Margaret Sanger, "Passports for Babies," Feb 1926.

Source: " Holland's Magazine, Feb. 26, 1926 Margaret Sanger Papers Microfilm, Collected Documents Series C16:278."

For typed draft version see Library of Congress Microfilm 130:461.

Passports for Babies.

By Margaret Sanger

"Of course," said the distinguished professor, "we all believe in Birth Control. There is no need to talk about it. The trouble in this country is that those who can afford to have large families limit the number of their children, while the unfit keep steadily on recklessly populating our lunatic asylums with imbeciles, idiots, and morons, and providing our prisons with inmates.

"The trouble with you people," continued the professor, "is that you do not reach those who should be taught the hygiene and technique of contraception. The only way to strike a balance is for the normal, healthy, fit elements of American society to have large families, so that our country won't be swamped by the unfit." The professor, by the way, seemed to have forgotten that he himself was "fit," healthy, wealthy--the father of only two children.

"I see what you mean," I answered. "A sort of cradle competition between the fit and the unfit."

"Call it what you will," he retorted.

"How long would the fit remain fit," I asked, "if they entered this race, full speed ahead, bringing children into the world without any thought of spacing their offspring or providing them with food, shelter, and education? Did you ever stop to think, my dear doctor, that perhaps the 'fit,' as you call them--the better classes, the mental and physical aristocrats--may have risen from the ranks of poverty precisely because they have limited their families?

"They remain 'fit' because they exercise foresight, respect good breeding, insist that their own children have an even better chance in life than they had. What is such discipline and sacrifice but Birth Control? Now you advocate the very opposite policy in family ethics. Would you encourage the best families to spawn children with reckless and irresponsible rapidity? Are you not holding the worst elements in our society up to them as examples? But no sane or thoughtful parents would follow your advice."

"Perhaps not," he admitted reluctantly. "But how do you expect to get your message of Birth Control to the people who need it? To the ignorant, the irresponsible, the poverty-stricken?"

"It can and must be done," I answered. "All that we need is the cooperation of intelligent serious-minded American citizens."

In the dozen years I have been battling for the liberation of motherhood through Birth Control, the professor's question has arisen almost daily.

In this paper I shall try to explain how this is possible, to show how the various obstacles that stand in the way of the widespread dissemination of this new education in hygiene and sanitation may ultimately be overcome.

The foremost duty of every American is to aid in the creation of a healthy, vigorous race of Americans. If the American citizen remains passively indifferent to the obstacles which are now obstructing the road to the fulfillment of our racial destiny, he cannot be called a good citizen.

The chief obstacles at present are various state and federal laws forbidding the dissemination of contraceptive information, even by physicians. Yet in many states, including Texas, Colorado, Utah, New Mexico, Illinois, and others, there is no such prohibition for physicians. These states are indeed fortunate in having escaped the blight of this near-sighted, hypocritical type of legislation fundamentally in conflict with constitutional rights of life, liberty, and the pursuit of happiness. Such ill-advised enactments implicitly deny the right of every American child to be well-born, the right of every child to be born with an equal opportunity of development, or to be born under conditions guaranteeing to each a fair chance of education and growth into a sturdy American citizen, instead of being foredoomed from birth to become a burden upon and a menace to our national development.

In such fortunate states as Texas, for instance, there is only the obstacle of public indifference and inertia, and the opposition of reactionaries and perhaps certain religious organizations. Granted that it would be possible to inaugurate a maternity school or clinic of the type already successful in such countries as Holland and Great Britain, what is the next step?

At this point it is necessary to revise our ideas of the place of the physician in any American community. It is said that in China you pay the doctor to keep you well. In our country, the family physician is, as a rule, called only in cases of illness or emergency. To-day we are beginning to change our whole attitude about doctors. It is not a very rash prediction to assert that more and more we shall appeal to the doctor as a counselor of health rather than to seek remedies for petty maladies.

To a certain extent this is the actual present situation of the relation of physician and patient. Nowadays most young wives who are approaching the threshold of maternity go to the doctor for advice concerning the problems of gestation. He counsels her concerning diet, exercise, rest, and all such problems. These frequent consultations between the mother-to-be and her physician are hygienic precautions in the interest of the mother's well-being and the baby's health.

Surely there is nothing shocking in the idea that parents should extend the period of these consultations still further back. In other words, that they should ask the doctor's advice even before the conception of the child, and even before marriage, so that before this hazardous task is undertaken, the health of the parents, as well as their economic, physical, and spiritual health may be assured.

