Testimony before the United States Senate on Senate Bill 4436, 24 June 1932.

S4436 was a bill to "amend Section 305(A) of the Tariff Act of 1930, and Sections 211, 245, and 312 of the Criminal Code as Amended." This excerpt from the complete hearings includes only Margaret Sanger's testimony and questions put to her. For testimony of May 19 and 20, 1932, see Testimony before the United States Senate on Senate Bill 4436.

Senator Austin: Mrs. Sanger, the committee wanted to resume these hearings in order to get more definite information bearing upon the precise question of what the immediate necessity is for the passage of this act, and there were certain ideas the committee wanted to develop. Perhaps you have others also, but if you do not mind, I would like to ask you a few questions which would indicate our objectives and the kind of evidence we would like to get. In the first place, I would like to ask you about the practical side of this thing. What knowledge is there that would be available that is not now available, regarding the use of contraceptives, if this act were passed?

Mrs. Sanger: As to the practical side, perhaps, it may be of interest to the committee to know that until 1915 the information they had in this country at that time applied only to the use by the male. Practically nothing was known on the whole general subject of contraceptives. I say it with a certain amount of pride, personally, that when I began to study this question as a trained nurse, and realized that the people we were trying to help most were the ones where the husbands were not so concerned about helping the women. I, therefore, started to make a general survey of the whole subject. I went to Europe and studied in 1915 and 1916, and in Holland I found that it was almost an old subject. They had proper information. They had different devices entirely, not depending upon the use by the male, but by the woman herself, placing the responsibility of the birth of a child mainly upon the woman’s shoulders, and Doctor Mensinga and another doctor invented a kind of pessary, which was harmless. This pessary was fitted to each individual. They made plaster of Paris casts of the different women until they got a certain number of pessaries of different sizes.

Senator Austin: How many?

Mrs. Sanger: They have different kinds. When I was there I saw at least 15 different kinds, with at least 20 different sizes in Holland. They had been giving contraceptive advice; instructions in such a normal, natural way; it was part of their whole general economic living.

Senator Austin: May I interrupt you and ask if those pessaries were used with gelatin?

Mrs. Sanger: Not at that time.

Senator Austin: Was their use accompanied by a douche?

Mrs. Sanger: Douches, in most of those countries are rather difficult. They do teach them a cleansing process of a douche, a spray douche, but it was not necessary. They teach them cleansing with toilet paper, or cotton, or some means of cleansing, but the pessary was washed in soap and water. They use soap and water a great deal. It was very primitive, and they had to teach the women to use the things in the home because of the expense.

In France, douching is more prevalent and more applied there than in Holland, but speaking of Holland, they have for 40 years used these contraceptive appliances which are removed so that the woman’s organs are kept healthy and in a normal condition. I found there that the infant mortality rate had gone down in proportion, that the birth rate had gone down, but the survival was very much higher than in any country in Europe. The infant mortality rate was the lowest at that time, in the cities where they had clinics, The Hague, Amsterdam, Rotterdam--those cities had the lowest rate in the world. I was interested to discover how their practice of contraception would affect the morality of the people, and I went to the central bureau of statistics at The Hague, and told them what I wanted. I was practically challenged to find a native woman living in prostitution--a native woman. They said, “We have prostitutes in Holland, but you will not find a Dutch woman living in prostitution.” I said, “Why, is there any difference in human nature?” and they said, “Our family life is different.” “We begin earlier and encourage early marriage among our younger people, and in that way when the girl and boy in our districts, in the butter and cheese districts, or in other districts are encouraged to marry early, they both work for one or two years after the marriage,” and the question of having a baby was considered very practical, for instance, in the light of or on the basis of purchasing a piano, or any other expense.

Senator Austin: You do not mind if I interrupt you?

Mrs. Sanger: No.

Senator Austin: We have one hour to try and find out a great deal here. Of these various types of devices, are there any that are not available in this country at the present time?

Mrs. Sanger: Yes, indeed: some very important ones.

Senator Austin: What are they?

Mrs. Sanger: There is a pessary which is of a special form, a special shape which they have in Holland and other countries, which protects the woman. In Holland, Germany, and in England there are no types of women that can not be protected, but we have to depend on those bootlegged here.

Senator Austin: Are they all made of rubber?

Mrs. Sanger: Yes.

Senator Austin: And the ring principle with the diaphragm involved in all of them?

Mrs. Sanger: Yes; but all of them are different. Each woman has to be examined, and the kind that would fit one woman may not fit another.

I would like to emphasize the fact that there is no one thing that we are pushing. We have no interest whatsoever in any particular device.

Senator Austin: Is there any device excepting the pessary that they have in Europe which is not available here?

Mrs. Sanger: Different kinds of pessaries! They are investigating, I think, experimenting with some interesting things there. There are three experiments. One is a serum that they believe will immunize the female from conception for a certain period of time.

Senator Austin: Is that a sort of emulsion?

Mrs. Sanger: No; I believe it is an injection of a special serum, like an antitoxin. That is an experiment.

Senator Austin: Taken in the blood?

Mrs. Sanger: Yes; in the blood.

