Women and Birth Control

Women and Birth Control

BY MARGARET SANGER

I was one of eleven children. My mother died in her forties. My father enjoyed life until his eighties. Seven of my brothers and sisters are still living. If I am not an "old-fashioned" woman, at least I was an old-fashioned child. I have never thought it necessary to call public attention to these circumstances of my life. Not that I ashamed of them, but, on the other hand, neither am I brazenly proud of them. I do not believe that these facts are sufficient as a foundation upon which to erect a code of moral for all men and women of the future to follow. I do not say: "My mother gave birth to eleven living children, seven of whom are still alive and more or less healthy. Ergo, all women should give birth to eleven or a dozen children." There are, it seems to me, a few other things to consider.

I have been impelled to cast aside my habitual reticence because I have just finished reading a highly personal essay in the March number of THE NORTH AMERICAN REVIEW, written by a lady known as Marjorie Wells. Mrs. Wells confesses herself the mother of ten children. Her family stretches "already as far as the eye can reach and with the end not yet in sight." This biological fact seems to endow Mrs. Wells with the glib authority to hand down decisions concerning complex problems which have puzzled humanity since civilization first began. I rejoice with Marjorie Wells in the peace and happiness she has found in her "monumental" family. But I confess that I am not convinced that feminine wisdom increases in direct proportion with the number of one's offspring.

Implicit in Marjorie Wells's confession I discover a certain condescension toward the mothers of smaller families. She knows all there is to know about keeping the stork from the door. She admits her vastly superior knowledge of practical biology. She has read my book Motherhood in Bondage, which is a compilation of case records in marital misery, of protests from slave mothers against the blind inhumanity of natural law. From the citadel of her self-satisfaction, Marjorie Wells asserts that my theories have become badly scrambled with my emotions and that I attempt to be "both scientific and sympathetic at the same time"--as though that were quite impossible! I have made, according to Mrs. Wells, "the usual mistake of women who attempt the guidance of public opinion, and try to transfer to public responsibility what is essentially and inevitably a private and local problem."

Intellectually speaking, she "high-hats" me. A mere woman who has borne only three children instead of ten, who can therefore never hope to reach that peak of serene Olympian indifference to the cries and moans of my less fortunate sisters which Marjorie Wells has attained, I cannot hope to equal in dialectic skill a lady who has enjoyed the educational advantage of ten pregnancies. I have not yet attained that point of self-confidence which enables me to cast aside as irrelevant and unimportant the conclusions of scientists who have devoted their lives to the study of genetics, nor can I close my eyes to the statistics of Government workers who have made deep researches into the conditions productive of the alarming maternity death rate in these United States. Having been only one of eleven hungry little brothers and sisters, I was not able to profit by the early educational advantages which Marjorie Wells evidently enjoyed. Her philosophic poise enables her to look upon the birth of a child as "a purely private and local problem." I have always assumed, and I do not believe that I am egregious in this assumption, that the birth of a child is an event of the utmost importance not only to the family into which it is born, but to the community, to the nation, to the whole future of the human race. I agree with President Hoover. "The ideal to which we should strive is that there shall be no child in America: That has not been born under proper conditions; that does not live in hygienic surroundings; that ever suffers from under-nourishment; that does not have prompt and efficient medical attention and inspection; that does not receive primary instruction in the elements of hygiene and good health; that has not the complete birthright of a sound mind and a sound body; that has not the encouragement to express in fullest measure the spirit within which is the final endowment of every human being."

I suppose those of us who subscribe to these ideas are in the eyes of Marjorie Wells hopeless sentimentalists.

My opponent sharply crystallizes a definite point of view not only concerning the theory and the practice of Birth Control, but toward all the social problems which confront us today. Hers is the attitude of "splendid isolation," of enlightened self-interest, of laissez-faire. She tells us in effect that she is the mother of ten healthy children, that she and her husband enjoy from them a daily dividend of satisfaction and delight, and that therefore she "should worry" about the behavior and condition of the less fortunate. "Am I my sister's keeper?" asks in effect Marjorie Wells.

It is late in the day to point out that all human experience teaches that an attitude of "splendid isolation" can no longer be logically maintained by any individual in the face of the problems which confront American civilization. If only from the motive of self-protection the well-born and the well-bred can no longer shirk responsibility concerning "the behavior and the condition of the unfortunates."

