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.
When a contraceptive method is adopted under satisfactory conditions,
with a due regard to the requirements of the individual couple, there
is little room to fear that any injurious results will be occasioned.
It is quite true that many physicians speak emphatically concerning the
injurious results to husband or to wife of contraceptive devices.
Although there has been exaggeration, and prejudice has often been
imported into this question, and although most of the injurious results
could have been avoided had trained medical help been at hand to advise
better methods, there can be no doubt that much that has been said
under this head is true. Considering how widespread is the use of these
methods, and how ignorantly they have often been carried out, it would
be surprising indeed if it were not true. But even supposing that the
nervously injurious effects which have been traced to contraceptive
practices were a thousandfold greater than they have been reported to
be--instead of, as we are justified in believing, considerably less
than they are reported--shall we therefore condemn contraceptive
methods? To do so would be to ignore all the vastly greater evils which
have followed in the past from unchecked reproduction. It would be a
condemnation which, if we exercised it consistently, would destroy the
whole of civilisation and place us back in savagery. For what device of
man, since man had any history at all, has not proved sometimes
injurious?
Every one of even the most useful and beneficent of human inventions
has either exercised subtle injuries or produced appalling
catastrophes. This is not only true of man's devices, it is true of
Nature's in general. Let us take, for instance, the elevation of man's
ancestors from the quadrupedal to the bipedal position. The experiment
of making a series of four-footed animals walk on their hind-legs was
very revolutionary and risky; it was far, far more beset by dangers
than is the introduction of contraceptives; we are still suffering all
sorts of serious evils in consequence of Nature's action in placing our
remote ancestors in the erect position. Yet we feel that it was worth
while; even those physicians who most emphasise the evil results of the
erect position do not advise that we should go on all-fours. It is just
the same with a great human device, the introduction of clothes. They
have led to all sorts of new susceptibilities to disease and even
tendencies to direct injury of many kinds. Yet no one advocates the
complete disuse of all clothing on the ground that corsets have
sometimes proved harmful. It would be just as absurd to advocate the
complete abandonment of contraceptives on the ground that some of them
have sometimes been misused. If it were not, indeed, that we are
familiar with the lengths to which ignorance and prejudice may go we
should question the sanity of anyone who put forward so foolish a
proposition. Every great step which Nature and man have taken in the
path of progress has been beset by dangers which are gladly risked
because of the advantages involved. We have still to enumerate some of
the immense advantages which Man has gained in acquiring a conscious
and deliberate control of reproduction.
III.
BIRTH CONTROL IN RELATION TO MORALITY AND EUGENICS
Anyone who has followed this discussion so far will not easily believe
that a tendency so deeply rooted in Nature as Birth Control can ever be
in opposition to Morality. It can only seem to be so when we confuse
the eternal principles of Morality, whatever they may be, with their
temporary applications, which are always becoming modified in
adaptation to changing circumstances.
We are often in danger of doing injustice to the morality of the past,
and it is important, even in order to understand the morality of the
present, that we should be able to put ourselves in the place of those
for whom birth control was immoral. To speak of birth control as having
been immoral in the past is, indeed, to underestimate the case; it was
not only immoral, it was unnatural, it was even irreligious, it was
almost criminal. We must remember that throughout the Christian world
the Divine Command, "Increase and Multiply," has seemed to echo down
the ages from the beginning of the world. It was the authoritative
command of a tribal God who was, according to the scriptural narrative,
addressing a world inhabited by eight people. From such a point of view
a world's population of several thousand persons would have seemed
inconceivably vast, though to-day by even the most austere advocate of
birth limitation it would be allowed with a smile. But the old
religious command has become a tradition which has survived amid
conditions totally unlike those under which it arose. In comparatively
modern times it has been reinforced from unexpected quarters, on the
one hand by all the forces that are opposed to democracy and on the
other by all the forces of would-be patriotic militarism, both alike
clamouring for plentiful and cheap men.
Even science, under primitive conditions, was opposed to Birth Control.
Creation was regarded as a direct process in which man's will had no
part, and knowledge of nature was still too imperfect for the
recognition of the fact that the whole course of the world's natural
history has been an erection of barriers against wholesale and
indiscriminate reproduction. Thus it came about that under the old
dispensation, which is now for ever passing away, to have as many
children as possible and to have them as often as possible--provided
certain ritual prescriptions were fulfilled--seemed to be a religious,
moral, natural, scientific, and patriotic duty.
