"Nature is made better by no mean
But Nature makes that mean ...
This is an art
Which does mend Nature, change it rather, but
The art itself is Nature."
Birth control, when it ceases to be automatic and becomes conscious, is an art. But it is an art directed precisely to the attainment of ends which Nature has been struggling after for millions of years, and, being consciously and deliberately an art, it is enabled to avoid many of the pitfalls which the unconscious method falls into. It is an art, but
"The art itself is Nature."
It is always possible for the narrow-eyed fanatic to object to the employment of birth control, precisely as he might object to the use of clothes, as "unnatural." But, if we look more deeply into the matter, we see that even clothes are not truly unnatural. A vast number of creatures may be said to be born in clothes, clothes so naturally such that, when stripped from the animals they belong to, we are proud to wear them ourselves. Even our own ancestors were born in clothes, which they lost by the combined or separate action of natural selection, sexual selection, and the environment, which action, however, has not sufficed to abolish the desirability of clothes.[9] So that the impulse by which we make for ourselves clothes is merely a conscious and volitional form of an impulse which, in the absence of consciousness and will, had acted automatically. It is just the same with the control and limitation of reproductive activity. It is an attempt by open-eyed intelligence and foresight to attain those ends which Nature through untold generations has been painfully yet tirelessly struggling for. The deliberate co-operation of Man in the natural task of birth-control represents an identification of the human will with what we may, if we choose, regard as the divinely appointed law of the world. We can well believe that the great pioneers who, a century ago, acted in the spirit of this faith may have echoed the thought of Kepler when, on discovering his great planetary law, he exclaimed in rapture: "O God! I think Thy thoughts after Thee."
As a matter of fact, however, it was in no such spirit of ecstasy that the pioneers of the movement for birth control acted. The Divine command is less likely to be heard in the whirlwind than in the still small voice. These great pioneers were thoughtful, cautious, hard-headed men, who spoke scarcely above a whisper, and were far too modest to realise that a great forward movement in natural evolution had in them begun to be manifested. Early man could not have taken this step because it is even doubtful whether he knew that the conjunction of the sexes had anything to do with the production of offspring, which he was inclined to attribute to magical causes. Later, although intelligence grew, the uncontrolled rule of the sexual impulse obtained so firm a grip on men that they laughed at the idea that it was possible to exercise forethought and prudence in this sphere; at the same time religion and superstition came into action to preserve the established tradition and to persuade people that it would be wicked to do anything different from what they had always done. But a saner feeling was awakening here and there, in various parts of the world. At last, under the stress of the devastation and misery caused by the reproductive relapse of the industrial era, this feeling, voiced by a few distinguished men, began to take shape in action.
The pioneers were English. Among them Malthus occupies the first place. That distinguished man, in his great and influential work, The Principle of Population, in 1798, emphasised the immense importance of foresight and self-control in procreation, and the profound significance of birth limitation for human welfare. Malthus relied, however, on ascetic self-restraint, a method which could only appeal to the few; he had nothing to say for the prevention of conception in intercourse. That was suggested, twenty years later, very cautiously by James Mill, the father of John Stuart Mill, in the Encyclopedia Britannica. Four years afterwards, Mill's friend, the Radical reformer, Francis Place, advocated this method more clearly. Finally, in 1831, Robert Dale Owen, the son of the great Robert Owen, published his Moral Physiology, in which he set forth the ways of preventing conception; while a little later the Drysdale brothers, ardent and unwearying philanthropists, devoted their energies to a propaganda which has been spreading ever since and has now conquered the whole civilised world.
It was not, however, in England but in France, so often at the head of an advance in civilisation, that birth control first became firmly established, and that the extravagantly high birth-rate of earlier times began to fall; this happened in the first half of the nineteenth century, whether or not it was mainly due to voluntary control.[10] In England the movement came later, and the steady decline in the English birth-rate, which is still proceeding, began in 1877. In the previous year there had been a famous prosecution of Bradlaugh and Mrs. Besant for disseminating pamphlets describing the methods of preventing conception; the charge was described by the Lord Chief Justice, who tried the case, as one of the most ill-advised and injudicious ever made in a court of justice. But it served an undesigned end by giving enormous publicity to the subject and advertising the methods it sought to suppress. There can be no doubt, however, that even apart from this trial the movement would have proceeded on the same lines. The times were ripe, the great industrial expansion had passed its first feverish phase, social conditions were improving, education was spreading. The inevitable character of the movement is indicated by the fact that at the very same time it began to be manifested all over Europe, indeed in every civilised country of the world. At the present time the birth-rate (as well as usually the death-rate) is falling in every country of the world sufficiently civilised to possess statistics of its own vital movement. The fall varies in rapidity. It has been considerable in the more progressive countries; it has lingered in the more backward countries. If we examine the latest statistics for Europe (usually those for 1913) we find that every country, without exception, with a progressive and educated population, and a fairly high state of social well-being, presents a birth-rate below 30 per 1,000. We also find that every country in Europe in which the mass of the people are primitive, ignorant, or in a socially unsatisfactory condition (even although the governing classes may be progressive or ambitious) shows a birth-rate above 30 per 1,000. France, Great Britain, Belgium, Holland, the Scandinavian countries and Switzerland are in the first group. Russia, Austro-Hungary, Italy, Spain and the Balkan countries are in the second group. The German Empire was formerly in this second group but now comes within the first group, and has carried on the movement so energetically that the birth-rate of Berlin is already below that of London, and that at the present rate of decline the birth-rate of the German Empire will before long sink to that of France. Outside Europe, in the United States just as much as in Australia and New Zealand, the same great progressive movement is proceeding with equal activity.
