There was an old woman who lived in a shoe.
She had so many children, she didn't know what to do;
She gave them some broth without any bread;
She whipp'd all their bums, and sent them to bed (1).

The Old Woman Who Lived In A Shoe

Like most nursery rhymes, "The old woman and the shoe" expresses a universal truth. Jonathan Swift wrote in 1729:

"It is a melancholy object to...see the streets...crowded with beggars of the female sex, followed by three, four, or six children, all in rags, and importuning every passenger for an alms...instead of being able to work for their honest livelihood, [they] are beg sustenance for their helpless infants who, as they grow up, turn thieves for want of work. [He proposed as (satirical) solution to the problem of surplus children, namely] a young healthy child well nursed, is, at a year old, a most delicious nourishing and wholesome food, whether stewed, roasted, baked, or boiled; and I make no doubt that it will equally serve in a fricasie, or a ragoust (2)."

This message regarding the negative consequences for children of unchecked fertility still applies today. For example, the popular press carried a story (not satire) about an Albanian mother who'd given her 3 year-old to an older, childless Italian couple in exchange for a T.V. set and the promise of future payments. When these were not forthcoming, she complained to authorities. In spite of living in such severe poverty that she is forced to sell her children, the woman had recently given birth to her 8th child (3). While the Albanian "old woman in a shoe" may be unusual, anthropologists have described numerous societies where high fertility, regardless of the consequences, is positively sanctioned.

In a very famous study, Nancy Scheper-Hughes documented the phenomenon of infant neglect leading to death that was widely accepted as normal. The very poor women of Ladeiras, NE Brazil are "used up" (acabado) from too many previous pregnancies and transfer this weakness to the fetus who is then born frail and skinny, unfit for the luta (fight) ahead. A mother is, therefore, not held accountable for the infant's death. The cultural basis of reproduction in this community is completely Darwinian-of the many offspring, only the fittest will survive (4). Among the Papel in severely overpopulated Guinea-Bissau, Einarsdottir records:

"I experienced the hopelessness and desperation of the mothers. Despite heavy and incessant work they could hardly feed themselves and their children. [Nevertheless, when she asked mothers how many children they would prefer, many responded:] 'You never have too many children' (5)."

Malnourished Toddlers

Similarly, a prolific Fulani (Burkina Faso) breeder is esteemed while her less prolific counterpart is scorned. "One man in his sixties, who had been through several wives, said, ‘you cannot love your wife if she gives you no children.'" In spite of the high rate of infant sickness, malnutrition and death...

There are no perceived disadvantages in having lots of children. Children are never seen as a drain on resources. The availability of food is believed to be purely a product of the God-given fortune of the child, and nothing to do with the level of resources available within the household or the number of mouths to feed: "BiDDo fuu rimdatakena e tindem-every child is born with its own luck" (6).

This cavalier attitude towards the child's well-being is by no means universal. Many, perhaps the majority, of the world's societies follow customs designed to improve the child's prospects. The practice of frequent, round-the-clock nursing releases prolactin that, in turn, reduces the likelihood of pregnancy (7). Prolonged (3 years+) nursing yields longer inter-birth-intervals as does the post-partum sex taboo. In Papua New Guinea, for example, the Enga see the man's semen as a component of his war magic. Was this potent substance to mix with breast milk the result for the infant could be fatal (8). These customary practices enhance both the mother's and infant's health. Among the Airo-Pai foragers of Amazonian Peru:

"Men and women have explicit ideas about family size and spacing. They say that the ideal number of children is three and that a woman should not become pregnant until her last child is capable of eating and moving around independently...Long birth spacings are necessary to provide an adequate upbringing for young children, who are bestowed with the undivided attention of their parents. Closely spaced children are said to suffer, cry and develop angry characters (9)."

Another widely employed practice is fosterage in which families with too many children transfer some to kin who have too few children (10).

Western Europe has had a dismal record on the subject of fertility and child welfare. Not only were there no effective contraceptives, any attempt to limit fertility was condemned as sinful. Infant and child mortality was so high in the middle ages that those who died were rarely given formal burials but were, rather, buried as waste. Analyzing these pathetic remains, "archeology corroborates the impression given by the texts. [Child] skeletons [exhibit] deep lesions, wounds, decalcification, bad teeth, in short, a state of relatively poor health." During this period, the sale of surplus children was widespread, e.g. "peasants of southern Italy got rid of their children at the marketplace during a large fair (11)."

