Margaret Sanger: The Case for Birth Control (1917)

Read by Heather Wen, women's health nurse

How often have I stood at the bedside of a woman in childbirth and seen the tears flowing 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 percent 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....

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 moral?

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 women into one of two ways: Celibacy, with its nervous results, or abortion. All modern physicians testify that both these conditions are t 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. I 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 manthe 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," l 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 today. 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....

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, shipbuild ing, bridges, etc., so must woman triumph over the laws which have made her a childbearing machine.