An Open Letter to Social Workers




"An Open Letter to Social Workers," Birth Control Review, June 1933, pp. 140-41
Margaret Sanger Microfilm Edition, Smith College Collections, S71:443



An Open Letter to Social Workers

In addressing this letter to the assembled delegates of the National Conference of Social Work, I do so with a feeling of kinship in a common purpose. Too often I find an Alice-in-Wonderland attitude prevailing–-with poverty, disease and kindred evils all seen as through a looking-glass, as spectres without substance. To the social worker, however, these are grim realities, calling on every ounce of courage, resourcefulness and common sense in their solution.

You who have dedicated yourselves to the welfare of others-–you who are working to build bridges for families to pass from dependency to self-support-–know full well that a knowledge of birth control must form the keystone of that bridge. You are already aware of the futility of pouring untold millions into palliative measures that disregard the obvious fact that without birth control, no permanent adjustment is possible between the size of a family and the family income.

A unique responsibility is today vested in the social workers of America, as a result of the gigantic increases that have taken place in the cost of public and private charities. For you are the intermediaries between the diseased, the defectives, the delinquent, and the dependent, and the vast agencies charged with the administrative responsibility of spending billions of dollars from public and private funds to help these groups. It is upon your recommendations that organization policies are established; and such policies must be reconciled with constructive race-building. Upon your vision, upon your intelligence, in this crisis, rests the welfare not only of countless troubled, worried parents, but also of the children born in the midst of the greatest depression in history, on whom we depend to carry on the torch of civilization.

I want to express my gratitude to the large and increasing number of individual socialworkers who are courageously bringing a knowledge of birth control to families crushed under the burden of feeding and clothing a constantly increasing family upon a stationary or diminishing wage. Through your efforts many mothers have been enabled to secure scientific information from dependable medical sources. Our common problem today is: How can we make it possible for every mother to obtain this help? How can we break the vicious circle of over large families, poverty, infant and maternal mortality, child labor, marital discord, prostitution, and other social cankers all linking up directlyto the difficulty of obtaining information so essential to the health of these mothers? How can we stop the senseless perpetuation of these evils?

Birth control clinics in every community are essential. These can be established under present State Laws, and can operate within certain limitations of the State Statutes. In 24 states no legal restrictions exist, and contraceptive advice can be given mothers for economic and social reasons as well as for health reasons. There are 133 birth control centers legally operating throughout this country. The present Federal Laws, however, Sections 211,245, 311, and 312 of the Criminal Code, class contraception with obscenity and abortion. They make it a criminal offense to send or receive from the U.S. mails or common carriers, information or supplies pertaining to contraception. They make no exceptions for physicians, hospitals or clinics, who are forced to violate the law in order to obtain necessary supplies from the manufacturers. Consequently, we have the spectacle of 133 legally operating birth control clinics that have become veritable “speak-easies” as far as the general public is concerned. It is difficult for the mothers in the communities where these clinics are operating almost surreptitiously, to know of their existence, and the consequence is that although a mother may live within a few hundred feet of a center, she is usually unaware of its existence. On leaving the maternity wards, or applying to maternity centers, or lying-in hospitals for such advice it is refused her. Only if she can pay the fee of a private physician can she obtain scientific individual instruction. For obviously, the physician who takes the personal responsibility of giving contraceptive advice in his private office, cannot involve the medical institutions with which he is connected in a subject classed by our Federal Statutes as illegal. He is compelled to protect himself and his institution in his public practice. It is here that the Federal Laws take their greatest toll in keeping in ignorance the most needy mothers who are dependent on hospitals, public dispensaries and clinics for their medical aid. It is class legislation, a sanction of knowledge for those who can afford to pay for it,and ignorance and misery for those who cannot.

The National Committee on Federal Legislation for Birth Control has sponsored legislation in Congress that would exempt physicians, medical colleges, hospitals and clinics from the provisions of the above Statutes, in order to enable every hospital to legally provide birth control information as part of its routine preventative health service. The amendment of the Federal Laws represents a “short cut” to bringing this needed relief to the greatest number in the shortest possible time. Hearings on our legislation have been held before Senate and House Committees. Medical, social and religious organizations with memberships approximating many millions of individuals, have endorsed these efforts to bring our Federal laws in line with decency and common sense.

Much remains to be done. You who are in touch with actual conditions are cognizant of the need. I am grateful to those among you who have had the courage to take an unqualified stand on this question, and who have thrown the weight of your influence into persuading the welfare agencies with which you are affiliated to openly endorse the work of our Committee. Your leadership is inspiring those who are more timid to do likewise. Each individual and group endorsement helps, and is urgently needed for our work during the next session of Congress.

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I am also looking to the social workers with their vast experience to help broaden the horizon on this important subject. Unfortunately, there are still many who, while reluctantly recognizing the need for contraceptive advice in cases of heart disease, cancer, tuberculosis, hereditary and transmissible diseases, and other health conditions where pregnancy is known to aggravate the disease, sometimes resulting in death, nevertheless do not always see the deeper social and ethical principles involved. There can be no justification for violating the right of every married woman to decide when and how often she shall undertake the physical and far-reaching responsibilities of motherhood. It is mediaeval and barbarous to treat parenthood as a punishment for shiftlessness or recklessness. On the contrary, the woman sufficiently socially-conscious to desire to take parenthood out of the sphere of accident, should be aided in obtaining scientific information that will enable her to space the births of children in consideration of her health, her husband’s earning capacity, and the future health, environmental and educational opportunities for her children. Unless there is intelligent direction of the movement, however, we will have continued attempts to legislate contraceptive advice into the same category as abortions. Only last week, an incredible bill was introduced, making it necessary for a woman to secure the consent of two physicians, one of them recommended by the State Board of Health and residing in an adjacent town, before contraceptive advice could be prescribed. This is an instance of the type of shortsighted legislation passed by lawmakers and paid for by the people.

In closing, may I again point out that yours is the responsibility and privilege of rendering an unequalled patriotic service to your country by taking a stand that will help to forward this constructive work. Birth control is here, it is being practiced, ithas already done great good. It can relieve the economic distress of countless families. Like all great forces, however, it must be directed, it must be accessible to all classes, so that it may truly become a constructive force for the regeneration of the race.