Part 52

3 were 41 years of age. 2 were 42 years of age. 1 was 43 years of age. 2 were 44 years of age. 1 was 47 years of age.

Haller reports the cases of two women who gave birth to children, one at the age of 63, the other at the age of 70 years. Meissner delivered a woman of 60 years of her seventh child; Rush attended the delivery of a woman aged 60; Dewees that of a woman aged 61. Mende and Bernstein report cases of delivery at the age of 60. Marion Sims saw, in the state of Alabama, a negro woman 58 to 60 years of age, who gave birth to a child at this age, at an interval of twenty years since her last pregnancy. Nieden reports a case in which the first pregnancy occurred 26 years after marriage. When married, the wife was 18 years of age, the husband 30; during their first twenty-five years of married life there was no sign of pregnancy, but when the wife was 44 years of age, menstruation, hitherto regular, suddenly ceased; the cause of the cessation proved to be pregnancy, and at term a healthy girl weighing nine pounds was born; the mother was able to nurse the child herself. Smith attended a woman aged 52 who was delivered of twins; the youngest of her eight other children, who were then all living, was ten years of age.

Rodzewitsch collected from the Russian literature of the years 1872 to 1881, eleven cases in which women aged 50 to 55 had given birth to children. Talquist reports that in Finland, in the year 1883, a woman 58 years of age was delivered; whilst Ansell records the case of an Englishwoman who became a mother when 59 years of age. John Kennedy records the case of a woman of 62 who was normally delivered at this age; she had begun to menstruate at the age of 13, and since the age of 20 had previously given birth to 21 children, the last five when she was 47, 49, 51, 53, and 56 years of age, respectively. Prior even reports the case of a woman 72 years of age, who not only menstruated, but had an abortion(!)

The ideal of fertility in women is that the first completed act of sexual intercourse should be followed immediately by conception, that the pregnancy should terminate after the normal lapse of time in the birth of a child, and that the same process should be repeated at intervals of about ten months until the end of active sexual life. In actual experience, however, this never occurs. Fertilization as an immediate consequence of the first act of sexual intercourse (which in the lower animals is regarded as the rule) is a very rare occurrence in human beings. Moreover, in no single marriage is the reproductive capacity of the wife utilized to the full, up to the time of extinction of her generative faculty; either because the potency of the male partner undergoes a gradual decline, or, it may be, because, after a while, sexual intercourse becomes less frequent, or because precautions against procreation are taken.

The number of children to which during the three decades of her sexual life, from the menarche to the menopause, a woman might theoretically give birth, is never actually born. If we assume that, during the period of active sexual life, a woman requires a period of fifteen months to two years for each pregnancy, parturition, and lactation, a woman could easily during this period have fifteen or sixteen children, and this figure would represent the normal product of the normal fertility of the human female. There are indeed, women who, it may be in consequence of an exceptionally long period of sexual activity, or through giving birth repeatedly to twins or triplets, or because they have married several husbands in succession, have given birth to twenty-four children or even more. In Berlin, in the year 1901, there lived a woman 41 years of age who had had 23 children; there were three women, aged respectively 40, 43, and 46 years, who had had each 21 children; 246 women with families numbering 13 to 20; and 169 women each of whom had given birth to 12 children. In the very great majority of cases, however, the fertility of the wife of the present day is never fully developed. It is modified in various ways by the conditions of marriage, by social circumstances, by considerations relating to the health of husband or wife, by actual illnesses, and by voluntary limitation of fertility. Generally speaking, according to the investigations of Quetelet, Sadler, and Finlayson, the fertility of women is greatest in marriages in which the husband is as old as the wife, or a little older, but without marked difference in age. Marriages contracted at a very early age are less fruitful; the highest fertility is found in marriages contracted when the husband is 23 and the wife 26 years of age.

Conception does not generally take place until sexual intercourse has been frequently repeated. As the result of a statistical enquiry of my own, relating to 556 fruitful marriages, I ascertained that in these the first delivery occurred:

Within 10 months after marriage in 156 cases. Within 11 to 15 months after marriage in 199 cases. Within 16 to 24 months after marriage in 115 cases. Within 2 to 3 years after marriage in 60 cases. More than 3 years after marriage in 26 cases.

Thus we learn that in 35.5% of the cases the first delivery occurred within 1¼ years after marriage; in 15.6% within 10 months; and in 19.9% within 15 months after marriage; and 11.5% of the cases, the first delivery was more than 1¼ years and less than 2 years after marriage; in 6.0% it was between 2 and 3 years after marriage; and in 2.6%, the first delivery did not occur until more than 3 years after marriage.

From examination of the birth registers of Edinburgh and Glasgow, Matthews Duncan determined the mean interval between marriage and the birth of a living child to be seventeen months. In the majority of cases, the first delivery does not occur until a complete year has elapsed since marriage; in fact, in nearly two-thirds of the instances the first delivery occurs during the second year of married life.

