Margaret Sanger, "Norman Harris Foundation 6th Institute Round Table Proceedings," 21 June 1926.

Source: " Norman Wait Harris Foundation, Round Table Discussion of Preventive Checks to Population Growth, p. 203-253."

Margaret Sanger led this roundtable discussion in Chicago. Others who participated included: John Randal Baker, Guy Irving Burch, Robert Emmet Chaddock, Robert Hamilton Coats, Walter Russell Crocker, Henry Pratt Fairchild, Ernst Freund, Corrado Gini, Harold Foote Gosnell, Mr. Hooker, Ellsworth Huntington, Oscar Edward Kiessling, Robert Rene Kuczynski, Leverett Samuel Lyon, Mrs. McLean, Shiroshi Nasu, Fielding William Ogburn, Mr. Okada, Raymond Pearl, Edward Byron Reuter, Mrs. Rich, Edward Allsworth Ross, Margaret Sanger, Samuel Johnson Schultz, Mr. Schuman, Mr. Simpson, Mr. Smith, Thomas Vernor Smith, Mr. Stehlc, Jesse Fredrick Steiner, Mr. Simon, Mr. Swen, Mr. A. E. Taylor, Mr. G. Taylor, Paul Schuster Taylor, Warren Simpson Thompson, Phillip Green Wright, Mrs. Q. Wright, Sewall Wright, Rachelle Yarros, Quincy Wright.The discussion was the Seventh Session of the Norman Wait Harris Foundation's Sixth Institute on Population and Migration, held on the afternoon of June 21, 1929The discussion focused on three points: 1. The general principles underlying the practice of birth control; 2. The extent and growth of birth control in England and the United States, including effects on the birth rate, laws, and clinical studies of birth control clinic patients; and 3. The role of birth control in the problems of population, including a more even distribution of wealth, increases in production and control of the birth rate. Other points raised were whether birth control practice was an inevitable result of civilization and whether population growth rate can be lowered without birth controlPortions of the transcript were omitted by the MSPP if they did not include a back and forth with Sanger.


Round Table Discussion of Preventive Checks to Population Growth

The Chairman: This afternoon our subject is Preventive Checks to Population Growth, and our leader is Mrs. Margaret Sanger, who will open the discussion.

Mrs. Sanger: Mr. Chairman, Ladies and Gentlemen: I first want to express my appreciation to the Chairman and the Committee for the invitation to attend this conference; and also for the privilege of having this question of birth control or preventive checks discussed here this afternoon, and especially do I wish to say that I have appreciated so much the opportunity of listening to the discussion on population problems by such distinguished experts.

My part this afternoon is going to be very insignificant, because I want to cover the first part of this outline down to question 3 and leave these questions for the discussion of those here.

I feel that there is one significant fact in the birth control movement that must have recognition, and that is that it is one of the very few social movements in modern life which needs no missionaries. It is different from the other movements, such as the eugenic or social hygiene, or the other movements, because no one has to go to the mass of the people to tell them what they should do. The people in almost all of the countries, especially of the so-called civilized countries, are ready and eager to get information, to control the size of their families. That to me is an important fact.

I think, too, that it seems almost a tie-up with that fact that almost at once people recognize the meaning of the words “birth control”. For instance, when I was going to Japan in 1922, I was met at Yokohama by a number of representatives from the government, and not altogether welcoming me to Japan, and after the newspaper men with their clicking of cameras and so forth had departed, a group of women, about twenty or twenty-two, came forward through the gangway, and one of them was pushed forward to welcome me to Japan. She spoke English in a very charming and most accurate manner and made an address something like this:

She Said: “We represent the modern, the new, the forward-looking women of Japan. We have much difficulty,” she said, “we have been for years trying to explain the importance of the women of their gaining political freedom.” She said, “They were not interested. We have tried to tell the women of the importance of gaining their economic freedom; it has been difficult for them to understand,” and she then enumerated the other trials and tribulations the modern woman has had in Japan and then she ended up by saying that “When the message of birth control came from Honolulu ,” where we had stopped and made some addresses, she said, “like lightening the women understood,” and I believe that also has a significant bearing on the subject and foreshadows the progress that this movement is bound to make.

Lord Dawson, that glorious churchman and statesman, a few years ago went before the bishops at Lambeth and plead with the churches to take up this idea to try to help the younger people and the younger generation mold their lives on a sensible basis; and he said, “You may shake your heads and disclaim the right of knowledge of birth control, but you might just as well try to push back the ocean with a broom, because it is here, and it is here to stay,” and I think that a great many people today, especially those who are thinking of the question of population and the future of the race, agree that Dawson was right.

Naturally, I look upon the question of birth control as not only a health and economic expedient, but I look upon it as a very great social principle, and that principle is interlocked with the progress of the nation and the future of the race. I think too that it represents a new moral responsibility on the part of our people, and especially of the younger generation, and that responsibility is shown in the consciousness of accepting responsibility for their conduct, for their acts, not only for their own children who are born, but also a responsibility for those who are unborn.

