"Introduction to Proceedings of the Seventh International Birth Control Conference

INTRODUCTION

On September 1, 1930, an earnest group of experts--men and women--from various parts of the civilized world gathered quietly together in Zurich, Switzerland.

These men and women were delegates to the Seventh International Birth Control Conference. They came together in the interest of the scientific quest for contraceptive knowledge.

For five days, more than one hundred scientists, physicians and clinicians discussed the technical problems of contraception. They compared notes, reported progress made in research laboratories and birth control clinics, and proved beyond doubt that the much troubled subject now universally known as Birth Control had entered a new phase of development.

All theories, all propaganda, all moral and ethical aspects of the subject were left in abeyance--practically forgotten--in the unanimity of cool, scientific conviction that today contraception as an instrument in racial progress is on the way to be reliable and efficient and may in the very future be perfected.

As the first international conference of its kind ever organized in the history of humanity, the Zurich Conference represents a milestone in the history of modern civilization. For this reason, I believe that it is highly desirable that the record of this conference be preserved in the present pages.

Civilization is being remade, not in parliaments, not in the conferences of international financiers on the Quai d’Orsay, but by obscure scientists in laboratories, by earnest workers in clinics, by the silent victories of modest physicians in preventive therapy. Just as the great spectacular achievements in aviation--the trans-atlantic and round-the-world flight--would never be possible without the vastly increased perfection of design which insures reliability and efficiency, so today contraception as an instrument of individual and racial well-being would not be possible without the efforts of these scientists, the bio-chemists and the clinicians through the agency of whose laboratories new methods, new materials, new processes can be effectively developed and proven.

A milestone and landmark this Conference must remain, because it has lifted the whole problem out of the troubled atmosphere of theory where previously it had been battered by the winds of doctrine and the brutal attacks of prejudice into the current of serene, impersonal, scientific abstraction. That such a gathering, widely international in character, coolly yet compassionately humanitarian in temperament, could become a reality in my own time, instead of a wish hoped for yet hardly to be attained, indicated to one soldier at least in the long battle that a new orientation in race welfare had indeed arrived.

For many years past I had been acutely cognizant of the fact--to me distressing and seeming insurmountable--that many of our most able physicians were absolutely lacking in knowledge of the technique of contraception. Even those who were familiar enough with the methods available recognized that the percentage of efficiency and safety were widely fluctuating. Such was the condition of affairs in the United States which impelled me to call together the men and women actually working on the problem in the various scattered clinics of Europe and Asia.

It was a sad commentary on the progress of medical science, with its recent emphasis on preventive therapy, that while it is roughly estimated that the number of abortions performed annually in this country amounts to no less than one million, the methods of contraception had not been advanced since the days of Mensinga. The medical attitude toward contraception has only recently changed. Its indifference may have been, to a large extent, influenced by the early crusaders for birth control, which until my own advent in the field hid under the name of Neo-Malthusianism. For almost a century they had been fighting in the fields of economic and social doctrine. Implicitly they had assumed that the known methods of contraception were already one-hundred per cent effective, and required only to be disseminated by the written or spoken word.

That this was a fallacy was soon discovered in the controversy of technique and methods by modern students of clinical contraception. But the first necessity was to ascertain what methods were being advised; how the method was applied; what percentage of success or failure attended the various methods. This was demonstrated in the experience with the diaphragm pessary as used in the clinics by Dr. Norman Haire and Dr. Hannah Stone--two different phases of technique by two competent students of gynecology through the means of the same pessary. This and other differences will be noticed as brought out in the papers as well as in the discussion.

It is of interest to note from the Proceedings of the Conference that greater advance in scientific contraception has been made in America and England than in continental countries (not excepting Holland and France where the practice of birth control has long been a part of family life). This is the result of directing the movement along professional lines, where emphasis has been placed on the keeping of records as well as on a greater consideration of contraception, keeping it separate and apart from sex hygiene and abortion.

Just as demand and supply are related to all economic questions, so is propaganda a related part of scientific research in the realms of sex psychology. The medical profession will ultimately meet the issue on the demands of public opinion.

The next and most important step in the progress of the movement is to perfect a method of contraception giving a greater security and confidence to those workers in the field.

In the early days Charles Bradlaugh and Annie Besant had been tried in London for circulating Dr. Charles Knowlton’s "Fruits of Philosophy",” a pamphlet written by the Boston physician about half a century previous and detailing in the sketchiest fashion crude methods upon which it would today be folly to rely.

The following year--1878--Edward Truelove, a London publisher, was sentenced for selling a similar book, Robert Dale Owen’s “Moral Physiology,” which was far more innocuous, from the point of view of contraception, than its advocates supposed. From the first publication of The Malthusian, which began its work in 1879 with the sub-title of "A Crusade against Poverty,” the advocates of birth control at the time unconsciously assumed that methods of contraception were already reliable, effective, and practically perfected. Statistics were unavailable; clinics which might have kept records, were either forbidden by law or unheard of; and the medical profession, as a whole, remained antagonistic or at best indifferent to this vast and complicated problem of human life.

