Those abhorrent conditions point to a blunder upon the part of those to whom we have entrusted the care of the health of the individual, the family and the race. The medical profession, neglecting the principle involved in preventive medicine, has permitted these conditions to come about. If they were unavoidable, we should have to bear with them, but they are not unavoidable, as shown by facts and figures from other countries where contraceptive information is available.
In Holland, for instance, where the information concerning contraceptives has been accessible to the people, through clinics and pamphlets, since 1881, the general death rate and the infant mortality rate have fallen until they are the lowest in Europe. Amsterdam and The Hague have the lowest infant mortality rates of any cities in the world.
It is good to know that the first of the birth-control clinics of Holland followed shortly after a thorough and enthusiastic discussion of the subject at an international medical congress in Amsterdam in 1878. The Dutch Neo-Malthusian League was founded in 1881. The first birth-control clinic in the world was opened in 1885 by Dr. Aletta Jacobs in Amsterdam. So great were the results obtained that there has been a remarkable increase in the wealth, stamina, stature and longevity of the people, as well as a gradual increase in the population.
These clinics must not be confused with the white enameled rooms which we associate with the term in America. They are ordinary offices with the necessary equipment, or rooms in the homes of the nurses, fitted out for the work. They are places for consultation and examination, opened by specially trained nurses who have been instructed by Dr. J. Rutgers, of The Hague, secretary of the Neo-Malthusian League, who has devoted his life to this work. There have been more than fifty nurses trained specially for this work by Dr. Rutgers. As a nurse completes her course of training, she establishes herself in a community and her place of consultation is called a clinic.
The general results of this service are best judged by tables included in the Annual Summary of Marriages, Births and Deaths in England, Wales, Etc., for 1912. [Footnote: (See table on page 208.)]
In Amsterdam, the birth rate dropped from 37.1 for the period of 1881-85 to 24.7 for 1906 and 23.3 in 1912. During the same periods, the death rate fell from 25.1 to 13.1, and in 1912 to 11.2. Infant mortality for the same period fell from 203 for each thousand living births to 90, and in 1912 to 64. Illegitimate fertility also decreased. Results in other cities, as shown by the table at the end of this chapter, are exactly similar.
In the Australian Commonwealth, where birth control is taken as a matter of course, and information concerning contraceptives is available to the masses, the births were so well distributed in 1915 that while the birth rate was 27.3, there was an infant death rate of only 10.7. New Zealand, which is also one of the typical birth-control countries, had a birth rate of 25.3 and an infant death rate of only 9.1 for the same year. These figures are in marked and happy contrast with those for the birth registration of the United States, where the reports for 1916 show a birth rate of 24.8, but an infant death rate of 14.7. A similar comparison may be made with the German Empire in 1913, where there was a birth rate of 27.5 in 1913 and an infant mortality rate of 15. In these countries, birth control information is not so generally within the reach of the masses and, consequently, the largest percentage of births come to that class least able to bring children to full maturity, as indicated in the infant mortality rates.
In conclusion, I am going to make a statement which may at first seem exaggerated, but which is, nevertheless, carefully considered. The effort toward racial progress that is being made to-day by the medical profession, by social workers, by the various charitable and philanthropic organizations and by state institutions for the physically and mentally unfit, is practically wasted. All these forces are in a very emphatic sense marking time. They will continue to mark time until the medical profession recognizes the fact that the ever increasing tide of the unfit is overwhelming all that these agencies are doing for society. They will continue to mark time until they get at the source of these destructive conditions and apply a fundamental remedy. That remedy is birth control.
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[Footnote: Amsterdam [Malthusian (Birth Control) League started 1881;
Dr. Aletta Jacobs gave advice to poor women, 1885]: