Here we have the mother with health undermined and reserve vitality reduced to a minimum by the strain of bearing and rearing a large family. She approaches the menopausal stresses with anxiety and apprehension, having done her duty to family and race, often having lived an exemplary self-sacrificing life, the intolerable contemplation of a late pregnancy drives her to desperate measures often for the first time in her life.

Again, there is the relatively young, tired, anaemic, debilitated mother, with a number of young children born at very close intervals, often denied even a half-holiday, let alone an adequate one, unable to afford suitable domestic a.s.sistance, often with poor housing or domestic arrangements, and completely exhausted with the incessant round of cleaning, cooking, and the strain of the inevitable fretfulness of a number of young children.

The Committee is of the opinion that it is the State's duty to ensure that mothers within this group should obtain the respite that the health of themselves and their present and future families demands.

The economic aspects of these problems are dealt with in our general recommendations, but we also recommend that departments should be established, preferably in conjunction with the out-patients'

departments of our public hospitals, whither medical pract.i.tioners could refer for instruction and equipment with contraceptive appliances mothers who in their opinion should be a.s.sured of temporary or permanent freedom from child-bearing.

It might be desirable that the certifying doctor's recommendation should be endorsed by the officer in charge of the department before admission, but that is a practical point which could be discussed at a later date with members of the Obstetrical Society and medical profession.

Though the Committee discounts the exaggerated statements that have been made at intervals about the sale of contraceptives to juveniles, and though no first-hand information on such matters was laid before the Committee, yet we are of the opinion that the sale of contraceptives to young persons should be prohibited.

(6) THE CONTROL OF THE ADVERTIs.e.m.e.nT AND SALE OF ABORTIFACIENT DRUGS AND APPLIANCES.

The Committee recommends the advertising and sale (except by doctor's prescription) of drugs euphemistically described as for the "correction of women's ailments" or "correction of irregularities" should be forbidded. For their alleged purpose of correcting functional menstrual irregularities they have no value; as abortifacients though usually ineffective their unrestricted sale should be forbidden. As stated previously, "their only value is as a lucrative source of gain to those people who, knowing their inefficiency, yet exploit the distress of certain women by selling them." An example of this exploitation was obtained by the Committee. The drugs were advertised as "corrective pills, ordinary strength, 7s. 6d.; extra strong, 12s. 6d.; special strength, 20s." A supply of the last was obtained, and a.n.a.lysis showed that they consisted of (1) a capsule containing about 12 drops of oil of savin, value about 6d., dangerous to health but usually useless for the purpose sold; (2) 9 tablets of quinine, worth about 4s., and quite ineffective; (3) 24 iron and aloes pills, worth about 6d., and equally ineffective. The gross profit on this 2s. worth of rubbish was at least 900 per cent. If it is possible to legislate to stop such fraudulent exploitation of people we recommend that it be done.

The Committee also recommends that the sale of surgical instruments which can be used for the purpose of procuring abortions, such as catheters, Bougies, and sea-tangle tents, be prohibited, except on the prescription of a medical pract.i.tioner, and that if possible their importation be placed under control.

PART IV.--QUESTIONS RELATING TO THE MEDICO-LEGAL ASPECTS OF ABORTION.

At the present time there is in many countries much criticism of the existing laws regarding abortion, and various suggestions have been made for the alteration of the law.

Such representations have, indeed, been made to this Committee.

A consideration of these matters, therefore, could not escape our attention.

THE NEW ZEALAND LAW REGARDING ABORTION.

The law in regard to abortion as set down in sections 221, 222, and 223 of the Crimes Act, 1908, is as follows:--

_Procuring Abortion._

"221. (1). Every one is liable to imprisonment with hard labour for life who, with intent to procure the miscarriage of any woman or girl, whether with child or not, unlawfully administers to or causes to be taken by her any poison or other noxious thing, or unlawfully uses any instrument or other means whatsoever with the like intent.

"(2) The woman or girl herself is not indictable under this section."

This section re-enacts s. 201 of the Criminal Code Act, 1893. _Cf._ s.

223, _infra_.

"Other means" must be read _ejusdem generis_ with "instrument." (_R._ v. _Skellon_ [1913] 33 N.Z.L.R. 102.)

