1 88 THE POPULAR SCIENCE MONTHLY 



The rate of infant mortality has been defined by experts as the ratio 

 of deaths during the first year to the total number of births, and not, 

 as sometimes figured, the ratio of deaths during the first year to the 

 number of living infants under one year of age. For the group of 

 registration states as a whole, the infant death rate calculated under 

 the latter plan was about eight times the death rate at all ages. The 

 death rate of children in the first five years of life was about ten times 

 that of children in the second five years. It is estimated that approxi- 

 mately three hundred thousand babies die annually in the United States 

 before reaching their first birthday. In terms of total population, this 

 means the annihilation of a great city the size of Chicago, or of a state 

 like New Jersey, in a single decade. And at least half of these little 

 lives are needlessly lost. In New York City, in the year 1910, there 

 were 125 deaths under one year for every thousand births; in Wash- 

 ington, D. C, 152; in Lowell, Mass., 231; in Seattle, Washington, only 

 82 ! The wide variation is sufficient proof that many, if not most of 

 such deaths are preventable. 



Stillbirths have been unaccountably neglected in vital statistics, fre- 

 quently being counted neither among births nor deaths. In American 

 cities, it has been estimated that 4 per cent, of all babies are born dead, 

 most of them from preventable causes. We do not know the number 

 of miscarriages (also mainly preventable), nor of ante-natal murders, 

 which frequently pass undetected. In France, the number of criminal 

 abortions has been reckoned at fifty thousand to one hundred thousand 

 a year. 



Causes of Infant Mortality 



It has sometimes been said that the elimination of the feebler chil- 

 dren, such as are often exposed to die in savage lands, tends on the 

 whole to the advantage of society. On the other hand, it is important 

 to remember that the causes productive of a high rate of mortality also 

 affect the resistive power of those who survive and sensibly weaken the 

 next generation. Our aim must be to insure that all be well born, 

 and all work for the preservation of the lives of little children helps 

 in the realization of this aim, as will be seen by an analysis of the 

 causes of death. About 10 per cent, of all who die within the year 

 live less than one day, and nearly one third perish before the end of the 

 first month, showing that prominent among the causes of infant mor- 

 tality is the mother's condition before and during the birth, as affected 

 by alcoholism, social disease and maternal overwork. These same evils 

 tend to produce stillborn and defective children. There is also ex- 

 tended lack of proper care during confinement. In American cities, 

 it is said that about one half of all births are attended by midwives, 

 90 per cent, of whom are inefficient (Mangold). 



The next greatest cause, and one depending partly upon the former, 