I think, too, that these preventative checks that we know now, while they come over rather a long distance from the preventive checks such as infanticide, or abortion, that birth control or preventing conception is the logical outcome of this long attempt on the part of human beings to control the size of their families.

We claim that the definition of birth control is best when we say it is the conscious control of the birth rate by means of preventing conception.

I like to emphasize the consciousness of our acts, because I think that there is a difference between the old laws or the attitude that there was no consciousness in birth, that God sent the children and he sent the food to feed them. I think today we have a different attitude when we say that it is the conscious control of the birth rate.

We say also to prevent conception, which we say does not mean interruption, does not mean interference, but it means prevention, and I take issue with the group who claim that to prevent conception is an interference with life. I say that if it is an interference with life, it is no more an interference than continence or remaining single is, and if that is an interference with life, then I say all right, we have got to make the most of it.

Another fact that we place great emphasis on in our educational work is that control does not necessarily mean limitation. When you control it means a letting out or a letting in, you do not necessarily put out desire when you control it, or necessarily shut off your engine when you control it. Control, I consider, is a word that means more and is a more progressive word, a more progressive attitude for us to take than limitation.

The birth control movement aside from what we might call the Malthusian movement, which I won’t dwell upon here, but the modern birth control movement which in my estimation differs considerably even from the neo-Malthusian movement in England, began after the publication written by a doctor in Boston, Dr. Knowlton. That pamphlet, the first one I believe, was published in 1833, went its way around the world for more than 40 years. I don’t quite know what effect the information in that pamphlet had upon the birth rate, but nothing particularly striking happened until 1877, when it found its way into a bookseller’s shop in England in Bristol, and it came just about the time when there were a few champions of the freedom of the press and freedom of speech, Charles Bradlaugh and Annie Besant and a number of people that belonged to the secular movement. This book, this pamphlet, which gives means and methods of contraception, was perhaps one of the first of that kind of pamphlet that had been published in the English language.

The book dealer who was selling that pamphlet was arrested, and it was claimed the pamphlet came under the obscenity law of England.

Besant and Bradlaugh would not allow that arrest to go unchallenged, and they took the case out of the bookseller’s hands and challenged the law themselves. They made quite a time about it, published over 40,000 of the pamphlets, slightly revised, and then went into the court and spent-–I believe the trial took three days, and Bradlaugh, who was his own attorney, and Besant threshed out the question and came through fairly victorious. They won, it is true, on technicalities, but, nevertheless, that information to prevent conception has not from that time to this day been considered in the obscenity class in England.

When in 1914 I came upon the horizon of my maternal and domestic background, I had previously been working in the nursing field where anyone who had eyes could not help but recognize that the large families were tied up very fundamentally with most of us on our social problems. You looked out and saw that your large families went hand in hand with the problems of poverty, infant and maternal morality, ignorance, slums, overcrowding, and almost all of them problems that most of the social workers and the medical profession were trying to solve. The only way they had in solving them was mainly through charities, or through palliative philanthropies.

On the other hand, if you were observant, you saw that the small family had very much of the best of it; it was not the children from the small families that were going into the fields and factories to labor for a mere existence.

I realize there is no use taking this up with you, because you doubtless recognize it too, but those were the conditions that I met and I became cognizant of the fact that there was something fundamentally wrong with the generation, my own generation, that was not trying to do something fundamental about it.

I saw day after day and practically month after month women who were living about us, that most of the energies of the nurses, and doctors and social workers would be spent in helping, doing what they could to alleviate the immediate suffering and going away feeling that our task was fairly well done, come back in another month or two, or after two or three months to find the same condition meeting us again, and especially is that so so far that women’s lives were concerned, and as far as abortions were concerned.

We spent a few years of time in bringing women out of septicemia, which were conditions that unwanted pregnancy had put them in, and then to come back in a few months and find them pregnant again, and you would go through it over and over again. Such a waste of mother power, of woman power, of child life that was going on at that time, one who had been brought up individually, could not help but revolt at the conditions they saw, and it seemed as if there was nothing more to do than to challenge the laws that surrounded us in the United States.

Well, you know that they say fools rush in where angels fear to tread, so I shot out and decided to challenge the constitutionality of the Federal law, under the assumption that all people are entitled to life, liberty and the pursuit of happiness. I challenged the Federal law, Section 211, which perhaps copied the old English law-–not exactly, because in England the laws there did not mention the prevention of conception, it was simply the interpretation of the judge who had a right to include anything in that statute, but in this country through the efforts of Anthony Comstock the words “and prevention of conception” had been carefully put in Section 211, the obscenity law, so that there was no question of what it meant.

It was not a question of opinion, it was a question of facts.