The wide survey of the question of birth limitation here taken may seem to some readers unnecessary. Why not get at once to matters of practical detail? But, if we think of it, our wide survey has been of the greatest practical help to us. It has, for instance, settled the question of the desirability of the adoption of methods of preventing conception and finally silenced those who would waste our time with their fears lest it is not right to control conception. We know now on whose side are the laws of God and Nature. We realise that in exercising control over the entrance gate of life we are not only performing, consciously and deliberately, a great human duty, but carrying on rationally a beneficial process which has, more blindly and wastefully, been carried on since the beginning of the world. There are still a few persons ignorant enough or foolish enough to fight against the advance of civilisation in this matter; we can well afford to leave them severely alone, knowing that in a few years all of them will have passed away. It is not our business to defend the control of birth, but simply to discuss how we may most wisely exercise that control.
Many ways of preventing conception have been devised since the method which is still the commonest was first introduced, so far as our certainly imperfect knowledge extends, by a clever Jew, Onan (Genesis, Chap. XXXVIII), whose name has since been wrongly attached to another practice with which the Mosaic record in no way associates him. There are now many contraceptive methods, some dependent on precautions adopted by the man, others dependent on the woman, others again which take the form of an operation permanently preventing conception, and, therefore, not to be adopted save by couples who already have as many children as they desire, or else who ought never to have children at all and thus wisely adopt a method of sterilisation. It is unnecessary here, even if it were otherwise desirable, to discuss these various methods in detail. It is even useless to do so, for we must bear in mind that no method can be absolutely approved or absolutely condemned. Each may be suitable under certain conditions and for certain couples, and it is not easy to recommend any method indiscriminately. We need to know the intimate circumstances of individual cases. For the most part, experience is the final test. Forel compared the use of contraceptive devices to the use of eyeglasses, and it is obvious that, without expert advice, the results in either case may sometimes be mischievous or at all events ineffective. Personal advice and instruction are always desirable. In Holland nurses are medically trained in a practical knowledge of contraceptive methods, and are thus enabled to enlighten the women of the community. This is an admirable plan. Considering that the use of contraceptive measures is now almost universal, it is astonishing that there are yet so many so-called "civilised" countries in which this method of enlightenment is not everywhere adopted. Until it is adopted, and a necessary knowledge of the most fundamental facts of the sexual life brought into every home, the physician must be regarded as the proper adviser. It is true that until recently he was generally in these matters a blind leader of the blind. Nowadays it is beginning to be recognised that the physician has no more serious and responsible duty than that of giving help in the difficult path of the sexual life. Very frequently, indeed, even yet, he has not risen to a sense of his responsibilities in this matter. It is as well to remember, however, that a physician who is unable or unwilling to give frank and sound advice in this most important department of life, is unlikely to be reliable in any other department. If he is not up to date here he is probably not up to date anywhere.
Whatever the method adopted, there are certain conditions which it must fulfil, even apart from its effectiveness as a contraceptive, in order to be satisfactory. Most of these conditions may be summed up in one: the most satisfactory method is that which least interferes with the normal process of the act of intercourse. Every sexual act is, or should be, a miniature courtship, however long marriage may have lasted.[11] No outside mental tension or nervous apprehension must be allowed to intrude. Any contraceptive proceeding which hastily enters the atmosphere of love immediately before or immediately after the moment of union is unsatisfactory and may be injurious. It even risks the total loss of the contraceptive result, for at such moments the intended method may be ineffectively carried out, or neglected altogether. No method can be regarded as desirable which interferes with the sense of satisfaction and relief which should follow the supreme act of loving union. No method which produces a nervous jar in one of the parties, even though it may be satisfactory to the other, should be tolerated. Such considerations must for some couples rule out certain methods. We cannot, however, lay down absolute rules, because methods which some couples may find satisfactory prove unsatisfactory in other cases. Experience, aided by expert advice, is the only final criterion.