Margaret Sanger, "English Methods of Birth Control," [Jan 1915] .

Published pamphlet. Source: Margaret Sanger Papers, Library of Congress , Library of Congress Microfilm 129:144 .

Sanger published this pamphletin England around January 1915. It was preced by Family Limition, Sept. 1914 and was followed by Dutch Methods of Birth Control, ca. Mar.-Apr. 1915 and Magnetation Methods of Birth Control, ca. Aug. 1915. For an additional copy see MSM S76:087>. Pages 15-19 have been omitted as they reprint descriptions of methods published in the Malthusian Leauge's Hygenic Methods of Birth Control.


ENGLISH METHODS OF BIRTH CONTROL

By MARGARET H. SANGER

This pamphlet is drawn up on lines similar to the leaflet called “Hygienic Methods of Family Limitation,” adopted by the Malthusian League of England.

The League sends this leaflet to all persons married or about to be married, who apply for it, in all countries of the world, except to applicants from the United States of America, where the Postal Laws will not allow of its delivery.

The methods printed herein are taken from the League’s leaflet; they are to a great extent a duplication of the methods contained in the preceding pamphlet, “Family Limitation”; but it is my desire to give the subscribers of the “Woman Rebel” and other applicants for this knowledge, all known methods employed by the different Leagues in the various countries of the world.

The Malthusian League had no knowledge of this pamphlet, nor is responsible for its publication in any way.

M. H. S.

TWO CLASSES OF SOCIETY.

Today in nearly all countries of the world, most educated people practice some method of limiting their offspring. Educated people are usually able to discuss at leisure the question of contraceptives with the professional men and women of their class, and benefit by the knowledge which science has advanced.

The information which this class obtains is usually clean and harmless.

In these same countries, however, there is a larger number of people who are kept in ignorance of this knowledge: it is said by physicians who work among these people that as soon as a woman rises out of the lowest stages of ignorance and poverty, her first step is to seek information of some practical means to limit her family.

Everywhere the woman of this class seeks for knowledge on this subject. Seldom can she find it, because the medical profession refuses to give it, and because she comes in daily contact with those only who are as ignorant as herself of the subject.

The consequence is, she must accept the stray bits of information given by neighbors, relatives, and friends, gathered from sources wholly unreliable and uninformed. She is forced to try everything and take anything, with the result that quackery thrives on her innocence, and ignorance is perpetuated.

The proper authority to give advice on preventive methods should be the medical profession; no class of men and women are so aware of the need of this knowledge among the working class as they -- yet they remain silent.

So until they awaken from their Rip Van Winkle slumber and take up this question, it is the duty of those who know reliable means and methods of birth control to spread this information among the class who are ignorant of it, yet who desire but cannot obtain it elsewhere.

ARE PREVENTIVE METHODS INJURIOUS TO HEALTH?

One of the questions quite commonly asked by women and men who are fearful of using preventives is: "Will preventive methods injure the health of either the man or the woman?”

A prominent authority, Wille (as quoted by Kisch), maintains “that the continued fear of pregnancy will in most cases do more injury to the feminine system than all the preventive measures in the world.”

It is further claimed by some physicians that to a nervously weak woman a preventive method is almost necessary, and even helpful in regaining her health; but that much depends upon the kind of method employed is not doubted.

One of the most directly injurious methods to the woman is the use of strong solutions of antiseptics for the douche. If these are above the proper strength, they are liable to injure the delicate membraneous lining of the parts. The same solutions in weaker proportions will act as a cleanser, and are seldom injurious.

But as each person is susceptible in a greater or less degree to all drugs, I advise the use of salt solution as a douche, as not only the least injurious and the cheapest, but as most beneficial.

Another question which has arisen in late years is the possibility that preventive methods have caused cancer. There is very little foundation for this assertion.

The constant use of the pessary, worn from month to month, or the “uterus button,” worn by women in the Western States, or any mechanical means worn constantly, might give rise to an irritation which could lead to the growth of cancer. But the temporary use of either of these would without doubt be quite harmless. By temporary use, I mean the use of either only when needed, followed by their removal.

In employing any preventive measures there is almost no danger to the man at all, even the habit of “coitus interruptus,” or withdrawal, which is the most common method practiced everywhere, is not considered as dangerous to the man’s health, as some authorities formerly viewed it; but, on the other hand, is considered by the most prominent authorities as injurious to the woman’s nervous system. The following are some of the best known men who look upon the practice as not beneficial to the woman: August Forel, Heinrich Kisch, Von Krafft-Ebing, Mensinga, Hirt, Freud, Lwenfeld, Elischer, Havelock Ellis, and many others.