To make a long story short, I brought out 100,000 pamphlets called “Family Limitation,” giving information on preventing conception. I challenged the law by saying that I was perfectly willing to go to jail, but if I was going to go I was going to go for doing something, and I thought 100,000 pamphlets would have a little effect upon relieving the conditions which distressed me considerably. So these went forth through the country, and there were seven indictments, which would have cost me about forty-five years in jail had convictions taken place, but then I am pleased to say after a fight of about a year or so, that case was dropped and so there has been no further work on the Federal bill. The Federal law stands exactly as it did, in spite of the fact that 100,000 pamphlets went through the mails and have continued to go through to a certain degree since that time.

When I first began the issuance of these pamphlets, I believed that the question of birth control was one of the freedom of press and speech. I had known very little of the Besant-Bradlaugh trial until after 1914, when I went to England and of course knew very much more about it then, but I believed it was a question of free speech and free press, and under that assumption challenged the law. After I had been to Holland, however, in 1916, I reversed my opinion.

In Holland up to 1914 there were fifty-four birth control clinics; they had been established and had been the outcome of the Besant-Bradlaugh trial. At this trial the medical profession in Amsterdam had sent a physician or two physicians to sit through the trial in London and out of that came Dr. Jacobs who established the first birth control clinic in the world. This was in Amsterdam.

Dr. Jacobs, after she had established that one clinic and saw the conditions around that clinic, within a region of so many miles, tremendously improved, summarized the story at a considerable length in her memoirs. Not only was there less deaths of mothers, less deaths of infants, children went to school, but there were better conditions altogether.

After that a group of enthusiastic people got together in Holland and formed the Neo-Malthusian League, and up to 1915 they had constantly and continuously established these various clinics.

Now, the word “clinic” differs when you use it in Europe from the meaning that we have for it here; nevertheless, when I say fifty-four clinics, those were places with either doctors or nurses and mostly nurses, who were in charge of giving individual contraceptive advice and instruction. I visited, myself, in 1915 more than twenty of these clinics and saw, myself, largely through Dr. Rutgers, the technique of contraception.

Then I spent three months at The Hague.

So I cam back from Europe at that time and had to change my opinion, that it was not a question of free speech, it was not a question of freedom of the press, but it was question of technique, and it was a question of having, inasmuch as the modern methods of contraception depended upon some physiological means, that it was necessary to have somebody who knew the physiology and anatomy of the human body, and that meant the medical profession, and that has been our work from 1916 up to the present time. We have been directing the movement through the channel of the medical profession, not trying to originate more methods, but to provide the best kind of methods to be employed suitable to the individual concerned.

In this country we have twenty-four states in which there is some limitation, not only to the average individual in obtaining information, but even for the physician. In New York State the law allows the physician to give contraceptive advice for the cure or prevention of disease only. We are not at all satisfied with that, because it seems that if a woman or man comes to us, brought to us from one of the charitable associations, and that individual has been unable to support himself even for the last ten years, or support his family, and we can find no definite disease or ailment, it seems that the individual has to be turned back or sent away from the clinic, or from the doctor in charge, and told to go back home until he or she gets a proper disease, or she has a few more children, and come back and get some information, and then the absurdity of it is simply unthinkable. Yet that is the status of the law in New York State.

In many of the other states, in fact, in twenty-four states, there is some sort of limitation even on the medical profession, but I believe throughout the United States that there is no state that will not allow the physician to give information for the cure or prevention of disease. I think New York has set the precedent for that, and not only in the law and amendments to the law, but also in a court decision that was rendered, in which the judge of the Court of Appeals stated that a physician actually practicing could give information for the cure or prevention of disease, and he did not take the medical dictionary’s interpretation of the word disease, but Webster’s, so that is rather broad, and we hope that will be interpreted in a broader sense in some of the other states, especially the Western states, than it is at this time.

Now, as for clinics, the first clinic that was established in New York City, even under this restriction, has up to the present day had 13,000 women who have come to it and applied for information. Far more than 13,000 have really applied because almost one-fourth of that number have been sent away because of the restrictions of the law. But 13,000 have come and have been examined by the physicians, and a larger percentage of those have got information.

We are at present making a survey of the case histories of 10,000 of these women, and I will give you just some of the facts, just a little later, that we are finding in the conditions of these case histories.

Since that first clinic has been established in the United States, there have since that time been about twenty-one others, so that altogether we have twenty-two, if not more than that, because you almost have to put mucilage on your feet to keep track of the birth control movement these days, it develops so rapidly.

In England the last time I heard of the development there, it was also growing very rapidly; there being twenty-five or twenty-six clinics in England. Germany has three in Berlin. There are some twenty in Austria, and Holland has the same number of clinics today that it had in 1914. There are various reasons why they have been, perhaps, cut in half. One on account of the new radical element coming in to take charge of the work, believing that the birth control movement and the whole idea of contraception belong to the workers, so that there have been various conditions there altering the situation.