The next is the vitamin E, which they are experimenting with, which they claim has a definite effect on sterility or fertility of the male or female.

Senator Austin: Is that permanent?

Mrs. Sanger: No. They are experimenting, but they want them to be temporary. Where vitamin E is, there is a certain high fertility or low fertility in its absence, and then there is another extract made from the corpus lutem with which they are experimenting. All these new experiments are going on open and above board in Oxford, Cambridge, and in Europe. The plan will be of great importance and significance to the whole population.

Senator Austin: Are there any other mechanical devices which you have suggested which might be available if this law were changed, that are not now available?

Mrs. Sanger: Well, I should think mainly, as far as I know, they are the pessaries of different kinds and different types. Of course, jellies are also combined with the pessaries today, and chemicals are used. The intrauterine pessaries are advised by physicians, but that is in an experimental state. We leave it entirely to the physician to advise with the patient, and we do not desire to interfere with what he or she wishes, but simply to inform them, and they do the rest.

Senator Austin: About the gelatins, are there numerous, different types of gelatins available?

Mrs. Sanger: Yes.

Senator Austin: Are they available in this country now?

Mrs. Sanger: They came from Europe--the original formula came from Germany, and, of course was sent back for a time, and finally the formula was sold to a manufacturing chemist in this country. When it was sold, it was not sold for contraceptive purposes, but mainly for some ailment like leucorrhea. That is mainly how these jellies are able to be sold today, for prevention of disease, but the market is being flooded in a dangerous way, because there is no control over them.

Senator Austin: Are these gelatins available in tubes, with devices for employing them?

Mrs. Sanger: Yes. Most of them are.

Senator Austin: What about the medical lore on this subject? Do you know whether the state of medical science here in America is up to the standard of that science abroad on this subject?

Mrs. Sanger: Doctor Moses is here with us, and I would like for her to go into that.

[A brief conversation between Dr. Moses and Senator Austin about her qualifications, followed by Moses' explanation of how diaphragms are fitted, was omitted by the MSPP editors.]

Senator Austin: Is the reason why you do not get these things [medical supplies] by automobile or private carrier because of the cost?

Dr. Moses: I do not think we ever considered that.

Mrs. Sanger: The Cleveland clinic does that. They send a messenger to Chicago or New York.

[A brief exchange between Bessie Moses and Senator Austin about her experience with medical societies and the training of physicians in birth control was omitted by the MSPP editors.]

Senator Austin. Do you not think the physicians of this country have learned these things already, and realize that one woman will be spared by one thing, and another by another?

Doctor Moses. No; I do not think so. I think they are extremely weak on the subject, and they themselves will tell you that. I know prominent gynecologists at Johns Hopkins who know absolutely nothing about this whole field. The reason I know it is because they come and talk to me, want to know what the methods are, and learn about it.

There have been books published recently, and also "The Practice of Contraception: An International Symposium and Survey" proceedings of the conference on contraception which was published by Mrs. Sanger and Doctor Stone. They gave the good and bad types of various devices that may be used. It is against the law to mail those books in this country. I suppose they are sent by express.

Mrs. Sanger. Yes.

I have here letter trying to the the proceedings on contraception, which I will read.

"October 2, 1930. William Wood & Co. New York City

Dear Sirs: I have recently come from an international conference on birth control, held in Zurich, Switzerland, on September 1 to 5.

The Proceedings of this conference are bound to be of importance to the medical profession, and I wonder if you would consider the publishing of this report. All the papers were written by physicians or scientists, and the discussions by physicians and scientists only. The only scientists who took part were biochemists and biologists from Edinburgh University, Oxford, and Cambridge, men of good standing and who are doing excellent work along biochemical lines.

I should very much like to talk to you about publishing this report, if you are at all interested. Would you kindly let me know.

Sincerely, Margaret Sanger."

I have many letters of that kind, like Wood & Co., even medical publications refusing to review one of these books because they said it was against the law and they did not want to be involved.

Senator Austin. That is right?

Doctor Moses. Yes.

"William Wood & Co., Publishers, New York, October 8, 1930

Mrs. Margaret Sanger. New York City

My Dear Mrs. Sanger

Thank you very much for your letter of October 2. Until the laws of this country have been changed, it is quite impossible forme to consider the publication even of accepted reports in England on this subject of birth control. You have talked with me a number of times about this, but I wish to keep out of jail.

Thanking you for your consideration, I am,

Sincerely yours, Gilbert C. Wood."

Mrs. Sanger. Just before I came I looked in our book, and at our clinic in New York we have had 700 physicians come there to us to learn he technique of contraception.

[An exchange between Austin and Moses on contraceptive jellies has been omitted]

Senator Austin: What is the type of physician, what kind of men?

Mrs. Sanger: A great many southern men. They have come to New York to a conference or something, and physicians have sent them to us, a large number of gynecologists or obstetricians. They want to know just what to do, and the physicians send them down to our clinic, and the same in Washington. When they come here they are sent to the clinic at Baltimore to Doctor Moses.

