Margaret Sanger, "How I Decided to Begin My Fight," Feb 1939.
Source: " Redbook Magazine, Feb. 1939, pp.36-39, 116-117 and 125Library of Congress Microfilm 129:597."
This article is an excerpt from Margaret Sanger: An Autobiography, published in Redbook Magazine.
During my early years in New York trained nurses were in great demand. Few people wanted to enter hospitals; they were afraid they might be “practiced” upon, and consented to go only in desperate emergencies. Sentiment was especially vehement in the matter of having babies. A woman’s own bedroom, no matter how inconveniently arranged, was the usual place for her lying in. I was not sufficiently free from domestic duties to be a general nurse, but I could ordinarily manage obstetrical cases, because I was notified far enough ahead to plan my schedule. And after two weeks, I could go home again.
Sometimes I was summoned to small apartments occupied by young clerks, insurance salesmen, or lawyers just starting out, most of them under thirty, whose wives were having their first or second baby. They were always eager to know the best and latest method in infant-care and feeding. In particular, Jewish patients whose lives centered around the family, welcomed advice and followed it implicitly.
But more and more my calls began to come from the lower East Side, as though I were being magnetically drawn there by some force outside my control. I hated the wretchedness and hopelessness of the poor, and never experienced that satisfaction in working among them that so many noble women have found. My concern for my patients was now quite different from my earlier hospital attitude. I could see that much was wrong with them which did not appear in the physiological or medical diagnosis. A woman in childbirth was not merely a woman in childbirth. My expanded outlook included a view of her background, her potentialities as a human being, the kind of children she was bearing, and what was going to happen to them.
The wives of small shopkeepers were my most frequent cases, but I had the wives of carpenters, truck-drivers, dishwashers, and pushcart vendors. I admired intensely the consideration most of these people had for their own. Money to pay doctor and nurse had been carefully saved months in advance--parents-in-law, grandfathers, grandmothers, all contributing.
As soon as the neighbors learned that a nurse was in the building, they came in a friendly way to visit, often carrying fruit, jellies or gefilte fish made after a cherished recipe. It was infinitely pathetic to me that they, so poor themselves, should bring me food. Later they drifted in again with the excuse of getting the plate, and sat down for a nice talk; there was no hurry. Always back of the little gift was the request: “I am pregnant (or my daughter, or my sister is). Tell me something to keep from having another baby. We cannot afford another yet.”
I tried to explain the only two methods I had ever heard of among the middle classes, both of which were invariably brushed aside as unacceptable. They were of no certain avail to the wife, because they placed the burden of responsibility solely upon the husband--a burden which he seldom assured. What she was seeking was self-protection she could herself use, and there was none.
Below this stratum of society was one in truly desperate circumstances. The men were sullen and unskilled, picking up odd jobs now and then, but more often unemployed, lounging in and out of the house at all hours of the day and night. The women seemed to slink on their way to market, and were without neighborliness.
These submerged, untouched classes were beyond the scope of organized charity or religion. No labor union, no church, not even the Salvation Army reached them. They were apprehensive of everyone, and rejected help of any kind, ordering all intruders to keep out; both birth and death they considered their own business. Social agents, who were just beginning to appear, were profoundly distrusted because they pried into homes and lives, asking questions about wages, how many were in the family, and had any of them ever been in jail. Often two or three had been there, or were now under suspicion of prostitution, shoplifting, purse-snatching, or petty thievery; and in consequence they passed furtively by the big blue uniforms on the corner.
The utmost depression came over me as I approached this surreptitious region. Below Fourteenth Street I seemed to be breathing a different air, to be in another world and country, where the people had habits and customs alien to anything I had ever heard about.
There were then approximately ten thousand apartments in New York into which no sun-ray penetrated directly; such windows as they had opened only on a narrow court from which rose fetid odors. It was seldom cleaned, though garbage and refuse often went down into it. All these dwellings were pervaded by the foul breath of poverty, that moldy, indefinable, indescribable smell which cannot be fumigated out, sickening to me but apparently unnoticed by those who lived there. When I set to work with antiseptics, their pungent sting, at least temporarily obscured the stench.