The interval between two successive births is, according to Matthews Duncan, on the average 18 to 24 months, according to Goehlert, 24 to 26 months; the latter, however, points out that in cases in which the child dies very soon after birth, the birth of the next child ensues on the average in 16 to 18 months. In this connection, we must not fail to take into consideration the influence of lactation, inasmuch as mothers who do not suckle their children become pregnant considerably earlier, on the average, than those who undertake this duty. In reigning families, for instance, it is by no means uncommon for the consort to be delivered twice within a single year. The degree to which lactation hinders conception is so widely known, that women often suckle their infant for a very long period, with the definite aim of preventing the speedy recurrence of pregnancy. A high official from the Dutch Indies informed me that for this reason the native women were accustomed to suckle their infants for several years, and that it was by no means uncommon to see a small boy running about smoking a cigar, and then hurrying to his mother in order to be suckled.

The age at which a woman contracts marriage has also to this extent an influence upon her fertility, inasmuch as it appears that those who marry very young are far less fertile than those who marry between the ages of 20 and 25 years; the latter moreover have, on the average, a shorter time to wait for their first conception than women who marry before the age of 20. Women who marry after the age of 25 have to wait longer after marriage for their first delivery; in fact the older the woman after 25, the greater, on the average, the interval between marriage and the first delivery.

Arranging the data already referred to, regarding 556 fruitful women, in relation to this point of view, it appears that the first birth ensued:

═════════════════════╤═════════╤═════════╤═════════╤═════════╤═════════ │ │ │15 months│ │ │ │10 to 15 │ to 2 │ 2 to 3 │More than │Within 10│ months │ years │ years │ 3 years │months of│ after │ after │ after │ after │marriage.│marriage.│marriage.│marriage.│marriage. ─────────────────────┼─────────┼─────────┼─────────┼─────────┼───────── In 163 women marrying│ │ │ │ │ at ages 15 to 20 │ │ │ │ │ years │ 36│ 53│ 46│ 18│ 10 In 313 women marrying│ │ │ │ │ at ages 20 to 25 │ │ │ │ │ years │ 98│ 113│ 56│ 32│ 14 In 70 women marrying │ │ │ │ │ at ages 25 to 33 │ │ │ │ │ years │ 18│ 30│ 12│ 9│ 1 In 10 women marrying │ │ │ │ │ at ages over 33 │ │ │ │ │ years │ 4│ 3│ 1│ 1│ 1 ═════════════════════╧═════════╧═════════╧═════════╧═════════╧═════════

To give percentages, the first birth occurred,

═════════════════════╤═════════╤═════════╤═════════╤═════════╤═════════ │ │ │15 months│ │ │ │10 to 15 │ to 2 │ 2 to 3 │More than │Within 10│ months │ years │ years │ 3 years │months of│ after │ after │ after │ after │marriage.│marriage.│marriage.│marriage.│marriage. ─────────────────────┼─────────┼─────────┼─────────┼─────────┼───────── Women marrying at │ │ │ │ │ ages 15 to 20 │ │ │ │ │ years, in │ 22.0%│ 32.5%│ 28.2%│ 11.0%│ 8.1% Women marrying at │ │ │ │ │ ages 20 to 25 │ │ │ │ │ years, in │ 31.3%│ 36.1%│ 17.8%│ 10.2%│ 4.4% Women marrying at │ │ │ │ │ ages 25 to 33 │ │ │ │ │ years, in │ 25.7%│ 42.8%│ 17.1%│ 12.8%│ 1.4% Women marrying at │ │ │ │ │ ages over 33 years,│ │ │ │ │ in │ 40.0%│ 30.0%│ 10.0%│ 10.0%│ 10.0% ═════════════════════╧═════════╧═════════╧═════════╧═════════╧═════════

Thus whereas in women who contracted marriage between the ages of 15 and 20 years, only 54.5% were confined for the first time within 15 months after marriage, in women who contracted marriage between the ages of 20 and 25 years, in 67.4% the first delivery occurred within 15 months of marriage. And whereas in those who married at the earlier age, the percentage of first deliveries occurring between 15 months and 2 years after marriage was 28.2, in those who married between the ages of 20 and 25, the percentage of first deliveries after the stated interval was only 17.8.

The figures compiled by Whitehead and Pfannkuch give similar results. Of 700 women who married between the ages of 15 to 20 years, there were 306 only who gave birth to a child within the first two years after marriage; whereas of 1,835 women who married between the ages of 20 and 25 years, no less than 1,661 gave birth to a child within two years after marriage—a percentage of 43.7 in the former case, and 90.6 in the latter case. Pfannkuch, as the result of a very large collection of figures relating to this question, found that in women marrying before the age of 20 years, the average number of months before the first delivery was 26; whereas in women marrying after the age of 20 years, the average number of months before the first delivery was 20.

