D. G. McMillan

“ Here we have the mother with health undermined and reserve vitality reduced to a minimum by the strain of bearing and rearing a large family. She approaches the menopausal stresses with anxiety and apprehension, having done her duty to family and race, often having lived an exemplary self-sacrificing life, the intolerable contemplation of a late pregnancy drives her to desperate measures often for the first time in her life. ”

“ That every medical practitioner who is convinced that criminal abortion has been practised on his patient should urge her, especially when she is likely to die, to make a statement which may be taken as evidence against the person who has performed the operation, provided always that her chances of recovery are not thereby prejudiced. ”

“ We agree with one witness who expressed the opinion that too much had been done in the past in the way of publishing the risks of maternity.
We feel that there are real grounds for confidence in the obstetrical services of the Dominion and that any fear of pregnancy which does exist would be largely removed if the public were made aware that New Zealand now has a very low death-rate in actual childbirth, that relief in labour is largely used, and that further developments in this direction are continually being investigated.
[15]
(3) Control of Abortion amongst the Unmarried. ”

“ Where a woman is beyond the reach of medical attendance and has to travel a considerable distance to hospital this adds materially to the cost of the confinement. To some women even moderate hospital and medical fees are prohibitive, and the problem is rendered more difficult still by the necessity for providing extra help in the home or on the farm during the wife's absence. It was, however, rightly pointed out by one witness that the fees paid to an abortionist and the economic waste due to subsequent ill health would in many cases more than pay the expenses of an ordinary confinement. ”

“ One factor of great importance we believe to be the widespread use of contraceptives amongst the unmarried.
It might, at first thought, seem likely that the use of contraceptives, however reprehensible, would tend to diminish the incidence of abortion.
But we believe that actually this is not the case: there is reason to think that many young women, relying on undependable methods of prevention, are tempted, and then, finding themselves in misfortune, resort to some method of abortion. ”

“ A doctor is under no legal obligation to inform the police as to the cause of the illness of a person which has been due to an illegal operation, either in a case where the patient recovers or in a case where the patient dies. He is, of course, under an obligation to insert in the certificate of death which he furnishes under the Births and Deaths Registration Act, 1924, the cause of death, both primary and secondary. In that certificate, where the death was the consequence of an illegal operation, he should insert the nature of the operation as the primary cause of death. ”

“ The evidence laid before the Committee shows that in New Zealand every year thousands of women imperil, and indeed negate, their future prospects of motherhood by submitting to the induction of abortion.
It has been shown that abortion is a delayed, dangerous, and unsatisfactory form of birth-control, and it can quite logically be argued that if a reliable and simple method of contraception was known to all married people the abortion problem would assume very small proportions. ”

“ Those who are opposed to any alteration of the present state argue that any specific legalization of therapeutic abortion to save the serious impairment of health as well as to save life might lead to abuses of this sanction. They point out that even at the present time doctors differ considerably in their views and in their practice, and they fear that such divergences in thought and practice might be seriously exaggerated.
As to the suggested safeguarding regulations, there is by no means general agreement in the medical profession concerning their advisability or their value. ”

“ An erroneous idea seems to be prevalent among certain sections of the laity that the total abolition of pain during labour is possible for every patient. The fear that such relief will be withheld has been suggested as a cause for women seeking the abortionist. It would seem, however, that, with the increasing knowledge of methods of pain-relief in labour, more extensive ante-natal and post-natal care, and the cultivation of a more normal psychological outlook [10] among pregnant women, the fear complex will in future assume progressively less importance. ”

“ To appeal to the womanhood of New Zealand in so far as selfish and unworthy motives have entered into our family life, to consider the grave physical and moral dangers, not to speak of the dangers of race suicide which are involved. ”

“ Poverty.—Cases arise where the parents are on the bread-line and have no means of supporting a child, but the Committee is of opinion that such extreme poverty is rare in New Zealand.
More common are the cases in which income is sufficient for a small family but a larger one would constitute hardship, or, alternatively, in which income is sufficient to support several small children but not to provide education, &c., in later life. ”