"_Procuring her own Miscarriage._

"222. Every woman or girl is liable to seven years' imprisonment with hard labour who, whether with child or not, unlawfully administers to herself, or permits to be administered to her, any poison or other noxious thing, or unlawfully uses on herself, or permits to be used on her, any instrument or other means whatsoever with intent to procure miscarriage."

This section re-enacts s. 202 of the Criminal Code Act, 1893.

"_Supplying the Means of Procuring Abortion._

"223. (1) Every one is liable to three years' imprisonment with hard labour who unlawfully supplies or procures any poison or other noxious thing, or any instrument or thing whatsoever, knowing that the same is intended to be unlawfully used or employed with intent to procure the miscarriage of any woman or girl, whether with child or not.

"(2) Every one who commits this offence after a previous conviction for a like offence is liable to imprisonment with hard labour for life."

This section re-enacts s. 203 of the Criminal Code Act, 1893. In _R._ v. _Thompson_ [1911] 30 N.Z.L.R. 690, a person was convicted of an attempt (s. 93. p. 209, _ante_) to procure a noxious thing although the thing actually procured was innoxious.

"Knowing" has the meaning of "believing," and a person supplying "a noxious thing" is guilty even when the person supplied, who states that he required it for procuring abortion, had no intention of using it and did not use it for that purpose (_R._ v. _Nosworthy_ [1907] 36 N.Z.L.R.

536).

If the evidence shows that prisoner intended the instrument to be used for the purpose stated, it is sufficient without evidence of intention on the part of the woman to use it or allow it to be used (_R._ v.

_Scully_ [1903] 23 N.Z.L.R. 380).

The word "thing" where secondly used in this section includes only things _ejusdem generis_ with instrument and capable of being used to produce miscarriage (_R._ v. _Austin_ [1905] 24 N.Z.L.R. 893).

_Therapeutic Abortion._--In New Zealand, as in Great Britain and other countries, the medical profession has always held that when the mother's life is seriously endangered by a continuation of the pregnancy the termination of the pregnancy is justifiable and right.

This the law allows, not specifically but by inference.

It is probably a correct statement of the position to say that, with advances in medical knowledge and thought, even the most conservative medical opinion, apart from that which is influenced by certain religious views, holds that the indications for the termination of pregnancy have been extended somewhat to include not only cases in which the mother's life is immediately jeopardized, but also certain cases in which her life is more remotely endangered.

This view is supported by the social thought of to-day.

This is not to say that the occasions for this operation are frequent; they are, indeed, infrequent.

The general standards which guide the medical profession in this matter are very strict, and are conscientiously conformed to by the majority of its members.

It is also a well-recognized rule of the profession that such operations should only be performed after consultation between two medical pract.i.tioners.

With this change in medical outlook, however, there has been no corresponding alteration in the law, which, as it stands, is as uncompromising as ever, and allows of no interference except to save the _life_ of the mother.

It is a fact that the law is _interpreted_ liberally, and no doctor who has acted honestly in the belief that the mother's health was seriously endangered has ever been challenged.

Nevertheless, it has been urged by a large body of the medical profession, especially of those most intimately affected by the question, that there are possible dangers in the situation, and that the law should be altered to indicate more specifically the rightful position of the doctor in this matter; in other words, it is advocated that the present interpretation of the law should be incorporated in the law itself.

Much is made of the fact that an honourable pract.i.tioner occasionally finds himself in the unsatisfactory position of having actually to break the letter of the law in doing what according to accepted medical standards is in the best interests of the patient.

As safeguards against the possible dangers of a widening of the law, it has been suggested that new regulations should be introduced governing the practice of therapeutic abortion.

It has been recommended that operations should only be performed after adequate consultation, and that written certificates should be given by both parties to the consultation; that in certain cases the consultant should be a specialist; that all operations should be performed in public or licensed hospitals; that every therapeutic abortion should be notified to the Medical Officer of Health, to whom also the two certificates should be forwarded; and that every operation not performed under these conditions should be subject to strict investigation.

It has also been recommended by some that there should be a general notification of all abortions.

Those who are opposed to any alteration of the present state argue that any specific legalization of therapeutic abortion to save the serious impairment of health as well as to save life might lead to abuses of this sanction. They point out that even at the present time doctors differ considerably in their views and in their practice, and they fear that such divergences in thought and practice might be seriously exaggerated.