Birth control and the state

by C. P. Blacker

Before proceeding to discuss the arguments heretofore propounded, it is necessary to emphasize the fact that from the technical point of view a really satisfactory contraceptive does not yet exist.

The chief disadvantage attaching to the contraceptive used by the man is that it is quite impossible to induce the type of individual whose procreation we would wish to restrict to use any contraceptive at all.

The child is usually begotten by such a parent when he is drunk, and everyone who has had experience of the conditions prevailing in bad slums will know that it is futile to expect to achieve anything along these lines through the man. The problem must be met through the woman who, unlike the man, has to put up with the discomfort and the pain of repeated pregnancies, and has to shoulder the main burden of large families. Were it not for this elementary human fact all attempts to teach Birth Control to the very poor and destitute would fail completely.

Essentially, contraceptives which the woman can use are of two sorts, and involve two principles—namely, a mechanical or occlusive, and a chemical or spermicidal principle.

The objections to the first are two, namely that they are far from being fool-proof, and that unless sanctioned by a doctor their use can be followed by serious harm. It will be clear to any medical man that for a patient suffering from gonorrhœal cervicitis, or indeed from any condition involving a chronic cervical discharge, the use of an occlusive pessary may lead to disastrous consequences. The broadcasting of promiscuous advice as to the utilization of these objects in the absence of an examination by a competent medical man or woman is therefore to be strongly condemned.

The drawback, to all existing spermicidal suppositories is simply their uncertainty, though they are as nearly fool-proof as anything of the kind can be. It is possible that by further research a suppository, physically harmless but of certain action may be discovered, in which case, from its practical and sociological aspect, the problem of birth control will be greatly simplified. It remains, however, a little doubtful whether the chemical principle, however actively spermicidal, will ever dispense with the necessity of some occlusive device. But this is a sphere in which later research may prove of great value, and nothing but a tentative statement is now possible. The statement may, however, be made that if there is one method of Birth Control as to whose harmfulness there is little room for doubt, it is the method of coitus interruptus. In both sexes it gives rise to a condition of chronic anxiety which, nowadays, is far from uncommon. In the absence of local disease any of the above methods of contraception is preferable to this one.

The effectiveness of those women’s contraceptives now in vogue is difficult to estimate. There is little doubt that an unduly high estimation of their success has been formed in certain quarters, based on the assumption that in cases of failure, the working woman will promptly report the event to the centre where the contraceptive was obtained. The writer is persuaded that this is often a mistaken assumption, and that many cases of failure pass in consequence unnoted. There is also difficulty in knowing whether the instructions in the adjustment of the occlusive pessary have been adequately followed out. This process is not always easy, and as has been said above, is far from fool-proof.

The arguments above advanced will now be considered in their relation to (a) the Individual and (b) the Race.

(a) The Individual.—The arguments relating to the individual are divisible into those applicable to (1) married, and (2) unmarried persons.