Margaret Sanger, "Birth Control--Past, Present and Future," June 1921.

Source: " Birth Control Review, June 1921, pp. 5-6, 11-13 Margaret Sanger Microfilm, Collected Documents Series, C16:153."

This article is the first in a three-part series of the same title. For following articles, see Birth Control Review, July 1921 and August 1921.


Birth Control--Past, Present and Future

By Margaret Sanger

The most revolutionary discovery of the nineteenth century, declares Bernard Shaw, is that of the deliberate limitation of families. Although this discovery is now scarcely one hundred years old, it is most intimately bound up with the whole of contemporary Western civilization. Denounced and repudiated by the leaders of the Christian Church and also by the Marxian Socialists, the idea of "Birth Control" has nevertheless firmly planted its roots in Europe and America, and has shown an ever increasing vitality. John Stuart Mill, one of the earliest and greatest economists, wrote: "Little improvement can be expected in morality until the producing of large families is regarded with the same feeling as drunkenness or any other physical excess." To understand the ramifications, the background and the pivotal importance of Birth Control as a world problem of the present and immediate future, we must have a thorough grasp of the birth and evolution of this simple yet central problem of human existence. Once we have grasped its history, we are in a much better position to understand its physiological, hygienic and eugenic aspects and the part Birth Control must play, as an international weapon in the reconstruction of a world of peace, security, and universal prosperity. In the present paper, therefore, I shall consider: First, the historical and philosophic aspects of Malthusianism, neo-Malthusianism and Birth Control; and secondly, its hygienic and physiological side, and its relation to the world problem of the present and immediate future.

In 1798, Rev. Thomas Malthus, a clergyman of the Church of England, published the first edition of his world famous "Principle of Population" which in 1806 was given to the world in a revised and more thorough form. In this epoch making essay, which was one of the most stimulating books ever given to the world and which attracted the attention of all great thinkers from that day to this, the English clergyman enunciated his challenging "theory of population," which has never been satisfactorily or completely refuted. His aim, in the "Principle of Population" was: "1 to investigate the causes which have hitherto impeded the progress of mankind toward happiness; and 2 to examine the probability of the total removal of those causes in future." The one great cause, he claimed, was "the constant tendency in all animated life to increase beyond the nourishment prepared for it." This theory was based upon studies and statistics he gathered from all countries of the world, including India, China and Japan, and led Malthus to the conclusion that "population, when unchecked, goes on doubling itself every 25 years, or increases in a geometrical proportion. . . .But the food to support the increase from the greater number will by no means be obtained with the same facility. . . .It may fairly be pronounced, that considering the present average state of the earth, the means of subsistence, under circumstances the most favorable to human industry, cannot possibly be made to increase faster than in an arithmetical ratio."

Malthus showed that there were two checks to this too rapid increase in population. Whatever tends to produce a smaller number of births is called a preventive check; whatever leads to a greater number of deaths is termed a positive check. Among the positive checks are wars, famines, epidemics, floods, infanticide and abortion. Among the preventive checks are the customs of continence, celibacy, late marriages, and prudence after marriage. Malthus advocated late marriages and "moral restraint." People should not marry until they had reached the age of about 38. But this was very soon seen to be impractical.

The Malthusian League, organized in England in 1877, was founded upon the great central principles of population laid down by Malthus; but in view of a wiser understanding of human nature, advocated early marriage and limited parenthood, by the means of the deliberate and scientific prevention of conception. The principles of this society, which has international affiliations in all of the countries of Europe and the United States of America, are an admirable summary of the Malthusian and Neo-Malthusian doctrines. They are:

1. That population (unless consciously and sufficiently controlled) has a constant tendency to increase beyond the means of subsistence. 2. That the checks which counteract this tendency are resolvable into positive or life-destroying, and prudential or birth-restricting. 3. That the positive or life-destroying checks comprehend the premature death of children and adults by disease, starvation, war, and infanticide. 4. That the prudential or birth-restricting checks consists in the limitation of offspring (1) by abstention from or postponement of marriage, or (2) by prudence after marriage. 5. That prolonged postponement of marriage is not only productive of much happiness, but is also a potent cause of sexual vice and disease. Early marriage, on the contrary, tends to ensure sexual purity, domestic comfort, social happiness and individual health; but it is a grave social offence for men and women to bring into the world more children than they can adequately house, feed, clothe, and educate. 6. That over-population is the most fruitful source of pauperism, ignorance, crime and disease. 7. That it is of great importance that those afflicted with hereditary disease, or who are otherwise plainly incapable of producing or rearing physically, intellectually and morally satisfactory children, should not become parents. 8. That the full and open discussion of the Population Question in all its necessary aspects is a matter of vital moment to Society.

How profound an influence upon European thought this Law of Population has, is indicated by the fact that it served as a basis for Darwin's theory of natural selection, a theory that changed the complete current of European science in the nineteenth century.

Until the advent of Neo-Malthusianism, when the attempt was first made to educate the population of the various European countries in various scientific methods of preventing conception, the Malthusian doctrine was still mostly in the philosophical stage of discussion. Its opponents, including the Marxians, argued that with increased production, the result of machinery in industry, and with wider more equitable distribution, there would be plenty of food for all classes of the population. But facts and statistics disproved this contention. With the increase of machine production, there arose an ever increasing demand for cheap labor, as well as for child labor. Machinery, by increasing production and distribution, became a fundamental cause in increasing the population. With the advent of the machine process in the nineteenth century in Europe and the United States that began the growth of the great, overcrowded cities, children became an economic asset. The birth rate increased enormously; and the helpless little victims of an inhuman industrial system were sent very early to work in the factories.

In 1877 widespread publicity was given to the doctrine of the prevention of conception by the arrest of Charles Bradlaugh, a distinguished member of the British Parliament, and Mrs. Annie Besant, for publishing the work of an American physician, Dr. Charles Knowlton, entitled "The Fruits of Philosophy." The attempt to curb their activities among the workers and the poor defeated its own purpose. The wide publicity resulted in the widespread adoption of their teaching. The better class of workers immediately began the exercise of voluntary parenthood; and this, combined with the laws forbidding child labor in the factories, had the effect of greatly decreasing the birth rate in England and Scotland, among the more skilled and intelligent laborers. From this date began the sharp decline in the birth rate, not merely in England, but in the more advanced countries of the European continent as well.

It was soon discovered that a lower birth rate brought with it a lower death rate, especially a lower infant mortality rate. Fewer children were born, but more of them survived. The whole influence was toward placing a greater and greater value upon children and child-life. So true has this been that the preventive checks upon population, notably in Holland, have had the opposite effect to that intended in the doctrine of Malthus: the adoption of family limitation had actually led to an increased and more healthy population.

In the criticism of the Malthusian doctrine, which was brought to the foreground of European thought by the famous case of Charles Bradlaugh and Mrs. Besant in 1877, there has been a persistent failure to touch the core of the doctrine of overpopulation. The root of the misunderstandings concerning this doctrine is to be found in the failure to distinguish between what we may call static and kinetic overpopulation. Let me briefly define these:

Static overpopulation is, the condition when the population of a country has increased up to its ultimate power of obtaining the necessary food supplies and subsistence.

Kinetic overpopulation exists when the rate at which new arrivals in a country (by birth or immigration) exceeds the rate at which additional subsistence can be provided for them.

It should be borne in mind that neither Malthus nor the Neo-Malthusians of today have been concerned about any absolute limit to the food supply. There may be a few countries, e.g. China, in which a limit may be considered as having been actually or nearly reached, and which might be called actually or statically over-populated; but we are actually concerned with kinetic overpopulation, with its more direct relation with poverty, disease, overcrowding, infant mortality, unemployment, insanity and feeblemindedness.

I have pointed out that the campaign and the propaganda brought directly to the workers of England in 1877 had a direct and profound effect in decreasing the birth rate and subsequently the infant mortality rate. But an even more eloquent example of practical family limitation is to be found in the case of Holland, where this doctrine has been implanted in the population with the approval of the Government. Since 1881, information and science concerning the prevention of conception have been available to the people, and since 1885 there have been clinics for the spreading of hygienic information, including "birth control" to all women. This followed in the wake of a thorough and enthusiastic discussion of the subject at the international medical congress in Amsterdam in 1878. The results have been so gratifying that today Amsterdam and The Hague have the lowest infant mortality rates of any cities in the Occidental world. So great are the results obtained that there has been a remarkable increase in the physical strength, the stature and the longevity of the people, as well as in prosperity. When we contrast this gratifying result with the shocking deterioration in the lower classes in Great Britain as a result of the so-called industrial revolution--with its overcrowding and overwork, there can be little doubt of the efficacy of Birth Control in developing national strength.

The practically universal practice of Birth Control in Holland for the last thirty-five years was put to the test during the Great War and was strikingly vindicated. Let us remember and reiterate that in Holland the Neo-Malthusian League has since 1885 been engaged in teaching the poorer people, through the agency of physicians, midwives and nurses, in the best scientific means of Birth Control; that it has had the countenance and support of the ministers of State; and that it has been registered since 1895 as a Society of Public Utility.

The most striking evidence of the success of this practice was brought out at the Eugenics Congress, when the fact was announced that the stature of the Dutch people was increasing more rapidly than that of any other race in the world. The Dutch have gained no less than four inches in fifty years.

The proportion of young men drawn for the army taller than 5 feet 7 inches in height has increased from 24.50 per cent to 47.50 since 1865, while the proportion of men less than 5 feet 2 1/2 inches in height has fallen from 25 per cent to less than 8 per cent. When the Dutch Army was mobilized, the highest army standards showed that the men of the proper age for the service were 95 per cent. efficient, according to the highest standards. Contrast this with the example of the United States of America, where we were shocked to discover that our men were only 65 per cent efficient, and that with a lowered military standard.

In my studies and investigations of this great problem I have paid several visits to Holland, both before and after the war, and my observations support these statistics. All the children you see there are suitably dressed. In the working classes there is a better personal and general hygiene, a fine moral and intellectual development. Morality is also on a much higher level. Prostitution, with its train of devastating diseases, is on the decline. Another great evidence, besides increased stature, is that of the constant increase in longevity. This is surely a test of physiological and financial progress. From 1890 to 1899 the average length of the Dutchman's life was 46.20 years.s From 1900 to 1909 it was 51. These figures are equalled only by those from the Scandinavian countries, where Birth Control was advocated and practiced even before it reached the Netherlands. It is also significant to point out that none of the dread consequences feared by its opponents, the clericalists, the moralists and the militarists have occurred. In spite of a low birth rate, the population of Holland is increasing. Undoubtedly this is because medical cooperation enables the Dutch people to practice the most scientific and hygienic methods of Birth Control. The race is not recruited from the underfed and the diseased. In Holland, where the poor are thoroughly educated in Birth Control, the families of the well-to-do are not so much reduced, in comparison with those of other European countries.

Germany on the other hand, is one of the few continental countries that discouraged and prohibited the practice of family limitation. It was opposed both by the government and the Social Democrats. It was the boast of Imperial Germany that the children who were brought into the world at the behest of the State were well cared for and well educated; that they were sent out into the world as highly efficient and valuable citizens. But the great difficulty was, the protagonists of this philosophy admitted, that the State which had thus invested in the health and efficiency of her children, was too often deprived of their services by the narrow limits of her territory. She lost the fruits of their labors because they were forced out by overcrowding; so that alien and rival countries reaped the harvest of the German state's educational and cultural advantages. This, I believe, was the German Imperialist's argument for expansion. Today that empire is prostrate; millions of children are starving to death; and even those who survive this bitter struggle for existence, may be permanently afflicted. But the great fact to remember is that Germany fell as a result of the blockade. It is a striking case of the evil influence of a starving and prostrate civilian population unable to serve as the solid foundation for an army or to furnish new and efficient recruits to replace the dead and wounded. It can thus be seen that in the most intelligent sense Neo-Malthusianism may be supported as a thoroughly patriotic philosophy.

Several years before the outbreak of the war, German advocates of Birth Control had pointed out that the underfeeding and overcrowding caused by large families was acting as a deterioration upon the physique of the conscripts for the Army. The masses were likewise beginning to see the light, although Birth Control was strenuously opposed by the Social Democrats. At a great meeting in Berlin, August 29, 1913, Rosa Luxemburg and Clara Zetkin tried to arouse the workers against the "birth strike." The audience of 5,000 turned the meeting into a cry for Birth Control, and after howling down the Socialists, speaker after speaker arose and championed family limitation as the only effective means by which the masses could escape the worst evils of poverty, underfeeding and overcrowding, and the scourge of the great cotnagious disease. Today Germany is paying the penalty of uncontrolled breeding.

In passing, it is an interesting fact to point out, that in the late war, it has been those European countries with a lower birth rate that have survived the conflict. France is an example especially of this. Birth Control had for decades been an ordinary and accepted practice in that country, growing out of the French habit of emphasizing the value of quality in contrast to mere quantity. The result of this had been prior to the war, that the struggle for life in France had not been too intense, and the people were permitted to enjoy the good things of the world. The result was a solidarity and stability of family life. The child was sure of the maximum of care, education and capital in continuing life. In great part it is owing to the low birth-rate that France had been one of the most prosperous countries in the world, and that her gold reserves per head exceeded the known averages of other European nations. Grinding poverty had been unknown in France, previous to the Great War. Temperance and thrift also are to be considered, but the small family unquestionably made for fair wages and fair rents. The outstanding feature of the French mother is her love for her children. It gains in intensity all that it loses in extent. The child is everything to her. Its well being, its early education, its training, are the perpetual care of the mother. Despite the present campaign to induce French women to have large families again, there is every indication that the spirit of intensive cultivation is too thoroughly ingrained in the French nature ever to be replace by a love of mere numbers.

In North America, a great virgin territory, which to its early settlers seemed limitless and inexhaustible in natural resources and industrial possibilities, the dangers of overpopulation seemed so remote that the Neo-Malthusian doctrine at first aroused no interest at all. But into this "great melting-pot" flowed vast masses of immigrants. In the eighteenth and nineteenth centuries the "New World" became the receptacle into which flowed all the surplus populations of the Old World. With the rapid development of machinery and vast railroad systems, great cities almost by magic sprang into existence. Population increased enormously, even more rapidly than Malthus had imagined. And with this uncontrolled human fecundity came the great unconquered problems of poverty, contagious and infectious diseases, epidemics, unemployment, labor troubles, race prejudice, and the limitation and exclusion of immigrants from other countries. Instead of preventing poverty or solving the population question, my own country, the United States, faces them today in a more serious and aggravated state than any of the nations of the Occidental world.

My own interest in this question was aroused when as a nurse and worker for fourteen years among the poorer women of the slums, I was horrified to discover the amazing amount of human waste--women and children dying in vast numbers, while millions of dollars was being appropriated by the Government for the protection of cattle, sheep and swine. I discovered that one out of every ten children born died in its first year. And more women die in childbirth in the United States than in any other country in the world. And the great majority of these wholesale deaths of mothers and babies, according to a recent report of the Children's Bureau of the United States Government, are preventable. These poor women always asked me, as a nurse, to help them. They wanted fewer children who might have a chance to survive and grow into healthy men and women.

When I began to search for the cause of the wide prevalence of the practice of abortion among all classes of American women, I discovered that the laws of the United States Government, as well as the laws of most of the separate states making up the Union, forbade the circulation of Birth Control knowledge, even by physicians and nurses. After a visit to the various countries of Europe, investigating the conditions of mothers and children, I returned to my own country to begin a campaign to educate the women of America in racial hygiene and health.

My "Birth Control" agitation was inaugurated not upon the basis of the Malthusian theory of population, not to check the increase of population, but to prevent the shocking waste of women and children. It was an answer to the cries of anguish that came to me from thousands of poor and diseased women who called out for relief bringing numbers of helpless, unwanted babies into their overcrowded world--infants foredoomed to an early death. It is one of the saddest sights in the poverty stricken and congested districts of any American city to notice the prevalence of busy midwives and prosperous undertakers, the latter exhibiting in their shops the various types of coffins for babies. These poor women are too ignorant perhaps to understand the philosophy of Malthus and his modern followers. But they can and do understand "Birth Control" because it is the direct answer to their immediate needs. This is the reason why the words "Birth Control" swept over the vast American continent from coast to coast, and Birth Control Leagues were organized in all the great cities.

Although the laws forbidding the circulation of Birth Control information are still in existence, they have for many years been ignored by the wealthy and intelligent upper and artisan classes of the American population. Uncontrolled breeding is the habit only of the ignorant poverty-stricken and submerged classes. Statisticians and eminent scientists show us that uncontrolled fertility is correlated with overcrowding, disease, unemployment, filth and ignorance; and that unless such fertility is checked in any community, the whole population will gradually deteriorate and degenerate. This is the great warning of Birth Control philosophy to all nations of the world today.

In other directions, our campaign in the United States has stimulated a great interest in the care of mothers and training of children. The western world which had long professed horror and the ancient Oriental practice of exposing unwanted infants for the purpose of their destruction has now been brought to a sharp realization that there was a justification of that action on the part of starving parents in a famine ridden country, whereas there is no moral excuse for "the richest country in the world" to commit a quarter of a million children to preventable death. Is not our crime greater? Spurred into belated activity by the sharp criticism of the advocates of Birth Control, and alarmed at the prospect, that unless the conditions for child life are improved in America, women might refuse to bring them into the world, legislators are now advocating appropriations for the protection of motherhood and childhood. Birth Control advocates showed that conditions for motherhood and childhood are growing worse in the United States instead of better. Fourteen other nations are more advanced in this respect than the United States of America. The philosophy and propaganda of Birth Control has therefore done a great service in directing attention to a phase of human life that is of central and primary importance to the world, and yet is now most exposed to disaster and risk.

It would be to neglect the most important phase of the philosophy of Birth Control, if, before taking up its hygienic aspect, I neglected to touch upon its relation to modern industry. Modern capitalism is desirous that kinetic overpopulation continue to provide abundant labor for the employing classes and thus to keep down wages, by the weight of a large margin of unemployed. But there is an unsuspected danger here. The statistics of the Galton laboratory for National Eugenics shows us that the unemployed in a generation or two are converted into the unemployable, and a dead weight on the community and the capitalist. Nevertheless the manufacture of babies and the extent of the supply of them still remains a matter of chance and passion very much as it is among animals in the wild state. To organized labor and to the working classes the philosophy of Birth Control emphasizes these facts:

The history of labor is the history of an unsuccessful attempt on the part of man to bring his productive ability up to the same level as his reproductive power. It has been a losing battle all the way. We have never been able to secure peace or prosperity. We have never been able to control the aggression and forward push of modern machinery and capitalism. The worker is only too willing to blame the capitalist, not only for his own poverty, but for all the misery of the world. But there is another cause; that is the reproductive instinct, the uncontrolled fertility of living organisms. That created the first poverty. That created the first famine. That goaded all of mankind into the present industrial frenzy, into warfare and wandering and want and starvation, across seas into new lands. The big battalions of babies have made of human life an endless burden of heavy work. The principle of restricting the number of mouths to be fed should be accepted as the battle cry of labor and labor unions, who have always recognized and applied a like principle in the conduct of their own organizations. In refusing to admit more than a fixed number of new members into their trades, they thus manage to uphold the standard of wages. For precisely the same reason the control of births is necessary to hold up the standards of subsistence in any country--this is true whatever may be the particular economic system prevailing. It is as true for the Orient as for the Occident. Wage slavery is the inevitable consequence of the uncontrolled reproduction of new wage slaves; and it will continue as long as wage slaves are ready and willing to create new units to perpetuate the same miserable conditions.

Such, in brief is the historical and philosophic background from which Birth Control as a doctrine derives its astonishing and ever growing vitality. It has now reached the scientific stage, drawing its strength and its arguments from facts and figures, from scientific experience and precise statistics, rather than from the theory or philosophy which gave it birth.

(To be continued)

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