Margaret Sanger, "Family Limitation," Nov 1914.

Source: "Leland Loveless Collection, Special Collections, Cline Library Margaret Sanger Microfilm, Smith College Collections, S76:0850:0710."

This is the first edition of Family Limitation. For other versions included in the digital edition, see Family Limitation, 8th edition, 1918, Family Limitation, 9th edition, 1919, Family Limitation, 12th edition, ca. 1922, Family Limitation, 17th edition, ca. 1927, and a draft of revisions for Family Limitation, ca. 1936. For additional editions, see the Margaret Sanger Microfilm, Smith College Collections, Collected Documents Series and Library of Congress Microfilm.For related pamphlets on methods, see English Methods of Birth Control, 1915, Dutch Methods of Birth Control, Mar.-Apr. 1915, and Magnetation Methods of Birth Control, Aug. 1915. Handwritten note by Margaret Sanger on cover page reads: "First Edition 1914."


FAMILY LIMITATION

By Margaret H. Sanger

INTRODUCTION.

There is no need for any one to explain to the working men and women in America what this pamphlet is written for or why it is necessary that they should have this information. They know better than I could tell them, so I shall not try.

I have tried to give the knowledge of the best French and Dutch physicians translated into the simplest English, that all may easily understand.

There are various and numerous mechanical means of prevention which I have not mentioned here, mainly because I have not come into personal contact with those who have used them or could recommend them as entirely satisfactory.

I feel there is sufficient information given here, which if followed, will prevent a woman from becoming pregnant unless she desires to do so.

If a woman is too indolent to wash and cleanse herself, and the man too selfish to consider the consequences of the act, then it will be difficult to find a preventive to keep the woman from becoming pregnant.

Of course, it is troublesome to get up to douche, it is also a nuisance to have to trouble about the date of the menstrual period. It seems inartistic and sordid to insert a pessary or a suppository in anticipation of the sexual act. But it is far more sordid to find yourself several years later burdened down with half a dozen unwished for children, helpless, starved, shoddily clothed, dragging at your skirt, yourself a dragged out shadow of the woman you once were.

Don't be over sentimental in this important phase of hygiene. The inevitable fact is that unless you prevent the male sperm from entering the womb, you are going to become pregnant. Women of the working class, especially wage workers, should not have more than two children at most. The average working man can support no more, and the average working woman can take care of no more in decent fashion. It has been my experience that more children are not really wanted, but that the women are compelled to have them either from lack of foresight or through ignorance of the hygiene of preventing conception.

It is only the workers who are ignorant of the knowledge of how to prevent bringing children in the world to fill jails and hospitals, factories and mills, insane asylums and premature graves, and who supply the millions of soldiers and sailors to fight battles for financiers and the ruling classes.

The working class can use direct action by refusing to supply the market with children to be exploited, by refusing to populate the earth with slaves.

It is also the one most direct method for you working women to help yourself today.

Pass on this information to your neighbor and comrade workers. Write out any of the following information which you are sure will help her, and pass it along where it is needed. Spread this important knowledge!

A NURSE'S ADVICE TO WOMEN.

Every woman who is desirous of preventing conception will follow this advice:

Don't wait to see if you do not menstruate (monthly sickness) but make it your duty to see that you do.

If you are due to be "sick" on the eighth of August, do not wait until the eighth to see, but begin as early as the fourth to take a good laxative for the bowels, and continue this each night until the eighth.

If there is the slightest possibility that conception may have taken place, take on these same nights before retiring, five or ten grams of quinine, with a hot drink. The quinine in capsule form is considered fresher, but if this is taken do not use alcoholic drinks directly after, as it hardens the capsules, thus delaying the action of the quinine.

By taking the above precautions you will prevent the ovum from making its nest in the lining of the womb.

Women of intelligence who refuse to have children until they are ready for them, keep definite track of the date of their menstrual periods. A calendar should be kept, on which can be marked the date of the last menstruation, as well as the date when the next period should occur.

Women must learn to know their own bodies, and watch and know definitely how regular or irregular they are: if the period comes regularly every twenty-eight days (normal) or every thirty days as in the case of many young girls.

Mark it accordingly on your private calendars; do not leave it to memory or guess work.

Only ignorance and indifference will cause one to be careless in this most important matter.

A very good laxative (though it is a patent medicine) is Beechams Pills. Two of these taken night and morning, four days before menstruation, will give a good cleansing of the bowels, and assist with the menstrual flow.

The American physicians may object to this advice because Beechams Pills are a patent medicine. But until they are willing to give open advice on this subject, we must resort to such as the least harmful, until such time as they do.

