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Margaret Sanger, "Notes from a Recent Trip to the Orient," Nov. 1937.

Source: " The Journal of Contraception, Nov. 1937, pp. 201-03 Margaret Sanger Microfilm, Smith College Collections S71:961."

Notes from a Recent Trip to the Orient

By Margaret Sanger

On August 7th, 1937, a group of us* sailed from Honolulu on a contemplated trip to China. The resolution adopted by the Chinese Medical Association “that contraception is a part of the activities of public health, especially in the field of maternity and child welfare,” the intensive educational campaigns carried on by the New Life Movement, the Mass Education Movement, and other organizations, and the cordial invitations from a number of Chinese public health officials to assist in the development of a practical birth control program, led me to make plans to return to China for the Fall months of this year.

Despite peaceful seas, there was not "smooth sailing" in our minds, owing to the rumors of war and the possibility of a major conflict involving the whole of Asia, and perhaps the world. But, opposed to these fears was the faith, based on experience in the past, that the difficulty would be likely to blow over, and the Chinese “incident,” so-called by the Japanese, be of short duration. It was the general opinion that by the time of our arrival in China, peace negotiations would be under way. On August 1st, I had written and wired the Secretary of State for advice, and was informed that the United States Government was not advising American citizens against going to China.

Daily radio reports, however, from Shanghai revealed that the “incident” was growing more and more serious. By August 14th communications with Shanghai were entirely cut off, and by the time we arrived at Kobe, no one knew what the actual conditions there might be. There we were met by Florence Rose, staff secretary, who had preceded us to China and who had managed to return to Kobe after the Shanghai bombardment. Her account of the terror and horror that accompanied successive bombings of sections of Shanghai crowded with helpless refugees, including the heart of the International Settlement where she had gone for greater safety, made it evident that all plans for China at this time must be abandoned.

We were met at Kobe also by Baroness Shidzue Ishimoto, who has bravely and gallantly led the birth control movement in Japan. Several reporters were also present, and in spite of the fact that war news was dominating the front pages of the Japanese and English papers published in Japan, the subject of birth control took its place as one of the outstanding topics of interest. The day after our arrival at Kobe, the Japan Chronicle devoted two columns in its leading editorial to my return to Japan and the significance of birth control to the future welfare of the country. In fact, throughout our stay there were daily interviews with the press, and every activity had some mention in both the foreign and Japanese press.

There is a vast difference in the Japan of 1937 and the Japan of 1922, at which time I made my first visit. In 1922 the population of Japan was 64 millions. Since then it has been increasing by from 800,000 to one million annually. Japan has annexed Manchukuo, and has thus added vastly to her territory. In spite of this increased territory, and its supplies of coal, ore, and petroleum, Japan’s ambitions have not been fulfilled. She is keenly disappointed over the natural resources of Manchukuo, and she is still land-hungry. Japan seeks more natural resources to build up her industries to feed her ever-increasing population. Owing to her mountainous, untillable acreage, Japan, like Italy, is one of the most densely populated countries in the world. As far back as 1925, Professor Warren Thompson, in his brilliant analysis of the population problem, named Italy and Japan and Germany as “danger spots” of the world. Japan is fulfilling that prophecy, and not only are these countries the danger spots of the world, but they are the destroyers of our civilization through their ruthless method of waging arrogant warfare against innocent, peaceful peoples.

Throughout Japan, especially in the cities, one notes the rapid Westernization. Not only in the broad, paved streets, the automobiles, the Western costumes of the men and the children; but also in the restaurants, in the use of knives and forks and spoons, high tables, iced tea, and even air-cooled systems, is the change noted. The rickshaw is fast disappearing. While many of the women still wear their kimonos and clogs and keep their old coiffure, the more educated women, particularly those who have traveled abroad, have already adopted the “bob” and prefer western chic costumes of French or American design. Baroness Ishimoto laughingly states that the only time she wears a kimono is when she visits America!

I was disappointed, however, to find that the progress of the women of Japan has been retarded. They have not been able to maintain the advances they had made as far back as 1922. Then they were making rapid strides on the wings of enlightenment in education, but soon after the earthquake the reactionary forces of government set up a strong, bureaucratic, militaristic government, and women since have not been allowed the natural freedom of evolutionary progress. While there is a certain equality of education in the lower grades, women are not granted degrees in their colleges and universities, and of all the women who have been allowed to attend medical universities, only a bare sixteen have been granted medical degrees, through “special dispensation.”

