seq.; L.M. Allen, "Prolonged Gestation," American Journal Obstetrics, April, 1907). It is possible, as Müller suggested in 1898 in a Thèse de Nancy, that civilization tends to shorten the period of gestation, and that in earlier ages it was longer than it is now. Such a tendency to premature birth under the exciting nervous influences of civilization would thus correspond, as Bouchacourt has pointed out (La Grossesse, p. 113), to the similar effect of domestication in animals. The robust countrywoman becomes transformed into the more graceful, but also more fragile, town woman who needs a degree of care and hygiene which the countrywoman with her more resistant nervous system can to some extent dispense with, although even she, as we see, suffers in the person of her child, and probably in her own person, from the effects of work during pregnancy. The serious nature of this civilized tendency to premature birth--of which lack of rest in pregnancy is, however, only one of several important causes--is shown by the fact that Séropian (_Fréquence Comparée des Causes de l'Accouchement Prémature_, Thèse de Paris, 1907) found that about one-third of French births (32.28 per cent.) are to a greater or less extent premature. Pregnancy is not a morbid condition; on the contrary, a pregnant woman is at the climax of her most normal physiological life, but owing to the tension thus involved she is specially liable to suffer from any slight shock or strain.
It must be remarked that the increased tendency to premature birth, while in part it may be due to general tendencies of civilization, is also in part due to very definite and preventable causes. Syphilis, alcoholism, and attempts to produce abortion are among the not uncommon causes of premature birth (see, e.g., G.F. McCleary, "The Influence of Antenatal Conditions on Infantile Mortality," British Medical Journal, Aug. 13, 1904).
Premature birth ought to be avoided, because the child born too early is insufficiently equipped for the task before him. Astengo, dealing with nearly 19,000 cases at the Lariboisière Hospital in Paris and the Maternité, found, that reckoning from the date of the last menstruation, there is a direct relation between the weight of the infant at birth and the length of the pregnancy. The longer the pregnancy, the finer the child (Astengo, _Rapport du Poids des Enfants à la Durée de la Grossesse_, Thèse de Paris, 1905).
The frequency of premature birth is probably as great in England as in France. Ballantyne states (_Manual of Antenatal Pathology; The Foetus_, p. 456) that for practical purposes the frequency of premature labors in maternity hospitals may be put at 20 per cent., but that if all infants weighing less than 3,000 grammes are to be regarded as premature, it rises to 41.5 per cent. That premature birth is increasing in England seems to be indicated by the fact that during the past twenty-five years there has been a steady rise in the mortality rate from premature birth. McCleary, who discusses this point and considers the increase real, concludes that "it would appear that there has been a diminution in the quality as well as in the quantity of our output of babies" (see also a discussion, introduced by Dawson Williams, on "Physical Deterioration," British Medical Journal, Oct. 14, 1905).
It need scarcely be pointed out that not only is immaturity a cause of deterioration in the infants that survive, but that it alone serves enormously to decrease the number of infants that are able to survive. Thus G. Newman states (loc. cit.) that in most large English urban districts immaturity is the chief cause of infant mortality, furnishing about 30 per cent. of the infant deaths; even in London (Islington) Alfred Harris (British Medical Journal, Dec. 14, 1907) finds that it is responsible for nearly 17 per cent. of the infantile deaths. It is estimated by Newman that about half of the mothers of infants dying of immaturity suffer from marked ill-health and poor physique; they are not, therefore, fitted to be mothers.
Rest during pregnancy is a very powerful agent in preventing premature birth. Thus Dr. Sarraute-Lourié has compared 1,550 pregnant women at the Asile Michelet who rested before confinement with 1,550 women confined at the H?pital Lariboisière who had enjoyed no such period of rest. She found that the average duration of pregnancy was at least twenty days shorter in the latter group (Mme. Sarraute-Lourié, _De l'Influence du Repos sur la Durée de la Gestation_, Thèse de Paris, 1899).
Leyboff has insisted on the absolute necessity of rest during pregnancy, as well for the sake of the woman herself as the burden she carries, and shows the evil results which follow when rest is neglected. Railway traveling, horse-riding, bicycling, and sea-voyages are also, Leyboff believes, liable to be injurious to the course of pregnancy. Leyboff recognizes
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