Margaret Sanger, "Introduction to Dutch Methods of Birth Control," Mar/Apr 1915.

Published Article. Source: Margaret Sanger Papers, Library of Congress , Library of Congress Microfilm, 128:737 .

This was the second in a series of pamphlets on birth control methods. For the other pamphlets see ""English Methods of Birth Control," 1915 and "Magnetation Methods of Birth Control," 1915. We have omitted the description of contraceptive methods reprinted from the pamphlet produced by the NieuwMalthusiaanche Bond; for enture pamphlet, see LCM 128:737.




The following methods are taken from the pamphlet published by the Neo-Malthusian League of Holland, called "Methods Used to Prevent Large Families," translated into English from the Dutch.

The Council of the Neo-Malthusian League calls attention to the fact that it has for its sole object the Prevention of Conception, and not the causing of abortion.

The Neo-Malthusian League of Holland knows nothing of this pamphlet, and is not in any way responsible for its publication. M.H.S.


In the year 1877 Mrs. Annie Besant and Mr. Charles Bradlaugh, two firm and honest advocates of the doctrine of Malthus, were prosecuted and sentenced to imprisonment for publishing a book entitled "The Fruits of Philosophy," which presented the physiological aspects of birth control.

The trial lasted several days, and aroused a greater interest in the subject than had been known since the days of Malthus. The English Press was full of the subject; scientific congresses gave it their attention; many noted political economists wrote about it; over a hundred petitions were presented to Parliament requesting the freedom of open discussion; meetings of thousands of persons were held in all the large cities; and as a result, a strong neo-Malthusian League was formed in London.

Interest in the subject did not confine itself to England, however, for the following year at an International Medical Congress in Amsterdam the subject was discussed with great enthusiasm. A paper prepared and read by Mr. S. Van Houten (later Prime Minister) caused a wider interest in the subject, and a year later the Neo-Malthusian League of Holland was organized. Charles R. Drysdale, then President of the English League, attended the Conference.

As is usual in such causes, many of the better educated and intelligent classes adopted the practice at once, as did the better educated workers; but the movement had as yet no interest among the poorest and most ignorant. The League set to work at once to double its efforts in these quarters. Dr. Aletta Jacobs, the first woman physician in Holland, became a member of the League, and established a clinic where she gave information on the means of prevention of conception free to all poor women who applied for it.

Naturally, this action on the part of a member of the medical profession aroused the animosity of many of its members against her; but Dr. Jacobs stood firm in her principles, and continued to spread the necessary information among the peasant women in Holland, in the face of professional criticism and gross misunderstandings.

All classes, especially the poor, welcomed the knowledge with open arms, and requests came thick and fast for the League's assistance to obtain the necessary appliances free of charge. The consequence has been that for the past twelve years the League has labored chiefly among the people of the poorest districts. Dr. J. Rutgers and Madame Hoitsema Rutgers, two other ardent advocates of these principles, have devoted their lives to this work. Dr. Rutgers says that where this knowledge is taught there is a reciprocal action to be observed: "In families where children are carefully procreated, they are reared carefully; and where they are reared carefully, they are carefully procreated."

The Neo-Malthusian League of Holland has over 5,000 men and women in its membership, and more than fifty nurses whom it endorses.


These nurses are trained and instructed by Dr. Rutgers in the proper means and hygienic principles of the methods of Family Limitation. They are established in practice in the various towns and cities throughout Holland. They not only advise women as to the best method to employ to prevent conception, but they also supply them with a well-fitted pessary, and teach them how to adjust, remove, and care for it--all for the small sum of 1 1/2 guilder, or about 60 cents. They work mainly in the agricultural and industrial districts, or are located near them; and their teachings include not only the method of prevention of conception, but instruction in general and sexual hygiene, cleanliness, the uselessness of drugs, and the non-necessity of abortions.

In this country, for a nurse to dare to fit a woman with a pessary would be considered a breach of professional rights. In Holland, they know the poor cannot pay the physicians, and this simple adjustment is looked upon by the medical profession much as they view the nurse administering an enema or a douche.

I had the pleasure of attending some of the classes where Dr. Rutgers gave this course of instruction. I also attended and assisted in the clinics where women came to be advised, instructed, and fitted. Many of them came for the first time, and though they were unacquainted with any means to be employed, they accepted the instructions in a most natural and intelligent manner. Other women came to be refitted, and many brought the pessary previously used, to ask questions concerning its adjustment.

There was a determined social responsibility in the attitude of these peasant women coming into The Hague from the surrounding districts. It seemed like a great awakening. They look upon a new baby in the family much as they look upon the purchase of an automobile or a piano or any other luxury where they have no room to keep it, and no means with which to purchase it or continue in its upkeep.

There is no doubt that the establishment of these clinics is one of the most important parts in the work of a Birth Control League. The written word and written directions are very good, but the fact remains that even the best educated women have very limited knowledge of the construction of their generative organs or their physiology. What, then, can be expected of the less educated women, who have had less advantages and opportunities? It is consequently most desirable that there be practical teaching of the methods to be recommended, and women taught the physiology of their sex organs by those equipped with the knowledge and capable of teaching it.