However, it would be unjust to minimize the progress made by the courageous physicians and pioneers of the movement. Dr. Stille, a physician of Hanover, as well as Max Hausmeister and Karl Lotter, who in 1889 founded the Sozial Harmonische Verein in Stuttgart, devoted themselves mainly to theoretical and economic aspects of the small family system. We may read of the enormous decline of the birth rate in certain German towns at the period; but it is impossible to definitely correlate in a precise scientific manner the two phenomena. In France, the birth rate had indeed been declining since 1831, and more sharply since 1871, although the late Paul Robin had not founded his Ligue de la régéneration humaine until 1896.

In 1900 the first International Neo-Malthusian Conference was held in Paris--in the office of M. Robin’s League. Delegates from four countries--England, France, Germany and Holland--took part in what for those days was considered a thorough discussion of technical methods of contraception. Dr. J. Rutgers of Holland in particular, we are informed, presented a discussion of such methods, both historical and contemporaneous. This, it seems, was the second international conference on methods, the first having taken place at an International Medical Congress in 1879 in Amsterdam.

Paul Robin had proposed the formation of an international federation of Neo-Malthusian leagues, and Dr. C. R. Drysdale was elected president of this organization. A second international conference was called in Liége, Belgium, in 1905. Records of this meeting indicate the swing of interest away from technical aspects of contraception to the problems of propaganda and popularization. At the Liége meeting the Neo-Malthusians came into sharp conflict with the Marxians, who were the advocates of larger and larger families as the surest method to precipitate social revolution. This clash of ideas had the effect of propelling public interest away from the technical and hygienic aspects of contraception to the social aspects of population pressure.

Subsequent international conferences followed: in the Hague (July, 1910); participation in the International Congress of Hygiene in Dresden (1911) in which representatives of thirteen countries participated. Two German women pioneers, Dr. Helene Stöcker and Frau Marie Stritt, acted as organizers. It was not until 1922 that the Fifth International Conference was held. In 1914 I had initiated the so-called Birth Control movement in the United States, and this movement, with its emphasis on the personal and racial aspects of contraception, had in less than ten years become a world movement. In 1922 in London, not only Europe, but the Americas, Japan, China and India were represented by delegates. In 1925 the Sixth Neo-Malthusian and Birth Control Conference was held in New York City, and delegates from sixteen countries attended.

Since 1914, in ever increasing numbers we had gradually succeeded in effecting the adherence of economists, sociologists, biologists and geneticists, the effect of which was to convert the intelligent laymen to the principle of birth control. In this field indeed, the battle seemed to be won. Because public opinion supported birth control, it was possible, despite the still strenuous opposition, to open and maintain contraceptive clinics--except in such countries as France and Italy, engulfed in waves of post-war reaction.

More and more it became apparent to me that a new direction was necessary. The theories, the ramifications, the racial aspects of birth control had been thoroughly threshed out. It was but a matter of time that these fundamental ideas should percolate to the masses--the masses indeed were already crying aloud for "safe and harmless" methods. But since the opening of the century, Medicine itself has evolved from its dogmatic stage. Prevention indeed was the cry--the prevention of epidemics, the prevention of disease, the conquest of the great scourges like tuberculosis or syphilis, instead of their alleviation. Medicine indeed was fast becoming, as a penetrating observer recently expressed it, the most personal of our sciences, and was advancing from the art of curing to the art of prevention. Science was effecting a veritable revolution in sanitation and general health education. The practical step then to take is to apply scientific knowledge to improve conditions of life.

From the beginning, I had insisted upon the establishment of birth control clinics as the swiftest, most effective, and most scientific method of advancing the cause of contraception.

Yet all of this work going on in various countries, under the most diverse conditions, must be correlated, coordinated, unified into a common human ideal. For this reason, after organizing the first World Population conference, assembled in Geneva in 1927, I began work on the problem of bringing the scientists, the research workers, and the directors of clinics together. The success achieved is recorded in the accompanying pages.

Not without significance, to me, was the quiet earnestness of this unheralded gathering. The press did not intrude upon the deliberation of the men and women assembled in the charming little town in the Alps. No publicity was sought. The most important as well as the most delicate of all human relationships was discussed without shame and without prejudice, and problems most deeply affecting the well-being of every individual man and woman, the health of all future generations, and the stability of nations, were brought closer to satisfactory and permanent solution.

Here indeed, the impartial observer might have discovered the true spirit of internationalism, the fundamental brotherhood of man, rather than in the bickerings and disagreements of the League of Nations at Geneva, or the truce in the warfare of governmental finances.

For these reasons, the record of the Zurich Conference demand permanent place in the annals of human progress.

New York, U.S.A.

MARGARET SANGER