Margaret Sanger, "Women Free," 25 Oct 1937.
Source: "Margaret Sanger Papers, Library of CongressLibrary of Congress Microfilm 131:433."
No published version found. A note at the top right on the first page reads: Keep in files.
“Won’t you please in God’s name help me?”
“I milked six cows at 6 a.m., had a baby at 9 that morning and five days later was working in the fields.”
“I am thirty years old, have been married fourteen years, and have twelve children. Every one is defective.”
“I didn’t even have enough for my babies to eat. Oh, how I cry to see my babies in this way.”
“We live 100 miles from the railroad. I have five children and am all alone when my babies come.”
“Oh! Tell me how to keep from having another. I feel like it’s more important to raise the eight I have than to bring more.”
“I live in constant fear, so please have pity on me and tell me what to do as I have to live for the children’s sake.”
“I’m just tired of living and bringing those children into this world to suffer.”
“The pitifullest sight on this earth is more children than can be cared for.”
“Is there anything in this world I can do to keep from having any more?”
“Oh! If I could only have a little peace before I die!”
These are keynotes of more than 250,000 letters which have come to me since I began the fight to free women from the bondage of excessive and untimely child bearing. Why have such poignant pleas gone up from literally millions of women in America?
Because in 1873 Congress gave in to pressure by a misguided “reform” group led by Anthony Comstock and passed a law which put contraceptive information in the same class with obscene pictures and writing. That law prevented the giving of birth control information even by a physician and barred it from the mails.
For nearly 65 years the law remained on the statute books, interpreted by the courts as binding. It put motherhood in bondage. It enslaved millions of mothers to ignorance and prejudice and sentenced them to bearing more children than their health, strength and ability to provide for them warranted.
This and similar archaic laws unjustly linking contraceptive information with filth stopped the clock of progress and denied to the women of the United States dependable, scientific information on family limitation and protection of motherhood and childhood. Mothers were cruelly denied the facts needed to protect their own lives and those of their offspring. Countless thousands of children have been born sick, weak, unwanted and unprovided for. It is estimated that these laws were responsible, directly or indirectly, for the deaths of a million mothers from abortions and from bearing children too frequently and when not in healthy physical condition for motherhood. They were responsible for the widespread bootlegging of contraceptive devices and quack remedies, and denying to the poor information generally available to the rich.
Looking back today, a year after that law was finally interpreted by an enlightened court as not prohibiting contraceptives under medical direction, does it seem possible that women with tuberculosis, heart and kidney disease, epilepsy, and other ailments, or in need of surgical operations, could not be given contraceptive information?
Doe sit seem possible that women could not have information which would permit them to space the arrival of their children in the interests of the health of both mother and child and with some regard to the ability of the parents even to clothe and feed their children, to say nothing of giving them an education and advantages?
Could information which was available to rich women able to pay the fees of private physicians be denied to millions of poor women who needed it most?
Could quacks go on year after year exploiting the miseries of mothers?
Is it possible that people went to jail in the effort to end such an intolerable situation?
Such things can’t happen here, you say? But they did happen!
I myself was one of those who went to jail in 1917 and served a month’s sentence for testing the law by opening a clinic in Brooklyn to aid poor mothers.
Exactly what do we mean by the term birth control? It has been the subject of so much misinformation and misrepresentation that a definition is needed. I am credited with originating the term. I did, but it almost originated itself. It means control, not merely preventing births. In many instances contraceptive measures promote births, properly spaced, by mothers who otherwise would not have been in a condition to bear children.
Birth control is the conscious control of the birth-rate by scientific means which prevent conception. It does not mean interference with life after conception has taken place. Indeed, one way to understand the significance and social values of birth control is to state clearly what birth control is not: Birth control is not abortion. It is not against the laws of nature. It is not a means of promoting sexual promiscuity and immorality. It is not an immoral practice. It does not endanger growth in population. It is not harmful to mothers. It does not cause sterility. It is not to be classed with filth and obscenity.
Birth control is the proper use of scientific knowledge to remove chance as the chief factor in the birth of children and to promote voluntary, planned parenthood. The aim is to have the number of children consistent with the mother’s health, the child’s possible heritage, the father’s earning capacity, and decent standards of living and education.
There are various means of birth control. Continence (complete abstinence from the sexual relation) cannot be recommended because it implies the abandonment of the natural marriage relationship, which too often results in the break-up of family life, in divorce, and promiscuous sex relations outside the family.
