The Birth Control Movement and American Society

The Birth Control Movement and American Society: From Private Vice to Public Virtue

Copyright Date: 1978
Pages: 486
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  • Book Info
    The Birth Control Movement and American Society
    Book Description:

    This is the first comprehensive history of the struggle to win public acceptance of contraceptive practice. James Reed traces this remarkable story from its beginnings, carefully documenting the roles of the diverse interests that supported birth control, including feminists, eugenicists, and physicians, and providing a unique account of the struggles of such pioneers as Margaret Sanger, Robert Dickinson, and Clarence Gamble to win the support of organized medicine, to change laws, to open birth control clinics, and to improve birth control methods.

    Originally published in 1984.

    ThePrinceton Legacy Libraryuses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

    eISBN: 978-1-4008-5659-6
    Subjects: Political Science

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-viii)
  3. Preface
    (pp. ix-xiv)
  4. Preface to the Princeton Edition
    (pp. xv-xxiii)
  5. Acknowledgments
    (pp. xxiv-xxvi)
    • CHAPTER 1 Contraceptive Technology in the Nineteenth Century
      (pp. 3-18)

      A demographic revolution took place in the United States between 1800 and 1940. The high birth rates and high mortality characteristic of a premodern society were replaced by a new vital economy of fewer births and fewer deaths. The course of the demographic transition in the United States greatly differed, however, from the model developed by demographers intent on discovering the dynamics of economic development in the Third World. Americans began having fewer children before large-scale industrialization or urbanization took place, and dramatic declines in fertility preceded by at least a century the late nineteenth century advances in public health...

    • CHAPTER 2 The Rise of the Companionate Family
      (pp. 19-33)

      Publication of Robert Dale Owen’sMoral Physiologyin 1831 marked the beginning of a national debate over the morality and safety of contraceptive practice. In an age that proclaimed the ability of every person to save his soul and to get rich, Americans began consuming self-help books in great quantity. The marriage manual, a part of this new literature, became a staple of American culture during the middle decades of the nineteenth century and provided a forum for discussion not only of family limitation but of the proper relationship between the family and society, as well as the role of...

    • CHAPTER 3 The Suppression of Contraceptive Information
      (pp. 34-45)

      In 1900, despite widespread discussion of contraception in print during the middle decades of the nineteenth century, the law, respectable opinion, and organized medicine were united in condemning contraceptive practice. Federal law defined the mailing of birth control information as an obscene act and a felony. A Connecticut statute outlawed the practice of family limitation, although no state investigators were hired to snoop out wrongdoers.¹

      The systematic suppression of birth control information began in the 1870s as a small part of a great crusade to make America live up to its sexual ideals. The main thrust of antebellum moral reform...

    • CHAPTER 4 The Anarchists
      (pp. 46-53)

      During the decade before World War I, a few physicians made major efforts to win a recognized place for contraception in regular medical practice. William Robinson (1869–1936), the medical journalist and muckraker, filled hisCritic and Guidewith pleas for sex education, repeal of the Comstock Act, and recognition of the need for family limitation. Robinson convinced Abraham Jacobi, the founder of American pediatrics, to include a word for birth control in his 1912 presidential address to the American Medical Association, but Jacobi’s colleagues ignored his request that they take up the problem of birth control, and Robinson, despite...

    • CHAPTER 5 Permissiveness with Affection: A Sexual Standard for an Affluent Society
      (pp. 54-64)

      Public opinion and laws on contraception would never be changed as long as it remained indecent to discuss human sexuality in public. Emma Goldman and Ben Reitman operated outside of what genteel America called “civilized morality,” the dominant codes of middleclass respectability. During the first decades of the twentieth century, however, not only Greenwich Village folk, but social workers, doctors, and a large part of the educated public perceived an accelerating crisis in sexual morality. The recognition that conventional standards of sexual conduct were somehow inadequate was reflected in a decline of reticence about discussing sex matters publicly. Articles on...

    • CHAPTER 6 The Burden of Domesticity
      (pp. 67-88)

      Margaret sanger(1879-1966) led a successful campaign from 1914 to 1937 to remove the stigma of obscenity from contraception and to establish a nationwide system of clinics where women could obtain reliable birth control services. She organized research, recruited manufacturers for birth control devices, and won court battles that modified the Comstock laws and laid the groundwork for the formal acceptance of birth control by organized medicine in 1937. After World War II she played key roles in the rise of an international planned parenthood movement and in the development of the birth control pill. Through these achievements she had a...

