The slow increase in the population of primitive peoples, which is also to be noticed wherever the conditions of life have not been influenced by European settlers and missionaries, is chiefly due to the want of proper midwifery, and no less to the frequent practice of abortion. The opinion is often met with, particularly in older writings, that among primitive people childbirth is extremely easy. But more extended knowledge has shown how dangerous childbirth is for the primitive mother also. Though childbirth is a natural physiological process, it does not always pass off quite without danger, no less under natural conditions than among highly civilised peoples. Primitive people know full well that the hour of childbirth is the hardest time in a woman's life, but not all have progressed far enough in the knowledge of physiology to be able to render efficient assistance to the woman in labour. Some people leave her, incredible as it may seem to us, without any assistance, either through indifference to life or through a superstitious fear of the mystery of life. Such cases are, however, very rare exceptions. Sometimes means are used for furthering the birth that are not only inefficacious, but actually injurious. Often, however, delivery is actually furthered by the assistance given. Internal manipulation is seldom resorted to, and operations are still more rare. R. W. Felkin's report about the operation of CÆsarian section among the negroes in Uganda seems to be unique. Ploss and Bartels have compiled a great deal of information about childbirth among primitive people. We add here some examples from the later literature.

Feticide occurs most likely among all primitive peoples to a larger or lesser degree, and injures them accordingly. The reasons are the same as with us: inability to support a large number of children or aversion to the worries of child-rearing. Unmarried girls procure abortion usually because the child might be a hindrance to a future marriage, particularly when the father of the expected child jilts the mother. Still pre-marital births are not always considered a disgrace among primitive people. The abortives resorted to are generally inefficacious, though some native peoples have discovered really effective remedies. KÜlz (p. 18) says quite rightly, "It is to be assumed that woman everywhere, even in a low state of civilisation, has her attention directed to the occurrence of involuntary premature birth by often recurring effective causes. Such external causes are not very remote from the mechanically and medically produced abortions. We only need to think of the fact that among all primitive peoples the chief work in the fields falls to the women, and that it is just heavy labour that has the tendency to interrupt pregnancy. It required only some little thought to discover this frequently observed coincidence and to learn from the involuntary interruption of pregnancy how to produce it voluntarily.... In the same way the production of abortions by poisons can easily be derived from a rational application of chance remedies producing corresponding involuntary effects.... Just as primitive man discovered many medicinal plants by repeatedly partaking of them, so he also found out the specific use of some of these for feticide. This could happen the more readily as among abortive remedies in use there were many that in a way served him as food and condiment, such as nutmeg, or the papaia kernels, or others that he used at the same time for poisoning fish, or others, again, like the aperient Cajanus indicus, which in moderate doses acts medicinally, in large doses, however, as an abortive."

The use of poisons and mechanical feticide not only brings about limitation of offspring, but often results in the death of the mother. Where they are very prevalent they contribute greatly to the scarcity of women, with all its attendant biological disadvantages. The contact of primitive people with Europeans generally increases the frequency of abortions. This is due partly to the desire for hiding the results of sexual intercourse with strangers, partly to the incitement to loose living which the acquaintance with European culture sometimes brings about.

How defective the state of midwifery is among primitive people is shown by many accounts in newer works of ethnology. Thus the missionary Endle writes (p. 41): "The native tribes of Assam and Burma have no special midwives. Every old woman may perform the duties of a midwife, and she does it without payment. There is no information about the treatment of the woman during parturition. The navel cord is generally cut off with a bamboo knife. The KatshÁri do not perform this with one cut, but make five cuts in the case of a boy and seven for a girl. The mother is considered unclean for several weeks after her confinement. This is also the case among many races of Southern and Eastern Asia, and in other parts of the world. Isolation even before the confinement sometimes occurs, and is due to the belief that women in this state are unclean."

Among the savage tribes of Formosa the birth of a child passes off so lightly that the lying-in woman is able to go on with her work on the following day. She only avoids heavy labour in the field for a month. After the birth certain superstitious ceremonies, according to old customs, are performed, such as driving away the devil, etc. Among many tribes twins are held to be a misfortune, and the second child is therefore killed. This also occurs frequently in other places (W. MÜller, p. 230).

Among the Igorots of Bontoc (Philippines) the woman works in the field almost to the hour of her confinement. There are no festivities or ceremonies connected with the birth. The father of the child, if he is the husband of the woman, is present, as is also the woman's mother, but no one else. The parturient woman bends her body strongly forward, holding firmly on to the beam of the house, or she takes up an animal-like position, so that hands and feet are on the ground. Medicines and baths are not resorted to for hastening the labour pains, but the people present massage the abdomen of the labouring woman. About ten days after the birth her body is washed with warm water. There is no special diet, but the mother refrains from field work for two or three months. If twins are born, it is believed to be due to an evil spirit who has had connection with the woman whilst she was asleep. No blame is attached to the mother, but the quieter of the children (and when both children are quiet, the longer one) is buried alive near the house immediately after birth. Abortion is practised by married women as well as by single girls, if for some reason the child is not wanted. The mother warns her unmarried daughter against abortion, telling her that a girl who produces abortion will not get a faithful husband, but will become the common partner of several men. The foetus is driven off in the second month of pregnancy by hot baths and massage. Abortion is not considered a disgrace (Jenks).

