Margaret Sanger, "The Necessity for Birth Control," 19 Dec 1928.

Typed Draft Speech. Source: Margaret Sanger Papers, Library of Congress , Library of Congress Microfilm 130:0226 .

Handwritten additions are by Margaret Sanger.

The Necessity for Birth Control

by Mrs. Margaret Sanger

Auditorium Theater, Oakland, California. December 19th 1928.

It was Victor Hugo who said there was no force in the world so great as that of an idea whose hour had come. Some of us believe that the hour for Birth Control has come. There are very few subjects ↑which have so large a ↓ of so practical a significance which ↑cut↓ so deeply into the foundations of social welfare ↑evolution↓ as Birth Control. There are few ↑other↓ subjects that have been left so long in obscurity while, at the same time, there are few that can so demonstrate their importance as Birth Control has done in the past few years.

George Bernard Shaw said that Birth Control is the most revolutionary idea of the twentieth century. H. G. Wells says it is the most momentous fact of modern living. I claim that Birth Control is a ↑the keynote of a ↓ new moral responsibility, a new social awakening. It is not only a health and economic safeguard ↑expedient↓ but a great social expedient ↑principle↓ interlocked with the ↑spiritual↓ progress of the human race ↑and its future↓ .

To define Birth Control, we say it is the conscious control of the birth-rate by scientific means that prevent the conception of human life. Prevent, remember. Prevent does not mean to interfere. It does not mean to destroy. There is no more interference with life through birth control than there is to remain unmarried or to live a celibate life. We also say “to control.” Control does not mean that you limit. When you control your furnace you do not have to put the fire out. When you control your motor you do not necessarily stop your car. To control the birth rate means that there shall be the same right for those who do not wish to have children as for those who do wish to have them. There are no objections to those who wish to increase the size of their families, but on the other side there seems to be a great deal of question and controversy as to the right of those who wish to limit or control the number of their children. Why, they say, should there be any necessity to control or limit population in this great land and especially out here in the west where there are so many large spaces ↑acres↓ of unused territory.

Civilization is confronted with two problems-- pressure of population on the food supply ↑of the world↓ and the reconciling of humanitarian efforts with the greatest improvement of the race ↑improvement↓ . I believe birth control is the key to both. Statistics tell us that from fifteen to twenty millions of persons are born in this country ↑world↓ every year. That means fifty thousand a day. Certainly we must believe that something must ↑should↓ be done with this enormous group ↑increase↓ of new population. It must be controlled. There are only two ways of controlling it. INCREASING the death rate or DECREASING the birth rate. Which shall it be? History records the fact that population has always been kept down by war, by famine, by disease by floods and pestilence. Nature is most ruthless in extermination; she crushes to the wall the old, the sick, the demented, the diseased, the inefficient and through these means was ↑is↓ able to perfect her type. But civilization today will no longer permit those methods to operate. With the hand of charity and philanthropy, democracy and Christianity, we reach out and grapple with Nature. We take to ourselves these inefficient, demented, or feeble-minded persons and we tax the normal, the fit and the healthy members of the population for their care. Through these methods we are brining civilization to a queer pass. William Sanyer ↑Starr Meyer↓ of Princeton University tells us that out of our [ illegible] ↑one↓ ↑105,000,000↓ hundred and twenty ↑five↓ million people, only twenty million can be classified as intellectual. From ↑the 85 million thru↓ psychological, biological and other tests it is found that 45-million are sub-normal, with intellects equal to juveniles of fifteen years; fifteen million were definitely feeble-minded, with eight year old minds; while 25-million could at best be classified as mediocre. Of course we all hope that we belong to the 20-million class. It is that enormous group of feeble-minded that gives concern to those of us who are socially minded.

Many of us remember the two famous families, the Kallikaks and the Jukes. The first started by a feeble-minded man marrying a normal woman. We know that two feeble-minded persons have never been known to bring to birth a normal child, but here we started with a normal woman. 470 of their descendants were normal: 143 were feeble-minded: 36 were illegitimate; three were epileptics: 83 died in infancy: three were criminals and twenty-four died in houses of ill fame.

The Jukes family had 1200 descendants; of these 130 were professional paupers; 135 were common criminals; 70 were thieves; the expense of maintaining this family was $1,300,00-- and that too, was in the days when we did not have to count the high cost of living. Today we know for a fact that the high proportion of feeble-minded in our population is one of the great problems of civilization.

All over the country we find that institutions are not numerous enough or large enough to take care of our feeble-minded population. California has been one of the few States advanced enough to take hold of this question and try to solve it through sterilization. Reckoning three children for each feeble-minded couple, out of six thousand sterilized, California has saved herself eighteen thousand feeble minded persons.

It is not sufficient to take only the feeble-minded who are in institutions; only a small proportion of them are there. Millions live with us-- with no regard whatever for the coming race. They continue to make our problems and to bring numerous children into the world.