    • CHAPTER 7 European Models
      (pp. 89-96)

      Margaret sanger’s year of exile in Europe marked a turning point in her career. She found new models of reform, gained valuable friends and contributors—both financial and intellectual—met a perfect lover and spiritual counselor, and at last found a contraceptive device in which women could place complete confidence.

      On arrival in London she wrote to Dr. Charles Vickery Drysdale (1874–1961), who was running the nearly moribund Malthusian League from his suburban home. The nephew of Dr. George Drysdale (1824–1904; author ofThe Elements of Social Science,the “textbook” of neo-Malthusianism) and the son of Dr. Charles...

    • CHAPTER 8 Competition for Leadership
      (pp. 97-105)

      When Margaret Sanger returned to the United States in October 1915, “Birth Control” blared out from the cover of thePictorial Reviewat the first newsstand she passed.¹ While she was away anagent provocateurfrom the New York Society for the Suppression of Vice had tricked William Sanger into giving him a copy ofFamily Limitation.Her first reaction was anger at Bill; perhaps he was trying to martyr himself to win her back. Anthony Comstock hoped Bill would tell his wife’s hiding place in order to escape prison. Instead, the entrapment made martyrs of both Sangers, drew the...

    • CHAPTER 9 Providing Clinics
      (pp. 106-128)

      On October 16, 1916, Margaret Sanger opened the first center for contraceptive instruction in the United States. The “clinic,” in the Brownsville section of Brooklyn, was advertised by leaflets in Yiddish, Italian, and English and by defiant press releases. For a fee of ten cents, Sanger and her sister, Ethel Byrne, showed applicants how to use pessaries, condoms, and other contraceptives. A police spy testified that Sanger told her, “the best method of birth control was the covering for the womb. ‘There are many womb supporters on the market, costing from seventy-five cents to ten dollars, but I would recommend...

    • CHAPTER 10 Woman and the New Race
      (pp. 129-140)

      In a hospital bed interview in May 1965, when asked to name the most important influence on her career, Margaret Sanger replied, “It was my father more than any other person, who influenced me through his teachings and his vital belief in truth, freedom, right.”¹ It was no fluke thatthestrident voice calling for controlled population growth in the midst of the Great Depression was the daughter of an Irish freethinker whose fighting faith rested on the revelations of Robert Ingersoll and Henry George.

      Margaret Sanger combined a feminist vision with the prophetic style of her father’s heroes, and...

    • CHAPTER 11 The Medical Man as Sex Researcher
      (pp. 143-166)

      After theOne Packagedecision (1936), the further progress of the birth control movement depended on the acceptance of contraception by organized medicine and its incorporation into public health programs. Sanger had forced changes in the law, had seen to it that reliable contraceptives were available, and provided the clinical data to prove that birth control worked. Organized medicine, however, could never accept demands from a laywoman. Medical endorsement of contraception depended on a different kind of lobbying, necessarily by interested physicians. This crucial role in the professional forum was to be played by Robert Latou Dickinson (1861–1950), Sanger’s...

    • CHAPTER 12 Clinical Studies
      (pp. 167-180)

      No one could outtalk Robert Dickinson, and no one could ignore him. “There’s nothing like a gray Van Dyke and crow’s feet to each temple . . . to get you past the people who are hired to keep you out.”¹ Willing or not, the medical profession was going to be informed on contraception. As Margaret Sanger learned from bitter experience, getting some things done required support from the rich and the competent. The best society was Dickinson’s natural milieu.

      Dickinson’s election as president of the American Gynecological Society had been engineered with an eye toward the title’s value when...

    • CHAPTER 13 Publisher and Clearing House
      (pp. 181-194)

      Dickinson was determined to make contraception a recognized and valued medical service. Bitter experience taught that the medical profession was unwilling to sponsor a clinical investigation of the subject. By 1929 the lay birth controllers in cooperation with individual doctors were collecting case histories in more than seventy medically supervised clinics.¹ These clinics, responding to Dickinson’s advice and criticism, improved general examinations, follow-up procedures, and records. Data was available to prove that many women could be taught to control their fertility without danger to their health or morals. Next to a breakthrough in basic science, the primary need became collation...

    • CHAPTER 14 Birth Control in American Social Science: 1870–1940
      (pp. 197-210)

      Social scientists have debated the meaning of population trends since the late nineteenth century, when universities began to include statistics in their curricula. By the 1970s, America had gone through a century of population crises in the literature of social science. While concern about the social implications of vital statistics has been a constant, the nature of the population problem perceived by demographers has changed radically over time. After World War II a series of best sellers announced that time was running out for mankind unless population growth could be curbed and fundamental changes made in attitudes toward nature. Although...