I remember one confinement case to which I was called by the doctor of an insurance company. I climbed up the five flights and entered the airless rooms, but the baby had come with too great speed. A boy of ten had been the only assistant.
Many families took in “boarders,” as they were termed, whose small contributions paid the rent. These derelicts, wanderers, alternately working and drinking, were crowded in with the children; a single room sometimes held as many as six sleepers. Little girls were accustomed to dressing and undressing in front of the men.
Pregnancy was a chronic condition among the women of this class. Suggestions as to what to do for a girl who was “in trouble,” or a married woman who was “caught,” passed from mouth to mouth. When they had word of a new remedy, they hurried to the drug-store, and if the clerk were inclined to be friendly, he might say: “Oh, that won’t help you, but here’s something that may.” The younger druggists usually refused to give advice because, if it were to be known, they would come under the law; midwives were even more fearful. The doomed women implored me to reveal the “secret” that rich people had, offering to pay me extra to tell them; many really believed I was holding back information for money.
Each time I returned to this district, which was becoming a recurrent nightmare, I used to hear that Mrs. Cohen “had been carried to a hospital, but had never come back,” or that Mrs. Kelly “had sent the children to a neighbor and had put her head into the gas oven.” Day after day such tales were poured into my ears--a baby born dead, great relief; the death of an older child--sorrow but again relief of a sort. I shuddered with horror as I listened to the details and studied the reasons back of them--destitution linked with excessive childbearing. The waste of life seemed utterly senseless. One by one, worried, sad, pensive and alone, they marshaled themselves before me in my dreams, sometimes appealingly, sometimes accusingly.
These were not merely “unfortunate conditions among the poor” such as we read about. I knew the women personally. They were living, breathing, human beings, with hopes, fears and aspirations like my own; yet their weary, misshapen bodies, “always ailing, never failing,” were destined to be thrown on the scrap-heap before they were thirty-five. I could not escape from the facts of their wretchedness; neither was I able to see any way out. My own cozy and comfortable family existence was becoming a reproach to me.
Then one stifling mid-July day of 1912 I was summoned to a Grand Street tenement. My patient was a small, slight Russian Jewess, about twenty-eight years old, of the special cast of feature to which suffering lends a Madonna-like expression. The cramped three-room apartment was in a sorry state of turmoil. The man, a truck-driver scarcely older than this wife, had come home to find the three children crying and his wife unconscious. He called the nearest doctor, who in turn had sent for me. The husband’s earning were trifling, and most of them had gone to keep the none-too-strong children clean and properly fed. But his wife’s ingenuity had helped them to save a little, and this he was glad to spend on a nurse rather than have her go to a hospital.
The doctor and I settled ourselves to the task of fighting the septicemia. Never had I worked so fast, never so concentratedly. The sultry days and nights were melted into a torpid inferno. It did not seem possible there could be such heat; and every bit of food, ice and drugs had to be carried up three flights of stairs.
Jake was more kind and thoughtful than many of the husbands I had encountered. He loved his children, and had always helped his wife wash and dress them. He had brought water up and carried garbage down before he left in the morning, and did as much as he could for me while he anxiously watched her progress.
After a fortnight, the wife’s recovery was in sight. Neighbors were genuinely pleased that she had survived. She smiled wanly at all who came to see her and thanked them gently, but she could not respond to their hearty congratulations. She appeared to be more despondent and anxious than she should have been, and spent too much time in meditation.
At the end of three weeks, as I was preparing to leave the fragile patient to take up her difficult life once more, she finally voiced her fears; “Another baby will finish me, I suppose?”
“It’s too early to talk about that,” I temporized.
But when the doctor came to make his last call, I drew him aside.
“She is terribly worried about having another baby.”