Time after time, it has been demonstrated in all the countries of Western civilization, that as we descend the social scale the birth-rate increases. Dependent, delinquent and defective classes all tend to become more prolific than the average normal and self-dependent stratum of society. With this high birth rate is correlated a high infant mortality rate. This law is true in all countries. More children are born; more babies die. So likewise, the maternal mortality rate jumps correspondingly. Out of the surviving infants are recruited the morons, the feeble-minded, the dependents, who make organized charities a necessity, and who later fill prisons, penitentiaries and State homes. To compute the cost in dollars and cents of these industriously prolific classes to society is beyond human power. Every one of us pays for their support and maintenance. Funds which legitimately should go to pure scientific research, to aid the fine fruition of American civilization, are thus diverted to the support of those who--in all charity and compassion--should never have been born at all.

We cannot ignore, as Marjorie Wells confesses she does, "such charming contingencies as inherited lunacy, disease and abject poverty." They press in upon us on all sides. These things, she says, do not belong in her personal problem. I beg to remind her that they do. For, despite her valiant efforts to bring up her own brood, Mrs. Wells will, in time, find out, if she has not already found out, that the children of the defective and the diseased will crowd into the schoolroom with her own children, and that standards of intelligence must perforce be lowered to meet their limited capacities. The community in which she lives will call upon her to aid the alleviation of the poverty and distress of the all too prolific. Her property and income will be taxed to maintain State institutions for the support of the dependent and the delinquent. She will resent bitterly this enforced expenditure of funds that should go for the higher education and the cultural development of her talented children. That is, if her resources are as limited as she admits them to be. And finally she will discover that her own good luck in life is not the general rule, but a fortunate exception, upon which it would be the utmost folly to attempt to generalize concerning this exceedingly human race.

"But", she may now retort, "you are speaking dogmatically, making a special plea for public approval of the dissemination of Birth Control." Marjorie Wells is convinced that the cases recorded in my book Motherhood in Bondage are abnormalities and horrors, gathered together merely to foist the practice of contraception upon unwilling parents.

Let us turn, then, to less prejudiced and partisan sources. Let us consider the findings of impartial investigators who have no interest in what our critics call propaganda. Let us find out, if we can, the truth concerning the conditions under which children are brought into our American world. For this evidence we need not go far afield. In a recent report published in The Survey, Hazel Corbin, R.N., general director of the Maternity Center Association New York, states that year after year, more than twenty thousand women die from causes due to childbirth--one mother for every one hundred and fifty babies born! The Newton bill had as its aim Government responsibility for the health of American citizens including the special needs of the mothers of the country. This bill died when the last Congress expired. The Sheppard-Towner Act expires June 30, 1929; and unless Congress provides a further Federal subsidy, the Government aid for mothers and children which its funds have furthered during the last six years will be brought to a close.

When correlated with the refusal of State legislatures to consider bills which would make Birth Control education permissive, these facts assume new significance. Our Government pronounces itself unwilling to assume responsibility in alleviating the hazardous trade of maternity. At the same time the State and Federal authorities refuse to countenance legislation which would allow American mothers to help themselves--which would permit them to choose the time and the conditions best suited for the fulfillment of the maternal function.

"The birth of a baby is such a common, every-day occurrence," writes Hazel Corbin, "that people do not realize that during pregnancy the margin between health and disease becomes dangerously narrow, and only by skilled medical supervision can the maintenance of health be assured. Every mother in the country needs skilled medical supervision, nursing care and instruction during pregnancy, at delivery, and for the six weeks that follow. Many families do not know of this need. Not all families can provide this care. It is not available at any price in many parts of this rich country. There are no doctors, nurses and midwives properly trained to give adequate care to all mothers."

Yet two million women in America are compelled, by law, to descend annually into the valley of the shadow of death, to bear two million children in a country that has enacted drastic immigration restriction laws to prevent over-population. No: we are not under-populated--there is no need for a "full speed ahead" policy of procreation. Since the revelations of Motherhood in Bondage are condemned as exceptional, let us listen further to the testimony of Hazel Corbin: "There are, caring for our mothers, midwives so ignorant and superstitious as to suppose hemorrhage can be controlled by placing an axe upside down under the patient's bed. Of about fifty thousand practicing midwives only a small portion are well-trained and the majority are untrained--yet in most instances they are licensed or registered by their States."