To-day the conditions have altogether altered, and even our own
feelings have altered. We no longer feel with the ancient Hebrew who
has bequeathed his ideals though not his practices to Christendom, that
to have as many wives and concubines and as large a family as possible
is both natural and virtuous, as well as profitable. We realise,
moreover, that the Divine Commands, so far as we recognise any such
commands, are not external to us, but are manifested in our own
deliberate reason and will. We know that to primitive men, who lacked
foresight and lived mainly in the present, only that Divine Command
could be recognisable which sanctified the impulse of the moment, while
to us, who live largely in the future, and have learnt foresight, the
Divine Command involves restraint on the impulse of the moment. We no
longer believe that we are divinely ordered to be reckless or that God
commands us to have children who, as we ourselves know, are fatally
condemned to disease or premature death. Providence, which was once
regarded as the attribute of God, we regard as the attribute of men;
providence, prudence, self-restraint--these are to us the
characteristics of moral men, and those persons who lack these
characteristics are condemned by our social order to be reckoned among
the dregs of mankind. It is a social order which in the sphere of
procreation could not be reached or maintained except by the systematic
control of offspring.
We may realise the difference between the morality of to-day and the
morality of the past when we come to details. We may consider, for
instance, the question of the chastity of women. According to the ideas
of the old morality, which placed the whole question of procreation
under the authority (after God) of men, women were in subjection to
men, and had no right to freedom, no right to responsibility, no right
to knowledge, for, it was believed, if entrusted with any of these they
would abuse them at once. That view prevails even to-day in some
civilised countries, and middle-class Italian parents, for instance,
will not allow their daughter to be conducted by a man even to Mass,
for they believe that as soon as she is out of their sight she will be
unchaste. That is their morality. Our morality to-day, however, is
inspired by different ideas, and aims at a different practice. We are
by no means disposed to rate highly the morality of a girl who is only
chaste so long as she is under her parents' eyes; for us, indeed, that
is much more like immorality than morality. We are to-day vigorously
pursuing a totally different line of action. We wish women to be
reasonably free, we wish them to be trained in the sense of
responsibility for their own actions, we wish them to possess
knowledge, more especially in that sphere of sex, once theoretically
closed to them, which we now recognise as peculiarly their own domain.
Nowadays, moreover, we are sufficiently well acquainted with human
nature to know, not only that at best the "chastity" merely due to
compulsion or to ignorance is a poor thing, but that at worst it is
really the most degraded and injurious form of unchastity. For there
are many ways of avoiding pregnancy besides the use of contraceptives,
and such ways can often only be called vicious, destructive to purity,
and harmful to health. Our ideal woman to-day is not she who is
deprived of freedom and knowledge in the cloister, even though only the
cloister of her home, but the woman who, being instructed from early
life in the facts of sexual physiology and sexual hygiene, is also
trained in the exercise of freedom and self-responsibility, and able to
be trusted to choose and to follow the path which seems to her right.
That is the only kind of morality which seems to us real and worth
while. And, in any case, we have now grown wise enough to know that no
degree of compulsion and no depth of ignorance will suffice to make a
girl good if she doesn't want to be good. So that, even as a matter of
policy, it is better to put her in a position to know what is good and
to act in accordance with that knowledge.
The relation of birth control to morality is, however, by no means a
question which concerns women alone. It equally concerns men. Here we
have to recognise, not only that the exercise of control over
procreation enables a man to form a union of faithful devotion with the
woman of his choice at an earlier age than would otherwise be possible,
but it further enables him, throughout the whole of married life, to
continue such relationship under circumstances which might otherwise
render them injurious or else undesirable to his wife. That the
influence thus exerted by preventive methods would suffice to abolish
prostitution it would be foolish to maintain, for prostitution has
other grounds of support. But even within the sphere of merely
prostitutional relationships the use of contraceptives, and the
precautions and cleanliness they involve, have an influence of their
own in diminishing the risks of venereal disease, and while the
interests of those who engage in prostitution are by some persons
regarded as negligible, we must always remember that venereal disease
spreads far beyond the patrons of prostitution and is a perpetual
menace to others who may become altogether innocent victims. So that
any influence which tends to diminish venereal disease increases the
well-being of the whole community.