In the preceding pamphlet on "Family Limitation,” I have explained this habit and the effects it has upon women, and shall not dwell upon it here. It is sufficient to say that “coitus interruptus” is considered as the cause of nervous disturbances and other serious conditions of the generative organs in woman by many prominent medical authorities of the day.

“The lack of sexual satisfaction,” concludes Kisch, “aggravates nervous and hysterical trouble in women, while suitably regulated intercourse with mutual satisfaction has an actively beneficial effect.”

There has been among men a common idea that woman had little or no sex desire or interest, and that marriage sanctioned a union which made of woman a recipient but not a mutual partner in the sex life. Fortunately this idea is giving way, and men of ideals and fine temperaments dislike the idea of the relation when it is not mutual. That is one of the reasons that the use of preventive measures has come to play so important a part in the lives of both men and women, and why it must sooner or later receive the fullest attention from the medical profession, as well as from society at large.

Tolstoy was opposed to the use of preventives because they liberate men from the cares and sorrows of having children, which he thought must be regarded as the penance to be paid for sensual love. One might naturally ask why the children should be made to suffer; and if sensual love is a degraded love, why not prevent children being born in it?

I think we, who have in view a new race, do not desire that race to be the penance of previous generations’ sins.

There are only a few authorities today who look upon the use of preventive measures as either immoral or injurious; it is more generally regarded as a rise in the physical and moral standards of the people who use them.

ARE PREVENTIVE MEASURES CERTAIN?

It is difficult to say that anything is certain in its results, but there is every reason to believe that if directions are carefully followed in preventive methods, some means are quite certain.

A surgeon would not succeed with an operation was he not most particular to take every precaution and insist that his directions be followed out. It is the same thing in using preventive measures; care must be taken in douching after intercourse; attention given to adjusting the pessary correctly (or the cot or condom); attention given to the date of the menstrual period, and a laxative taken four days before the time expected. If these attentions and suggestions are applied before the date, there will seldom be any difficulty after.

The educated classes have been practicing the methods of prevention for nearly a half-century, and have found them certain and safe. If a woman is indifferent or too indolent to take precautions, then nothing will be certain; but I recommend the following as safe and harmless:--

The use of the Mizpah pessary (not to be left in the vagina longer than twenty-four hours without cleansing).

The use of a salt solution before and after the removal of the pessary; two level tablespoonsful of salt to a pint of water: use two quarts for a thorough cleansing.

5 or 10 grains of quinine two or three nights preceding the date of menstruation, to eject any semen escaping into the uterus.

The pessary may be left in the vagina over night, which does away with the necessity of getting up in cold rooms to douche. It may be removed the following day at leisure; better in the morning; if possible, before it gets out of place by standing much on the feet.

There is no doubt that the use of the pessary and the use of the cot or condom are both safe and certain, if they are used intelligently.

DO PREVENTIVE METHODS LEAD TO STERILITY?

This question is often asked by women early in marriage, who desire to use preventive methods for a period, until it becomes economically possible to care for a child. It is feared that the use of preventives will cause sterility, and when a child is desired the woman will be unable to conceive.

There is no ground for this fear. It has been shown by hundreds of cases where parents have lost a child, that though they had practiced preventives for four, five, or even ten years, conception has taken place when desired. Personally, I know a patient who gave birth to a child after 20 years’ use of preventives.

As mentioned before, strong solutions should be especially avoided in this respect. But it is well to get the advice of your family physician and bring these questions before him.

WHEN SHOULD WOMEN AVOID HAVING CHILDREN?

It is well for a woman not to give birth to a child–- 1. Before she is at least twenty-two years of age; better twenty-five if possible. 2. From two to three years after the birth of the last child, in order to properly nurse the last child and to allow the mother to renew her strength for the next. 3. Whenever a woman or man suffers from diseases such as tuberculosis, gonorrhea, syphilis, cancer, epilepsy, pelvic deformities, insanity, drunkenness, and mental diseases. 4. When parents, though healthy themselves, find that their children are physically or mentally defective. 5. Whenever the conditions of life and the uncertainty of livelihood do not give the prospect of bringing up children decently and of giving them a better chance than the parents have had.

And for Working Women–

6. So long as society remains indifferent to the needs of the worker’s children. 7. So long as child slaves toil in mill and factory. 8. So long as the wage system exists, for it dictates in what locality you shall live, and what you may give of the things of life to your children. 9. So long as there is a class war and the workers must fight for their economic emancipation. Working women should not produce children who will become slaves to feed, fight, and toil for the enemy– Capitalism.

