In spite of the fact that the subject of birth control is much better known now than it was when we first started to propagate it, still it cannot be mentioned too often, for the misapprehensions concerning it almost keep pace with the propaganda. First, there is a foolish notion that we would try to regulate the number of children forcibly, that we would compel people to have a small number of children. Nothing could apparently be more absurd, and still many people sincerely believe it. Nothing is further from the truth. On the contrary, much as we are in favor of birth control, we advise limitation of offspring only to those who for various reasons, financial, hereditary or hygienic, are unable to have many children. We emphatically believe that couples who are in excellent health, who are of untainted heredity, who are fit to bring up children, and have the means to do so, should have at least half a dozen children. If they should have one dozen, they would deserve the thanks of the community. All we claim is that in such an important matter as bringing children into the world, the parents who have to carry the full burden of bringing up these children should have the right to decide. They should have the means of control. They should be able to say whether they will have two or six or one dozen children.
Contraceptive Measures
And the argument that contraceptives are injurious to the health of the woman, of the man, or of both, may be curtly dismissed. It is not true of any of the modern contraceptives. But even if it were true, the amount of injury that can be done by contraceptives would be like a drop of water in comparison with the injuries resulting from excessive pregnancies and childbirths. Some of the contraceptive measures require some trouble to use, some are unesthetic, but these are trifles and constitute a small price to pay for the privilege of being able to regulate the number of one's offspring according to one's intelligent desires.
The commonest argument now made against contraceptives is that they are not absolutely safe, that is, absolutely to be relied upon, that they will not prevent in absolutely every case. This is true; but there are three answers which render this objection invalid. First, many of the cases of failure are to be ascribed not to the contraceptives themselves, but to their improper, careless and unintelligent use. The best methods in the world will fail if used improperly. Second, if the measures are efficient in 98 or 99 per cent, and fail in one or two per cent., then they are a blessing. Some women would be the happiest women in the world if they could render 98 per cent. of their conjugal relations unfruitful. Third, the imperfections of our contraceptive measures are due to the secrecy with which the entire subject must necessarily be surrounded. If the subject of birth control could be fully discussed in medical books there is no doubt that in a short time we would have measures that would be absolutely certain and would leave nothing to be desired. But even such as they are, the measures are better than none, and as said in the beginning of this chapter, it is the duty of every young woman to acquire as one of the items of her sex education the knowledge of how to avoid too frequent pregnancies. In fact, I consider this the most important item in a woman's sex education, and if she has learned nothing else she should learn this. For this information is absolutely necessary to her future health and happiness.
A Few Everyday Cases
In my twenty years' work for the cause of rational birth control I have come in contact with thousands and thousands of cases which demonstrate in the most convincing manner possible the tragic results of forced or undesired motherhood, and of the fear of forced or undesired motherhood.
Some of the cases were in my own practice, some were related to me by brother physicians, some were described to me by the victims living in all parts of this vast country. Were I to collect and report all the cases that came to my notice during those twenty years, they would without exaggeration make a volume the size of the latest edition of the Standard Dictionary, printed in the same small type. Some of them are positively heartbreaking. They make you sick at the stupidity of the human race, at the stupidity and brutality of the lawgivers. But I do not wish to appeal to your emotions. I do not wish to take extreme and unique cases. I will therefore briefly relate a few everyday cases, which will demonstrate to you the beneficence of contraceptive knowledge and the tragedy and misery caused by the lack of such knowledge.
Case 1. This class of case is so common that I almost feel like apologizing for referring to it. She, whom I will call by the forbearing name of Mrs. Smith, had been married a little over nine years, and had given birth to five children. She was an excellent mother, nursed them herself, took good care of them, and all the five were living and healthy. But in caring for them and for the household all alone, for they could not afford a servant or a nurse-girl, all her vitality had been sapped, all her originally superb energy had dwindled down to nothing; her nerves were worn to a frazzle and she became but a shadow of her former self. And the fear of another pregnancy became an obsession with her. She dreamed of it at night, and it poisoned her waking hours in the day. She felt that she simply could not go through another pregnancy, another childbirth, with its sleepless nights and its weary toilsome days. She asked her doctor who brought her children into the world to give her some preventive, but he laughed the matter off. "Just be careful," was all the advice she got from him. And when in spite of being careful, she, horror of horrors, became pregnant again, she gathered up courage, went to the same doctor, and asked him to perform an abortion on her. But he was a highly respectable physician, a Christian gentleman, and he became highly indignant at her impudence in coming to him and asking him to commit "murder." Her tears and pleadings were in vain. He remained adamant.
Whether he would have remained as adamant if instead of Mrs. Smith, who could only pay twenty-five dollars for the abortion, the patient had been one of his society clientele, who could pay two hundred and fifty dollars, is a question which I will not answer in the affirmative or negative. I will leave it open. I will merely remark that in the question of abortion in certain specific cases the moral indignation of some physicians is in inverse proportion to the size of the fee expected. A doctor who will become terribly insulted when a poor woman who can only pay ten or fifteen dollars asks to be relieved of the fruit of her womb, will usually discover that the woman who can afford to pay one hundred dollars is badly in need of a curettement. Oh, no. He does not perform an abortion. He merely curets the uterus.
But to come back to Mrs. Smith. She went away from the indignant adamant doctor. But she was determined not to give birth to another child. She confided her trouble to a neighbor, who sent her to a midwife. The midwife was neither very expert, nor very clean. Mrs. Smith had to go to her two or three times. After bleeding for about ten days she developed blood poisoning, from which she died a few days later, at the early age of twenty-nine, leaving a disconsolate father, who in time to come will probably find consolation with another woman, and five motherless children, who will never find consolation. One may find a substitute for a wife, there is no substitute for a mother.