THE DISTRICT NURSES.
These nurses are trained and instructed by Dr. Rutgers in the proper means and hygienic principles of the methods of Family Limitation. They are established in practice in the various towns and cities throughout Holland. They not only advise women as to the best method to employ to prevent conception, but they also supply them with a well-fitted pessary, and teach them how to adjust, remove, and care for it—all for the small sum of 1½ guilder, or about 60 cents. They work mainly in the agricultural and industrial districts, or are located near them; and their teachings include not only the method of prevention of conception, but instruction in general and sexual hygiene, cleanliness, the uselessness of drugs, and the non-necessity of abortions.
In this country, for a nurse to dare to fit a woman with a pessary would be considered a breach of professional rights. In Holland, they know the poor cannot pay the physicians, and this simple adjustment is looked upon by the medical profession much as they view the nurse administering an enema or a douche.
I had the pleasure of attending some of the classes where Dr. Rutgers gave this course of instruction. I also attended and assisted in the clinics where women came to be advised, instructed, and fitted. Many of them came for the first time, and though they were unacquainted with any means to be employed, they accepted the instructions in a most natural and intelligent manner. Other women came to be refitted, and many brought the pessary previously used, to ask questions concerning its adjustment.
There was a determined social responsibility in the attitude of these peasant women coming into The Hague from the surrounding districts. It seemed like a great awakening. They look upon a new baby in the family much as they look upon the purchase of an automobile or a piano or any other luxury where they have no room to keep it, and no means with which to purchase it or to continue in its upkeep.
There is no doubt that the establishment of these clinics is one of the most important parts in the work of a Birth Control League. The written word and written directions are very good, but the fact remains that even the best educated women have very limited knowledge of the construction of their generative organs or their physiology. What, then, can be expected of the less educated women, who have had less advantages and opportunities? It is consequently most desirable that there be practical teaching of the methods to be recommended, and women taught the physiology of their sex organs by those equipped with the knowledge and capable of teaching it.
The Neo-Malthusian League of Holland endorses, as the most reliable means of prevention of conception, the Mensinger pessary (which differs in construction from the French or the American Mizpah pessary). The nurses also recommend this; but other methods are discussed with the patient, and the husband’s attitude toward other methods considered and discussed. The pessary is the commonest recommendation, as giving the most satisfactory results.