The First Birth Control Clinics in America and England

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The First Birth Control Clinics in America and England

Overview

Primarily through the efforts of Margaret Sanger (1879-1966) in America and Marie Stopes (1880-1958) in England, deliberate family planning emerged as a social force in the early twentieth century.

Background

Until the second decade of the twentieth century, women had little choice but to bear as many children as they conceived. Rape victims, incest victims, prostitutes, sexually active unmarried women, and even wives whose husbands wanted no more children did not have any safe, readily available, or medically reliable means to prevent unwanted pregnancies. Women who used contraception were regarded as immoral, unfeminine, or abnormal.

The contraception movement began in the early nineteenth century. It drew much of its inspiration from a famous book by British political economist Thomas Malthus, An Essay on the Principle of Population (1798). Malthus argued that the world's population could eventually grow beyond the ability of the earth to support it. Famine, epidemics, and general poverty would result.

The first significant advocate of pregnancy prevention was Francis Place (1771-1854), one of the most revolutionary Britons of his day. His book, Illustrations and Proofs of the Principle of Population (1822), sought only to influence social policy and suggested no practical contraceptive methods.

The militant advocacy of birth control can be said to have originated between 1910 and 1912 when Margaret Sanger was working on Manhattan's Lower East Side as a nurse among impoverished mothers of large families. The experience radicalized her. She immediately began writing incendiary newspaper columns and staging rallies. She founded a short-lived radical journal, The Woman Rebel, in March 1914.

When Sanger was arrested in August 1914 for sending obscene materials through the mail in violation of the 1873 "Comstock Law," she jumped bail and fled to England. She returned from her self-imposed exile almost a year later, determined to reap the publicity of her trial, but growing public sympathy induced federal prosecutors to drop their case against her in February 1916. Deprived of this opportunity for publicity, she embarked on a nationwide birth control promotional tour, and managed several arrests along the way. Her boldness was the initial catalyst of the movement.

The two main leaders of the birth control movement were Sanger and Marie Stopes. Other important participants in their era were British psychologist Havelock Ellis, American feminist Mary Ware Dennett, American gynecologist Robert Latou Dickinson, American pediatrician Hannah Meyer Stone, British novelist H.G. Wells, Russian-American anarchist Emma Goldman, Swedish feminist Ellen Key, South African feminist Olive Schreiner, American first lady Eleanor Roosevelt, and Katharine Houghton Hepburn, the mother of the actress. Sanger's friend Otto Bobsein coined the term "birth control" in 1914.

Dennett founded the National Birth Control League (NBCL) in 1915 while Sanger was in England. When Sanger returned, she found that Dennett had attracted a wider and more sympathetic audience for birth control and had tied contraception issues to the women suffrage question. Sanger resented Dennett usurping her leadership. Their styles were different: Dennett preferred gradual legislative change while Sanger preferred confrontation and street action. Sanger's propensity for civil disobedience and radical reform soon grew into an unbridled disapproval of Dennett and the entire gradualist, progressive wing of the movement.

Stopes met Sanger in England in 1915. This encounter motivated Stopes to devote her energy to the birth control cause and to write her polemical bestseller, Married Love (1918). Yet the two women did not like each other. They differed on both philosophy and strategy. Sanger was a socialist rebel and Stopes was a class-conscious eugenicist. After 1920 they were no longer on speaking terms. Stopes allied herself with Dennett against Sanger to contest the leadership of the movement. Sanger enlisted Ellis to propagandize against Stopes.

Sanger opened America's first birth control clinic at 46 Amboy Street in the Brownsville section of Brooklyn, New York, on October 16, 1916. It advertised in English, Yiddish, and Italian that trained nurses would provide birth control information, counseling, and devices. Women of all socio-economic backgrounds stood in line for these services. In the few weeks of its existence it served 464 women. On October 26 Sanger and her sister, Ethel Byrne, were arrested for selling obscene materials and the clinic was closed. Out on bail, Sanger re-opened it. The police closed it in November under the public nuisance laws. Sanger and her sister were convicted and each spent 30 days in prison.