Birth control permits normal sex life in marriage. It eliminates fear and the uncertainty of pregnancies when an addition to the family is unjustified on economic, moral or medical grounds. As Dr. Hannah M. Stone has pointed out, “we cannot overlook the role which birth control plays in married life generally. The fear of pregnancy, when a pregnancy must be avoided for medical, social or economic reasons, is a source of recurring anxiety in many families. It often leads to physical and emotional strains which make a satisfactory marital adjustment difficult to attain. Obviously, the sexual relation in marriage cannot be limited to the few occasions when a child is desired. Marital continence for the purpose of preventing conception is neither feasible nor desirable. It is an ascetic ideal which is unsound both physiologically and psychologically and which tends to destroy the finest qualities of the marital union.”
Sterilization is sometimes recommended by physicians in extreme cases where other forms of temporary contraception are not advisable or possible, especially in cases of mental or physical deficiency, or venereal disease.
Chemical and mechanical methods of contraception suited to each individual case and used under medical direction are best adapted to the needs of most mothers.
Let us see why birth control is needed. It is common experience that nearly every married couple in average circumstances passes through a time when the birth of another child- or of several children in close succession- is a family disaster. The mother’s strength is sapped, her health impaired, children are born weak or sick, and their arrival taxes the ability of the family to provide for them and to give them the heritage of health and security and the advantages of education, protection and opportunity for development which should be the right of every child.
Many women suffering from tuberculosis, heart disease, kidney disease and other ailments die as a result of pregnancy, or bring weak, sick, or dead children into the world. In the case of most of these unfortunate children their capital of life has been used up before they were born! Many mothers die needlessly from pregnancy when ill, and from abortions. Thousands would have been alive today if contraceptive information had been available to them.
Many children are born to parents suffering from venereal disease. There are approximately 500,000 new cases of syphilis in this country every year, according to reports of the Public Health Service.
In families of poverty, the burden of too many children, born at too frequent intervals, is crushing. It often reduces the whole family to the level of mere animal subsistence. Lack of sound, effective means of birth control is a tragedy to such families at all times. During the depression the higher birth rate among the families of the unemployed, which studies revealed, aggravated the problem of supporting millions of persons unable to provide for themselves by still further increasing the number of the dependents. Not only is the quality of family life- the realization of the higher values of family life- at stake, but the resources of society are being taxed to support children born to families who do not want and cannot support them.
One report indicated that in a group of families studied in 1932 “the birth rate in families without employed workers was 197 as compared with 154 in families with part-time workers only, and 134 in families with one or more full-time workers. Thus, the families without any employed workers in 1932 had a birth rate during the depression 48 per cent higher than those which had one or more full-time workers in 1932.”
Birth control is perhaps the most immediate factor in reducing preventable infant mortality. A report to the White House Conference on Child Health and Protection indicated that some 80,000 infants a year are born too weak to live even one month. Almost as many more are still-born. Studies of the U.S. Children’s Bureau revealed that infant mortality rates increase with the order of birth; there is a rapid rise from the fourth child on.
Lack of birth control information has driven vast numbers of distracted mothers to seek abortions. There has been a notorious increase in the number of abortions, now estimated at more than a million a year in the United States. Aside from the moral issue involved, abortions cause many deaths of mothers, and ill health and disability among thousands of others.
A report submitted to the White House Conference on Child Health and Protection stated: “It is appalling to note that in the childbearing years from fifteen to forty-five, in that epoch when mothers are most needed for the care of their young children, this scourge of abortion is responsible for deaths almost equalling those from childbirth.”
The death rate among American mother is abnormally high. Abortions are a major factor in the maternal death rate, and a large proportion of them have been due to lack of contraceptive information and hygiene. Many studies have been made to ascertain the prevalence and causes of maternal mortality. The most extensive inquiry was made by the Children’s Bureau. It was a case-by-case check of 7,500 maternal deaths occurring in two years in fifteen states. It revealed a startling toll of deaths from abortions. Almost exactly a fourth of these women had died after some form of abortion.
Every year thousands of mothers seek relief in bootleg contraceptive devices. They are victimized by unscrupulous purveyors of unreliable, ineffective and dangerous devices, quack remedies and advice without a sound scientific basis. In tests of more than one hundred commercial “contraceptives,” so-called, undertaken by the Birth Control Clinical Research Bureau, New York, forty-five were found wholly unreliable.
I was working as a trained nurse among the poor in the slums of New York when I first realized the need for birth control. That was in 1914. From the day when I saw a poor woman die needlessly because information of how to prevent her becoming pregnant was denied her, I decided what my life work was to be. It was to bring to such women the information which they had every right to have from the standpoint of their health, their children, the welfare of their families and the public good. The fight lasted for 25 years. It has been won at last. A great host of men and women joined me in assailing the outmoded law, in breaking through the barbed wire entanglements of legalism, prejudice and opposition.
