Again, where in the case of husband or wife there is a serious inheritance of mental or physical disease, and especially when the same weakness exists in both families, it is justly regarded as a duty by the married pair not to bring children into the world.  It may be contended that men and women with such an inheritance should not marry, but that is a matter for the decision of the individuals concerned.  It not infrequently happens that marriage has taken place before they know of the inherited tendency.  In such cases clearly the advice of the family doctor should be given as to the best course to pursue in order to avoid conception.

The case of the overworked and burdened mother with a large and increasing family is nearly allied to that of a woman with disease, though in her case the causes for ill-health are more complicated.

While it is true that ill-health and premature ageing in working women are the result of many causes, yet where child-bearing still further injures health it is essential that she should consult her medical adviser on this point, for she not only needs treatment to restore her health, but also advice specially suitable to her own case, as to the best method to avoid conception for the time being, and such advice will vary according as the disability is temporary or permanent.

It is, happily, as possible for the poor woman to obtain advice in all matters of health as it is for the rich.  The mothers of the country are in touch everywhere with maternity clinics, where doctors advise them on all questions of health relating to pregnancy, and treat each woman as a separate individual.

But the case of the poor working woman overburdened with work which she cannot accomplish—­yet with the added burden of bearing more children than her more fortunate sisters, deserves some further consideration.

What is it that prematurely ages so many of these women of the slums—­is it child-bearing alone?

The answer to that is immediately in the negative, for women in comfortable circumstances may have large families, with no sign of weariness and dejection.  No, the causes of ill-health and debility are diverse, and to pretend to solve the question by conception control is a mockery, for it salves the conscience of the community without really dealing with the question of the disabilities of the working woman, or the true cause of her excessive fertility.

Ill-health in working-class mothers often has its origin in inherited weakness and lack of care in childhood.  It is further accentuated by overwork, with no labour-saving devices; lack of suitable food; too few, if any, hours of recreation, and hence very little out-door exercise.  Badly ventilated homes deprive the mother of necessary supplies of oxygen, and insufficient sleep is often the last straw which breaks down the patient burden bearer.  A true and haunting picture is given in a recently published book called The Woman in the Little House (which first appeared in a series of articles in the journal “Time and Tide"), describing the anxiety of a working woman at night to keep her baby quiet that the husband may sleep.