The Neo-Malthusian League of Holland endorses, as the most reliable means of prevention of conception, the Mensinga pessary (which differs in construction from the French or American Mizpah pessary). The nurses also recommend this; but other methods are discussed with the patient, and the husband's attitude toward other methods considered and discussed. The pessary is the commonest recommendation, as giving the most satisfactory results.


It stands to the credit of Holland that it is perhaps the only country where the advocates of Birth Control have not been prosecuted or jailed. This does not mean there has been no opposition to this propaganda; on the contrary, there is today strong opposition by the Church, and only a few years ago, in 1911, when a Clerical Government came into power, laws were made against the propagation of these ideas, and much of the freedom previously enjoyed by the League was denied it; but on the expulsion of the Clerical Government later on, the rights of free speech and free press were regained.

In the year 1895 the League was given a royal decree of public utility, which again does not necessarily mean this propaganda is sanctioned by the Government; but the laws regarding the liberty of the individual and the freedom of the press uphold it, and it is thus that its advocates are not molested.

The League has thirty sub-divisions, which include all the large cities and towns and many of the smaller ones. Over 7,000 pamphlets of the kind printed herein are sent out in the Dutch language and several hundred in English and Esperanto each year. These are only sent when asked for by the applicant.

There is no doubt that the Neo-Malthusian League of Holland stands as the foremost in the world in organization, and also as a practical example of the results to be obtained from Birth Control teaching. Aside from the spreading influence of these ideas in Belgium, Italy, and Germany, Holland presents to the world a statistical record which proves unmistakably what the advocates of Birth Control have claimed for it.

The infantile mortality of Amsterdam and The Hague is the lowest of any cities in the world, while the general death rate and infantile mortality of Holland has fallen to be the lowest of any country in Europe. These statistics also refute the wild sayings of those who shout against Birth Control and claim it means race suicide. On the contrary, Holland proves the practice of anti-conceptional methods leads to race improvement, for the increase of population has accelerated as the death rate has fallen. There has also been a rapid improvement in the general physique and health of the Dutch people, while that of the high birth rate countries, Russia and Germany, is said to be rapidly deteriorating.

The following figures will suffice to show some of the improvements which have been going on in Holland since 1881, the time the League became actively engaged in the work:--


Taken from Annual Summary of Marriages, Births, and Deaths in England and Wales, etc., for 1912.

AMSTERDAM (Malthusian League started 1881; Dr. Aletta Jacobs gave advice to poor women, 1885).

----------1881-85. 1906-10.1912.

Birth Rate 37.1 24.7 23.3 per 1000 of population.

Death Rate 25.1 13.1 11.2* per 1,000 of population.

Infantile Mortality (deaths in first year) 203 90 64* per 1000 living births.

The HAGUE (now the headquarters of the Neo-Malthusian League.

----------1881-85. 1906-10. 1912.

Birth Rate 38.7 27.5 23.6 per 1,000 of population.

Death Rate 23.3 13.2 10.9* per 1,000 of population.

Infantile Mortality deaths in first year) 214 99 66* per 1,000 living births.


-----------1881-85. 1906-10. 1912.

Birth Rate 37.4 32.0 29.0 per 1,000 of population.

Death Rate 24.2 13.4 11.3* per 1,000 of population.

Infantile Mortality 209 105 79 per 1,000 living births.


-----------------------1880-2. 1890-2. 1900-2.

Legitimate Fertility----306.4 296.5 252.7--Legitimate Births per 1,000 Married Women aged 15 to 45.

Illegitimate Fertility--- 16.1 16.3 11.3-----Illegitimate Births per 1,000 Unmarried Women aged 15 to 45


--------------------- 1880-2. 1890-2. 1900-2.

Legitimate Fertility---346.5 303.9 254.0

Illegitimate Fertility--13.4 13.6 7.7*

(*Lowest figure for the Continent.)


---------------------1880-82. 1890-2. 1900-02.

Legitimate Fertility 331.4 312.0 299.0

Illegitimate Fertility 17.4 16.5 13.1

(*These figures are the lowest in the whole list of death rates and infantile mortalities in the summary of births and deaths in cities in this Report.

The Neo-Malthusian propaganda in Holland is founded on feministic and economic grounds. Birth Control is the pivot around which both of these important movements [must?] swing. Mr. S. Van Houten, late Minister of the Interior for the Netherlands, says:"Wage-slavery exists as a consequence of the carelessness with which the former generation produced wage-slaves; and this slavery will continue so long as the adult children of these wage-slaves have nothing better to do than reproduce wage-slaves."

There has been marked improvement in the labor conditions in Holland during these last ten years especially, wages having increased and hours of labor decreased, with the cost of living taking a comparatively very small rise.

There is perhaps no country in Europe where the educational advantages are so great as in Holland. Many English women and widows with children, living on small incomes, move to Holland on account of the splendid education to be obtained in the public schools.

That the Birth Control propaganda has been a success in Holland any one travelling through that delightful, clean, and cheerful country can testify. There is no doubt that as first there were objections and abuses, but, in the words of Dr. Rutgers, "Certainly there are abuses, but the abuses of knowledge are never so enormous as the abuses of ignorance. And hygiene is the highest form of morality."

Following are the methods, reprinted from the practical pamphlet given out by the Neo-Malthusian League of Holland:--

Subject Terms:

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