The most of the clinics give information for the same reasons. We started off at first by saying that anyone who has a transmissible disease, syphilis, insanity, feeble mindedness, and various other transmissible diseases, should not have children; the second is that women suffering from temporary disease, such as tuberculosis, heart or kidney trouble should not have children or have more than they already have until the disease is cured; and in the third place we claim that there should be a spacing out of children, there should be a time between the births for the woman to recuperate from the birth of one child, and try to rest and try to prepare for the coming of another child; and fourth, we claim that the couple who already have subnormal children should not have more children, even on the possible chance of having a normal child, because we know that it takes all the care and the attention human beings can give to children that are subnormal. At least we discourage their having more children.

In the fifth place, we say that couples should not have children, and especially the mother should not have children, until she has finished her adolescent development, That is the age from the fourteenth to the twenty-second year. We believe that, while there is a large percentage of us perhaps who have been born of young mothers, we consider that it is a very much better thing for the mother and for the child if she is fully developed first, both mentally and physically, before she takes up the burden of pregnancy and of motherhood.

We further state that the couple who is not able to support themselves and not able to support two children should not have ten more. People, many people, may differ with that, but nevertheless, that is part of our educational plan; and then, last, is the belief and the encouragement of young people after marriage to wait a year or two years before they undertake the responsibility of parenthood.

We believe that marriage after all today in its modern sense is not as easy of adjustment as it was in the old days, when women had to take the man’s word as gospel. Things have changed considerably, and that adjustment isn’t so simple. When you put a marriage certificate in the hands of your young people and throw a few pounds of rice after them, it is by no means certain that they are going to live happily ever after, as our divorce records and other records show.

So we ask our young people to take a period of a year or two years to strengthen the bonds between them and make the development of the woman so and of the man so, and to make the development of marriage something before parenthood, and we believe that this practice will not only make for a more permanent and happier marriages, but it will make for bigger families; that if pregnancy is not an accident, if it is planned for, if there is a possibility of recuperation after the ordeal of a birth, that there is a very much better chance of that couple having their children slowly and spacing time, of having more children than there would be if they should come along by accident, and by chance, and they had to make the best of it.

Now, there are three we will say, groups of methods, continence, sterilization and the chemical or mechanical means of prevention. You will all probably recognize that the first one, of continence, there is very little objection to, as far as the opposition of this work is concerned. The churches all stand back of that and applaud it, in fact, even the Roman Catholic Church, which is opposing the movement quite vigorously in all countries, claims that it has no quarrel with the principle of birth control, but with the methods of contraception; that when continence is employed, it is perfectly willing to agree that that is alright.

So that after all even the opposition has recognized that there is a necessity for limitation of the family, or for control of the birth rate.

Sterilization, of course, belongs to the province of the medical profession, and I think that there is no doubt it is coming to play an important, a large part in the whole question of the prevention of disease.

But the real fight and the real war seems to be waged around the third group or the chemical and mechanical means of preventing conception. As I stated before, we placed this in the hands of the medical profession because we believe that is where it belongs. We know that every woman is different in her construction and anatomy, and particularly after she has had children; the woman who has had seven or eight or nine or ten children and had no particular care, who has had to go back to work three days after the birth of a child, is quite likely to have a condition differing from the woman who has only had one or two children. The economic condition makes a difference. So, after all, the methods of contraception have to be individually applied. The economic and physiological condition of the individual, and in many cases even the mental condition of the individual, determine to a certain extent the methods of birth control applied to the woman even more than considering the application to the man, because we have found that the methods that are known, especially those discovered by Mensinga, and that have been down to the present day more generally used, we might say by applying them to the women, are more economically applied, are easier of adjustment, more satisfactory as to the results in all ways than methods used by men.

Now, as to our work in the Research Bureau, perhaps it would be of some interest to you: The 10,000 case records are being analyzed and will be ready perhaps for distribution sometime about the first of the year, and I should be most pleased if anyone here is interested in having a copy of this record, I should be most pleased to have you send for it or give me your name and address, and it will be sent to you when it is ready, – of course, it was impossible to take the 10,000 records, so we took 200 cases out of 10,000. These ran from January 8, 1926, to May 2, 1926, taken in sequence from the files and fairly exhaustively studied.

In the 200 cases, at lease 29 months had elapsed since the first visit, and mentioning that in passing, with regard to these cases, many women returned to the clinic many times, returned for supplies, returned to give an account of themselves and of their condition, so that we have a pretty good method of follow-up on most of these cases.

Of these 200 cases, 198 were examined by one doctor and advised accordingly. It was fortunate at this time that we had but one physician, now we have eight, so that it will be a little more difficult to have the same consistency perhaps in questions and in the conditions as it was with these first 200 cases.

Only eleven women out of the 200 in this preliminary report stated they had never used any contraceptive methods and the remaining 189 used not only one contraceptive method, but more than one kind. Of the 200 women reported, there were 674 pregnancies, and 93 of these had more than two pregnancies; 167 of these were abortions and 93 of these had more than one abortion, and an interesting thing which is going to show up rather badly perhaps for the medical profession is that 78 per cent of these abortions had been induced by the medical profession, by doctors and midwives. 172 of these patients totaled 546 ailments, 440 were gynecological, and 97 were general medical.