Due to the courteous hospitality of the Mayor of Tokyo, we were officially received at his request by the Commissioner of Health of Tokyo and his staff in the beautiful and picturesque Kiyosumi Garden, reserved for such occasions. The Director of the Tokyo Division of Hygiene, a Rockefeller fellowship physician of vision, assisted in the arrangements for this reception, and a staff member of St. Luke's International Hospital graciously acted as interpreter. Among those present were directors and representatives of many public health institutions in Tokyo.

Contrary to American custom, in his “official capacity” the Commissioner welcomed us, agreeing that the cause of birth control was noble and good, but “unofficially” he expressed himself as being uncertain where he stood because of the difference between “perpendicular versus horizontal morality” of the two civilizations. In Japan, the Commissioner claimed, morals came down “perpendicular” from the Emperor to the head of the family, on downwards, to the husband and then down to the wife, whereas, in the Western countries there is a “horizontal” morality or equality of men and women, husband and wife. In other words, behind the objections to birth control lies the fact that it is going to give woman more power, greater freedom, and a greater chance to develop her personality; and from this growth her economic dependence on man, and on the male members of her family clan, will be lessened.

On the evening of the same day a meeting was held at the St. Luke’s International Hospital. This meeting was arranged and presided over by the President of the Japanese Gynecological Society. Over 300 professional people assembled, and the Chairman informed me later that every outstanding medical authority who was in Tokyo at the time was present at the meeting. Also attending were 25 public health nurses, now receiving training at St. Luke’s International Hospital, as well as the officials of leading organizations of midwives, who hold a respected position in Japan. They represent an important link in the public health system, as many communities are solely dependent upon midwives for any medical service whatever. Prominent social workers, and individuals active in community projects were also present at this meeting, which was not open to the public. Altogether it was an influential group which, if once authorized to act, could exert a far-reaching influence in the curtailment and elimination of many social and health problems that now confront civil and health authorities.

A national campaign of public health is just raising its head in Japan, and through the establishment of the new Public Health Institute, a gift of the Rockefeller Foundation, which will open next year, there will be a thousand or more professional positions open to the professions in the rural districts. This should be an excellent opportunity for the mothers in outlying districts to receive medical aid. If birth control could go hand in hand with public health instruction, it would not only be a blessing in the reduction of maternal and infant mortality, but also an indirect means of bringing peace on earth and good will to the mothers and fathers of Nippon.

Most encouraging was the gathering held to celebrate the opening of the first modern birth control clinic in Japan. While Baroness Ishimoto has, in the past, single-handed practically, carried on birth control service and educational work under great difficulties, this new clinic is the first clinic comparable to those in Western countries. The clinic will be open every day including Sundays, with a medical woman in charge, regular schedules will be kept, medical examinations given, scientific, accurate records maintained, and in general the new clinic will conform to the standards of the Birth Control Clinic Research Bureau, with which it is affiliated.

We congratulate Baroness Ishimoto and her co-workers; and feel that now in Japan the work has started on its way to the goal of eventual adoption by medical and public health authorities.

Although it was not my intention to do more than make a few social visits in Japan, it happened that a great deal has been started in many directions.

One of the foremost gynecologists has agreed to institute and to carry on a piece of research on Foam Powder under his direction in his Gynecology and Obstetrics Department at a leading hospital. It had also been my hope to visit Korea en route to Peiping, but this proved impossible. Arrangements however were made for a medical social worker from Seoul, who has been cooperating with Mr. A. Kaufman of Canada in doing birth control work in Korea, to also set up a Foam Powder project among the Koreans, and to keep suitable records.

In many directions excellent contracts were made, and renewed impetus given to our courageous co-worker, Baroness Ishimoto, in her ceaseless struggle to carry birth control to the mothers of her country. One can never foresee what may happen in a militaristic country, and so the future is still dark and overclouded, but with the cooperation offered by many of the outstanding medical men and the approaching inauguration of a public health program, I dare hope that the seeds planted may eventually bear flourishing fruit.

* The group consisted of Mrs. Alexander C. Dick, Mrs. Joanne Parker, Mrs. Rackham Holt and Margaret Sanger.

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