Thus far we have been discussing mainly one class in America—the workers. Most women who belong to the workers' families have no accurate or reliable knowledge of contraceptives, and are, therefore, bringing children into the world so rapidly that they, their families and their class are overwhelmed with numbers. Out of these numbers, as has been shown, have grown many of the burdens with which society in general is weighted; out of them have come, also, the want, disease, hard living conditions and general misery of the workers.

The women of this class are the greatest sufferers of all. Not only do they bear the material hardships and deprivations in common with the rest of the family, but in the case of the mother, these are intensified. It is the man and the child who have first call upon the insufficient amount of food. It is the man and the child who get the recreation, if there is any to be had, for the man's hours of labor are usually limited by law or by his labor union.

It is the woman who suffers first from hunger, the woman whose clothing is least adequate, the woman who must work all hours, even though she is not compelled, as in the case of millions, to go into a factory to add to her husband's scanty income. It is she, too, whose health breaks first and most hopelessly, under the long hours of work, the drain of frequent childbearing, and often almost constant nursing of babies. There are no eight-hour laws to protect the mother against overwork and toil in the home; no laws to protect her against ill health and the diseases of pregnancy and reproduction. In fact there has been almost no thought or consideration given for the protection of the mother in the home of the workingman.

There are no general health statistics to tell the full story of the physical ills suffered by women as a result of too great reproductivity. But we get some light upon conditions through the statistics on maternal mortality, compiled by Dr. Grace L. Meigs, for the Children's Bureau of the United States Department of Labor. These figures do not include the deaths of women suffering from diseases complicated by pregnancy.

"In 1913, in this country at least 15,000 women, it is estimated, died from conditions caused by childbirth; about 7,000 of these died from childbed fever and the remaining 8,000 from diseases now known to be to a great extent preventable or curable," says Dr. Meigs in her summary, "Physicians and statisticians agree that these figures are a great underestimate."

Think of it—the needless deaths of 15,000 women a "great underestimate"! Yet even this number means that virtually every hour of the day and night two women die as the result of childbirth in the healthiest and supposedly the most progressive country in the world.

It is apparent that Dr. Meigs leaves out of consideration the many thousands of deaths each year of women who become pregnant while suffering from tuberculosis. Dr. S. Adolphus Knopf, addressing the forty-fourth annual convention of the American Public Health Association, in Cincinnati in 1916, called attention to the fact that some authors hold that "65 per cent of the women afflicted with tuberculosis, even when afflicted only in the relatively early and curable stages, die as the result of pregnancy which could have been avoided and their lives saved had they but known some means of prevention." Nor were syphilis, various kidney and heart disorders and other diseases, often rendered fatal by pregnancy, taken into account by Dr. Meigs' survey.

Still, leaving out all the hundreds of thousands of women who die because pregnancy has complicated serious diseases, Dr. Meigs finds that "in 1913, the death rate per 100,000 of the population from all conditions caused by childbirth was little lower than that from typhoid fever. This rate would be almost quadrupled if only the group of the population which can be affected, women of child-bearing ages, were considered. In 1913, childbirth caused more deaths among women 15 to 44 years old than any disease except tuberculosis."

From what sort of homes come these deaths from childbirth? Most of them occur in overcrowded dwellings, where food, care, sanitation, nursing and medical attention are inadequate. Where do we find most of the tuberculosis and much of the other disease which is aggravated by pregnancy? In the same sort of home.

The deadly chain of misery is all too plain to anyone who takes the trouble to observe it. A woman of the working class marries and with her husband lives in a degree of comfort upon his earnings. Her household duties are not beyond her strength. Then the children begin to come—one, two, three, four, possibly five or more. The earnings of the husband do not increase as rapidly as the family does. Food, clothing and general comfort in the home grow less as the numbers of the family increase. The woman's work grows heavier, and her strength is less with each child. Possibly—probably—she has to go into a factory to add to her husband's earnings. There she toils, doing her housework at night. Her health goes, and the crowded conditions and lack of necessities in the home help to bring about disease—especially tuberculosis. Under the circumstances, the woman's chances of recovering from each succeeding childbirth grow less. Less too are the chances of the child's surviving, as shown by tables in another chapter. Unwanted children, poverty, ill health, misery, death—these are the links in the chain, and they are common to most of the families in the class described in the preceding chapter.

Nor is the full story of the woman's sufferings yet told. Grievous as is her material condition, her spiritual deprivations are still greater. By the very fact of its existence, mother love demands its expression toward the child. By that same fact, it becomes a necessary factor in the child's development. The mother of too many children, in a crowded home where want, ill health and antagonism are perpetually created, is deprived of this simplest personal expression. She can give nothing to her child of herself, of her personality. Training is impossible and sympathetic guidance equally so. Instead, such a mother is tired, nervous, irritated and ill-tempered; a determent, often, instead of a help to her children. Motherhood becomes a disaster and childhood a tragedy.

It goes without saying that this woman loses also all opportunity of personal expression outside her home. She has neither a chance to develop social qualities nor to indulge in social pleasures. The feminine element in her—that spirit which blossoms forth now and then in women free from such burdens—cannot assert itself. She can contribute nothing to the wellbeing of the community. She is a breeding machine and a drudge—she is not an asset but a liability to her neighborhood, to her class, to society. She can be nothing as long as she is denied means of limiting her family.

In sharp contrast with these women who ignorantly bring forth large families and who thereby enslave themselves, we find a few women who have one, two or three children or no children at all. These women, with the exception of the childless ones, live full-rounded lives. They are found not only in the ranks of the rich and the well-to-do, but in the ranks of labor as well. They have but one point of basic difference from their enslaved sisters—they are not burdened with the rearing of large families.

We have no need to call upon the historian, the sociologist nor the statistician for our knowledge of this situation. We meet it every day in the ordinary routine of our lives. The women who are the great teachers, the great writers, the artists, musicians, physicians, the leaders of public movements, the great suffragists, reformers, labor leaders and revolutionaries are those who are not compelled to give lavishly of their physical and spiritual strength in bearing and rearing large families. The situation is too familiar for discussion. Where a woman with a large family is contributing directly to the progress of her times or the betterment of social conditions, it is usually because she has sufficient wealth to employ trained nurses, governesses, and others who perform the duties necessary to child rearing. She is a rarity and is universally recognized as such.

The women with small families, however, are free to make their choice of those social pleasures which are the right of every human being and necessary to each one's full development. They can be and are, each according to her individual capacity, comrades and companions to their husbands—a privilege denied to the mother of many children. Theirs is the opportunity to keep abreast of the times, to make and cultivate a varied circle of friends, to seek amusements as suits their taste and means, to know the meaning of real recreation. All these things remain unrealized desires to the prolific mother.

Women who have a knowledge of contraceptives are not compelled to make the choice between a maternal experience and a marred love life; they are not forced to balance motherhood against social and spiritual activities. Motherhood is for them to choose, as it should be for every woman to choose. Choosing to become mothers, they do not thereby shut themselves away from thorough companionship with their husbands, from friends, from culture, from all those manifold experiences which are necessary to the completeness and the joy of life.

Fit mothers of the race are these, the courted comrades of the men they choose, rather than the "slaves of slaves." For theirs is the magic power—the power of limiting their families to such numbers as will permit them to live full-rounded lives. Such lives are the expression of the feminine spirit which is woman and all of her—not merely art, nor professional skill, nor intellect—but all that woman is, or may achieve.