Among the Kayan of Borneo there are everywhere older women who serve as midwives. One of them is called in good time to the pregnant woman. She examines her abdomen from time to time, and pretends to be able to give the child the right position. She hangs some magical remedies about the living room, and applies various remedies externally. The pregnant woman follows her usual occupation until the labour pains commence. Then the midwife and other old relatives or friends assist her. The husband may also remain in the room, but he is prevented by a screen from seeing the parturient woman, who gets hold tightly of a cloth hung over or in front of her. The pains are generally of short duration, rarely lasting more than two or three hours. In order to prevent the rising of the child, the women bind a cloth tightly round the abdomen of the parturient woman, and two of them press firmly on the womb on either side. After the delivery of the child the navel cord is cut with a bamboo knife. If the after-birth does not follow soon, the women become anxious; two of them lift up the patient, and if that has no result, the navel cord is fastened to an axe in order to prevent it from re-entering the body, and presumably also to hasten the delivery of the after-birth. Internal manipulations are not resorted to. The after-birth is buried. If the child is born with a caul, the caul is dried, pounded into powder, and used in later years as medicine for the child. If the labour pains are exceptionally severe or long-lasting, or if an accident happens, the news travels rapidly. Everybody is overcome by fear, as the death of a parturient woman is particularly dreaded. The men and the boys take flight. If death actually ensues, most of the men remain in hiding for some time, and the corpse is quickly buried by old men and women who are least afraid of death.

The pregnant women of the Punan of Borneo continue with their usual work until the arrival of labour pains, and they resume it immediately after the confinement. To assist delivery the body is tightly bound above the womb. Nothing further is known about special help (Hose and McDougall, II., pp. 154, 185).

The Papua women are said to give birth easily, as a rule, but difficult deliveries and fatal cases do occur exceptionally. The custom exists in various places for the mother to throw the after-birth into the river or the sea after confinement (Williamson, p. 178; Seligmann, p. 85). Of the Mafulu Williamson says that when the after-birth is thrown into the river the mother gives the new-born child some water to drink. If the child partakes of it, it is considered a good omen; otherwise the child is believed not to be viable and is drowned. Williamson thinks that the purpose of this custom is to enable the mother to choose whether she wishes to keep the child alive or not. It also may happen that a childless woman accompanies the mother to the river and there adopts the child. Wilful abortion also occurs very often, not only in single girls, but also in married women, who thus keep their families small.

Among the Barriai in New Pomerania the woman is confined whilst sitting on a log of wood, being massaged from above downwards by an older woman. The husband is not allowed to be present. The birth generally passes off quite easily. The navel cord is cut off with an obsidian knife. The parents may not eat pork and certain kinds of fish until the child has begun to walk. Disregard of this prohibition is believed to bring about the death of the child. The parents abstain also during this time from sexual intercourse. Abortives do not seem to be known, though miscarriages sometimes occur through the rough treatment of pregnant women by men (Friederici, p. 89). In Polynesia abortion is generally produced by women professionally. This is brought about by the use of certain foods or drinks, by the application of mechanical means, etc. How widespread feticide is in Melanesia can be seen from a statement of Parkinson, according to whom in New Mecklenburg quite young girls make no secret of having produced abortion three or four times. Among the Jabim (Finschhafen) the mothers present their daughters with abortives when they get married (Buschan, I., p. 62).

On the eastern islands of the Torres Straits (Australia) the women chew as a prevention of pregnancy the leaves of Callicarpa, or of a Eugenia species called sobe, also the leaves of a large shrub called bok; but these remedies are inefficacious. Medicines and mechanical methods are used for abortion. Among the former are the leaves of the convolvulus, of Clerodendron, Pouzolzia microphylla, Macaranga tanarius, Terminala catappa, Eugenia, Hibiscus tiliaceus, and Callicarpa. If these do not help, the abdomen is beaten with large stones, with a rope or twigs or a wand, or a heavy load is put on it. Sometimes the woman leans with her back against a tree, and two men grasp a wand and press it against her abdomen, so as to bring about the delivery of the foetus. This often results in the death of the mother.