In other words, I believe that the day is not far distant when the physician shall be as intimately concerned in the matter of marriage-making and the task of parenthood as is the clergyman, the county, or the lawyer to-day.

The more one thinks of this possibility, the more inevitable it seems as the next necessary step of American civilization. For what does civilization mean if not the increasing command of and control over all the factors of human life? And control of reproduction, mastery of the quantity and the quality of the very stuff of life, the raw material of civilization, is the very first of these factors. Animals are not permitted by breeders to bear young when they are unfit. Surely American babies--not some of them, but every last one of them--should be assured the birthright of being as well born and as well cared for as calves and pigs!

As long as they do not involve the future of the race, and therefore the future of our great country, it may be admitted that the intimate relationships of married life are no one's business but the participants. But when a new life is concerned, when it is a question of brining no just a baby, but a new citizen into this county, all should be willing to accept the best biological advice concerning the proper time, place, and environment for this all-important event.

Our federal government is now beginning to take precautions about immigration, permitting only properly qualified foreigners to enter our gates, and those only in restricted numbers. And yet within our gates, our chaotic laws and traditional prejudices encourage the entrance into these United States of ill-born, unfit, undesirable citizens. Poor little victims who have neither pedigree nor passport!

This situation has suggested to my mind that it should be a point of honor with all American parents that babies should be provided with health passports!

Passports for babies, beginning their perilous, adventurous voyage into this stormy old world of ours would insure at least a happy arrival, for such passports would mean that the baby had been conceived in love, born of a health mother's conscious desire, and bringing with it the heritage of health.

The duty of the physician would be to represent the unborn child, to stand as the representative of public health and racial purity, and to offer his benevolent advice as spokesman for the child-to-be.

Sometimes, in moments of idle revery, I have wondered what would happen if there were some sort of a baby bureau, to which all prospective parents would have to apply and answer the questions of the unborn. You would have to apply at these bureaus for a baby, just as you apply at an employment bureau for a cook, and there the wise baby-to-be would ask for references, and make certain, before it undertook the hazards of Life's voyage, that these parents were desirable, the possessors of a happy home, and really desirous of a new baby. Think of the question an intelligent baby might ask. For instance:

"Have you paid for your last baby yet?"

"How many children have you already? Are you sure your hands are not already too full, and your pocketbook empty? What are your plans for bringing me up?

"Can you furnish a happy home for me? Proper food? A sunny nursery? Love and affection and understanding?

"Can you furnish a certificate of health?

"Do you look upon children as a reward or a penalty?

"What's that you say? Five children already? Two dark rooms in the slums? No! Thank you! I don't care to be born at all if I cannot choose to be well-born. Good-bye!"

So the interview might be abruptly terminated if all parents had to apply for babies at a sort of bureau of the unborn. Since such a bureau is nothing but a fantastic impossibility, the best substitute we can suggest is that the family physician act as attorney for the new generations to come.

If the physician, the woman doctor as well as the man, could be a true counselor of racial as well as individual health for every husband and wife, not only from the beginning of marriage, but even before, there would be no need of enacting new laws of a compulsory or prohibitive nature. Instead, there would be a frank, honest relationship, not only between this counselor and his clients, but a finer, more unselfish, and therefore more enduring, love between husband and wife.

For instead of merely concerning himself with the petty ailments of his patients, the physician would become more of a true creative educator in the difficult science of marriage and parenthood.

But, the reader may object, you are not telling us how to reach those parents who cannot afford the counsels of such a physician and are so sunk in the mire of poverty that they would not know such advice could be obtained?

In the first place, the objection that one cannot reach the parents who most need to be instructed in Birth Control is without foundation in fact. As I pointed out in my first article published in these pages, thousands of poor conscript mothers throughout the country are clamoring for emancipation from their endless slavery of involuntary maternity. Not only do they appeal directly to me by the thousands every year, they appeal to doctors, to hospitals, to clinics, to maternity centers, to the directors of settlement houses. Everywhere they are seeking reliable knowledge--from neighbors, friends, as well as druggists, midwives, clergymen, nurses, social workers, any one, every one, yet they are consistently refused.

Even though these mothers realize the tragedy of brining helpless children into this world by chance, they are forced to go through the tragedy of enslaved maternity.

What can we do to help them?

In the first place, education in the control of conception must be accepted as an integral part of medical and hygienic education, so that every hospital, every free clinic, every dispensary, every licensed physician, and every visiting registered nurse may become of real help to the mothers of America. It is the public duty of each specialist to uphold our racial strength and purity.