Stopes and her husband, Humphrey Roe, opened Great Britain's first birth control clinic in North London on March 17, 1921. This facility survived until 1977, when British reproductive health care was nationalized. Unlike Sanger, Stopes had upper-class political connections. Stopes enforced strict rules at her clinic to prevent the kind of trouble that Sanger experienced in Brooklyn. Whereas Sanger's clinic had served anyone who walked through the door, Stopes insisted that her clinic would serve only women who could prove they were already mothers. Sanger openly attacked Stopes's rules.

Stopes in England had fewer legal troubles than Sanger had in America. Stopes courted the political right and was generally content to write books and pamphlets rather than campaign in the streets. Yet she could be confrontational and even flamboyant. She took her lawsuit against a prominent Roman Catholic for libel all the way to the House of Lords, chained a copy of her book on Catholic birth control methods to the font of Westminster Cathedral, and passed around cervical caps at fancy dinner parties. On most such occasions she made sure that journalists were present to provide publicity.

Impact

History shows that when contraception is restricted, abortion rates increase, and when abortion and contraception are both restricted, infanticide rates increase. With the notable exception of Stopes, birth control advocates in the early twentieth century generally sought to dissociate themselves from advocating abortion rights. They tended to regard abortion, infanticide, and overly large families as tragedies that could be prevented by dependable, safe, and convenient contraceptive devices. Sanger and most of her colleagues mentioned the physical danger and moral undesirability of abortion in their efforts to educate the public about the reasonableness of preventing unwanted pregnancies rather than either terminating them or allowing women to bring unwanted children into the world.

Despite its standard argument that better contraception would decrease the incidence of abortion, the birth control movement earned the vigorous opposition of the Roman Catholic Church. In its campaign against birth control, and especially against the ideology that Stopes expressed in her books, the Catholic Church emphasized and sometimes exaggerated the movement's involvement with racial and class politics and with various theories of population control, eugenics, social Darwinism, and neo-Malthusianism. The opinions of Father Thomas A. Ryan and Patrick Cardinal Hayes in several official Catholic publications were a major part of this debate. They pointed out that Catholic doctrine expressly forbade the use of contraception. The most important statements of Catholic beliefs about marriage, the family, sex, parenthood, and birth control were the encyclicals of Pope Pius XI, Casti connubii (1930), and Pope Paul VI, Humanae vitae (1968).

In 1922 Sanger founded the American Birth Control League (ABCL), partly to fill the void left by the demise of the NBCL in 1919. In 1923 she founded the Birth Control Clinical Research Bureau. Its purpose was to involve physicians more significantly in the birth control movement. The Bureau encouraged doctors to monitor their patients' use of contraceptives and promoted scientific research into contraceptive methods. A raid on the Bureau in 1929 by the New York City Police backfired. The international medical community was outraged by the arrest of two physicians, the seizure of private medical records, and the violation of the confidential relationship between physician and patient. After this highly publicized raid, physicians flocked to the movement, and in 1937 the American Medical Association officially endorsed birth control as a legitimate medical enterprise.

In 1939 the ABCL and the Bureau merged to create the Birth Control Federation of America. In 1942, against Sanger's wishes, it changed its name to the Planned Parenthood Federation of America.

Birth control methods in the early twentieth century were physical barriers, not chemical or pharmaceutical preparations. Sanger's millionaire husband, J. Noah H. Slee, began manufacturing diaphragms in 1925, the first such venture in America. Stopes preferred these mechanical means, but Sanger encouraged research into spermacides and other non-mechanical contraceptives. In 1948 Planned Parenthood gave biologist Gregory G. Pincus funding to develop an oral contraceptive. This research was successful. Between 1953 and 1956 Pincus, Min Chueh Chang, and John Rock published scientific results that eventually led to the commercial production of the birth control pill.

Major legal victories for the American birth control movement occurred in 1936 when the Second U.S. Circuit Court of Appeals ruled in U.S. vs. One Package (of Japanese Pessaries) that contraceptives are not obscene, and in 1965 when the U.S. Supreme Court ruled in Griswold vs. Connecticut that states could not restrict the use of contraceptives by married couples.

ERIC V.D. LUFT