On the Easter Island, in the Eastern Pacific Ocean, there were several men with a knowledge of midwifery, but recently only one of them has survived. Nowadays older women act as midwives. Walter Knoche writes (1912, pp. 659 et seq.): "The birth takes place either in the open or in the house, the woman standing with legs spread out, or recently in a sitting position. The accoucheur stands behind the parturient woman, embracing her abdomen. The thumbs are spread out, and touch each other in a horizontal position somewhat above the navel, while the remainder of the hand is turned diagonally downwards. In this way massage is applied by a slow, rhythmical, strong and kneading movement vertically from above downwards. When the birth is sufficiently advanced, the child is drawn out; the assistant bites off the navel cord (among some Brazilian Indian tribes the husband does this, but on the Easter Island he takes no part in the delivery); then a knot is made a few centimetres from the navel. The after-birth is not specially dealt with; it is buried. The navel cord, however, is placed in a calabash, which is buried or put under a rock. After the event the lying-in woman lies down upon a mat in the house, and warm, flat, fairly heavy stones are applied to the abdomen. Perhaps this is the reason why even women who have had difficult confinements still preserve a good figure. The infant remains at the mother's breast for about a year." Knoche also heard that the women sometimes pass a piece of an alga into the vulva right up to the womb before intercourse with a stranger, believing this method to be a very safe one. It could, unfortunately, not be ascertained whether this precaution was formerly, as seems likely, resorted to generally in order to limit the number of children, or whether its use was only intended to keep the tribe untainted by foreign blood. The latter assumption is contradicted by the fact that "the Easter Island women have children from strangers living for some time on the Easter Island, and that nowadays the use of contraceptives in the case of strangers who come and go quickly may simply be due to the circumstance that at the birth of a child there would be no man to support it. It is most probable that the use of preventives had its origin in Malthusian principles. The little island, whose population has been variously estimated by travellers of the eighteenth and the first half of the nineteenth century at a few thousand, must herewith have reached its maximum number of inhabitants, which could of necessity not be exceeded. Deaths and births had therefore to balance. This employment of contraceptives in Polynesia is unique, and it may be truly reckoned as a sign of a higher civilisation, together with other facts, such as the existence of a script, of stone houses and of large stone idols, the Moai, which have made this lonely little island so famous. On the other Oceanic Islands, as, for instance, on the westward-situated Tahiti, infanticide, committed by the mother as many as ten times in succession, served to limit the number of children, either on account of economy or for reasons of convenience. Contraceptives are otherwise unknown in Oceania."

Of the Jao in East Africa Karl Weule relates (p. 61): "During the delivery the parturient woman lies upon her back on a mat on the floor of the hut. The older children and the husband are not allowed to be present, but a number of older women are there, amongst whom there is always a near relative of the husband, who takes special note of any evidence of extra-marital intercourse given by the parturient woman. It is the chief business of the midwives to submit the woman to a very strict questionnaire: 'How many men have you had, three, or four, or even more? Your child will not come until you have mentioned the right father. Yes, you will die, if you do not tell us how many men you have had.' Such speeches are hurled at the woman from all sides. No mechanical help is given her. She rolls about in pain, under great bodily and mental torture, and shrieks and cries until all is over. The navel cord is cut off by an old woman. Ancient instruments, such as are used by the East African Bantu tribes, are unknown among the Jao. The cutting of the navel cord seems to be performed clumsily, for umbilical rupture, which has become an ideal of beauty in many places in Eastern Africa, is here frequent. The after-birth and the navel cord are buried, if possible without a witness. They are considered effective magical remedies. The new-born child is washed and then wrapped in a cloth or a piece of bark fabric. A real lying-in is not kept up; the mother gets up again the same or the following day. Sex intercourse can only be resumed again with the permission of the village elder. It is only given when the child can sit up, or when it is six or seven months old. Children are welcome; twins are no less joyfully received. But infanticide is said to occur. If, however, children are not wanted, married women as well as girls resort to abortion. Plant juices are generally used for this purpose, though sometimes mechanical means are resorted to. Abortion is in no way considered reprehensible. In order to prevent conception, the woman puts herself into communication with a fundi, who understands something of making knots. The fundi goes into the wood, seeks out two different barks, and twists them together into a cord. Into the cord he rubs the yolk of an egg, for to the Jao the curse of infertility abides in the egg. He knots into the cord three knots, saying at the same time, 'You tree are called thus and thus, and you thus; but you egg, you become a living animal. But now I do not want anything living.' He then twists the final knot. This cord is worn by the woman round her body. Boots are also placed under her head at night to prevent conception. If the woman wishes to become pregnant again, she needs only to untie the knots in the cord, to put it into water, and then drink the water. Afterwards the cord is thrown away."

