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The Case For Birth Control
A Supplementary Brief and Statement of Facts


To Aid the Court in its Consideration of the Statute designed to prevent
the dissemination of information for Preventing Conception




Copyright by


Introductions to Birth Control by Margaret H. Sanger,
Havelock Ellis, August Forel and G. F. Lydston.

Genesis of Movement,
United States,
Other Countries.

Birth Control, by Havelock Ellis,
Population Facts in United States,
Birth Rate of British Empire,
Birth Rate of Other Countries (With Tables).

General Statistics,
Results of Children’s Bureau Survey at Johnstown, Pa., by Emma
Manchester Report.

Children’s Bureau Report, by Grace L. Meigs,
Death Rates from Child Birth in Foreign Countries,
A Municipal Birth Control Clinic,
Kidney Diseases,
Pelvic Deformities,
Heart Disease,
Too Frequent Pregnancies,
Pernicious Vomiting.

Coitus Interruptus,
The Objects of Marriage, by Havelock Ellis,

The Social Evil,

Child Labor.

The Progress of Holland,
Eminent Opinions



The purpose of the Appellant in presenting the various statistics and
medical and social facts incorporated in the supplementary brief,
entitled THE CASE FOR BIRTH CONTROL, is to give the Court a clear
conception of the meaning of birth control. The historical stages
through which this question has gone have been reviewed, its status in
foreign countries outlined. Finally, the effects upon the commonwealth
of the prohibition contained in the Section known as 1142 of the Penal
Law have been made clear. Said Section comprises in its prohibition the
very points of knowledge most necessary to human liberty, and has
resulted in extreme harm to the individual, to the family and to society
at large.

The idea of the social and racial value of knowledge to prevent
conception is new in the United States, and therefore it has been
difficult to get first-hand facts and comprehensive statistics with a
local bearing. Consequently, the Appellant has been obliged to lay
emphasis upon data from foreign countries where the subject has been
exhaustively studied, both theoretically and practically. However, the
American case for birth control, as presented in this compilation, is
the most complete possible in view of the records available.



_The material in this general introduction to the question of the
prevention of conception comprises an article by Margaret H. Sanger and
extracts from the works of Havelock Ellis, August Forel and G. F.
Lydston, M.D. The last three are eminent authorities, whose opinions are
selected as being the clearest exposition of the social philosophy—Birth

NOTE: All the notations of pages and tables refer to original
documents and not to the present volume.



(_The following is the case for birth control, as I found it during my
fourteen years’ experience as a trained nurse in New York City and
vicinity. It appeared as a special article in “Physical Culture,” April,
1917, and has been delivered by me as a lecture throughout the United
States. It is a brief summary of facts and conditions, as they exist in
this country._)

For centuries woman has gone forth with man to till the fields, to feed
and clothe the nations. She has sacrificed her life to populate the
earth. She has overdone her labors. She now steps forth and demands that
women shall cease producing in ignorance. To do this she must have
knowledge to control birth. This is the first immediate step she must
take toward the goal of her freedom.

Those who are opposed to this are simply those who do not know. Any one
who like myself has worked among the people and found on one hand an
ever-increasing population with its ever-increasing misery, poverty and
ignorance, and on the other hand a stationary or decreasing population
with its increasing wealth and higher standards of living, greater
freedom, joy and happiness, cannot doubt that birth control is the
livest issue of the day and one on which depends the future welfare of
the race.

Before I attempt to refute the arguments against birth control, I should
like to tell you something of the conditions I met with as a trained
nurse and of the experience that convinced me of its necessity and led
me to jeopardize my liberty in order to place this information in the
hands of the women who need it.

My first clear impression of life was that large families and poverty
went hand in hand. I was born and brought up in a glass factory town in
the western part of New York State. I was one of eleven children—so I
had some personal experience of the struggles and hardships a large
family endures.

When I was seventeen years old my mother died from overwork and the
strain of too frequent child bearing. I was left to care for the younger
children and share the burdens of all. When I was old enough I entered a
hospital to take up the profession of nursing.

In the hospital I found that seventy-five per cent. of the diseases of
men and women are the result of ignorance of their sex functions. I
found that every department of life was open to investigation and
discussion except that shaded valley of sex. The explorer, scientist,
inventor, may go forth in their various fields for investigation and
return to lay the fruits of their discoveries at the feet of society.
But woe to him who dares explore that forbidden realm of sex. No matter
how pure the motive, no matter what miseries he sought to remove,
slanders, persecutions and jail await him who dares bear the light of
knowledge into that cave of darkness.