If a woman will give herself attention BEFORE the menstrual period arrives, she will almost never have any trouble, but if she neglects herself and waits to see if she "comes around," she is likely to have difficulty.

It takes quinine from four to six days to bring about the desired results, and if one finds a longer time has elapsed and the flow is not brought on, then the only remedy is an abortion. When once one has been convinced that an abortion is necessary, do not indulge in medicines of any kind. They only weaken the system, and require a much greater length of time to recuperate. Never allow a pregnancy to run over a month.

If you are going to have an abortion, make up your mind to it in the first stages, and have it done. On the other hand, there is often a feeling of the strongest desire to continue with the pregnancy. It is for each woman to decide this for herself, but act at once, whichever way you decide.

There is current among people an idea that conception can take place at only certain times of the month. For instance: ten days after the menstrual period, and ten or fourteen days before the next period. This is not to be relied upon at all, for it has been proven again and again that a woman can conceive at any time in the month. Do not depend upon this belief, for there is not reliable foundation for it. There is also the knowledge that nursing after childbirth prevents the return of the menstrual flow for several months and conception does not take place. It is well not to depend upon this too much, especially after the fifth or sixth month, for often a woman becomes pregnant again without having "seen anything" or without her realizing that she has become pregnant. She thus finds herself with one at the breast and another in the womb. Use some preventive.

Again, it is believed that conception cannot take place if the woman lies upon her left side at the time of the act. It makes no difference which side she lies upon; she can become pregnant if the semen is not prevented from entering the womb.

Perhaps the commonest preventive excepting the use of the condom is "coitus interruptus," or withdrawal of the penis from the vagina shortly before the ejaculation of the semen. No one can doubt that this is a perfectly safe method; and it is not considered so dangerous to the man as some authorities have formerly viewed it, but it requires a man of the strongest will-power to be certain that he has withdrawn before any of the semen has been deposited in the vagina. It is very difficult to determine exactly whether this has been done. The greatest objection to this is the evil effect upon the woman's nervous condition. She has not completed her desire, she is under a highly nervous tension, her whole being is perhaps on the verge of satisfaction. She is then left in this dissatisfied state, which is far from humane. This does her injury. A mutual and satisfied sexual act is of great benefit to the average woman, the magnetism of it is health giving, and acts as a beautifier and tonic. When it is not desired on the part of the woman and she has no response, it should not take place. This is an act of prostitution and is degrading to the woman's finer sensibility, all the marriage certificates on earth to the contrary notwithstanding. When a woman desires the sexual act, and is completely satisfied, her whole being is built up and beautified through it, her form develops, her eyes become brighter, her health improves, color comes in to her cheeks. All life is changed for her and would continue thus if it were not for the fact that she allows intercourse when she has no natural desire for it, and then allowing it, she is without means for prevention of conception, and is so throughout the act conscious and fearful of its consequences. Withdrawal on the part of the man should be substituted by some other means that does not injure the woman.

DOUCHES AND THEIR IMPORTANCE.

The most important part which every woman should learn in the methods of preventing conception, is to cleanse herself thoroughly by means of the vaginal douche.

After the sexual act go as quickly as possible to the bath room and prepare a douche. Lie down upon the back in the bath tub. Hang the filled douche bag high over the tub, and let the water flow freely into the vagina, to wash out the male sperm which was deposited during the act.

Do not be afraid to assist the cleansing by introducing the first finger with the tube and washing out the semen from the folds of the membrane. One can soon learn to tell by the feeling when it is sufficiently clean. It is said, that the French women are the most thorough douchers in the world, which helps greatly in keeping the organs in a clean and healthy condition, as well as preventing the male sperm from reaching the womb to mate with the ovum.

Following are some of the solutions to be used for the douche which, when carefully used will kill the male sperm or prevent its entering the womb:

Lysol--is a brown oily liquid which added to water forms a clear soapy solution.

One teaspoonful of lysol to 2 quarts of water (warm) makes a good solution for douching. Mix into a pitcher or vessel before placing it in the bag.

Bichloride--Get the tablets blue or white from the druggist; the blue are less dangerous to have about because of the color. Always mix this solution thoroughly in a glass or pitcher before turning it into the bag. Never drop the tablet directly into the bag. One tablet to two quarts of water makes a splendid solution for preventive purposes.

Potassium Permanganate--This also makes a good solution, especially where there is a vaginal discharge. The special objection to this is that it stains the skin and clothing. This can be purchased in crystal form, and one teaspoonful dissolved in two quarts of water is the proper strength.

Carbolic acid solution is also used, but it is difficult to opbtain this without a physician's prescription. It is no better than others herein mentioned, not so difficult to obtain.

