ARE PREVENTIVE MEANS CERTAIN?
There are several means of preventing conception which are both
certain and harmless. What those means are the state laws forbid me to
say. If I should defy the state laws and name those contraceptives,
the federal laws would forbid this book's going through the mails. Nor
can I, without coming into conflict with the laws, tell _why_ these
means are reliable. It is difficult to discuss the subject without
using franker language than the statutes permit, and I do not wish to
violate the law in this particular book.
"Can I rely upon this? Is it certain? Will it prevent absolutely?"
Such questions, always asked by women who seek advice concerning
contraceptives, testify both to their fear of involuntary motherhood
and their doubt as to any and all means offered for their deliverance.
Doubt as to the certainty of contraceptives arises from two sources.
One is the uninformed element in the medical profession. A physician
who belongs to this element may object to birth control upon general
grounds, or he may repeat old-fashioned objections to cover his
ignorance of contraceptives. For, strange as it may seem, there is an
amazing ignorance among physicians of this supremely important
subject. The uninformed objector often assumes to speak with the voice
of authority, asserting that there are no thoroughly dependable
contraceptives that are not injurious to the user.
The other source of distrust is the experience of the woman herself.
Having no place to go for scientific advice, she gathers her
information from neighbors and friends. One offers this suggestion,
another offers that, each urging the means that she has found
successful and condemning others. All this is very confusing and
extremely disturbing to the woman who, for one reason or another, is
living in constant fear of pregnancy.
It is not at all surprising that such a state of affairs exists. There
has been so much secrecy about the whole subject and so much
dependence upon amateurish and nonprofessional advice that it is
almost impossible for anyone to procure reliable information or to
recognize it when given. This is especially true in the United States
where there are both federal and state laws to punish those who
disseminate knowledge of birth-control methods.
Even under present conditions, however, there is a certain amount of
reliable information concerning methods of birth control. We know that
there are several methods of prevention which are not only dependable,
but which can be used without injury either to the man or the woman.
Knowledge of what these methods are and how to apply them should be
available to every married man and woman. It is safe to predict that
in a very few years they will be available.
Some methods are more dependable than others, just as there are some
more simple of adjustment than others. Some are cheap and less
durable; others are expensive and last for years. There are some which
for a quarter of a century have stood the test of certainty in
Holland, France, England and the United States among the wealthier
classes, as the falling birth rate among these classes indicates. And
just as the reliable, primitive wheelbarrow is antiquated beside the
latest airplane, so, as scientific investigators turn their attention
more and more to this field, will the awkward, troublesome methods of
the past give way to the simpler, more convenient methods of the
morrow.
Although the law forbids information concerning reliable means of
contraception, it is hardly likely that it can be invoked to prevent
warnings against widely practiced methods which are NOT reliable. The
employment of such methods leads not only to disappointment but often
to ill health.
One of the most common practices of this kind is that of nursing one
baby too long in the hope of preventing the birth of the next. The
"poor whites" of the South and many of the foreign-born women of the
United States pin their hopes to this method. Often they persist in
nursing a child until it is eighteen months old--almost always until
they become pregnant again.
Prolonged nursing hurts both child and mother, it is said. In the
child it causes a tendency to brain disease, probably through
disordered digestion and nutrition. In the mother it causes a strong
tendency to deafness and blindness. If a child is nursed after it is
twelve months old, it is generally pale, flabby and unhealthy, often
rickety, one authority points out, while the mother is usually
nervous, emaciated and hysterical. If pregnancy occurs under these
conditions, the mother not only injures her own health but that of the
next child, often developing in it a weakness of constitution which it
never overcomes.
Moreover, prolonged nursing has been found to be unreliable as a
contraceptive. We know this upon good authority. It should not be
depended upon at all.
In the same class is the so-called "safe period" referred to in
another chapter. For many women there is never any "safe period."
Others have "safe periods" for a number of years, only to find
themselves pregnant because these periods have ceased without warning.
One of the most frequent of all the mistakes made in recommending
contraceptives is the advice to use an antiseptic or cold-water
douche. This error seems to be surprisingly persistent. I am
particularly surprised to hear from women that such douches have been
prescribed by physicians. Any physician who knows the first rudiments
of physiology and anatomy must also know that necessary and important
as an antiseptic douche is as a cleanser and hygienic measure, it is
assuredly not to be advised as a means of preventing conception.
A woman may, and often does, become pregnant before she can make use
of a douche. This is particularly likely to happen if her uterus is
low. And the woman who does much walking, who stands for long hours or
who uses the sewing machine a great deal is likely to have a low
uterus. It is then much easier for the spermatazoa to enter almost
directly into the womb than it would otherwise be, and the douche, no
matter how soon it is used, is likely to be ineffective. The tendency
of the uterus to drop under strain goes far to explain why some women
who have depended upon the douche for years suddenly find themselves
pregnant. Do not depend upon the douche. As a cleansing agent, it is a
necessary part of every woman's toilet, but it is not a preventive.
Even if the douche were dependable, the absence of sanitary
convenience from households in remote districts and the difficulty of
using a douche in crowded tenements would prevent many women from
making use of it.
Despite the unreliability of some methods and the harmfulness of some
others, there _are_ methods which are both harmless and certain. This
much the woman who is seeking means of limiting her family may be told
here. _In using any method_, whatsoever, all depends upon the care
taken to use it properly. No surgeon, no matter how perfect his
instruments, would expect perfect results from the simplest operation
did he not exercise the greatest possible care. Common sense, good
judgment and taking pains are necessary in the use of all
contraceptives.
More and more perfect means of preventing conception will be developed
as women insist upon them. Every woman should make it plain to her
physician that she expects him to be informed upon this subject. She
should refuse to accept evasive answers. An increasing demand upon
physicians will inevitably result in laboratory researches and
experimentation. Such investigation is indeed already beginning and we
may expect great progress in contraceptive methods in the near future.
We may also expect more authoritative opinions upon preventive methods
and devices. When women confidently and insistently demand them, they
will have access to contraceptives which are both certain and
harmless.