In certain serious general disorders, in diseases of the heart, or of the lungs, in pelvic deformity, and in pathological changes of the female reproductive organs, it may be right to employ means for the prevention of pregnancy—not merely sexual abstinence, but actual measures to prevent fertilization. P. 395.
Based upon the observations of Schauta and Fellner, the latter author advances the rule that in the case of a woman suffering from disease, marriage should be forbidden only when the mortality from the disease in question is not less than 10%. In this category we must include severe cases only of pulmonary tuberculosis, whilst cases of laryngeal tuberculosis will, according to this rule, be absolutely unfit for marriage. Among heart affections contra-indicating marriage, he includes mitral stenosis, other valvular affections in which there is serious disturbance of compensation, and myocarditis; he considers marriage inadmissible also in cases of chronic nephritis, and among surgical affections, in case of malignant tumor. No case in which during a previous pregnancy the patient has been affected by one of the following diseases; viz. severe chorea, mental disorders, severe epilepsy, pulmonary tuberculosis which progressed much during pregnancy, morbus cordis, with considerable disturbance of compensation, severe heart trouble due to Graves disease—in all such cases a repetition of pregnancy should be avoided. P. 261.
FOURTH ANNUAL REPORT OF THE CHIEF OF CHILDREN’S BUREAU OF THE U. S. DEPARTMENT OF LABOR, JUNE 30, 1916
A study of maternal mortality, by Dr. Grace L. Meigs, head of the hygiene division of this bureau, has been undertaken as a direct corollary to the infant mortality inquiry. The sickness or death of the mother inevitably lessens the chances of the baby for life and health. A large proportion of the deaths of babies occur in the first days and weeks of life, and these early deaths can be prevented only through proper care of the mother before and at the birth of her baby.
In the introduction to the report on “Maternal mortality in connection with childbearing,” issued as a supplement to his report as medical officer of the local government board of Great Britain for 1914–15, Sir Arthur Newsholme says: