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

Source: " Birth Control Review, July 1921, pp. 5-6, 15 Margaret Sanger Microfilm, Collected Documents Series C16:158."

This article is part two of a three-part series of the same title. For previous article, see "Birth Control--Past, Present and Future," June 1921; for the final article see August 1921.

Birth Control--Past, Present, and Future

By Margaret Sanger

(continued from June Issue)

We have pointed out that Malthus, discoverer of the theory of population and the precursor of the Darwinian theory of evolution, advocated as preventive checks upon overpopulation, "moral restraint" and very late marriage. His knowledge of human instincts was limited. Malthus proposed "moral restraint," abstention as long as possible from sexual intercourse, or so late a marriage that between the marriageable age and that of the critical period of the woman (the time of the cessation of menstruation) that it would be impossible for her to bear very many children. This is in the narrow sense Malthusianism. The Neo-Malthusians very quickly saw that this was impractical and productive of much unhappiness and misery. The sociological doctrine became a psychological one. Restraint with the direst and most unfortunate of consequences, both psychological and physiological, to the individual and to the race. Although advocated by the Church fathers, continence and celibacy had never been practiced by the masses of the Occidental world. But in thus driving sex expression into underground and secret channels, prostitution and its train of evils, diseases and insanity became firmly entrenched institutions of the western world.

Nevertheless, the spirit of Malthus' own reform stopped at marriage. He was radical enough in interposing difficulties between the desire to marry and actual marriage; but when a man and woman were once married, he did not presume to counsel sexual restraint. But from other quarters the theory was soon carried to its logical and serviceable conclusion. In the supplement to the Encyclopedia Britannica published in 1818, James Mill wrote that it was time to "discard the superstitions of the nursery" and in his "Elements of Political Economy" (1821) he concluded "The grand practical problem is . . . to find means of limiting the number of births."

Answers to this question were almost immediately forthcoming. In 1823 was published the so-called "diabolical handbill" addressed "To the Married of Both Sexes," and setting forth the economic disadvantages of excessively large families. From this time to the present, advocates of Birth Control have published, throughout Europe and America, various handbooks and pamphlets giving explicit directions to men and women of the physiological and practical aspects of family limitation. These directions have been made up, partially upon the basis of scientific investigation and partially upon the traditional practices of people which have, notably in France, proved to be expedient and serviceable.

But the great advance has been made since the discovery by [Pasteur?] of the germ theory, in the latter half of the nineteenth century. Applied to Birth Control, the germ theory of life gave rise to the practice of Spermaticide, the name to those preparations destined to sterilize the male cells (spermatozoa). But the question has often been asked: Is there a perfect or safe method of prevention of conception? Such a method should combine the following conditions: (1) It should depend exclusively upon the woman; (2) it should cause neither the man nor the woman any inconvenience; (3) it should be absolutely certain and dependable; (4) it should cost very little.

Let us answer this question at the outset. There is no magic method, no perfect method of preventing conception, that does not require care and attention. But the experience of the movement in Europe and America has shown us that this is partially due to the ignorance and inertia of the medical profession, many of whom profit largely by the practice of abortion, and many of whom do not wish to give to women a much needed education in sexual prophylaxis. Women are thus thrown back, for the source of their knowledge in these matters, upon neighbors and friends. Here they receive numbers of conflicting suggestions, each presented in an unscientific and unhygienic fashion. Altogether this is very disturbing and confusing to the poor woman whose ideas on sexual hygiene are of the most primitive, and who is living in constant fear of pregnancy.

It is on account of this confusion that the best authorities in Europe and America have decided that the greatest present need is for Birth Control clinics in all of the poorer sections of our cities, where all the women may receive safe and sane instruction in all matters of personal hygiene, so that they may protect themselves from unwanted pregnancy.

Our Occidental world has come to see that "an ounce of prevention is worth a pound of cure." The great weapons of prevention, in the battle against infectious and contagious diseases, are hygiene and sanitation. Contagious and infectious diseases breed and propagate their disastrous deaths in the soul of filth and overcrowding. A stifled, weakened, undernourished, dirty group of humans is the very breeding ground of the great racial scourges, such as tuberculosis, typhus, typhoid, venereal maladies, trachoma, as well as the lesser contagions. Most of these evils, or the predisposition to them (diathesis), are heritable; and it is precisely among the children of the crowded unsanitary filthy slums, in all parts of the world, that these great scourges are enabled to propagate and perpetuate their curse.

The only means of preventing, of uprooting, is by sanitation and personal hygiene, and by reducing the birth rate among the carriers of transmissible and heritable diseases. A great Dutch authority, Dr. Rutgers, has pointed out that personal hygiene, so essential to the well-being of the individual and the community, is practically equivalent with preventative methods of Birth Control. In answer to the contention that mechanical devices and antiseptic fluids are provocative of irritation to the mucus membranes, the same objection might be made of the hygienic care of the teeth, yet we realize that the proper care of the teeth is an absolute essential to health. Ever increasing numbers of civilized men and women today are wearing "mechanical devices" in their mouths and are daily, and even more frequently, washing out their mouths with fluids that are sometimes identical with, and often even stronger than, those employed for Birth Control. Yet such precautions are not considered "immoral" or "unnatural."

