200 WHAT THE OBSTETRICIAN CAN DO 



(d). Care of illegitimate and abandoned infants: In view of 

 the very poor results obtained with artificial feeding in most infant 

 asylums the obstetrician should exert every effort to persuade 

 mothers to keep and suckle their illegitimate children instead of 

 placing them in such institutions. Aside from the sociological 

 and humanitarian aspects of the question, "placing out" such 

 infants is practically equivalent to slowly murdering them, as I 

 am credibly informed that less than 5 per cent, of those admitted 

 to the best institutions in this city survive the first year, instead of 

 75 or 80 per cent, which might be saved under ideal conditions. 

 This means that most institutions fail to do their full duty 

 towards such children. At the same time I do not desire to 

 criticize them too harshly, as I know that the good women in 

 charge are doing as well as their circumstances permit. They 

 fully realize their short-comings, and frankly attribute them to 

 inadequate financial support. Unfortunately, it is very expensive 

 to raise babies artificially in institutions, and if the public does not 

 support them adequately, it has only itself to blame that they 

 do not fulfill the purposes for which they were founded. 



Among other reasons, the lack of financial support may be 

 attributed to the fact that many charitable, and otherwise well 

 intentioned, persons feel that illegitimacy is so serious a handi- 

 cap that they regard death as a providential solution of the diffi- 

 culty. For my part, I feel that they would be much more logical 

 and humane, and at the same time more likely to realize the 

 fallacy of their position, if they attempted to legalize the prompt 

 destruction of such infants. This would permit the authorities 

 to drown them decently, like worthless dogs, instead of having 

 the community delude itself into feeling that it had done its 

 duty sending them to institutions, where they slowly succumb to 

 slow starvation and the absence of the individual care, which is so 

 essential to young infants. 



I have already indicated how this evil may be combatted in the 

 case of children born in well regulated lying-in hospitals, but how 

 to save the abandoned infant and foundling is a still more serious 

 problem. In this event, there is no possibility of attempting to 

 educate the mothers, as they have already abandoned the chil- 

 dren, with the result that they often come into the hands of the 

 authorities in a pitiable physical condition due to neglect or 

 disease. Undoubtedly the chances of saving them would be 

 greatly increased if it were possible to place them at once in 

 suitable surroundings in the care of a wet nurse, but this is not 

 feasible on account of our ignorance of their antecedents, with 

 the possibility of subsequent infection of the foster-mother with 

 syphilis, as well as the practical difficulty of having such women 

 available at all times. 