This is an essential part of true patriotism, a more profound patriotism than taking an oath to uphold the laws of our country or to protect the flag. The future of our country depends upon the men and women we produce.

That this new education in parenthood can be made universal is not wild theory. It has been tested successfully in other countries.

This system of marital and parental education is being carried on among the poorer classes in a number of countries, notably in Holland, and more recently in Great Britain, under the name of "Birth Control Clinics."

These maternity education centers--or, as we call them to-day, Birth Control Clinics--were inaugurated no less than forty years ago in Holland, under the pioneering leadership of two Amsterdam physicians, Dr. Aletta Jacobs and her colleague, J. Rutgers. Their success in establishing a beneficial balance between the birth rate and the death rate in Holland, in diminishing the evils of poverty and overcrowding, led to the rapid spread of maternity education centers. Finally, in the compressed little kingdom of Holland, there were no less than fifty-two such clinics, recognized by the Dutch government as achieving social service of national importance.

Since the war, a large number of these clinics have been opened in London and other important cities of England. Some of them are known as Birth Control Clinics and others as Welfare Centers. They are supported in the belief that the welfare of the nation demands that married couples suffering from diseases which are likely to be transmitted to or to damage the offspring should be advised against parenthood and instructed how to avoid it "without having recourse to the unnatural method of prolonged sexual abstinence which strikes at the very roots of marriage itself."

At such clinics women would be advised against childbearing:

First: When either parent has an inheritable disease, such as insanity, feeble-mindedness, epilepsy, or syphilis. Second: When the mother is suffering from tuberculosis, kidney disease, heart disease, or pelvic deformity. Third: When either parent has gonorrhea. This disease in the mother is the cause of ninety per cent of blindness in newborn babies. Fourth: When children already born are not normal, even though both parents are in good physical and mental condition. Fifth: Not until the woman is twenty-three years old and the man twenty-five. Sixth: Not until the previous baby is at least three years old. This gives a year to recover form the physical ordeal of the birth of the baby, a year to rest, be normal and enjoy her motherhood, and another year to prepare for the coming of the next. Seventh: Children should not be born to parents whose economic circumstances do not guarantee enough to provide the children with the necessities of life. Eighth: A woman should not bear children when exhausted form labor. This especially applies to women who marry after spending several years in industrial or commercial life. Conception should not take place until she is in good health and has overcome her fatigue. Ninth: Not for two years after marriage should a couple undertake the responsibility of becoming parents.

When children are conceived in love and born into an atmosphere of happiness, then will parenthood be a glorious privilege, and the children will grow to resemble gods. This can be obtained only through the knowledge and practice of Birth Control.

"Even when parents are healthy," it is further pointed out, "too frequent childbearing weakens the health of both mothers and babies, especially if their life is one of poverty and squalor." Therefore, at these clinics both antenatal and postnatal care is given. In addition, competent medical men and women advise and instruct parents in safe and hygienic methods of family limitation whenever for reason of public and private health they are convinced that disease or extreme poverty renders childbearing prejudicial to the health of either mother or child. In such cases temporary or permanent avoidance of pregnancy is advised.

The best scientific thought, not only on the continent and Great Britain, but in this country as well, now recognizes medicine's responsibilities in forwarding the Birth Control movement as an essential factor in the maintenance of public and racial health. In the words of Dr. William Allen Pusey, formerly president of the American Medical Association: "The relation of medicine to this problem is obvious. Methods of birth control have to do with the human body: and that is our province. . . Medicine has not give to this problem the attention that it deserves--not because medicine is not confronted with it every day, but because the subject is taboo and the adequate exchange of scientific knowledge concerning it is illegal. It is a problem that requires the technical skill fo medicine. . . .

"This is peculiarly woman's problem. Of course it is man's problem also, but men are not concerned in it in the way that women are. It is women who bear the penalties in injury, disease, death, and mental torture that are involved in it. They have a right to know how they can intelligently--not crudely and dangerously-- Control their sexual lives, and they are justified by the highest considerations in fighting vociferously and persistently until they have this right granted to them."

In recent years there has likewise been a great awakening among liberal churchmen and religious teachers as to the ethical and moral justification of the theory and practice of Birth Control. Leading churchmen of all Protestant sects are not practically unanimous in urging this scientific and hygienic education as necessary to the foundations of contented marital life, to strong, happy family bonds and the welfare of posterity.