Chinosol is highly recommended as a vaginal douche, as being less injurious to the membranes than bichloride. It can be obtained from Parmele Pharmacal Co., 54 South St., New York.

Salt solution--Mix four tablespoonsful of table salt in two quarts of warm or cold water and dissolve thoroughly.

Vinegar solution--Many peasants in Europe use vinegar as an antiseptic almost exclusively. One glassful to two quarts of water is the strength usually desired. Cider vinegar is preferred. Douche afterward with clear water.

Cold water douche--This will sometimes remove the semen quite effectively without the aid of an antiseptic. But as the semen can hide itself away in the wrinkled lining of the vaginal cavity, the cold water will only impede its progress for a time. As soon as the warmth of the body revives its activity, the semen continues on its journey to meet the ovum.

Every woman should possess a good two quart rubber douche bag called fountain syringe. Hang it high enough to insure a steady direct flow.

Figure 1-- Fountain Syringe

Some women use the douche before the sexual act as a preventive. Any astringent such as boric acid, alum, citric acid, hydrochlorate of quinine used in solution. Only a pint of the solution is needed for this purpose, following the act a larger quantity is used as a cleanser. This can also be allowed with the regular antiseptic douche.

THE USE OF THE CONDOM OR "COTS."

There is little doubt that a thorough douching of the genital passage with an antiseptic solution performed by skilled hands immediately after the sexual act would destroy the male sperm, and nothing else would be necessary. But there is always the possibility that the sperm has entered the womb before the solution can reach it.

It is safer therefor to prevent the possibility of the contact of the semen and the ovum, by the interposition of a wall between them. One of the best is the condom of rubber "cot."

These are made of soft tissues which envelope the male organ (penis) completely and serve to catch the semen at the time of the act. In this way the sperm does not enter the vagina.

The condoms are obtainable at all drug stores at various prices. From two dollars a dozen for the skin gut tissues to one fifty a dozen for the rubber tissue. These are seamless, thin and elastic and yet tough: if properly adjusted will not break. Fear of breaking is the main objection to their use. If space has not been allowed for expansion of the penis, at the time the semen is expelled, the tissue is likely to split and the sperm finds its way into the uterus. The woman becomes pregnant without being conscious of it. If on the other hand care is given to the adjustment of the condom, not fitting it too close, it will act as one of the best protectors against both conception and venereal disease. Care must be exercised in withdrawing the penis after the act, not to allow the condom to peel off, thereby allowing the semen to pass into the vagina.

It is desirable to discard the condom after it has been used once. But as this is not always done, care must be taken to wash the condom in an antiseptic solution before drying it and placing it away for further use.

The condom is one of the most commonly known preventives in the United States. It has another value quite apart from prevention in decreasing the tendency in the male to arrive at the climax in the sexual act before the female.

There are few men and women so perfectly mated that the climax of the act is reached together. It is usual for the male to arrive at this stage earlier than the female, with the consequence that he is further incapacitated to satisfy her desire for some time after. During this time the woman is in a highly nervous condition, and it is the opinion of the best medical authorities that a continuous condition of this unsatisfied state brings on or causes disease of her generative organs, besides giving her a perfect horror and repulsion for the sexual act.

Thousands of well meaning men ask the advice of physicians as to the cause of the sexual coldness and indifference in their wives. Nine times out of ten it is the fault of the man, who through ignorance and selfishness and inconsiderateness, has satisfied his own desire and promptly gone off to sleep. The woman in self defense has learned to protect herself from the long hours of sleepless nights and nervous tension by refusing to become interested.

The condom will often help in this difficulty. There are many girls who have had no education on this subject, no idea of the physiology of the act, who upon any contact of the semen have a disgust and repulsion, from which it takes some time to recover. Much depends upon the education of the girl, but more depends upon the attitude of the man toward the relation.

THE PESSARY AND THE SPONGE.

Another form of prevention is the pessary (see cut). This is one of the most common preventive articles used in France as well as among the women of the middle and upper class in America. At one time the cost of these ranged up to seven dollars, as they were imported into this country from France. Today they are manufactured in this country, and may be had from fifty cents up to two dollars. The Mizpah is the name of one of the best and costs one dollar and a half at the reliable drugstores.

They come in three sizes--large, medium, and small. It is well to get the medium size, as the small ones are only for very small boned women and easily get out of place.

[Figure 2 French pessary--slightly different from the American.}

In my estimation this pessary is the surest method of absolutely preventing conception. I have known hundreds of women who have used it for years with the most satisfactory results. The trouble is women are afraid of their own bodies, and are of course ignorant of their physical construction. They are silly in thinking the pessary can go up too far, or that it could get lost, etc., etc., and therefore discard it. It can not get into the womb, neither can it get lost. The only thing it can do is to come out. And even that will give warning by the discomfort of the bulky feeling it causes, when it is out of place.