Let us turn to the testimony of Julia Lathrop, ex-chief of the Children's Bureau, under whose supervision Government agents made extensive investigations surrounding infant mortality in eight typical cities of our country. Infant mortality rates concern all children who die during the first five years of life. On the whole, according to Miss Lathrop in The Woman's Journal, the evidence is overwhelming that poverty, ignorance, or both, lack of medical and nursing care, unwholesome living conditions, overworked mothers, remoteness from doctors and nurses in rural areas, and other types of inability to give babies needed care are in marked degree coincident with high infant morality rates. A vast number of babies and of mothers die needlessly every year in this country. This fact is well-known to statisticians, doctors and to some social workers, but details as to social and economic conditions under which the parents live are seldom disclosed or frankly discussed.

Today the situation remains fundamentally unnoticed. Women clamor for deliverance from compulsory motherhood. Yet dull-witted legislators, both State and Federal, refuse to sanction the dissemination of harmless contraceptives to those unable or unwilling, due to the conditions discovered by Government agents, to undergo a pregnancy that may be fatal to mother or child. Yet measures aiming to improve by Governmental agencies dysgenic conditions surrounding maternity and infancy are condemned and defeated as "paternalistic." The situation calls for a Shaw or a Swift.

Perhaps this dilemma has been created not so much by the laws and the legislators themselves as by the smug and bland indifference of women themselves--of those fortunate, well-bred, well-educated women who refuse to concern themselves with the sordid tragedies of those they consider their social inferiors.

Whether Birth Control is right or wrong, moral or immoral, a need or a nuisance, one thing is certain. Mothers of ten or of one can no longer, by the mere exercise of a function common to all living creatures consider themselves exempt from social responsibility. As Miss Lathrop has expressed it: "One thing is in my opinion certain--only mothers can save this cooperative work for maternity and infancy. If prosperous, intelligent mothers do not urge the protection of the lives of all mothers and babies, why should we expect Congress to come unasked to their aid?"

Though Julia Lathrop is here making a plea only for Government protection of maternity and infancy, the same truth is applicable to the doctrine of Birth Control. The most stubborn opposition to Birth Control has come, not from the moralists nor the theologians, the most distinguished of whom recognize its legitimate necessity, but from those women who, like Marjorie Wells, "know as much about keeping the stork from the door as my most friendly and unfriendly critics," yet nevertheless assume that such knowledge, simple, harmless and hygienic as it is, must be kept for the privileged few and from the very women most in need of it. Such an attitude seems to grow out of a frantic feminine desire to retain a certain superiority, social or otherwise, over one's less fortunate neighbors.

Even for that very limited and very special type of woman who is gifted by nature and natural inclination--and also by wealth--to undertake a specialized career in maternity and to become the mother of ten or a dozen children, there is need for the practice of Birth Control. For if she be intelligent and farseeing, such a woman will recognize the necessity of "spacing" her children, of recuperating her full physical strength and psychic well-being after the birth of one child before undertaking the conception of another. Mothers of large families have written me expressing their gratitude for the benefits of Birth Control. It has enabled them to give each of their children a good start in life. It has prevented crowding, and has moreover permitted them to enjoy marital communion which would otherwise have been impossible. But let us recognize today--with the ever-increasing cost of living, and the high cost of childbirth--that the large family must more and more be considered the privilege of the moneyed class. A large family, if the income is small, is a crime against the children born into it. I was one of eleven, and I believe that I am slightly more entitled to speak on this subject than Marjorie Wells, who is, after all, only the mother of ten! I may be prejudiced, but I feel that the testimony of a child born into a large family is of more interest and importance than that of the mere progenitor of a large family. It all depends on the point of view!

American civilization has long passed the pioneer stage of its development. We no longer have a vast continent to populate. We no longer need mere numbers. But we are only beginning to realize that there are other values in life than those of mere quantity. We have not yet outgrown the adolescent habit of worshiping the biggest this, the largest that, the most of the other thing. So I think, no one need take any excessive pride in the production of a large family, even though the rotogravure sections of our Sunday newspapers will undoubtedly, for the delight and amusement of their millions of readers, continue to publish photographs of large families which imitate visually a long flight of steps.

The attitude of those who have been rewarded by life, and cannot see the punishment inflicted upon others reminds me always of Dr. Pangloss in Voltaire's Candide. "It has been proved," said Dr. Pangloss, "that things cannot be otherwise than they are; for, everything being made for a certain end, the end for which everything is made is necessarily the best end." And though the world went to wreck and ruin about him, he still maintained that "it does not become me to retract my words. Leibnitz cannot possibly be wrong--the pre-established harmony is the finest thing in the world. All events are inextricably linked together in this best of all possible worlds."

Rather, I think, in this matter of mothers and children--whether we be the mother of ten, or the sister of ten--we must heed the counsel of Candide himself and cultivate our garden.