So long as that fight is on, the woman’s place is on the battlefield with her her class brothers. Neither should be burdened or hampered in this fight with the care of children.

HOW CONCEPTION TAKES PLACE.

It is important that every adult should know and clearly understand what conception means and how it takes place.

In one of the chapters in my little book, "What Every Girl Should Know,” I show the action of the cells and explain how the sexual impulse in both boys and girls leads up to conception.

Here I shall go only briefly into the subject to give a general idea of what actually occurs.

In every woman’s ovaries there are embedded millions of ovules or eggs. They are there in every female at birth, and as the girl grows into womanhood these ovules or eggs develop also. At a certain period or age, the ripest ovule leaves the nest or ovary and comes on down the tubes into the womb, and passes out of the body. When this takes place, it is said the girl is at the age of puberty, for the ovule is now ready for fertilization (or conception) by the male sperm.

About the same time that the ovule is ripening or developing, the womb is preparing to receive the fertilized ovum by a reinforced blood supply brought to its lining, to which the ovum will cling and gather its nourishment after fertilization takes place. If fertilization or conception does not take place, then the ovum passes on out of the body, and the uterus throws off its surplus blood supply. This is called the menstrual period, and occurs once a month or about every twenty-eight days.

In the male sexual organs there are glands (testes) which secrete a fluid called the semen. In the semen is the life-giving principle, the sperm.

When intercourse takes place (if no preventive is used) the semen is deposited in the woman’s body (vagina).

The ovule is not in the vagina, but further up in the womb in safety, or perhaps in the tube on its way to the womb. It is the nature of the male principle of life to pursue, and when the sperm is active it starts on its way to seek the ovum, as steel is attracted by the magnet.

Several sperm cells go to meet the ovum, but only one enters it and becomes absorbed within it. This is called fertilization, or conception, or impregnation. This action of the male sperm meeting the ovule must be prevented if no children are desired.

It must be remembered that the sperm is very active and moves quickly towards its attraction. Usually it is deposited so near the mouth of the womb that it is out of reach of a douche in a few minutes after intercourse. That is why it is best to have a covering over the mouth of the womb so that it cannot enter.

To prevent the male sperm from meeting the female ova is called prevention of conception.

As soon as the two cells have met and joined together in the fertilized egg, any attempt at removing it or preventing its development or further growth is called abortion.

ABORTIONS.

That there is almost no other country in the world where abortions so frequently occur as in the United States, is a fact worthy of consideration and interest. That the laws in these same United States are perhaps the most rigid, and the penalty the heaviest for any action toward abolishing abortions (by education and knowledge), of any country in the world, is also worthy of interest.

Abortion is the most common as well as one of the most serious disturbances of pregnancy, yet it is said that one out of every five pregnancies terminates abruptly in abortion. In what proportion “criminal abortion” is of this it is difficult to state, but it is roughly estimated that at least 150,000 abortions occur in the United States each year, and that 25,000 women die from its effects.

There is no doubt that women are apt to look upon an abortion as of little consequence, and to treat it accordingly. An abortion should be regarded as important a matter as a confinement, and requires as much attention as the birth of a child at full term.

It is only the women of wealth who can afford to give an abortion the proper care and treatment both at the time and afterwards. Consequently, these women seldom suffer any serious consequences from its occurrence.

The women whose incomes are limited, and who must continue at work before they have recovered from the effects of an abortion, are the great army of sufferers, and it is from among these women that the deaths due to abortion usually ensue.

If women had the knowledge how to prevent conception, there would be almost no necessity for abortions.

It is because of abortions occurring so frequently among the women of the working class today, the suffering, illness, operations, invalidism, and deaths resulting from the carelessness of their performance, that has urged me to make any sacrifice, and direct my efforts to make it possible for these women to obtain clean and harmless knowledge of the means to prevent conception, and thereby prevent abortions, and the necessity for them.

During my nursing on the lower East Side of New York City a few years ago I came in contact with some of the midwives, and had occasion to view their instruments and appliances which they use in this profession. I was horrified at the filthy condition of the scissors, forceps, brushes, etc., their kit contained.

Is it any wonder that deaths of the poorer women mount high?

The more I see of women who have aborted, and the more I see the results of abortions, the more convinced I am of their injurious effect on women, and the stronger do I urge the knowledge of prevention of conception.

The results of abortion are usually of far more serious effect on the woman’s health than a full-term child birth.

There is the possibility of the womb not returning to its natural size, but remaining large and heavy, tending to fall away from its proper position in the body.

Then one abortion so often leaves the uterus in a condition to conceive very easily again, and unless prevention is strictly followed another pregnancy will surely occur.

