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SummaryThis paper reports the findings of longitudinal studies of married primigravidae resident in Aberdeen city:(1) All 1026 primigravidae delivered in 1949 were followed up 5 years later.(2) A 1-in-6 random sample of primigravidae delivered 1950–53 (330 women) were studied intensively and followed up at 5 and 10 years.The findings are biased in favour of families of manual workers because more upper social class families left Aberdeen.Many primigravidae had no definite ideas on family size but they made up their minds or changed their preferences (sometimes to accommodate to reality) as they gained experience of marriage and motherhood. Most women wanted 2 or 3 children and none wanted more than 4 children.There were striking differentials in fertility at both 5 and 10 years. Women who were under 20 years of age when they had their first baby, those who conceived prenuptially, and those married to a semi-skilled or unskilled manual worker had the largest families at both 5 and 10 years. At 5 years, although on average such women were having intercourse more frequently, they were the least likely to have been regular users of contraceptives.Two-thirds of all pregnancies which occurred in the first 5 years were 'unintended'. Only 15% of couples had used contraceptives regularly from marriage and a further 20% became regular users in the 5 years following the birth of their first child. At the end of the first 5 years, 10% of women already had more children 'than they felt able to manage without excessive strain'. The number increased in the following years but was modified partly by delegation of responsibility for a few children to other women but more especially by the liberal policy to sterilization pursued in Aberdeen. The repetition of the disadvantages in the childhood environment of the largest families is illustrated. It is argued that 'the pill', which was not available to the women in the studies reported, may reduce the number of 'unintended' pregnancies in future, but that sterilization may remain the most satisfactory measure of family limitation in a small group of women whose way of life is not conducive to forward planning and sustained rational behaviour.

Richard Titmuss was one of the 20th century's foremost social policy theorists. This accessible Reader is the first compendium of his work on public health, health promotion and health inequalities. Most of Titmuss's work has been out of print for many years. This volume, like its predecessor, Welfare and wellbeing (The Policy Press, 2001), is important in bringing the work of this highly influential thinker to the attention of a new generation of social policy students and policy makers. It also enhances current debates about how complex societies can best provide for the health of all their citizens