    • CHAPTER 15 Birth Control Stalled
      (pp. 211-217)

      Blamed for projected declines in the quality and quantity of the population, birth controllers fought an uphill battle in the late 1930s and the 1940s. In May 1937, in an effort to take advantage of the acceptance of contraception by the American Medical Association in January, the National Committee on Maternal Health called together a group of interested demographers, doctors, and educators to discuss criticism of birth control. Heated debate over “The Eugenic Effect of Contraception—The Significance of the Decline in the Birth Rate” revealed deep antagonism between eugenicist and feminist, social scientist and physician. The participants shared concern,...

    • CHAPTER 16 The Parents’ Information Bureau
      (pp. 218-222)

      In her eagerness to win allies for birth control, Margaret Sanger often minimized ideological differences and ignored bureaucratic or professional proprieties. Critics claimed that Doris Davidson and other wellmeaning idealists not only failed but usually hurt the chances for permanent progress. To a feminist activist like Sanger, however, continual effort through every available means was a moral imperative. The distribution of simple contraceptives to women who could not be reached by clinics was perfectly consistent with her overall strategy of autonomy for all women.

      Delivery of birth control through nurses and social workers could also be defended on wholly utilitarian...

    • CHAPTER 17 A Recruit for Birth Control
      (pp. 225-238)

      When Margaret Sanger asked Robert Dickinson for his public support in 1916, he turned her down. His career as a physician came first, and he believed that association with Sanger would end his influence among other medical leaders. Dickinson, in turn, had great difficulty in recruiting younger men for contraceptive research. In October 1925, Clarence James Gamble (1894–1966), an assistant professor of pharmacology in the medical school of the University of Pennsylvania, and heir to the Ivory soap fortune, wrote his mother about an interview with Dickinson. Dickinson had explained that first-class scientists neglected contraceptive research because of the...

    • CHAPTER 18 Policing the Marketplace
      (pp. 239-246)

      While Elsie Wulkop was winning the Midwest for birth control, Gamble, inspired by correspondence with A. R. Kaufman and the high cost of doing business with doctors, began searching for contraceptives that would allow him to reach the indigent without aid of clinics or of organized medicine.¹ In the 1930s an estimated 13 million fertile married couples in the United States faced the question every night of whether to risk creating a new life. The great majority of married people limited their fertility, but marriage without children was still a disreputable state. Family limitation was justifiable as a means of...

    • Chapter 19 Experiments in Population Control: Logan County, West Virginia, and the North Carolina Public Health Department
      (pp. 247-256)

      The Standards Program of the National Committee on Maternal Health provided the factual basis for federal regulation and AMA reports. These activities were merely by-products of Gamble’s central concern, the mass delivery of contraceptives. After Randolph Cautley completed his survey of the birth control business in early 1936, he was replaced on the NCMH payroll by Gilbert Beebe, a Columbia Ph.D. candidate in statistics. Gamble and Beebe began publishing statistical studies of the effectiveness of simple methods, beginning with data drawn from the obstetrics department of a single urban hospital and ending with attempts to lower birth rates in rural...

    • CHAPTER 20 Conflict and Isolation
      (pp. 257-278)

      Clarence gamble wanted to be known as a working philanthropist and not just as a rich man. He believed he had ideas and experience, as well as money, to contribute to the cause. Anxious to give of himself, he hated “gold digging” and frequently demanded greater efficiency from the professional staffs of the organizations he supported.¹ He won a reputation as tightfisted with nickel tips and by always traveling economy class, but he was also capable of secret acts of real generosity. When the wife of a part-time employee died after a long illness, Gamble sent him a check for...

    • CHAPTER 21 The Population Explosion
      (pp. 281-288)

      During the decade after World War II the focus of demographic study in the United States shifted from the declining fertility of the West to a startling increase in world population, an estimated 700 million between 1940 and 1960. Revolutionary advances in public health, particularly the control of famine and epidemic disease, accelerated by the wartime use of DDT to control malaria, made possible the rapid population increase. Declines in mortality that had been spread over a century in Europe and North America were achieved in a few years in the Third World, but birth rates remained high, leaving nations...

    • CHAPTER 22 Margaret Sanger from Exile: The Founding of the International Planned Parenthood Federation
      (pp. 289-293)

      Margaret sanger had made two dramatic world tours between the world wars (1922, 1936), forcing her way into Japan despite the opposition of the government, debating sexual morality with Mahatma Gandhi in India, and establishing friendships with Western-oriented liberals. Nothing substantial came of these tours. Sanger’s Japanese supporters established a few clinics in the 1920s, but they were suppressed when the militarists came to power. The British rulers of India were indifferent, while Jawaharlal Nehru’s Congress Party, although advocating a policy of population control, was not able to do much after it came to power (1947) in a country with...