Frequent abortions have a tendency to establish sterility or barrenness in the woman as well as result in pelvic ailments.

That there are cases where an abortion is justifiable, no intelligent person can deny; but I do claim that the hundreds of thousands of abortions being performed in America each year is a disgrace to civilization, and I lay the necessity for them and the illness and sufferings and deaths resulting from them at the doors of a Government whose authority extends beyond the limits of the people’s intention, and which in its puritanical blindness insists upon suffering and death from ignorance rather than life and happiness from knowledge and prevention.

Nearly all authorities today agree that the necessity of abortions could be greatly abolished by knowledge of prevention. One quotation from Havelock Ellis ("Sex and Society”) sums it up in a nutshell. "In order to do away with the need for abortion, and to counteract the propaganda in its favour, our main reliance must be placed, on the one hand, on increased foresight in the determination of conception and increased knowledge of the means for preventiing conception; and on the other hand, on a better provision by the State for the care of pregnant women, married and unmarried alike, and a practical recognition of the qualified mother’s claim on society. There can be no doubt that in many a charge of criminal abortion the real offence lies at the door of those who failed to exercise their social and professional duty of making known the more natural and harmless methods for preventing conception, or else by their social attitude have made the pregnant woman’s position intolerable.”

IS THERE A SAFE PERIOD?

There are some women who believe there is a safe period in the month when conception does not take place. That if intercourse does not occur from four days before menstruation until a week after it has ceased, in the time remaining conception will not occur.

There may be women who have found this to be true in their own experience, but most medical authorities deny its infallibility, and personally I have known of more abortions resulting from this method than those with whom it has been successful. It is not wise to trust it.

There are also many women, and a few men, who claim that intercourse is intended only for procreation, and that it should not take place unless a child is desired. In this way no preventives are necessary.

I must admit I held this view for years, and have a sneaking regard theoretically for it still. I believe the sexual act involves a creative energy which can be directed into channels for creative work and self-expression.

I lay special stress on creative work, which in my estimation draws on different forces in the body than the mechanical, physical, or routine labor.

But I know, too, that the sexual life of man differs greatly in nature and the course of its development from the sexual activity of woman, and also that the majority of men and women today are doing very little creative work, which leaves almost the only outlet for their creative energy through the sexual act.

The consequence is, all modern life forces a sexual outlet through intercourse, and it is only the few exceptions who are able to live up to this theory, even if it is accepted.

WILL FAMILY RESTRICTIONS HELP THE CAUSE OF LABOR?

There is a general opinion among some people of Europe that the national use of preventive measures will reduce the wages of the working class.

They claim that the worker does and will receive wages according to his least amount of subsistence. That if a man has ten children he will have more needs, and therefore demand a higher wage than the man with only two children. We in the United States of America know that a job does not pay according to the size of the family or the man’s needs. We know that a man who has a family of ten children does not receive wages above the man with two children. A job or trade pays a maximum standard wage regardless of the size of the applicant’s family.

In some trades, like the weavers, or piece work where the wage depends upon the individual’s output, the man with the large family earns far less because his individual earning capacity is lessened through poverty, less nourishment, poorer home surroundings, lower standards of living, more worry, greater responsibility, more anxiety, than the man with only with only two children. The man with a large family must bring his standards down to fit the wage his job pays; if he does not like the price, he can leave it, others will accept it gladly. The working class have produced sufficient slaves to keep the army of the unemployed always ready to accept a job at any price. When men cannot be had cheap enough, woman’s labor will do; child labor is still cheaper. Industry demands profits; profits demand cheap labor.

It has been my experience to find that the average man with a large family is compelled to sell his labor power cheaper thn the man with a small family. His family needs are more pressing and more urgent, and he must accept a job at any price. It is the Labor Union which forces him to demand the standard wage, and backs him up getting it. His urgent needs would soon be taken advantage of by the master class were it not for the Union or the trade solidarity of Labor (even the little there is of it).

The man with the large family is usually the drag and burden of a strike. He is the last to go out, and the first to return. The cry of hunger of several children has a subtle way of reducing the most revolutionary spirit to a minimum, and if he sacrifices the future cause of Labor to the present and urgent needs of his family, it is because Labor has not taken this question into consideration before and included it in its propaganda.

I do not propagate the limitation of offspring as a panacea for all economic problems, but I emphatically do advocate it as the most necessary immediate step the workers should take in the struggle for their emancipation.

[ (The Editors have omitted a section extracted from the leaflet, “Hygienic Methods of Family Limitation.” adopted by the British Malthusian League.]


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