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single positive (Rh.rh.) or negative (rh.rh.). If the husband of a
Rhesus negative woman is double positive every child conceived
will be Rhesus positive ; if the husband is single positive there is
an even chance that a child conceived may be positive or negative.
The antibodies developed in the blood of a Rhesus negative mother
may not affect the first child conceived, but if each succeeding child
conceived is Rhesus positive practically all the later pregnancies
will terminate in still births. Obviously, in marriages where the
mothers are Rhesus positive, or the fathers are Rhesus negative this
particular danger does not occur.
This phenomenon may explain in part the sharp increase in the
still birth rate as the number of pregnancies increases. One can
ascertain whether an individual is Rhesus positive or Rhesus
negative, but the knowledge obtained will be of no practical value
in trying to prevent still births, because there is no way of preventing
or arresting this destructive process if the conditions for its
development exist. Of course the condition would be prevented if
women who were Rhesus negative refrained from marrying men
who were Rhesus positive.
Toxaemias of Pregnancy and difficulties arising during labour
are, in theory, preventable. Nothing can be done in the present
state of our knowledge to prevent the occurrence of malformations
in the infant in the course of development.
For the rest, it would appear that the prevention of many still
births is a social matter and not a purely medical one—earlier
marriage, with an earlier age for child bearing, adequate income for
the purposes of nutrition, and previously ascertained compatibility
of the respective blood groups concerned.