According to Matthews Duncan

═══════════════════════════════════╤═══════════════════════════════════ OF EVERY 100 WOMEN WHO MARRY │ THERE BECOME MOTHERS ───────────────────────────────────┼─────────────────┬───────────────── „ │ In the 1st year │In the 2d year of │of married life. │ married life. ───────────────────────────────────┼─────────────────┼───────────────── Between the ages of 15 and 20 years│ 13.71│ 43.70 Between the ages of 20 and 25 years│ 18.48│ 90.51 Between the ages of 25 and 30 years│ 12.41│ 75.80 Between the ages of 30 and 35 years│ 11.44│ 62.93 Between the ages of 35 and 40 years│ 9.27│ 40.97 ═══════════════════════════════════╧═════════════════╧═════════════════

Sadler examined the relationship between the age at which marriage was contracted and the number of offspring in the case of the wives of English peers. He obtained the following results:

Age at marriage. Births per marriage. 12 to 16 years 4.40 16 to 20 years 4.63 20 to 24 years 5.21 24 to 28 years 5.43

From exact statistical data of births in the Scandinavian countries of Europe (Denmark, Sweden and Norway), Goehlert compiled the following table, showing the percentages of fertility at various ages:

═════════════════╤══════════════════════════╤══════════════════════════ AGES. │ MARRIED WOMEN. │ UNMARRIED WOMEN. ─────────────────┼────────┬────────┬────────┼────────┬────────┬──────── „ │Denmark.│Sweden. │Norway. │Denmark.│Sweden. │Norway. ─────────────────┼────────┼────────┼────────┼────────┼────────┼──────── Under 20 years. │ 1.0│ 1.0│ 0.7│ 9.1│ 7.0│ 4.9 From 20 to 25 │ 13.9│ 12.8│ 11.9│ 43.9│ 35.1│ 37.0 years. │ │ │ │ │ │ From 25 to 30 │ 26.5│ 24.7│ 24.7│ 28.1│ 27.9│ 32.4 years. │ │ │ │ │ │ From 30 to 35 │ 26.7│ 26.1│ 25.3│ 11.4│ 16.8│ 14.9 years. │ │ │ │ │ │ From 35 to 40 │ 21.0│ 21.6│ 21.3│ 5.4│ 9.0│ 7.1 years. │ │ │ │ │ │ ─────────────────┼────────┼────────┼────────┼────────┼────────┼──────── From 40 to 45 │ 9.9│ 12.0│ 13.0│ } 2.1│ 4.2│ 3.7 years. │ │ │ │ │ │ Over 45 years. │ 1.1│ 1.8│ 3.1│ „ │ „ │ „ ─────────────────┴────────┴────────┴────────┴────────┴────────┴────────

From this table it appears that the fertility of married women increases steadily up to the age of 35 years, but after this age it begins to decline. What a marked influence the age at marriage has upon fertility is shown by the comparison of the figures relating to married women with those relating to unmarried women; the fertility of unmarried mothers attains its maximum at the ages of 20 to 25 years. In the countries under consideration the average age of women at the time of marriage is 25 to 27 years.

In order to obtain a still clearer picture of the fertility of women in relation to age, Goehlert has combined the figures relating to the married and the unmarried, and then calculated the percentages, with the following results:

════════════════════════════════════════════╤══════════════════════════ AGES. │ MARRIED AND UNMARRIED │ WOMEN. ────────────────────────────────────────────┼────────┬────────┬──────── „ │Denmark.│Sweden. │Norway. ────────────────────────────────────────────┼────────┼────────┼──────── Under 20 years. │ 1.7│ 1.6│ 1.1 From 20 to 25 years. │ 16.6│ 15.1│ 14.1 From 25 to 30 year │ 26.6│ 25.0│ 25.3 From 30 to 35 years. │ 25.3│ 25.1│ 24.4 From 35 to 40 years. │ 19.6│ 20.4│ 20.0 From 40 to 45 years. │ 9.2│ 11.2│ 12.2 ────────────────────────────────────────────┼────────┼────────┼──────── From 45 to 50 years. │ } 1.0│ 1.6│ 2.9 Over 50 years. │ „ │ „ │ „ ────────────────────────────────────────────┴────────┴────────┴────────

If, finally, we combine into a single table the figures relating to all three of these countries, we obtain the following results:

Under 20 years 1.5% From 20 to 25 years 15.3% From 25 to 30 years 25.6% From 30 to 35 years 24.9% From 35 to 40 years 20.0% From 40 to 45 years 10.9% Over 45 years 1.8%