Medicine: Lost Babies

Of every 100 women who become pregnant, the statistics show, some 85 will give birth to live babies after about nine months, and five will bear premature babies, of which four will live. But in the remaining one-tenth of all pregnancies, the women will lose their children by involuntary abortion before they are mature enough to survive independently. Why? And what can be done about it? In Spontaneous and Habitual Abortion,* published this week (Blakiston; $11). Dr. Carl Theodore Javert. a busy, unorthodox

Manhattan obstetrician, gives this life-and-death subject the full treatment for 450 illustration-packed pages, comes to some unconventional conclusions.

As Dr. Javert, 50, tells it, he was "an ignorant neophyte" in 1936 when he blithely prescribed a high-mineral, high-vitamin diet for a three-time aborter of 41, gave her full emotional reassurance, and was rewarded by delivering her normal baby—although older and supposedly wiser men were using more complex treatments. Since then it has not always been so easy, but Dr. Javert has an enviable record (and a large following of husbands and wives who are convinced that they would never have had children if they had not met him).

Mismarriage, Miscarriage. First problem is to try to decide why a woman aborts. Says many a layman after taking

Biology I: "Nature is discarding a defective fetus." But Dr. Javert and colleagues at New York Hospital made microscopic examinations of 2,000 aborted fetuses, found no abnormality in 22%. In nearly all these cases he suspected some fault in the mother's physical or psychic setup (cases attributed to defective sperm were exceedingly rare). One astonishing statistic, suggesting factors introduced by marriage: while 10% of married women abort, only 1% of unmarried women do so. Also surprisingly uncommon (seven cases in 2,000) was injury as a cause of abortion. "Nearly all pregnant women sustain some type of external trauma and do not abort," says Dr. Javert.

After personally supervising more than 200 pregnancies for women who had had three or more consecutive pregnancies ending in abortion. Javert developed a highly personal method of treatment. He still relies heavily on vitamins A. C and K. also on hesperidin (sold as a source of the controversial vitamin P) to discourage the premature bleeding which often signals (and may cause) abortions. He was one of the first to use tranquilizers. Impressed with the fact that many patients do not gain weight early in their pregnancies, but may actually lose, he encourages them to eat all they want then, watches later to make sure that the gain does not become excessive.

Insecurity Is Catching. Because Dr. Javert believes so strongly that the marital situation is often to blame, he calls in both husband and wife for detailed interviews. He finds that a wife who feels insecure about her husband's love or overshadowed by his having had a previously successful marriage with children, is likely to have an insecure fetus. Often such couples rate high on the Kinsey scale of sexual activity: Dr. Javert holds that orgasm predisposes to uterine contractions and premature labor, therefore forbids intercourse during pregnancy. Granting that much remains co be learned about the workings of sex hormones, he is dead set against using stilbestrol, a synthetic drug on which many obstetricians rely heavily.