Finally victory came through public opinion and a liberal court. The end of that dark, dismal, disgraceful chapter was written when an enlightened court saw beyond the dead letter of a law, which never should have gone on the statue books and which had already become dead and obsolete in the light of modern science, medicine and morality, and refused longer to interpret it as preventing physicians from giving contraceptive information in good faith where the need for it was clearly indicated.
Birth control under medical direction finally became legal throughout the United States on November 30, 1936, when the United States Circuit Court of Appeals for the Second District rendered a decision in a test case brought by Dr. Hannah M. Stone that the Federal obscenity laws do not apply to the legitimate activities of physicians, and that they may prescribe contraceptives in the interests of the health and general well being of their patients. This momentous decision signed by Justice Learned Hand, Thomas W. Swan and Augustus N. Hand, marked the end of the long fight against the outmoded Comstock law. It brought the birth control movement to the goal which it had sought through legislation.
Within a few months, too, the American Medical Association, representing the physicians of the country, which had appointed a special committee to study birth control, adopted it as an integral part of medical practice and education. Thus, both legally and ethically, the way is now open for physicians in private practice to give contraceptive information for the health and welfare of their patients, and for medical college to give instruction to their students in this branch of medicine.
The court’s decision was the emancipation proclamation of American motherhood. Motherhood is no longer in bondage. It is also a Bill of Rights to the medical profession in the field of contraception. Thus it marks the dawn of a new era. It guarantees to mothers the legal as well as the moral right to have something to say about how many children they shall have, how often, and under what conditions.
The future is one of hope. The next steps are to actually put into practice what is now legally permissible and desirable from the standpoint of mothers, children, family welfare and the public good.
In addition to making contraceptive information available to mothers through physicians in private practice, the doors of hospitals, clinics, dispensaries, health centers and other sources of medical counsel and help must be opened, especially to the poor. It is also most important to help mothers who do not have easy access to doctors and clinics. There are today 500 or more birth control clinics in this country. This number should be increased ten-fold. We need at least 3,000 such clinics. We should also send visiting nurses into isolated homes remote from medical service to teach contraceptive measures to forgotten mothers.
Only by adequate effort to save the lives of women and to promote maternal and child health can the community atone for the deaths of a million mothers during the six decades while the Comstock laws were in force. Those who won the legal fight for birth control must now move fast- and keep moving- for women and children still are needlessly dying. Their lives may be saved if contraceptive facilities become adequately available in every community.
Especially must we help the mothers who as yet are not reached through public health channels. We need contraceptive caravans of education and help for mountain women, farm women, mothers on distant homesteads, mothers in all districts, city and country, who are now neglected. They are the ones who should now be reached and helped. Thousands of letters have testified where these women are and that they are untouched by the social service of either community or state. There is a vast number, thousands, tens of thousands, doubtless millions of such women who cannot or do not come to a clinic, women who never come out of their own restricted areas, who seldom leave their homes.
We should send an organization of birth control instructing nurses to visit the homes of these underprivileged mothers. Just as the members of the American Visiting Nurses Association have gone into the homes to help through bedside work, so we need an army of quipped, sympathetic, understanding nurses to take up this task of educating and instructing mothers in contraceptive techniques and thus free them from the constant fear which haunts their lives.
Means must also be provided for testing contraceptive products and standardizing those offered for sale. Research looking toward simpler and cheaper methods (suitable to the poorest and least educated women) must go forward, and experimental methods must be carefully studied.
For the benefit of women in the larger centers within reach of medical service, we must move with all our might and force to influence the public health authorities of the city, county, state and nation to see that birth control instruction is carried on under medical auspices as a part of their program.
Social service agencies and workers should be awakened to the need of birth control. Many such agencies have been asleep or have refused to act. In many cases the workers have been more alert and progressive in this field than the managing boards of such organizations. Often the Boards of Directors, the officials who dictate the policies of philanthropic organizations, tie the hands of the actual workers. They are the ones who sacrifice constructive work, progress and the very lives of those in their care, in order to maintain a neat structure of harmony and pleasantness among themselves.
Birth control clinics substitute competent medical attention for quackery and bootlegged advice and devices. There are about 7,000 hospitals and 10,000 other agencies where medical aid is sought by mothers, which are now legally free to give contraceptive advice and information to women who apply. We must induce them actually to provide such service. Women everywhere should help to get their own communities to provide birth control facilities. The General Federation of Women's Clubs have made birth control a part of their public welfare and health activities.
