care is given, rarely results in sepsis. Therapeutic abortion, done with all the safeguards of modern surgical practice, is associated with very little acute sepsis.

But criminal abortion is associated with an extremely high sepsis rate.

The reasons are not far to seek: the surreptitious nature of the operation and the lack of skill and surgical cleanliness so frequently shown by the operator make this result almost inevitable.

Has the Practice of Abortion Increased in Recent Years?

In so far as the deaths from septic abortion can be taken as a comparative indication of the occurrence of abortion generally—and the Committee believes this is a fair index—there seems little doubt that there has been a marked increase.

A reference to the graph already given will indicate this rise.

There is reason to hope that the fall in 1935 means an improvement in the general situation.

Professor Dawson, giving evidence regarding admissions to the Dunedin Hospital, showed that in the five-year period 1931-35 there was an increase of 23.7 per cent. in the cases of abortion as compared with the previous five-year period.

The evidence of other medical witnesses was practically unanimous on this point.

How does New Zealand compare with other Countries in this Matter?

According to the report of the British Medical Association Committee on the Medical Aspects of Abortion (1936), the position in Great Britain would appear to be very similar to that existing in New Zealand.

In that report it is stated that the incidence of abortion is generally reckoned at from 16 per cent. to 20 per cent. of all pregnancies.

The spontaneous-abortion rate is suggested as probably about 5 per cent. of all pregnancies.

The evidence set before that Committee suggested that there has been an increase in criminal abortion in the last decade.

In England and Wales 13·4 per cent. of the total maternal deaths were due to abortion.

That Committee concludes that "illegal instrumentation contributes to an overwhelming degree to the mortality from abortion."

One of the most interesting investigations into this aspect of the subject is reported by Parish¹ in a study of 1,000 cases of abortion treated as in-patients in St. Giles's Hospital, Camberwell, during the years 1930 to 1934.

In 374 of these cases where instrumentation was admitted the febrile rate was 88·2 per cent., and the death rate 3·7 per cent., while in 246 cases with no history of interference and presumably spontaneous the febrile rate was 5·7 per cent. and the mortality rate nil.

The following table compiled by the Government Statistician shows New Zealand's position in comparison with eleven other countries:—

Puerperal Mortality per 1,000 Live Births in Eleven Countries, 1934.

PART II.—THE UNDERLYING CAUSES OF ABORTION IN NEW ZEALAND.

As seen by the Committee, the reasons which lead to a resort to abortion may be set out under the following broad headings:—

(1) Economic and domestic hardship.

(2) Fear of labour and its sequelæ.

(3) Pregnancy in the unmarried.

(4) Changes in social outlook.

(5) Ignorance of effective methods of contraception and of the dangers of abortion.

(6) Influence of advertising.

(1) Economic and Domestic Hardship.

(a) Poverty.—Cases arise where the parents are on the bread-line and have no means of supporting a child, but the Committee is of opinion that such extreme poverty is rare in New Zealand.

More common are the cases in which income is sufficient for a small family but a larger one would constitute hardship, or, alternatively, in which income is sufficient to support several small children but not to provide education, &c., in later life. The view, formerly widely accepted, that membership of a large family is in itself a valuable contribution to education and to the training of responsible citizens, appears to be at a discount, and many parents now consider that advantages which can be given to a child as a result of family limitation outweigh the