The Christian church offered a mixed blessing. In simultaneously banning infanticide and contraception, it forced mothers to abandon their surplus children. The response to this very public display of sick or deceased children was to bundle them into foundling homes. Called brephotrophia, the earliest opened in Milan by the end of the 8th century CE (12). Supply could never keep up with demand. The Ospedale degli Innocenti in Florence (one of 16 brephotrophia in Tuscany alone) admitted 100 infants in its first year, admitting as many as 1000 babies/year in succeeding years, two-thirds of whom perished before their first birthday (13). It was widely acknowledged that "being sent to foundling homes presaged early death (14)." Children that survived infancy were treated little better than slaves and, in the early colonial era, 1000s were, involuntarily, shipped to the colonies as agricultural laborers (12). Meanwhile, the well-to-do also had reason to limit fertility but lacked a legal and socially acceptable means to do so. Hence, they winnowed their offspring via "maltreatment," as records showing higher infant and child mortality among the gentry than among peasants would suggest (15).

The industrial revolution had a major impact on child rearing cost/benefit calculations as factories offered parents the opportunity to earn wages through their children. While the size of one's landholding limited the scope for child employment, the industrial revolution encouraged a rise in fertility levels (12). By the 1720s, 4-year olds were employed in French textile mills, and 100 years later in Lancashire, one-quarter of all the 10-15 year old girls were making cotton (16). Restrictions were gradually imposed so that, by 1830, factory workers had to be at least 8 years old, yet a 14+ hour work day was the norm, and they could be beaten for tardiness (12). However, outside the rural farm and urban proletariat, high fertility gradually began to lose its cachet.

The Quakers, at the end of the 18th century, became the first polity to deliberately limit fertility-in sharp contrast to the Puritans 150 years earlier (17).

"Relying primarily upon abstinence, coitus interruptus, and the rhythm method, supplemented by abortion (usually chemically induced or a result of trauma to the uterus), parents dramatically reduced [fertility]...The drop in the birthrate also reflected new cultural ideals, including a rejection of the view that women were chattel who should devote their adult lives to an endless cycle of pregnancy and childbirth (18)."

Fertility reduction greatly accelerated during the second half of the 20th century following what has been called the "great" or demographic transition (19). Many factors were involved, including the reduction of opportunities to earn an economic return from one's children, the transition to nuclear families and loss of extended family members as child minders and the need for more education, thereby delaying marriage and family formation (20). There is also the growing appreciation for how expensive it is to support children through the years of schooling now required for steady employment (21). And, perhaps most important, children have acquired emotional and social value for parents rather than being seen, primarily, as "helpers" in the present and caretakers in the future (22). Quality now trumps quantity.

The quality vs quantity trade-off has been measured empirically. In studies spanning 35 years, children born into large families have lowered expectations for academic success and life chances (23, 24). In a recent study, for example, the authors' conclude:

"...mothers and fathers can only achieve large family size at a significant cost to the quality of care provided to individual children. In fact, family size was the strongest explanatory variable considered in our analysis. [The] negative relationships between family size and offspring outcomes in modern societies are mediated by reduction in parental investment (25)."

Nevertheless, in much of the developing world, women encounter barriers in their attempts to limit their fertility, from religious sanctions to machismo husbands to patriarchal government attitudes. And, in the US, poverty and fundamentalist religious tenants encourage child bearing. For example, in my home state of Utah and the surrounding border areas dominated by adherents of the LDS faith, large families are the norm. This pro-natalist culture has come to national attention recently via TV shows highlighting Mormon polygyny and the prosecution of fundamentalist Mormon elders for impregnating their child brides.

Mormon Family

Cultures that support high fertility tend to foster teenage pregnancy or the early onset of breeding and short inter-birth intervals. Both of these trends are in turn predictive of premature delivery and low birth weight. These practices lead to lower quality infants with impaired mental functioning and chronic illness. And the costs do not fall only on the child and its family. Again, to take the Utah case, the state has maintained its position atop the personal bankruptcy rankings for many years (26), directly attributed to a kind of "It's in God's Hands," mentality, similar to that expressed by the Fulani villagers. Mortgage foreclosure rates are nearly as high, again passing along the cost of large families on to the general population (27). Another strategy for securing taxpayer subsidy of Mormon fertility is the practice of beginning child-bearing while still in college. "Poor" (yet culturally middle-class) students qualify for and take advantage of Medicaid which (in 2008) paid for 44 percent of births to parents who listed "student" as their occupation (28).

So, in a period when our federal, state and local governments are desperately trying to stem the tide of red ink, why do we continue with tax and social policies that reward people for having more children? The "old woman in the shoe" may be a nursery figure but she's no Snow White.