I just want to emphasize that, that these women who came into this clinic do not know of the restrictions of the law; a large majority of these women come and do no know that it is necessary for them to have a disease or some ailment in order to get instruction. They think they are quite all right, they do not know they have something the matter with them, in the great majority of cases, and yet, you see, of these 175 had ailments of which they were unconscious.

As to the religious composition of these people, 37 per cent were Jewish, 34 per cent were Protestants and 24 per cent Catholics, and in this early study that is a little different than that which we believe will show in a full record, because we have practically every reason to think they go along more nearly one-third; in a different report we will show 33, 32 and 31 per cent for the religions.

Twenty-six per cent of them came from social agencies, 37 per cent came from former patrons that had told their neighbors or their relatives, and they came along, 31 per cent came from publicity. Three-quarters of the wives and husbands were of foreign parentage, and one-half of them were foreign born. The average income of this number studied was rather higher than we had anticipated; it was $43 a week, it averaged that. While one-fourth of the number had an income of less than $35 a week; another one-fourth, had an income of more than $75 a week; and we found that much of it came from the wife’s work outside of the home, so while the income of some of these was large, it meant a double income from husband and wife, when the combined income was that amount.

Now, this is just a brief survey of this question and of the work done there, but I hope it may be of interest to you.

Now, I consider, just to conclude, it was very interesting to me the last few days, especially yesterday, to hear the demolishment, you might say, of the theory of Malthus, that the pressure of food supply governs population. As far as America is concerned, it seems we do not have to wrestle with that problem in the immediate future, but I do believe there is a second problem that confronts civilization, and especially confronts us in this country where we have such a heterogeneous population, and that is the reconciliation of humanitarian efforts for race improvements. I believe that is one of the great problems that confronts us in this country, when you recall that in 1927, nine billions of dollars were spent on defectives and delinquents and dependents and that is no more than nine billion dollars foolishly spent to let a certain number of people live and propagate and to increase the needs for more billions in the next five or ten years.

The Chairman: Mrs. Sanger has presented this subject in a way which I am sure will suggest many questions. I believe that Mrs. Sanger suggested that the third topic on the outline which is before you would be the most suitable to raise questions about. The floor is open for general discussion.

Dr. Ross: Mr. Chairman, I would like to ask Mrs. Sanger if such information is given to the unmarried.

Mrs. Sanger: In our clinic it is not given to the unmarried, first, on account of the laws; and, second, because we are making a study of the subject and we are rather careful. On occasion women do not come to us saying they are about to be married, in many cases the man comes with them, and they say that they are to be married, and they would both like to have any instructions given; and in many other cases the mother comes with a daughter saying that her health is thus and so and she should not have children immediately, but we have not given information to the unmarried.

Dr. Ross: Is it given to those who are married where there is no reason why they should not have children, but where the woman, for example, for one reason or another, wants to sidestep maternity entirely?

Mrs. Sanger: You mean in case where she does not wish to?

Dr. Ross: Yes, in other words, if she wishes not to have children, is that conclusive, or do you use your own judgement whether she is entitled to sidestep children?

Mrs. Sanger: In this case it has to be given on disease in our clinic. A woman in coming to our clinic there has to have something the matter with her physically or mentally, some ailment in order to get information.

Dr. Ross: Would that be true elsewhere in the United States.

Mrs. Sanger: No, not at all. I think in Chicago and in almost every one of the other clinics, I think they would perhaps-–Dr. Yarros is here and will probably give you some information upon the clinics in Chicago, how they are conducted, but I think there is a much broader interpretation of the needs in the other clinics than there is in ours.

Dr. Huntington: Mrs Sanger, I would like to ask, since the clinic began, has there been any change in the social status of the people who come? Naturally, such things begin with a higher level and is there any evidence that birth control is going down to the lower levels?

Mrs. Sanger: As to the kind of people who come to the clinic?

Dr. Huntington: Yes.

Mrs. Sanger: Very definitely; very definitely, there is a change. In fact, if we should have our clinic supported so that we didn’t have to depend upon it, we do try to make it self supporting, but if we could have it supported from the outside, we can devote the entire time of our seven doctors to giving attention to people who come from the charities and from the associations, who are dependent upon outside help for their existence.

Dr. Huntington: Are you making any special effort to reach those who are dependent?

Mrs. Sanger: Oh, yes, a very great effort, but I say we don’t have to, we have more people coming to us than we can take care of.

Dr. Huntington: Are you making any effort to reach them more than to reach others?

Mrs. Sanger: Well, I think it is safe to say all of our – we call it propaganda--is directed to what we call the unfit, or those who should have it for eugenic or other considerations.

Dr. Ross: Mrs. Sanger, are the lines of the Catholic Church holding firm, or are some of the priests beginning to shake a little?