Follow the directions given with each box, and learn to adjust it correctly; one can soon feel that it is on right. After the pessary has been placed into the vagina deeply, it can be fitted well over the neck of the womb. One can feel it is fitted by pressing the finger around the soft part of the pessary, which should completely cover the mouth of the womb. If it is properly adjusted there will be no discomfort, the man will be unconscious that anything is used, and no germ or semen can enter the womb.

[Figure 3 a-womb; b-pessary covering mouth of womb; c-vagina; d-bladder]

[Figure 4 Finger touching mouth of the womb a-womb; b- mouth of womb.]

If the woman should fall asleep directly after no harm can happen, and it is not necessary to take a douche until the following morning. Take part of about a quart of an antiseptic douche BEFORE the pessary is removed; after removing it continue the douche and cleanse thoroughly.

Wash the pessary in clear cold water, dry well and play away in the box. One should last two years, if cared for.

I recommend the use of the pessary as the most convenient, the cheapest and the safest. Any nurse or doctor will teach one how to adjust it; then women can teach each other.

It is not advisable to wear the pessary all the time. Take it out after using, and wear it only when needed. A little experience will teach one that to place it is a simple matter.

SPONGES.

Sponges can also be had at the drugstore. They have a tape attached to them to be conveniently removed. They should be soaked in an antiseptic solution for a few minutes before coitus and then introduced into the vagina as far up as they can be placed. Some physicians have recommended the use of the cotton plug, instead of the sponge, to be soaked in a solution of three per cent carbolic and glycerine, before the act. The male sperm is destroyed by the weakest solution of carbolic acid. Some of the peasants in Europe use the cotton plug soaked in vinegar for the same purpose, and find it satisfactory. In this country a boric acid solution has been used for the same purpose and with satisfactory results. Of course this requires a saturated solution, as, for instance, one teaspoonful of the powder to a cup of water stirred until dissolved.

Sponges and plugs can be recommended as perfectly safe, if followed by an antiseptic douche before the removal of the plug or sponge, thus preventing the sperm from entering the womb. The problem is: to kill the male sperm upon entering the vagina, or to wash it out or to kill it directly afterwards. A weak solution of alum may also be used for cotton plugs and sponges.

VAGINAL SUPPOSITORIES.

These may be found at any reliable pharmacy. The majority of them are made from cocoa butter or gelatine, which makes it necessary that they be deposited in the vagina several minutes before the act, in order for them to melt. Special ingredients negate the effect of the male seed.

Any reliable druggist will make this up for you:

Boric acid, 1 gram Salicylic acid, 10 grains Quinine bisulphate, 2 grams Chondrus jelly (KY), 2 oz. Dispense in a collapsible tube.

Among other suppositories are the following:

Boric acid, 0.6 grams Salicylic acid, 0.12 grams Quinine bisulphate, 0.2 grams >Chinosol, 0.12 grams Glycerine gelatine, 6.0 grams Allow twenty minutes for melting.

Another form of suppository, which was recommended by a physician who charged a fee of $10 for the prescription, is the following:

Boric acid, 10 grains Cocoa butter, 20 grains

Another suppository, which is the same as the well-known Aseptikon, is the following:

Salicylic acid, 2 grains Boric acid, 10 grains Quin. purol (alkal). 1 grain Chinosol, 2 grains Cocoa butter, 90 grains M. f. suppos. glob No. 1

(Introduce into vagina three minutes before the act.)

Practically all vaginal suppositories act as preventives but the most commonly used is the Aseptikon, manufactured by Chinosol Company. They are to be secured at any reliable druggist, upon demand. They should be kept in a cool place. They are not poisonous and cause no injury to the membranes. They are distributed 10 a box costing 85 cents. The prescription quoted above can be made up more cheaply, however.

It is interesting to note that in the rural districts in France, the peasant women make up their preventive suppositories themselves placing them carefully away in glass jars. This is one of the recipes which has been used:

Gelatine, 1 part Water, 2 parts Glycerine, 5 parts Bichloride of Quinine--one-half a part

Make this into a paste. Allow to spread out and solidify, then cut into pieces of 2 grams each wrap separately and put in a cool place (air-tight).

In some countries, preventive pastille are used commonly. A type is composed of boric acid and metaborate of soda compressed into pastilles. Injected into the vagine a few minutes before coitus (the sexual act), the pastille melts into the secretions and forms an antiseptic preventive. Personal advice on any of these is necessary before beginning to use them.


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