates are measured as usual on live births only, or whether still-births are included. When children born alive are considered, then the lowest death-rate is found among first children, and families with the lowest death-rates are the one child families. Out of 1,000 children born alive in County Durham in 1930, the figures for those dying between birth and five years were for firsts 89, for seconds 93, for thirds 99, and for seventh and later children 174. This entirely agrees with the findings of the Registrar- General in his special 1911 investigation, in which he showed that whatever the marriage age of the mother, and however long the marriage had lasted, deaths per 1,000 were always lowest among only children. Are first children less healthy than subsequent children? Neither his investigation nor the one reported here gives any support to the opinion commonly held that first children are less healthy than later children, but this investigation shows how the idea arose. If the proportion of still-births per 1,000 total births is considered then the following figures are found, for firsts 43, seconds 26, thirds 32, and seventh and later births 64. Moreover the high death-rate before or during birth found in first children continues in the first month after birth, the figures for the death-rate in that period being, for firsts 40, for seconds 34, for thirds 32, and for seventh and later births 72. Thus round about birth, the comparable figures for death-rates are firsts 83, seconds and thirds 60 and seventh and later births 136. But practical people only note the stage of family where death occurs round about birth, and hence the emphasis laid on death-rates among first children. Kvery family that has a child has a first child, but few families have seventh or later children, and therefore the excessive death-rates round about birth among these is not observed to be related to the place in the family. Among the first three children in the family, death-rates after the first month tend to offset the high death-rate among first children in the earlier period, rates between one month and five years being respectively 50, 62 and 70, while for seventh and later children the high initial death-rate is followed by the high later rate of 90, (to compare with 50 for first children). When still-births are included, the death-rate up to five years of age for the first three children are 132, 122 and 132 per 1,000, but in seventh and later children the death rate up to the end of the first month at 136 per 1,000 is greater than in the early children up to five years, and there is no subsequent drop to offset this. This may mean that, in first children, birth is a relatively dangerous period, and the unfit are weeded out. Those who survive have a relatively low subsequent death-rate. The late children of large families have however a high death-rate at all stages, i,e., they are the unfit, and they present very special problems. A