1. Ritson, J. 1794. Gammer Gurton's Garland. Whitefish, MT: Kessenger Reprint.
2. Swift, J. 1729. A Modest Proposal: For Preventing the Children of Poor People in Ireland, From Being a Burden on Their Parents or Country, and for Making Them Beneficial to the Publick. Project Gutenberg.
3. Kirka, D. 2003. Albanian mom seeks to help family, but ends up losing son. The Salt Lake Tribune, November 30th, A18.
4. Scheper-Hughes, N. 1987. Cultures, scarcity, and maternal thinking: Mother love and child death in Northeast Brazil. In N. Scheper-Hughes, (Ed.), Child Survival: Anthropological Perspectives on the Treatment and Maltreatment of Children. (pp. 187-208), Dordrecht, Holland: D. Reidel Publishing Company.
5. Einarsdottir, J. 2004. Tired of Weeping: Mother Love, Child Death, and Poverty in Guinea-Bissau. Madison, WI: The University of Wisconsin Press.
6. Hampshire, K. 2001. The impact of male migration on fertility decisions and outcomes in northern Burkina Faso. In Managing Reproductive Life: Cross-Cultural Themes in Sexuality and Fertility. S. Tremayne (Ed.), (pp. 107-125), Oxford: Berghahn Books.
7. Konner, M. and Worthman, C. 1980. Nursing frequency, gonadal function and birth spacing among !Kung hunter-gatherers. Science, 207:788-91.
8. Gray, B. M. 1994. Enga birth, maturation and survival: Physiological characteristics of the life cycle in the New Guinea Highlands. In C. P. MacCormack (Ed.), Ethnography of Fertility and Birth. (pp. 65-103), Prospect Heights, IL: Waveland Press.
9. Belaunde, L. E. 2001. Menstruation, birth observances and the couple's love amongst the Airo-Pai of Amazonian Peru, in Managing Reproductive Life: Cross-Cultural Themes in Sexuality and Fertility. In S. Tremayne (Ed.), (pp. 127-139), Oxford: Berghahn Books.
10. Hewlett, B. S. 1991. Demography and childcare in preindustrial societies. Journal of Anthropological Research. 47: 1-37.
11. Alexandre-Bidon, D. and Lett, D.1999. Children in the Middle Ages: Fifth-Fifteen Centuries. Notre Dame, IN: The University of Notre Dame Press.
12. Sommerville, J. C. 1982. The Rise and Fall of Childhood. Beverly Hills, CA: Sage Publications.
13. Gavitt, P. 1990. Charity and Children in Renaissance Florence: The Ospedale degli Innocenti, 1410-1536. Ann Arbor, MI: The University of Michigan Press.
14. Colón, A. R. with Colón, P. A. 2001. A History of Children: A Socio-cultural Survey Across Millennia. Westport, CT: Greenwood Press.
15. Johansson, S. R. (1976) Neglect, abuse, and avoidable death: Parental investment and the mortality of infants and children in the European tradition. In Gelles, Richard J. and Lancaster, Jane B (Eds) Child Abuse and Neglect: Biosocial Dimensions. Pp. 57-93. New York, NY: Aldine de Gruyter.
16. Chaudhuri, N. 1991. England, in Children in Historical and Comparative Perspective. In J. M. Hawes and N. R. Hiner (Eds), (pp. 53-70), Westport, CT: Greenwood Press.
17. Moynihan, B. 2002. The Faith: A History of Christianity. New York: Doubleday.
18. Mintz, S. 2004. Huck's Raft: A History of American Childhood. Cambridge, MA: Belknap Press.
19. Caldwell, J. C. 1982. "The Great Transition": Theory of Fertility Decline. New York: Academic Press.
20. Lancy, D.F. 2008. The Anthropology of Childhood: Cherubs, Chattel, Changelings. Cambridge: Cambridge University Press.
21. Lawson, D. W. and Mace, R. 2010. Optimizing modern family size. Human Nature 21: 39-61.
22. Zelizer, V. A. 1985. Pricing the Priceless Child: the Changing Social Value of Children. New York: Basic Books.
23. Terhune, K.W. 1974. A review of the actual and expected consequences of family size. Calspan Report DP-5333-G-1. Washington, D.C.: Center for Population Research. National Institute of Child Health and Human Development. 75-799.
24. Blake, J. 1989. Family Size and Achievement. Berkeley, CA: University of California Press.
25. Lawson, D. W. and Mace, R. 2009. Trade-offs in modern parenting: A longitudinal study of sibling competition for parental care. Human Behavior 30(3): 170-183.
26. Lown, J. M., and Rowe, B. R. 2003. A profile of Utah consumer bankruptcy petitioners. Journal of Law and Family Studies, 5, 113-130. House, D. 2010. Bankruptcies on record pace. Salt Lake Tribune, April 15th, C-1.
27. Anonymous 2010. Utah remains among the highest in surge of foreclosure filings. Salt Lake Tribune, April 15th, C-2
28. Stewart, K. 2010. Medicaid delivers for students. The Salt Lake Tribune, March 18th, A1, A10.

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