So great was the ignorance of the women and girls I met concerning their
own bodies that I decided to specialize in woman’s diseases and took up
gynecological and obstetrical nursing.

A few years of this work brought me to a shocking discovery—that
knowledge of the methods of controlling birth was accessible to the
women of wealth while the working women were deliberately kept in
ignorance of this knowledge!

I found that the women of the working class were as anxious to obtain
this knowledge as their sisters of wealth, but that they were told that
there are laws on the statute books against imparting it to them. And
the medical profession was most religious in obeying these laws when the
patient was a poor woman.

I found that the women of the working class had emphatic views on the
crime of bringing children into the world to die of hunger. They would
rather risk their lives through abortion than give birth to little ones
they could not feed and care for.

For the laws against imparting this knowledge force these women into the
hands of the filthiest midwives and the quack abortionists—unless they
bear unwanted children—with the consequence that the deaths from
abortions are almost wholly among the working-class women.

No other country in the world has so large a number of abortions nor so
large a number of deaths of women resulting therefrom as the United
States of America. Our law makers close their virtuous eyes. A most
conservative estimate is that there are 250,000 abortions performed in
this country every year.

How often have I stood at the bedside of a woman in childbirth and seen
the tears flow in gladness and heard the sigh of “Thank God!” when told
that her child was born dead! What can man know of the fear and dread of
unwanted pregnancy? What can man know of the agony of carrying beneath
one’s heart a little life which tells the mother every instant that it
cannot survive? Even were it born alive the chances are that it would
perish within a year.

Do you know that three hundred thousand babies under one year of age die
in the United States every year from poverty and neglect, while six
hundred thousand parents remain in ignorance of how to prevent three
hundred thousand more babies from coming into the world the next year to
die of poverty and neglect?

I found from records concerning women of the underworld that eighty-five
per cent. of them come from parents averaging nine living children. And
that fifty per cent. of these are mentally defective.

We know, too, that among mentally defective parents the birth rate is
four times as great as that of the normal parent. Is this not cause for
alarm? Is it not time for our physicians, social workers and scientists
to face this array of facts and stop quibbling about woman’s morality? I
say this because it is these same people who raise objection to birth
control on the ground that it _may_ cause women to be immoral.

Solicitude for woman’s morals has ever been the cloak Authority has worn
in its age-long conspiracy to keep woman in bondage.

When I was in Spain a year ago, I found that the Spanish woman was far
behind her European sisters in readiness or even desire for modern
freedom. Upon investigation as to the cause of this I found that there
are over five thousand villages and towns in Spain with no means of
travel, transportation and communication save donkeys over bridle paths.
I was told that all attempts to build roads and railroads in Spain had
been met with the strongest opposition of the Clergy and the Government
on the ground that roads and railroads would make communication easier
and bring the women of the country into the cities _where they would
meet their downfall_.

Do we who have roads and railroads think our women are less moral than
the Spanish women? Certainly not. But we in this country are, after all,
just emerging from the fight for a higher education of women which met
with the same objection only a few years ago.

We know now that education has not done all the dreadful things to women
that its opponents predicted were certain to result. And so shall we
find that knowledge to control birth, which has been in the hands of the
women of wealth for the past twenty-five years, will not tend to lower
woman’s standard of morality.

Statistics show us that the birth-rate of any given quarter is in ratio
with and to its wealth. And further figures prove that in large cities
the rich districts yield a birth-rate of a third of that of the poor
districts. In Paris for every 1,000 women between the ages of 15 and 50
the poor districts yield 116 births and the rich districts 34 births. In
Berlin conditions are approximately the same. For every 1,000 women
between the ages of 15 and 50 the poor districts yield 157 births while
the rich yield 47. This applies also to all large cities the world over.

It can be inferred from these figures that the women of wealth use means
to control birth which is condemned when taught to the poor. But the
menace to our civilization, the problem of the day, is not the
stationary birth-rate among the upper classes so much as the tremendous
increase among the poor and diseased population of this country....

Is woman’s health not to be considered? Is she to remain a producing
machine? Is she to have time to think, to study, to care for herself?
Man cannot travel to his goal alone. And until woman has knowledge to
control birth she cannot get the time to think and develop. Until she
has the time to think, neither the suffrage question nor the social
question nor the labor question will interest her, and she will remain
the drudge that she is and her husband the slave that he is just as long
as they continue to supply the market with cheap labor.