Apart from the relationship to morality, although the two are
intimately combined, we are thus led to the relationship of birth
control to eugenics, or to the sound breeding of the race. Here we
touch the highest ground, and are concerned with our best hopes for the
future of the world. For there can be no doubt that birth control is
not only a precious but an indispensable instrument in moulding the
coming man to the measure of our developing ideals. Without it we are
powerless in the face of the awful evils which flow from random and
reckless reproduction. With it we possess a power so great that some
persons have professed to see in it a menace to the propagation of the
race, amusing themselves with the idea that if people possess the means
to prevent the conception of children they will never have children at
all. It is not necessary to discuss such a grotesque notion seriously.
The desire for children is far too deeply implanted in mankind and
womankind alike ever to be rooted out. If there are to-day many parents
whose lives are rendered wretched by large families and the miseries of
excessive child-bearing, there are an equal number whose lives are
wretched because they have no children at all, and who snatch eagerly
at any straw which offers the smallest promise of relief to this
craving. Certainly there are people who desire marriage, but--some for
very sound and estimable reasons and others for reasons which may less
well bear examination--do not desire any children at all. So far as
these are concerned, contraceptive methods, far from being a social
evil, are a social blessing. For nothing is so certain as that it is an
unmixed evil for a community to possess unwilling, undesirable, or
incompetent parents. Birth control would be an unmixed blessing if it
merely enabled us to exclude such persons from the ranks of parenthood.
We desire no parents who are not both competent and willing parents.
Only such parents are fit to father and to mother a future race worthy
to rule the world.
It is sometimes said that the control of conception, since it is
frequently carried out immediately on marriage, will tend to delay
parenthood until an unduly late age. Birth control has, however, no
necessary result of this kind, and might even act in the reverse
direction. A chief cause of delay in marriage is the prospect of the
burden and expense of an unrestricted flow of children into the family,
and in Great Britain, since 1911, with the extension of the use of
contraceptives, there has been a slight but regular increase not only
in the general marriage rate but in the proportion of early marriages,
although the _general_ mean age at marriage has increased. The ability
to control the number of children not only enables marriage to take
place at an early age but also makes it possible for the couple to have
at least one child soon after marriage. The total number of children
are thus spaced out, instead of following in rapid succession.
It is only of recent years that the eugenic importance of a
considerable interval between births has been fully recognised, as
regards not only the mother--this has long been realised--but also the
children. The very high mortality of large families has long been
known, and their association with degenerate conditions and with
criminality. The children of small families in Toronto, Canada, are
taller than those of larger families, as is also the case in Oakland,
California, where the average size of the family is smaller than in
Toronto.[12] Of recent years, moreover, evidence has been obtained that
families in which the children are separated from each other by
intervals of more than two years are both mentally and physically
superior to those in which the interval is shorter. Thus Ewart found in
a northern English manufacturing town that children born at an interval
of less than two years after the birth of the previous child remain
notably defective, even at the age of six, both as regards intelligence
and physical development. When compared with children born at a longer
interval and with first-born children, they are, on the average, three
inches shorter and three pounds lighter than first-born children.[13]
Such observations need to be repeated in various countries, but if
confirmed it is obvious that they represent a fact of the most vital
significance.
Thus when we calmly survey, in however summary a manner, the great
field of life affected by the establishment of voluntary human control
over the production of the race, we can see no cause for anything but
hope. It is satisfactory that it should be so, for there can be no
doubt that we are here facing a great and permanent fact in civilised
life. With every rise in civilisation, indeed with all evolutionary
progress whatever, there is what seems to be an automatic fall in the
birth-rate. That fall is always normally accompanied by a fall in the
death-rate, so that a low birth-rate frequently means a high rate of
natural increase, since most of the children born survive.[14] Thus in
the civilised world of to-day, notwithstanding the low birth-rate which
prevails as compared with earlier times, the rate of increase in the
population is still, as Leroy-Beaulieu points out, appalling, nearly
half a million a year in Great Britain, over half a million in
Austro-Hungary, and three-quarters of a million in Germany. When we
examine this excess of births in detail we find among them a large
proportion of undesired and undesirable children. There are two opposed
alternative methods working to diminish this proportion: the method of
preventing conception, with which we have here been concerned, and the
method of preventing live birth by producing abortion. There can be no
doubt about the enormous extension of this latter practice in all
civilised countries, even although some of the estimates of its
frequency in the United States, where it seems especially to flourish,
may be extravagant. The burden of excessive children on the overworked
underfed mothers of the working classes becomes at last so intolerable
that anything seems better than another child. "I'd rather swallow the
druggist's shop and the man in it than have another kid," as, Miss
Elderton reports, a woman in Yorkshire said.[15]