[Another brief conversation between Bessie Moses and Senator Austin about the difficulty in obtaining contraceptive supplies due to legal bans was omitted by the MSPP editors.]

Senator Austin: Can you not obtain these supplies without breaking the law?

Mrs. Sanger: Not by common carrier, or express or mail.

Senator Austin: You have an option as to whether you can do it one way or another.

Mrs. Sanger: There is only one way. I suppose they get supplies from New York and Chicago. Unless you have a manufacturing center of these pessaries in every community, you have to violate the law. This section says express companies and common carriers, and not only that, but it is violating section 211 for us to tell another person where to go and give her the address where contraceptive information may be obtained. I have been written to by the Department of Justice where complaints have been made that I gave the address of this clinic at Baltimore to a person who was a decoy, and that was all, gave no information, said “go to the doctor there, and they will probably give you such advice.”

[A brief conversation between Bessie Moses and Senator Austin on the education of physicians on contraceptive methods was omitted.]

Mrs. Sanger: I was going to say, as far as the physicians are concerned in this country, we have had to help the poor people. Where a poor woman writes to us, and especially to me, and asks what she can do, I advise her to go to a physician in her community, a physician who has come in and taken a course in technique, and these physicians are glad to help. We often pay her fare to the doctor’s office, and the doctor will giver her advice free. We get in contact with social workers and tell them to tell her to go to the doctor. I have letters from physicians asking me if I can tell them about the law. They say they do not want to break the law; they want to do the right thing, but the doctors are confused as to the law.

Senator Austin: I want to ask a question, and you need not answer it if you do not want to. Have you had any evidence that the medical profession generally regards your activities as an intrusion into their particular sphere?

Mrs. Sanger: I think at first they did, as a layman. Just a trained nurse. I think that was very much resented by them, my intrusion, first, because I was a layman, and they had a guilty conscience themselves. They knew every word about the conditions were true, and I had found means of contraception that were safer than any, and there was resentment.

Senator Austin: If it were true the American Medical Society at its last meeting tabled this suggestion very abruptly and declined to act upon it one way or the other, what would your reaction be to that? What would you think that indicated?

Mrs. Sanger: To me it would indicate the natural trend of events of the history of the medical profession as an organization. All throughout their history they have declined to take up certain things, and gradually the public conscience pushes them into it and they have taken it. I was not surprised at all. The division of gynecologists and obstetricians did come out with a statement concerning our objects, and this whole group of the American Medical Association, most of whom are general practitioners--very few of them are gynecologists or obstetricians-- are not brought face to face with this issue. It looked controversial and something that thy were divided on. Certain elements get into the organization, and I was not at all surprised at that.

Senator Austin: I am glad to see you do not attribute any selfish or ulterior motive.

Mrs. Sanger: No. I do not consider it in that way.

[A conversation between Moses and Austin on one thr the trustees of the American Medical Association was omitted by the editors. Also omitted was a short statement by Dr. Russell J. Clinchy, minister of the Mount Pleasant Congregational Church.]

Senator Austin. Do you think if this law were passed it would be any more legitimate for letting the girl getting this information than before.

Doctor Clinchy. That would depend entirely upon the doctor. This is entrely in the hands of doctors.

Senator Austin. You think it would be asier for her to get it?

Doctor Clinchy. Dependent upon her circumstances.

Senator Austin. But not any more lawful.

Mrs. Sanger. I should not think it would be so easy. In a case where young, unmarried people are living together, they are not using this sort of pessary. They can not use it without a medical examination; in other words, if this law had some provisions for the physician to legitimately give proper advice 20 or 25 years ago, I believe we would not have our young people bootlegging it over the counter and getting anything at all.

When our young men went to war there were two things that they were taught. The physicians taught our men two things, that they must not impregnate a girl in Europe and they must not run the risk of a venereal disease, and they were taught the use of condoms; that is mostly what these people are using. As soon as we can educate them not to take such risks and not to violate the sanctity and beauty of sex we will be accomplishing a great deal. Condoms are generally unsafe.

Senator Austin. They are unsafe?

Mrs. Sanger. They may be unsafe as they get them over the counter.

Senator Austin. They still may conceive?

Mrs. Sanger. Yes; there is no 100 per cent safety, but there is a possibility of 99 per cent safety when properly taken care of. I believe firmly that we are working in the right direction for clinics and physicians to instruct women and to have them go to qualified physicians to receive this information.

[A brief conversation between Bessie Moses and Senator Austin about giving giving contraceptive information to unmarried women was omitted.]

Mrs. Sanger. Today with the laws as stringent as they are, with no leeway, no exemption, we are having this terrific condition. We are trying to improve it.

You asked a question about the immediate necessity. I believe there never has been the time that it is so necessary as it is today. We have had a number come to us who were ready to commit suicide, husbands out of work two or three years, and these women having the double burden, not only the economic burden but the constant worry and fear of the possibility of another pregnancy, when they do not know what they are going to do. A woman came in a few days ago and said that her husband is home all the time, not working. What are we going to do--the anxiety and nervousness?

Senator Austin. You are imparting information to these people?

Mrs. Sanger. We can do it in New York for the prevention of disease.