Let me ask you: Has the State any more right to ravish a woman against
her will by keeping her in ignorance than a man has through brute force?
Has the State a better right to decide when she shall bear offspring?

Picture a woman with five or six little ones living on the average
working man’s wage of ten dollars a week. The mother is broken in health
and spirit, a worn out shadow of the woman she once was. Where is the
man or woman who would reproach me for trying to put into this woman’s
hands knowledge that will save her from giving birth to any more babies
doomed to certain poverty and misery and perhaps to disease and death.

Am I to be classed as immoral because I advocate small families for the
working class while Mr. Roosevelt can go up and down the length of the
land shouting and urging these women to have large families and is
neither arrested nor molested but considered by all society as highly

But I ask you which is the more moral—to urge this class of women to
have only those children she desires and can care for, or to delude her
into breeding thoughtlessly. Which is America’s definition of morality?

You will agree with me that a woman should be free.

Yet no adult woman who is ignorant of the means to prevent conception
can call herself free.

No woman can call herself free who cannot choose the time to be a mother
or not as she sees fit. This should be woman’s first demand.

Our present laws force woman into one of two ways: Celibacy, with its
nervous results, or abortion. All modern physicians testify that both
these conditions are harmful; that celibacy is the cause of many nervous
complaints, while abortion is a disgrace to a civilized community.
Physicians claim that early marriage with knowledge to control birth
would do away with both. For this would enable two young people to live
and work together until such time as they could care for a family. I
found that young people desire early marriage, and would marry early
were it not for the dread of a large family to support. Why will not
society countenance and advance this idea? Because it is still afraid of
the untried and the unknown.

I saw that fortunes were being spent in establishing baby nurseries,
where new babies are brought and cared for while the mothers toil in
sweatshops during the day. I saw that society with its well-intentioned
palliatives was in this respect like the quack, who cures a cancer by
burning off the top while the deadly disease continues to spread
underneath. I never felt this more strongly than I did three years ago,
after the death of the patient in my last nursing case.

This patient was the wife of a struggling working man—the mother of
three children—who was suffering from the results of a self-attempted
abortion. I found her in a very serious condition, and for three weeks
both the attending physician and myself labored night and day to bring
her out of the Valley of the Shadow of Death. We finally succeeded in
restoring her to her family.

I remember well the day I was leaving. The physician, too, was making
his last call. As the doctor put out his hand to say “Good-bye,” I saw
the patient had something to say to him, but was shy and timid about
saying it. I started to leave the room, but she called me back and said:

“Please don’t go. How can both of you leave me without telling me what I
can do to avoid another illness such as I have just passed through?”

I was interested to hear what the answer of the physician would be, and
I went back and sat down beside her in expectation of hearing a
sympathetic reply. To my amazement, he answered her with a joking sneer.
We came away.

Three months later, I was aroused from my sleep one midnight. A
telephone call from the husband of the same woman requested me to come
immediately as she was dangerously ill. I arrived to find her beyond
relief. Another conception had forced her into the hands of a cheap
abortionist, and she died at four o’clock the same morning, leaving
behind her three small children and a frantic husband.

I returned home as the sun was coming over the roofs of the Human
Bee-Hive, and I realized how futile my efforts and my work had been. I,
too, like the philanthropists and social workers, had been dealing with
the symptoms rather than the disease. I threw my nursing bag into the
corner and announced to my family that I would never take another case
until I had made it possible for working women in America to have
knowledge of birth control.

I found, to my utter surprise, that there was very little scientific
information on the question available in America. Although nearly every
country in Europe had this knowledge, we were the only civilized people
in the world whose postal laws forbade it.

The tyranny of the censorship of the post office is the greatest menace
to liberty in the United States to-day. The post office was never
intended to be a moral or ethical institution. It was intended to be
mechanically efficient; certainly not to pass upon the opinions in the
matter it conveys. If we concede this power to this institution, which
is only a public service, we might just as well give to the street car
companies and railroads the right to refuse to carry passengers whose
ideas they do not like.

I will not take up the story of the publication of “The Woman Rebel.”
You know how I began to publish it, how it was confiscated and
suppressed by the post office authorities, how I was indicted and
arrested for bringing it out, and how the case was postponed time and
time again and finally dismissed by Judge Clayton in the Federal Court.

These, and many more obstacles and difficulties were put in the path of
this philosophy and this work to suppress it if possible and discredit
it in any case.

My work has been to arouse interest in the subject of birth control in
America, and in this, I feel that I have been successful. The work now
before us is to crystallize and to organize this interest into action,
not only for the repeal of the laws but for the establishment of free
clinics in every large center of population in the country where
scientific, individual information may be given every adult person who
comes to ask it.