“ The Committee has concluded that, beyond the economic and domestic considerations already discussed, there are many changes in modern social outlook which are operating in the direction of family limitation, and which, in many cases, lead to the practice of abortion.
Can anything be done to prevent the occurrence of abortion resulting from these tendencies in modern life?
Concerning birth-control the realities of the position must be faced. There can be no doubt that there is a widespread uncontrolled and ill-instructed use of contraceptives. ”

“ As already pointed out, it has been urged by the Police Department that in every case where a patient is admitted to a hospital and is suspected to be suffering from the effects of induced abortion or attempted abortion it should be the duty of the Medical Superintendent or Senior Medical Officer of the hospital to notify the police forthwith, and supply all information in his possession which would assist in establishing the identity of the offender and bringing him to justice. ”

“ It was stressed by some witnesses that many women have no idea of the risks to life and health involved in the procuring of abortion, a medical witness mentioning, among other evils, the tendency to spontaneous abortion arising from damage to the generative organs sustained at an initial induced abortion. Other witnesses, on the contrary, maintained that these risks are well known to the majority of women, but that when faced with an unwanted pregnancy they are willing to incur any risk. ”

“ It is clear that, whether the motives be worthy or selfish, women of all classes are demanding the right to decide how many children they will have. Methods which depend on self-control are ruled out as impracticable. Contraceptives are largely used, and, judging by the marked decline in the birth-rate in recent years, are in many cases successful. In other cases, however, they are not so, and there is then frequently a resort to abortion. ”

“ Much is made of the fact that an honourable practitioner occasionally finds himself in the unsatisfactory position of having actually to break the letter of the law in doing what according to accepted medical standards is in the best interests of the patient.
As safeguards against the possible dangers of a widening of the law, it has been suggested that new regulations should be introduced governing the practice of therapeutic abortion. ”

“ While dealing with this question of social outlook, it will not be out of place to refer to an aspect which, though mentioned by only a few witnesses, is known to all social workers as a factor of increasing importance. This is the fear of war. It may take the form of (a) conscious visualization of the horrors of war, or (b) sub-conscious fear evidenced by excessive anxiety regarding the future. In either case it acts as a powerful deterrent from child-bearing, although it is doubtful whether those who are influenced by this fear would resort to abortion where contraception had failed. ”

“ The most sympathetic administration would have its hands full for many a year coping with the problem of helping those thousands of our people who have been just on or very near the bread-line. Those worst off hitherto need help first. A man earning between three and four hundred a year should not claim Government help to breed children, when there are such numbers of people living on a much lower wage. ”

“ Therapeutic Abortion.—In New Zealand, as in Great Britain and other countries, the medical profession has always held that when the mother's life is seriously endangered by a continuation of the pregnancy the termination of the pregnancy is justifiable and right. ”

“ Excellent work in assisting the single mother is done by various religious and charitable organizations, and where a girl is driven to the abortionist this is more likely to be due to fear of social ostracism than to lack of ways and means of caring for the child.
Several witnesses mentioned ignorance of matters relating to sex as being frequently responsible for pregnancy in the unmarried. This is undoubtedly the case, and the responsibility of parents, guardians, and teachers in this matter is evident. ”

“ It is a further complaint of the police that they are hampered by the fact that rarely are they notified of a case of criminal abortion until the woman's condition is so critical that it is impossible to obtain a statement from her, and if she dies the evidence she might have given is lost. ”

“ Just as therapeutic abortion is, in certain cases, legitimately performed by medical practitioners, so has the operation of sterilization a recognized place in medical treatment of exceptional cases in which a woman's life is likely to be endangered or her health gravely impaired by further pregnancy. ”

“ Of course there are others who confine their advocacy of legalized abortion to cases in which there are elements of real tragedy and which appeal to public sympathy, but, granting that there are many cases in which social and economic conditions create situations of great hardship, nevertheless the Committee is fairly convinced that abortion is not justifiable ”