We should also aid the nation-wide campaign to check venereal diseases, especially syphilis, which is now being carried on by the United States Public Health Service and State and local public health authorities.
As long ago as 1932, Dr. Stokes, testifying in behalf of a birth control bill, said:
“Syphilis stands somewhere between first and fourth among the causes of death in the world... a major cause of insanity, of death from heart disease, of infant mortality. . . Given the physician’s power to prescribe clearly and exactly the use of contraceptive and disinfectant measures. . . there will be a radical change in our situation with respect to one of the most tragic aspects of syphilis, the helplessness of the innocent.”
With birth control legalized, the National Committee on Federal Legislation for Birth Control finished its work and disbanded. The Birth Control Clinical Research Bureau, New York, founded fourteen years ago, continues, however, and will increase both its clinical work and its services of research and counsel to aid other clinics and organizations. It will provide clinic research, serve as a clearing house of information about the establishment and operation of clinics and promote new centers throughout the country.
More than 58,000 women have received contraceptive instruction at the Bureau, representing every walk of life, every diversity of race, religion and education. Additional thousands have benefited through other services of the Bureau.
As the first large center for contraceptive counsel, it has long since become internationally known and is now the largest clinic of its kind in the world. Doctors and scientists from many countries have visited it for technical training. Representatives from nearly every European country, as well as from Japan, China and India, have sought information about the Bureau’s methods, along with innumerable visitors from all parts of the American continent. In many other countries similar work has been started.
As the Bureau has had an experience and has collected a mass of data paralleled nowhere in the world, it is logical that it should be the center with which other contraceptive clinics should be allied. It is the only large birth control teaching center in the United States. It is the only center doing research in a variety of methods. It is the only center which has published any considerable number of reports on its work so that members of the medical profession could be informed on more than a series of a few hundred or possibly a few thousand cases.
More than 145 clinics throughout the country are affiliated with the Bureau in a mutual effort to maintain and improve clinical service and contraceptive methods. The number of clinics needs to be greatly increased. If mothers everywhere in the land are to have contraceptive information, it must be within reach in their own communities, not alone in the headquarters of some distant city.
A few words of warning against misuse of birth control are in order. It is for married women - for mothers- not unmarried women and women about to be married. It is not a negative but a positive force. These clinics servce as centers of maternal and child health. They provide medical examination of and counsel to mothers in the hygiene of conception and child bearing - in conception as well as contraception. They substitute competent medical attention for quackery and bootlegged advice and devices.
Perhaps no other question is asked so frequently as this: “Is birth control the same as abortion?” No. It is entirely different. Abortion destroys the already fertilized ovum or interferes with its development. Birth control or contraception prevents by mechanical and chemical means the union of the two cells, thereby preventing the conception from taking place. Birth control prevents the conceiving of a life. Abortion is the interruption of pregnancy, after a life has been conceived.
It cannot be too strongly emphasized that responsible birth control clinics do not perform, counsel or countenance abortions. Their work is wholly preventive. When a competent medical examination indicates that a mother is pregnant, the case is wholly outside the clinic field and becomes a matter of obstetrical care from the patient’s own physician.
Birth control is not forced on any woman. Legalizing it does not make contraceptive information compulsory; it is permissive and optional--available to those who wish it. No physician will be compelled to give such information. The court decision permits contraceptive information and supplies to be sent to doctors, to hospitals and clinics and to druggists for use in legitimate prescription business.
Finally, we may appropriately sum up again the reasons why birth control is needed. They are clear and compelling. The main reasons are:
To insure to every child the heritage of a sound mind in a healthy body.
To assure children who are wanted and welcome.
To safeguard the health of women who should postpone or refrain entirely from motherhood.
To space births so that each child may have adequate care and the mother any recuperate from childbirth before starting another pregnancy.
To enable parents to bring into the world only the number of children they can afford to rear.
To prevent over-population--a major cause of war.
The practice of birth control affords opportunities for the development of the higher qualities of personality on which the future and progress of the race on the higher levels depend. It makes for a real “survival of the fittest.” Fitness is not merely physical strength, but also involves the mental and spiritual attributes which enrich life and assure the spiritual advancement and rounded development of the race.
The time and opportunity for birth control to take its proper place as a way of life have come. It will reduce suffering, fear, misery, ill health, abortions and deaths. It will make for healthier and happier mothers, fathers, and children. It will promote the welfare of the race as well as the family.
Women are free--at last.
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Copyright, Margaret Sanger Project