Among the Makua, on the Makonda plateau in East Africa, at the first sign of labour pains the woman lies down upon her back on a mat in the house. A cloth is put under her back by the helping women, which is drawn tightly and pulled up when the pains become stronger. After the birth the navel cord is cut, not with a knife, but with a splinter from a millet stalk. Here, as in other phases in the life of man, an ancient implement has survived for sacred purposes long after the period of its common use. The navel cord is not tied, but dries off. The removed part is buried. The lying-in woman remains at home three or four days.

Among the Masai an old woman is always called in as midwife. If the birth goes on normally, no superstitious or useless operations are undertaken (Merker, pp. 189 et seq.). Should an increase of labour pains appear necessary, the parturient woman is led round by the women for a few steps, and if this does not produce the desired result light massage is applied. Only when these remedies prove to be inefficacious an extreme step is taken: the labouring woman is slowly lifted up by her feet by several women until her body hangs perpendicularly and her head touches the ground, whereupon the midwife massages the body in the direction of the navel. Medicaments are seldom used for hastening the delivery. Internal manual or operative manipulations do not seem to be practised anywhere. In the case of a narrow pelvis preventing birth, no help is available; mother and child perish. The confinement takes place on all fours or in a sitting position; in the latter case the legs and the back are pressed against the posts of the hut. For the production of abortion a decoction of dried goat dung or of cordia quarensis or some other remedy is used.

Of the Hottentots it has sometimes been reported that the women have easy births. According to Schulze's inquiries (p. 218), this is not always the case. The birth takes place in the side position. During very difficult births the women attempt to widen the vulva of the parturient woman. If that does not help, the perineum is deliberately torn up to the anus. No attempt is made to cure the perineal tear, for the belief exists that it would hinder the passage of the next child. All manipulations are carried out beneath the skin rug under which the woman lies. The navel cord is cut without delay; no one troubles about the delivery of the after-birth. The woman resumes her occupation generally on the seventh or eighth day. Feticide is not unusual among the Hottentots. A hot decoction of badger urine, drunk, if necessary, for several days in succession, is considered an effective abortive remedy. The procedure itself is characteristically called "drinking and falling" (Schulze, p. 320).

Among the Uti-Krag Indians of the Rio Doce (Espirito Santo, Brazil) the woman goes through the labour alone. She disappears in the bush, and herself bites off the navel cord; after the delivery she goes to the nearest stream to wash herself and the child, and rejoins her tribe immediately (Walter Knoche, 1913, p. 397).

Among the Indians of the Aiary, when a woman is taken with labour pains all the men leave their house, which is common to several families. The woman lies in her hammock in her part of the house, which is securely closed by a lattice railing. All the women remain with her and help at the birth. The navel cord and after-birth are buried immediately on the spot. After the birth the mother and the child remain strictly secluded for five days. The husband remains in the house during the lying-in period, but there is no real couvade (the male lying-in custom).

The women of the KobÉua Indians give birth in the common family house, or in an outlying hut, or even in the wood, with the assistance of all married women, who first paint their faces red for the festive occasion. The navel cord is cut off by the husband's mother with a blade of scleria grass, and is immediately buried, together with the after-birth. Of twins the second born is killed, or the female if they are of different sexes. After the birth, the witch doctor performs exorcism. The parents keep up a five days' lying-in, and eight days after the birth a drinking feast is held (Koch-GrÜnberg, I., p. 182; II., p. 146).

Among the Bakairi of Brazil, according to Karl von den Steinen (p. 334), abortion is said to occur frequently. The women are afraid of the confinement. They prepare for it by drinking tea, and mechanical measures are also resorted to. The women are delivered on the floor in a kneeling position, holding firmly to a post. The hammocks must not be soiled. Women who have had experience declared with emphasis, and showed by pantomime, that the pains were great. But they soon get up and go to work, the husband going through the famous couvade (the man's lying-in), keeping strict diet, not touching his weapons and passing the greatest part of his time in his hammock. He only leaves the house to satisfy his physical needs, and lives completely on a thin pogu, manioc cake crumbled into water. There exists the belief that anything else might injure the child, as if the child itself ate meat, fish or fruit. The couvade only ends when the remainder of the navel cord falls off.

Among the Bororo, according to the same author (p. 503), the woman is delivered in the wood. The father cuts the navel cord with a bamboo splinter, and ties it with a thread. For two days the parents do not eat anything, and on the third day they may only partake of some warm water. If the man were to eat he and the child would become ill. The after-birth is buried in the wood. The woman is not allowed to bathe until the reappearance of menstruation; but then, as generally after menstruation, she does it frequently. Abortion by the help of internal means is said to be frequent, especially among the Ranchao women. If the mother wishes to stop suckling, they squeeze the breasts out, and "dry the milk over the fire, whereupon it keeps away." Medicine for sick children, which the chemist had prepared, was swallowed by the parents, as among the Bakairi.

Among the Paressi the woman is confined in a kneeling position, being held by her mother under her breast. The couvade is also customary among them.