    • CHAPTER 23 The Failure of Simple Methods: The IUD Justified
      (pp. 294-308)

      The Population Council and the International Planned Parenthood Federation played key roles in bringing the governments of the world to recognize the value of contraception as part of both economic and public health policy. Nevertheless, the theoretical usefulness of birth control was a moot question without methods that were accessible and acceptable to the masses of the Third World. Birth controllers in the early 1950s faced the disheartening fact that contraceptive technology had not advanced since the perfection of the spring-loaded diaphragm in the 1920s. When Robert Dickinson died in 1950, his effort to attract attention to the contraceptive possibilities...

    • CHAPTER 24 The Prospects for Hormonal Sterilization
      (pp. 311-316)

      The anovulant pill was the first absolutely new contraceptive developed in the twentieth century. For years birth controllers had dreamed of a “physiological” method that would be completely divorced from the act of coitus. The movement had suffered from the lack of a universally acceptable method. Robert Dickinson once observed that even if conflicting values could be reconciled, birth controllers still faced the fact that many women would not use a mechanical contraceptive. An oral contraceptive might solve a number of problems. Those who would not use methods that required sacrifice of pleasure or attention to details might be reached...

    • CHAPTER 25 A Life in Experimental Biology
      (pp. 317-333)

      Gregory goodwin pincus, the father of the birth control pill, was born in Woodbine, New Jersey, in 1903, the eldest son of a teacher and editor of a farm journal.¹ His family on both sides were Russian Jews, farmers who had emigrated to New Jersey in the nineteenth century. One of his uncles was dean of the agricultural college of Rutgers University, and “Goody” Pincus wanted to be a farmer, but his father disapproved, pointing out “the nonpaying character of a farmer’s life,” so Goody’s Iqve of nature found expression in a biology major at Cornell (B.S., 1924), where he...

    • CHAPTER 26 The Lady Bountiful
      (pp. 334-345)

      A few key individuals played crucial roles in the progress of the American birth control movement. Margaret Sanger, Robert Dickinson, and Clarence Gamble irritated professional administrators by their numerous personal initiatives, but they forced innovations that advanced the cause. In Gamble’s case the need for acceptance as an expert on contraception rather than as a source of funds became a major point of contention in the movement, just as Sanger’s drive for personal dominance had divided birth controllers in the late 1920s.

      Katharine Dexter McCormick (1875–1967) gave “tenacious and conscientious attention” to every detail of the philanthropic projects that...

    • CHAPTER 27 The Product Champion
      (pp. 346-366)

      In 1967 the National Science Foundation commissioned a study of the relationship between basic research and technological innovation. What role did “nonmission” research, research motivated solely by a desire for knowledge, play in the development of new products of great economic and social significance, such as the electron microscope, the videotape recorder, and the oral contraceptive pill? Since the National Science Foundation existed to promote research, it was not surprising when the study revealed that 70 percent of the key events leading to technological innovation resulted from so-called nonmission research. Seventy-six percent of this basic work was done in university...

    • [PART VIII Introduction]
      (pp. 369-382)

      Paul ehrlich, the Stanford biologist and prophet of environmental apocalypse, told an interviewer forPlayboymagazine in 1970: “Despite the fact that family planning has existed in many countries for well over 60 years, we still have rapid population growth. We’ve tried family planning and we know it doesn’t work.”¹ Ehrlich’s dismissal of family planning as too little and too late echoed the position outlined in the late 1960s by the University of California demographers Kingsley Davis and Judith Blake (husband and wife), the two leading critics of population control through voluntary programs designed to maximize individual free choice. According...

  14. Abbreviations Used in the Notes
    (pp. 383-384)
  15. Notes
    (pp. 385-438)
  16. Bibliographical Essay
    (pp. 439-447)

    This work is largely based on the papers of Margaret Sanger, Robert Dickinson, Clarence Gamble, and Gregory Pincus. I have also drawn heavily on published sources in fields ranging from medicine and experimental biology to demography, sociology, and literary criticism. The following essay deals with sources that provided unique information or strongly influenced this work. A fuller list of sources is provided in the Notes.

    Until recently historians have been reticent about discussing sexual behavior or values. The literature is reviewed by John C. Burnham in “American Historians and the Subject of Sex,”Societas(Autumn 1972). Arthur Calhoun,A Social...

  17. Index
    (pp. 448-456)