Mrs. Sanger: Yes, I think we have had, in the last year several women come to us who have been sent by one Catholic priest in New York, and even some of the Catholic charities, and their social workers have brought us cases to give instruction to. I think there is a gradual giving way on the part of the Catholic Church, especially part of the church, at least some of those in the church.

Dr. Baker: May I ask, Mrs. Sanger, as to the percentage of individuals who have not individually practiced contraception, I forget it. It seemed very significant; it does not seem to be a means for disseminating information, but merely of disseminating better information.

Mrs. Sanger: Yes, eleven women out of 200, I don’t think I gave the percentage, only eleven had never used any contraception; 189 had used more than one contraceptive method.

The Chairman: Does that include abortions, that 189?

Mrs. Sanger: It would include abortions, yes. I mean sometimes the contraceptive method fails and would result in abortion.

Dr. Fairchild: In reference to that inquiry of Dr. Ross’ about the Catholic Church, Mrs. Sanger, I would like to suggest a qualification. An amount of the Catholic literature, it is perfectly true, a good deal of Catholic literature seems to me, all the way up from the pater dicta by the bishop, but there is also other authentic Catholic literature in pater dicta, that protests against any family limitation, no matter how achieved, on the ground that it interferes with the maximum number of people to furnish a world which is pleasing to divinity. There is, however, a good deal of Catholic literature that seems to leave the way open for family limitation by continence. If any of you care for a complete reference on that, I can give you one or two references that give the foremost Catholic authorities on the subject of the predetermination of the family of the married couples, the weight of authority is that it is contrary to the Catholic doctrine.

Mrs. Sanger: Dr. Fairchild, may I ask you if there has ever been a pronouncement from the Vatican, for instance?

Dr. Fairchild: The most empathetic statement that I have in mind on this movement is in a book by a Catholic priest, which bears the sign manual of Archbishop Hayes, and the signet of the official censor, in which the statement is very positively made, another which I recall at the moment is the fact that a publication some few years ago issued as a rule of conduct for, I think the Holy Name Order, an argument for large and holy families, which was a matter of the subject of an editorial in one of the leading Catholic magazines. That does not necessarily say that large and holy families means the largest possible families, but there is no doubt at all that the implication was that Catholic families, to meet the standards set up by the Pope, were to be as large as possible. That was a doctrine which, I believe, bears the technical name of an interpretation.

Mr. Burch: Mr. Chairman, I think perhaps I might be able to throw a little light on that subject, in the Forum of the Academy of Medicine about a month ago, one of the speakers was a priest, and there are certain passages from various Councils and various pronouncements of the authorities in Rome condemning birth control. That was supposed to be the word of an official from Rome.

Dr. Ross: Mrs. Sanger, do you know whether in this country the priest is at liberty in the confessional of women to inquire as to why there have been no children born for two or three or four years? I understand in France public opinion obliged them to abandon that entirely, they do not inquire into that, but I know in some parts of this country they are doing that right now. Do you know how that is?

Mrs. Sanger: Yes, I think I do, they do ask that here, I have heard that they do, that is a question that is asked.

Dr. Huntington: I know that they do and Catholic neighbors of mine told my sister so; this neighbor already had a large family of four or five and she said that the priest said she ought to have more, and that was a family of fairly well to do people.

Mr. P. S. Taylor: Mr. Chairman, may I ask the basis of that statement, that birth control sometimes meant more children per family, do I understand Mrs. Sanger to say that?

Mrs. Sanger: Yes, I do; I do think that birth control when it is properly disseminated is likely to mean more children in many cases than if the individuals had to bring children into the world by chance. We have had in a good many cases, and there are records of women who became perhaps after the birth of one child, nervous, irritable, on the verge of a divorce or separation, and after an adjustment and after four years’ time there has been an increase in the family and plans of more in the future. We have records of that, but I cannot give them to you now on account of this very limited record, but they will show up, I think, quite well in our larger study.

Dr. Fairchild: Did you urge that as a compensation, that that would be the total social effect?

Mrs. Sanger: I don’t know as I would urge it as a compensation, but I believe it will make its appearances in many families. I think it will make an increase in many families that would not otherwise have had the same number.

Mr. Ogburn: May I ask Mrs. Sanger about the selection of these 200 cases. You had how many thousand, ten thousand cases which you studied?

Mrs. Sanger: Yes.

Mr. Ogburn: You selected for study 200 cases about which you are reporting this afternoon?

Mrs. Sanger: Yes.

Mr. Ogburn: How did you select these?

Mrs. Sanger: Well, we took just the first 200 in the record, we took them out from March 8 to May 2, 1926, just in one year, because one physician was taking care of all the cases over the period of that time, of two years, of 1926. They might have been any other 200 cases, they pick them out, and he took them out in sequence.

Mr. Ogburn: Took them out in sequence because they were at a particular time when a particular physician handled them?

Mrs. Sanger: Yes.

Mr. Ogburn: Did you believe these 200 samples were representative of the whole 1,000, or if not in what way would they be considered?