Incontrovertible figures and statistics, of the most definite and exact precision, drive us to the conclusion that filth, unsanitary conditions, and infectious diseases, are the inevitable companions of large families and numerous children. It is no less true that cleanliness, personal hygiene, and sanitary surroundings go hand in hand with birth control and fewer children. We also learn that these fewer and cleaner children are not so often victims of diseases that increase the infant mortality rate among the less fortunate.

It is more imperative than ever that women should now be taught the great necessity of personal hygiene and cleanliness. This is the only safe way to prevent the transmission of the venereal diseases and to avoid unwanted children.

In approaching the great problem of hygiene and sanitation through the agency of Birth Control clinics, the great advantage is that we are thus enabled to offer poor and unfortunate women immediate relief and to begin their education in sex and personal hygiene and prophylaxis upon the great fundamental basis of their own personal needs and interests; thus ours is a campaign not imposed from without or above, not a charity nor a philanthropy, but the one inevitable answer to a crying demand. It helps the woman to help herself. And more than any other scheme or program or policy for social and world betterment, it is truly preventive of the evils of the world. It does not make two evils grow when one grew before; but it is the only safe and certain way to eradicate social evils at their very root.

Such clinics as these, which have, as I have tried to show, so brilliantly proved their value in Holland, are of the greatest necessity to our Western civilization, even in countries like France where an effort is being made to remedy the losses of the war by repopulation. Their function would be to substitute scientific Birth Control in place of the devastating practice of abortion and that inevitable result of bringing unwanted children into the world--the high rate of infant mortality.

When one [eminent authority?] informs us that there are at least one million abortions performed every year in the United States of America, and others place the figure even higher, when even the Government of the United States points to an inordinately high death rate among children, we are able to understand that scientific Birth Control, aiming to prevent the dangers and the deaths from this cause, is truly hygienic and eugenic in its aim. While the women of the wealthy classes are permitted by their physicians to use Birth Control, the poorer women, in order to escape a forced maternity, are forced to seek relief in abortion. Despite the fact that abortion is forbidden by law in the United States, there are very few prosecutions of midwives and physicians who practice it. Moralists and authorities close their eyes to this practice, so universally practiced is it, though with great risks to life and health.

Thus the question is reduced in America not to whether family limitation should be practiced. It is practiced, by fair means or foul. It explains to a large extent the large number of maternal deaths. The problem that American society must solve is this: Shall family limitation be attained through abortion or through Birth Control? Shall normal, safe scientific methods be employed, or shall women be forced to continue to resort to dangerous, surgical operations, often performed in the most dangerous circumstances? In view of the permanent injuries that often result from abortion – hemorrhage, sepsis, tetanus, perforation of the uterus, as well in many cases of sterility, anemia, malignant diseases, displacement, neurosis, endometritus,-–there can be but one logical and sane answer to these questions. As a great medical authority, Dr. Max Hirsch puts the question: "He who would combat abortion and at the same time combat Birth Control may be likened to the person who would fight contagious diseases and at the same time forbid disinfection. For contraceptive measures are important weapons in the fight against abortion. America has had since 1873 a law which prohibits by criminal statute the distribution and regulation of contraceptive measures. It follows, therefore, that America stands at the head of all nations in the huge number of abortions."

Infanticide and abandonment are likewise the result of the present enforced restrictions. Orphan asylums, organized charities, foundling homes, are becoming a great and greater drain upon the resources of the American public; while practically nothing is done to check the fertility of the feeble-minded and the insane. Not merely from the standpoint of personal and family hygiene, but from that of the well-being of the nation, Birth Control is an imperative necessity at the present moment.

From the point of view of the coming generation, that is of the future of the nation and the race, the practice of Birth Control more than justifies itself. In every country of Europe and America in which investigations have been made, it has been shown that children born into large families have less chance of survival, of becoming the men and women of tomorrow, than the children born into small families. It has been discovered that children should be spaced out. If a woman submits to a rapid and successive series of pregnancies without a sufficient interval between to recuperate and recover her strength, her weakened constitution and physical debility react unfavorably upon her children. Even from the economic point of view, the large family is more apt to be underfed and undernourished. In the creation of a great new race, the first essential is the development of strong healthy mothers.

It is not merely theory, but carefully tested facts, which indicate for us the close interrelationship between uncontrolled fecundity and misery. The salary of the worker is not apportioned according to the number of mouths he has to feed. One more child in the family is an added burden to the shoulders of all. To keep up the home, the father and mother are forced to work harder. The elder children are forced out to work also at a much earlier age. The home becomes more and more neglected, and the younger children are more and more neglected, particularly as they come into the world as the penalty of ignorance. It is from such families as these that we recruit our dependent classes, our paupers and our criminals, who fill the various institutions or are the endless subjects of charities--thus consuming wealth that should go to the enhancement and advancement of human life.

(To be concluded in the next issue.)

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Copyright, Margaret Sanger Project