“ The Committee believes, however, that the most important cause of all is a change in the outlook of women which expresses itself in a demand of the right to limit—or avoid—the family, coupled with a widespread half-knowledge and use of birth-control methods—often ineffective. These failing, the temptation to abortion follows. ”

“ The Committee agrees that the possession of reliable contraceptive knowledge by the married women of New Zealand would tend to augment rather than to diminish further the natural rate of increase of our population, for an additional factor to those given above lies in the large amount of sterility which follows induced abortion, that most unsatisfactory of all forms of birth-control. ”

“ But having made all allowances for the more difficult circumstances of modern times, the more thoughtful consideration of some husbands for their wives and of some parents for their children, and a legitimate intention to maintain a higher standard of living, it seems clear that amongst a considerable section of the community the demand for the limitation of families has passed beyond these motives into regions of thoughtlessness and selfishness. ”

“ Regarding the obstetrical care given to the unmarried mothers in these homes, the evidence given indicates clearly that it is of a standard equal to that in our other maternity hospitals.
Indeed, whereas the risks of childbirth amongst unmarried mothers the world over is notoriously high, amongst the women who place themselves in the care of these homes in New Zealand the maternal mortality and the infant mortality are both exceedingly low. ”

“ Since the rise in the death-rate from septic abortion in 1930, the Department of Health, the medical profession, and women's organizations and societies have shown great concern regarding the problem. The Obstetrical and Gynæcological Society of the New Zealand Branch of the British Medical Association conveyed to the Prime Minister a resolution passed at the meeting of its executive held in Wellington on 12th March, 1936, wherein it begged the Prime Ministry to consider the advisability of setting up a Committee of inquiry to investigate this matter. ”

“ Usually she is more sinned against than sinning; but she carries all the blame which belongs not only to the man but also to society, which has been guilty of supine acquiescence in the surrender of standards of moral conduct. ”

“ In many cases professional abortionists have the assistance of one particular doctor who attends their patients when medical skill becomes necessary. The doctor either treats the patient successfully or sends her to hospital on his own personal note, and in neither case does the identity of the abortionist come to light. ”

“ Every woman or girl is liable to seven years' imprisonment with hard labour who, whether with child or not, unlawfully administers to herself, or permits to be administered to her, any poison or other noxious thing, or unlawfully uses on herself, or permits to be used on her, any instrument or other means whatsoever with intent to procure miscarriage. ”

“ Domestic Assistance.—Equally important is the provision of domestic assistance, and here we are faced with a problem of the greatest difficulty—a national problem which is affecting women in all walks of life and of which this is but one aspect.
In many farming districts it is clear that lack of domestic help is a greater burden to the harassed mother than even financial stringency. ”

“ Speaking generally, there is a moral duty on every person having knowledge of a serious crime which is an offence against morality as well as against law, to assist the police as far as possible in its detection and suppression. The confidence of a patient may be a legitimate ground for excluding that duty in some, or even in most, of the cases of this kind. ”

“ New Zealand has, according to comparative international statistics, one of the highest death-rates from abortion in the world.
II. The Committee, after taking evidence from witnesses representing all sections of the community, has formed the conclusion that the main causes for this resort to abortion are:— (1) Economic and domestic hardship; (2) changes in social and moral outlook; (3) pregnancy amongst the unmarried; and (4) in a small proportion of cases, fears of childbirth. ”

“ Another serious fact is that, while, owing to the strenuous efforts of those engaged in the direction and practice of midwifery, there has been a most gratifying fall in deaths from post-confinement sepsis from 2.02 per 1,000 live births in 1927 to 0.4 per 1,000 in 1935, deaths from post-abortion sepsis in the same period rose from 0.50 per 1,000 live births in 1927 to 1.73 per 1,000 in 1934, with a fall to 1 per 1,000 in 1935. ”