In Holland there are fifty-two clinics with nurses in charge, and the
medical profession has practically handed the work over to nurses. In
these clinics, which are mainly in the industrial and agricultural
districts, any woman who is married or old enough to be married, can
come for information and be instructed in the care and hygiene of her

These clinics have been established for thirty years in Holland, and the
result has been that the general death-rate of Holland has fallen to the
lowest of any country in Europe. Also, the infant mortality of Amsterdam
and The Hague is found to be the lowest of any city in the world.
Holland proves that the practice of birth control leads to race
improvement; her increase of population has accelerated as the
death-rate has fallen.

In England, France, Scandinavia, and Germany, information regarding
birth control is also freely disseminated, but the establishment of
clinics in these countries is not so well organized as it is in Holland,
with the consequence that the upper and middle classes, as in this
country, have ready access to this knowledge, while the poor continue to
multiply because of their lack of it. This leads, especially in France,
to a high infant mortality, which, rather than a low birth-rate, is the
real cause of her decreasing population.

We in America should learn a lesson from this, and I would urge
immediate group action to form clinics at once. We have in this country
a splendid foundation in our hospital system and settlement work. The
American trained nurse is the best equipped and most capable in the
world, which enables us, if we begin work at once, to accomplish as much
in ten years’ time as the European countries have done in thirty years.

The clinic I established in the Brownsville district of Brooklyn
accomplished at least this: it showed the need and usefulness of such an

The free clinic is the solution for our problem. It will enable women to
help themselves, and will have much to do with disposing of this
soul-crushing charity which is at best a mere temporary relief.

Woman must be protected from incessant childbearing before she can
actively participate in the social life. She must triumph over Nature’s
and Man’s laws which have kept her in bondage. Just as man has triumphed
over Nature by the use of electricity, shipbuilding, bridges, etc., so
must woman triumph over the laws which have made her a childbearing

_RACE REGENERATION. HAVELOCK ELLIS. New Tracts for the Times. Cassell
& Co., Ltd., London, New York, Toronto and Melbourne. 1911._

HENRY HAVELOCK ELLIS: L.S.A. Hon. Member Medico-legal Society of New
York. Hon. Fellow of the Chicago Academy of Medicine; Foreign Associate
of the Societe Medico-Historique of Paris, etc.; General Editor of the
Contemporary Science Series (1889); born Croydon, Surrey, 2nd Feb.,
1859; belonging on both sides to families connected with the sea; spent
much of childhood on sea, (Pacific, etc.); educated, private schools;
St. Thomas’s Hospital; engaged in teaching in various parts of New South
Wales, 1875–79. Returned to England and qualified as medical man, but
only practiced for a short time, having become absorbed in scientific
and literary work. Edited the Mermaid Series of Old Dramatists, 1887–89.
Publications: The New Spirit, 1890; The Criminal, 1890 (4th edition
revised and enlarged 1910); Man and Woman, a Study of Human Secondary
Sexual Characters, 1894 (5th edition revised and enlarged 1914); Sexual
Inversion, being Vol. II of Studies in the Psychology of Sex, 1897 (3rd
edition revised and enlarged 1915); Affirmations, 1897; The Evolution of
Modesty, etc., being vol. I of the studies in Psychology of Sex, 1899
(3rd edition revised and enlarged, 1910); The 19th Century; A Dialogue
in Utopia, 1900; A Study of British Genius, 1904; Analysis of the Sexual
Impulse, 1903, (2nd edition revised and enlarged 1913); Sexual Selection
in Man, 1905; Erotic Symbolism, 1906; Sex in Relation to Society, being
vols. 3, 4, 5 and 6 of studies in psychology of sex; The Soul of Spain,
1908; The World of Dreams, 1911; The Task of Social Hygiene, 1912;
Impressions and Comments, 1914; Essays In War Time, 1916.

When we survey the movement of social reform which has been carried on
during the past one hundred years, we thus see that it is proceeding in
four stages. 1—The effort to clear away the gross filth of our cities,
to improve the dwellings, to introduce sanitation, and to combat
disease. 2—The attempt to attack the problem more thoroughly by
regulating conditions of work, and introducing the elaborate system of
factory legislation. 3—The still more fundamental step of taking in hand
the children who have not yet reached the age of work, nationalizing

Online LibraryMargaret SangerThe Case for Birth Control → online text (page 1 of 32)