The Bishop of Birmingham has preached vigorous sermons urging the adoption of Birth Control as a national policy. The Society of Friends (the Quakers) have issued a report approving of the small-family system. The only religious organization bitterly and violently inimical to Birth Control is the Roman Catholic Church.

But this does not mean that Birth Control is contrary to the teaching of Christ. This point has been effectively presented by Dean Inge of St. Paul's Cathedral, London, whose recent visit to this country attracted so much attention. Dean Inge claims that Birth Control is an essential part of Christian morality. On this point he has written:

"We wish to remind our orthodox and conservative friends that the Sermon on the Mount contains some admirably clear and unmistakable eugenic precepts. 'Do men gather grapes of thorns, or figs of thistles? A corrupt tree cannot bring forth good fruit, neither can a good tree bring forth evil fruit. Every tree which bringeth not forth good fruit is hewn down, and cast into the fire.' We wish to apply these words not only to the action of individuals, which spring from their inherited qualities. This extension of the cope of the maxim seems to me quite legitimate. Men do not grapes of thorns. As our proverb says, 'You cannot make a silk purse out of a sow's ear.' If we believe this and do not act upon it by trying to move public opinion, we are sinning against the light, and not doing our best to bring in the kingdom of God upon earth."

Elsewhere this courageous churchman has written: "Either rational selection must take the place of the natural selection which the modern state will not allow to act, or we must go on deteriorating. When we can convince the public of this, the opposition of organized religion will soon collapse or become ineffective. . . . The Christian conception of a kingdom of God on earth teaches us to turn our eyes to the future and to think of the welfare of posterity as a thing which concerns us as much as that of our new generation."

The enemies of contraceptive methods declare them to be unnatural and, therefore, immoral. The American Birth Control League, of which I have the honor to be president, effectively answers the objection that Birth Control is unnatural.

We admit the accusation.

Yes. Emphatically yes. Of course it is!

As unnatural as the hat on your head. As unnatural as the shoes on your feet. As unnatural as the house you live in. The natural man shivered in a dark cave, and lived on raw roots and uncooked flesh.

Contraception is as unnatural as the radio you listen in on. It is unnatural, like talking over the telephone, or riding in a motor car, or a flight in an aeroplane.

All inventions are unnatural. Civilization had advanced by conquering and controlling the forces of nature. Man has in the past century worked miracles in controlling the great forces of nature outside of himself. He has harnessed great water power. He has enslaved electricity for his uses and comforts. He has discovered radio activity, and he is busy upon his conquest of the air, and with fine bravery and illimitable courage is going forth on his greatest voyage of exploration--the exploration of the atom.

He has still to learn to conquer and control these mysterious forces of nature, forces the great power of which has never yet been adequately measured, which well up to his own consciousness from the dark uncharted depths of his own procreative instincts.

Sanitation is unnatural. Hygiene is unnatural. And so is contraceptive foresight, which is, none the less, the safest, surest, and only effective instrument by which men and women may become the masters of instinct and desire, instead of their slaves.

We are held back by silence, by inertia, by prejudice. But all of us--every American citizen--must join in this campaign sooner or later. Because the life happiness and opportunity of every man, woman, and child among us is bound up with the success or failure of the movement for Birth Control. Upon the shoulders of the normal, the healthy, the independent, and the self-supporting falls the ever-increasing burden of the reckless and the improvident. Every state of the Union is carrying thousands of wards, criminals, and delinquents. Subnormal and mentally defective children are cluttering up the public schools and impeding the progress of gifted and talented children.

We advocates of Birth Control are not aiming, as our enemies assert, upon the destruction of the morals of the country. On the contrary, we are fighting for the realization of all the latent possibilities of development now hidden. We claim that the true wealth of the United States can be measured only by its strength in real men and real women. And we refuse to remain indifferent to truths that are crying aloud for general recognition.

Therefore, we insist on passports for babies. We insist on the recognition and the rigid observance of necessary racial traffic regulations.

Without going out of their way, every wife, every mother, every thoughtful husband can influence public opinion to a new understanding of our problem.

You are being continually asked to contribute to charities. Find out what the particular organization is doing to prevent the repetition of the distress it is seeking to alleviate.

Find out the laws of your state concerning the liberty it affords physicians to act as counselors in parenthood.

Break through the conspiracy of silence on parenthood and Birth Control, and help those less fortunate than yourself toward independence, self-support, and parental prudence.

We crusaders for Birth Control invite opposition; we invite discussion; we invite questions and cross-examination. Lethargy and indifference are the only true enemies of human progress.

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Copyright, Margaret Sanger Project