“She well may be,” replied the doctor; and then he stood before her and said: “Any more such capers, young woman, and there’ll be no need for me.”
“I know, Doctor,” she replied timidly. “But,”--and she hesitated as though it took all her courage to say it--“what can I do to prevent it?”
The doctor was a kindly man and he had worked hard to save her, but such incidents had become so familiar to him that he had long since lost whatever delicacy he might once have had. He laughed good-naturedly. “You want to have your cake and eat it too, do you? Well, it can’t be done.”
I glanced quickly at the wife. Even through my sudden tears I could see stamped on her face an expression of absolute despair. We simply looked at each other, saying no word until the door had closed behind the doctor. Then she lifted her thin, blue-veined hands and clasped them beseechingly.
"He can’t understand. He’s only a man. But you do, don’t you? Please tell me the secret, and I’ll never breathe it to a soul. Please!”
What was I to do? I could not speak the conventionally comforting phrases which would be of no comfort. Instead, I made her as physically easy as I could, and promised to come back in a few days to talk with her again.
Night after night her wistful image appeared before me. I made all sorts of excuses to myself for not going back. I was busy on other cases; I really did not know what to say to her or how to convince her of my own ignorance; I was helpless to avert such monstrous atrocities. Time rolled by, and I did nothing.
The telephone rang one evening three months later, and Jake’s agitated voice begged me to come at once; his wife was sick again and from the same cause. For a wild moment I thought of sending someone else; but actually, of course, I hurried into my uniform, caught up my bag, and started out. All the way I longed for a subway wreck, an explosion, anything to keep me from having to enter that home again. But nothing happened, even to delay me. I turned into the dingy doorway and climbed the familiar stairs once more. The children were there, young little things.
The wife was in a coma, and died within ten minutes. I folded her still hands across her breast, remembering how they had pleaded with me, begging so humbly for the knowledge which was her right. I drew a sheet over her pallid face. Jake was sobbing, running his hands through his hair and pulling it out like an insane person. Over and over again he wailed, “My God! My God! My God!”
I left him pacing desperately back and forth, and for hours I myself walked and walked and walked through the hushed streets. When I finally arrived home and let myself quietly in, all the household was sleeping. I stood looking out of my window and down upon the dimly lighted city.
Its pains and griefs crowded in upon me; a moving picture rolled before my eyes with photographic clearness; women writhing in travail to bring forth little babies; the babies themselves naked and hungry, wrapped in newspapers to keep them from the cold; six-year-old children with pinched, pale, wrinkled faces, old in concentrated wretchedness, pushed into gray and fetid cellars, crouching on stone floors, their small scrawny hands scuttling through rags, making lamp-shades, artificial flowers; white coffins, black coffins, coffins, coffins interminably passing in never-ending succession. The scenes piled one upon another on another. I could bear it no longer.
As I stood there, the darkness faded. The sun came up and threw its reflection over the house-tops. It was the dawn of a new day in my life also. The doubt and questioning, the experimenting and trying, were now to be put behind me. I knew I could not go back merely to keeping people alive.
I went to bed, knowing that no matter what it might cost, I was finished with palliatives and superficial cures; I was resolved to seek out the root of evil, to do something to change the destiny of mothers whose miseries were vast as the sky.
How were mothers to be saved? I went through many revolving doors, looked around, and not finding what I was seeking, came out again. I talked incessantly to everyone who seemed to have social welfare at heart. Progressive women whom I consulted were thoroughly discouraging. “Wait until we get the vote. Then we’ll take care of that,” they assured me. I tried the Socialists. Here, there, and everywhere the reply came: “Wait until women have more education. Wait until we secure equal distribution of wealth.” Wait for this and wait for that. Wait! Wait! Wait!
Having no idea how powerful were the laws which laid a blanket of ignorance over the medical profession as well as the laity, I asked various doctors of my acquaintance: “Why aren’t physicians doing something? Information does exist, doesn’t it?”