Mrs. Sanger: Well, I think they are fairly representative except in this way: That as the movement advances, I mean since 1926 to the present time, we have in the first place I think poorer patients who are coming to us, this may change that in some degree. I think that any piece of work done by one person is likely to give a little more consistency perhaps than by several people, I mean in the examination by several doctors. That may make a little change but not material, it will not have any great effect. I think the whole change will probably be as far as the individuals are concerned, assisted, a higher percentage from the various organizations, and also lower social status.

Mr. P. G. Wright: I should like to ask one question of Mrs. Sanger: I have heard it stated that one of the problems at the present time was the fact the well to do class already practiced birth control successfully to a great extent, but the lower class did not, and that, therefore, there was a disturbing movement in the population to an inferior racial type. Have you anything to say on that question?

Mrs. Sanger: Well, I think that that is probably true, I think that is so. We can tell to a certain extent from our birth rate that there has been a certain group of the natives, those that are better able in the country, who have been having fewer children, and I think this, and that is my reference to the contingencies affecting the differential birth rate, I believe that it can be brought about, I think it can be quite effective upon the differential birth rate, if this movement is properly directed. I believe that is what appears today to be more than anything else its direction.

Mr. P. G. Wright: And one of the advantages would be an economical one.

Mrs. Sanger: Yes, particularly with what I would call a hook-up with the social agencies. The social agencies in this country are well organized, they come in contact with all of the people in the conditions that are having large families, which we say they should not have, either way they are not able to maintain them and not able to take care of them, and I think that could be done within a generation, I should say, I believe there could be a tremendous change in the differential birth rate if that were done.

Comment by Dr. Yarros was omitted by the editors.

Mr. Lyon: Portions of Mr. Lyon’s comment were omitted by the editors.

What I am anxious to know is whether you think the question-–I suppose I am not giving any information on that matter that you do not have–-as to whether you think there is probably real danger now from that sort of thing, not on the question of there being too much freedom of speech unless you consider all advertising too much freedom of speech, but whether there is a danger of a restrictive sort through the facilities of the law apparently permitting a commercial enterprise, making it possible to obtain this sort of thing without any clinical examination or clinical service, in view of what seems to be happening in the neighborhood drug stores, for we are talking about a few clinics where that information can be obtained. I wonder whether it may get us in a position where we have as much concern about controlling and preventing information as we have had in the past about disseminating it.

Mrs. Sanger: Of course, that same condition applies to European countries in England they seem to have all the devices for contraception in book shops and not in the drug stores, and certainly in Holland it is much the same, except in Holland they try to direct people to go to the clinics and receive some instruction as to the application and the kind of method used. I think the only answer to promiscuous information is that it is on a par with getting your glasses at the ten cent store. If we get people to recognize it is a personal application, just as the proper shoe fitted to your feet, then I think the matter is safe, but it is very interesting what you tell about Chicago. I had not imagined it was going to grow as fast as that.

Comment by Dr. Yarros was omitted by the editors.

Dr. Huntington: In this connection, I had a question I was going to ask. On the train coming here this morning I picked up a copy of Liberty, I don’t read Liberty very often, but in that copy I found an advertisement of a birth control device which was veiled, but it was perfectly clear what it meant. There we have a direct challenge of the National law about carrying things through the mails, so it looks to me in view of what has just been said, as if things were going so rapidly that the difficulty soon might be to prevent birth control information from being given in the wrong way. What do you think?

Mrs. Sanger: Well, I think it needs direction, I certainly agree that it does need it, and in fact to me that is the whole thing, that we have simply got to give the direction, we have got to have clinics and have it established in the organization and institutions where it would be accessible to those who applied. I think if there were more easily accessible proper information for the people that they would prefer to go there, where it is given in the proper way than to take it hit or miss. I think that is especially so far as women are concerned.

The Chairman: I wish we might have some of the questions relating to the influence of birth control on the solution of social problems suggested in the third question, and suggest that to Dr. Kuczynski.

Comment by Dr. Kuczynski was omitted by the editors.

Mr. P. G. Wright: Portions of Mr. P. G. Wright’s comment was omitted by the editors.

Now, perhaps the chief thing to make such an adjustment is to have this general sentiment broadcast, that it is an obligation for a man and woman to have as many children as they feel they can bring up to an economic status a little better than their own. That would seem pretty nearly adjusting population to means of substance, if it were carried out by widespread public sentiment. I should like to have Mrs. Sanger’s opinion on that.

Mrs. Sanger: Yes, I quite agree. I should like to have Professor Ross answer Dr. Kuczynski’s question. It seems to me, as I have seen in families, and I don’t know why it should not apply to a nation or to a population, that it seems more like a question of absorption in the family. I mean four children can come to a man and woman with great rapidity before they are adjusted, before they have the equipment to take care of four children, but if these same four children come over a long period of time with more experience, with better organization of the home, having more equipment to look after four children, without pushing down their standards, I believe, and I have seen it, that these four children are not only more welcome, but are an asset to the family, and I don’t see why the same thing would not apply to a nation.

Dr. Ross, will you answer Dr. Kuczynski’s question?

Comments by Dr. Ross, Dr. Kuczynski, Mr. P. G. Wright, Mr. Ogburn, Dr. Fairchild, and Mr. Chaddock were omitted by the editors.

Mr. T. V. Smith: I wonder if it is accurate to emphasize in the application of the so-called regulator that Mr. Wigmore proposes, of a constitutional amendment in this country, where the contest between the sociologist and physician-– Are you a physician, Mrs. Sanger?

Mrs. Sanger: No, I am not a physician.

Comments by Mr. T. V. Smith, The Chairman, Dr. Yarros, Dr. Huntington, Dr. Schultz, Mr. P. G. Wright, and Dr. Thompson were omitted by the editors.

Dr. Kuczynski: I think the question of income is not so essential in this connection. The essential and the interesting point is: does the more efficient-–with birth control – have more children than the less efficient? If this is the case, it would, of course, be in contradiction to what we have usually assumed, that is, that the so-called proletarians have the largest number of children while the more successful have less children. But if birth control has the effect that it will bring about a stronger increase among the superior class we should be aware that it is only a small minority of the population, which are really efficient, and it would, of course, have a very strong numerical effect if in the future the ten per cent efficient would have a family of three surviving children, and the ninety percent inefficient, and probably those who have not taken an academic degree would be still less than efficient – would have one child only. From the standpoint of eugenics birth control would then certainly be most welcome, but it would certainly very greatly diminish the total number of the population.

Mrs. Sanger: May I suggest that I brought up the question on that point about some of the cases having more children, because I think Dr. Fairchild-–Dr. Fairchild, you read the case, and you suggest I relate this, because of some of the cases.

We had dinner in New York, a money raising scheme, and we had some of the women themselves come there and tell about their own family conditions, and many people were much impressed with the fact that one young Russian woman got up and said that she, I think, had been born just previous to the outbreak of the war, and had tuberculosis, and she came to this country and had to go to Saranac, or some such place, she was very much in love with a young man who was working his way through the university, she had been told on account of the tuberculosis she must not marry, to have children would endanger her life, and she heard about birth control, she came to get information, went to one of the doctors and got information and was eventually married and was eventually cured of tuberculosis, and she now had her baby and turned around to her audience and said, “I have a baby and I am going to have another, but I want to have a little time”. That was quite impressive to the people there.

It might be interesting also, the number of children recorded at this clinic. Twenty families of unskilled laborers had seventy-four children, 3.7 per family, I think that is about what you would expect; twenty-five families in a small trade group; eighty-six children, 3.7; sixty-four families, 127 children, or two per family; seventeen families in the transportation group had thirty-six children, or two per family; eight families in the domestic group, eleven children, or 1.3 per family; twenty-nine families in the big business group, thirty children or one per family; miscellaneous group had one.

The Chairman: That would be the reverse: Dr. Huntington’s group was chosen from university graduates, this was from the whole population.

Mrs Sanger: You must recognize that in the clinic after all, we do have a more selective group, we have to take those who have something to matter with them, so there is something different. I would like to ask Professor Smith, is your objection to the medical profession on grounds of education or on technical grounds?

Mr. Smith: Oh, not technical, but we were talking here of an optimum population and the medical profession hasn’t any standard, individual or collective, and I wouldn’t expect it to have a standard at the present time.

Mrs. Sanger: I think as far as the birth control movement is concerned, the whole point, and I think Dr. Yarros will bear me out, is that were are not asking the medical profession to judge for us how many children we may have, as much as what methods would be most suitable for us to use for success.

The Chairman: This Round Table cannot last very much longer. I should like to give an opportunity to everyone who has not spoken yet who wishes to say something.

Comments by Mr. P. G. Wright, Dr. Huntington, The Chairman, Dr. Kuczynski, Mr. Ogburn, Mr. Thompson, Mr. Fairchild, Dr. Simpson, Dr. Nasu and Mr. Crocker are omitted by the editors.

Dr. Kuczynski: As to Spain, I don’t see any reason, in fact, I know there is a good deal of birth control, and I wonder why in the city of Barcelona, which is their most modern city, there should not be birth control. We have just heard that in Japan there is after all also birth control. In France there are more births in cities than in rural districts, because for more than a hundred years there has been a new law which compels every farmer to divide his land among his children.

Mrs. Sanger: You are quite right about Spain, because I was there in 1915, and there was a lot of information going through there, which was quite a surprise to me.

Mr. Ogburn: I would like to ask Mrs. Sanger if she would make a guess, if she doesn’t know the answer to this question, what percentage of families in England have knowledge of contraception, about what percentage?

Mrs. Sanger: I should say within the last five years that it is safe to say over sixty per cent.

Mr. Ogburn: And how about a state like New York, for instance?

Mrs. Sanger: That might be less.

Comments by Mr. Thompson, Dr. Kuczynski and Dr. Fairchild were omitted by the editors.


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