“Perhaps; but I doubt whether you can find it. Even if you do, you can’t pass it on. Comstock’ll get you if you don’t watch out.”
In order to ascertain something about this subject which was so mysterious and so unaccountably forbidden, I spent almost a year in the libraries--the Astor, the Lenox, the Academy of Medicine, the Library of Congress and dozens of others. Hoping that psychological treatises might inform me, I read Auguste Forel and Iwan Bloch. At one gulp I swallowed Havelock Ellis’ “Psychology of Sex,” and had psychic indigestion for months thereafter.
I read translations from the German in which women were advised to have more children because it could be proved statistically that their condition was improved by childbearing. The only article on the question I could discover in American literature was in the Atlantic Monthly, by Edward Alsworth Ross of the University of Wisconsin, who brought to the attention of his readers the decline of the birth-rate among the upper and educated classes, and the increase among the unfit, the consequences of which were sure to be race-suicide.
The pursuit of my quest took me away from home a good deal. The children used to come in after school and at once hunt for me. “Where’s Mother?” was the usual question. If they found me at my mending-basket, they all leaped about for joy, took hands and danced, shouting: “Mother’s home, Mother’s home, Mother’s sewing.” Sewing seemed to imply a measure of performance.
I too wanted to drive away the foreboding barrier of separation by closer contact with them. I wanted to have them solely to myself, to feed, to bathe, to clothe them myself. I had heard of the clean, wind-swept Cape Cod dunes, which appeared to be as far from the ugliness of civilization as I could get. Socialism, anarchism, syndicalism, progressivism--I was tired of them all. At the end of the spring, thoroughly depressed and dissatisfied, I tucked the children under my arms, boarded a Fall River boat, and sailed off, a pioneer to Provincetown.
In 1913 the tip of the Cape was only a fishing village with one planked walk--which, I was told, had been paid for by Congress. Up and down its length walked the bellman, the last of the town criers, proclaiming the news.
At first we lived in the upper story of a fisherman’s house right on the water. After he went out in the morning, his wife and her children, and I and mine, were left alone. Then the old women recalled scenes from their early days on the whaling vessels. Their mothers had brought them forth unaided; and their own sons, in turn, had been born on the ships and apprenticed to their husbands. They fitted into life simply; but the younger Portuguese, who were taking over the fishing industry, were asking what they should do about limiting their families.
The village was rather messy and smelled of fish. I was still too close to humanity and wanted to be more alone, so we moved to the extreme end of town. Our veranda faced the Bay, and when the tide was high, the water came up and lapped at the piles on which the cottage was built. Stuart, Grant and Peggy used to sit on the steps and dabble their toes. At low tide they had two miles of beach on which to skip and run; it was a wonderful place to play, and all summer we had sunrise breakfasts, sunset picnics.
I spent the entire season at Provincetown, groping for knowledge, classifying all my past activities in their proper categories, weighing the pros and cons of what good there was in them and also what they lacked. It was a period of gestation. Just as you give birth to a child, so you can give birth to an idea.
Between interims of brooding and playing with the children, I took part in the diversions of the minute colony of congenial people. Charles Hawthorne had a school of painting; Mary Heaton Vorse and her husband Joseph O’Brien were there; so also were Hutch Hapgood and Neith Boyce. Jessie Ashley had lifted Big Bill Haywood out of the slough of the Paterson strike and brought him down to rest and recuperate.
Big Bill was one of the few who saw what I was aiming at, although fearful that my future might involve the happiness of my children. Even he did not feel that the small-family question was significant enough to be injected into the labor platform. Nevertheless, as we rambled up and down the beach, he came to my aid with that encouragement of which I was badly in need. He suggested I go to France and see for myself the conditions resulting from generations of family limitation in that country. This struck me as a splendid idea, because it would also give Bill Sanger a chance to paint, instead of continuing to build suburban houses.
The trip to Europe seemed so urgent that no matter what sacrifices had to be made, we decided to make them.
Copyright, Margaret Sanger Project