Our insane question is almost as serious. In New York State a few years ago there was a great deal of pride on the part of the Governor and Legislature because they came before the public and said they had been able to appropriate the sum of twenty-five million dollars for the care of the insane. No one seemed to ask what they were doing to decrease the numbers of the insane. New York has, and I presume California also, the practice of allowing inmates of asylums suffering from certain types of insanity to return home periodically on what is called the parole system. A man confined in an asylum after for a certain period of time is allowed to return to his family on certain occasions; also a mother or woman. There is no responsibility on the part of the State to see that anything is done, or any knowledge given to that inmate or his family to see that children do not come from that individual.

We have had many cases where women, having been informed that the husband is returning, have come to our social agencies and begged that something should be done, often stating they already have two or three feeble-minded children or idiots. Often the women in these families are the bread-winner and she has begged the organizations, who are there to protect motherhood, to do something about this problem. In no case, in New York city, have I know that these women were ever helped in a fundamental way. They have been told not to worry, have been cheered as much as they could be cheered, and told that when such a condition arose they could come to the pre-natal clinic and care given them-- and that is all. That seems to me a very short-sighted policy on the part of the social agencies and other groups, well-meaning, no doubt, but nevertheless very sentimental.

Not only the feeble-minded and insane deserve consideration. There are two groups of people in the world-- not only in the United States but in almost all large cities of the civilized world. One group is what I term the small family group; the other is the large family group. When you look at the small family group you will see they have by far the best of it. It is there we find health, wealth, culture, education, intelligence. It is where there are few children, well spaced, that those few are brought up to full maturity. The children of this group are not sent to factories but to school, because of the desire of the parents to give them the best opportunities. They go to high school, to colleges, to universities. It is from this group that the best positions in the community are usually filled. It is from this group that those who desire to see large populations desire they should come.

On the other hand is the large family group; it has a hard time. You find there poverty. Poverty and large families almost always go hand in hand. You find mothers bearing children far too frequently, without regard to her health or the father’s earning capacity. It is there we find slums, overcrowding, not only in homes but in the community. We find there, too, terrible infant and maternal mortality, ignorance, disease, unemployment, child labor, and all the problems we are trying today to solve.

I know this group fairly well and I know the mothers here are not desirous of frequent child-bearing any more than the mothers of the other group. But seek and ask where they will there is no way for them to get advice or instruction on how to control the size of their families. All agencies are turned against them; they must turn to the interrupted pregnancy or bring unwanted children into the world year in and year out.

We are known in America to be a very generous hearted people; we are known throughout the world as being very large spenders. We have in the past ten years spent NINE BILLION DOLLARS on what are called the four D’s-- DISEASE: DEFECTS: DELINQUENCY: DEPENDENCY. I have no quarrel even with that enormous amount if we could only be assured that it was not going to increase the next year and the following year. But we have no such assurance. In fact, judging by the past ten years, we have no reason to believe anything, except that we will be paying, not nine or ten but perhaps fifteen billion dollars to take care of the four D’s in the next ten years.

Will all you who are interested in social work follow me for a moment to see how we really attack one or two of these questions.

Take Maternal Mortality. It is really a disgrace that this country, which has so many spendid social organizations and institutions, should yet have its maternal mortality increased during the last few years. Twenty thousand mothers passed out from causes due to pregnancy during the past year. Twenty thousand mothers means two mothers for every hour, night and day. We know that tubercular women, or women with heart or kidney trouble should never be allowed to take the risk of motherhood. We know, too, that even tubercular women die, not from tuberculosis but from pregnancy. We know that the medical profession has every right, legally and morally, to interrupt that condition. Then what? They send her back to her home, to face the same conditions, in utter ignorance and with a death sentence hanging over her head.

With Infant Mortality we have done better. It is today I believe down to two hundred thousand infants who died before reaching their first birthday. We have reduced it but oh, at such a cost, not only in money but a whole group of individuals have devoted the best part of their lives to keeping alive children who never should have been born.

We do everything to keep our children alive but in most cases it is like locking the door after the horse is stolen. We have our Milk Stations, our Maternity Centers; we have Nurseries; we send nurses into the homes to tell the mothers of eight or nine children how to have their tenth child. What those mothers really want to know is how not to have that tenth or eleventh baby. Worst of all, we allow the 200,000 mothers and fathers of these children to remain in ignorance of how to prevent the birth of two hundred thousand children next year.

The Children’s Bureau of the Labor Dept. at Washington throws a light on the infant mortality of this country by telling us that the father’s wage has much to do with it. As his wage goes down, his family goes up. They also tell us that the spacing of children in the family has much to do with infant death; if there is an interval of two, three or four years that child has a better chance to live. They tell us also that number of children in the family has much to do with infant mortality and that the second child has a much better chance to live than the tenth or twelfth. For every second child born there is less than 100 deaths per thousand; for the fifth child, about 350; for the twelfth it is 600 out of every thousand Sixty per cent of twelfth children born do not live to see their first birthday. What useless waste of womanhood and motherhood. What an orgy of agony!

I maintain that if we are ever going to do anything about infant mortality we have got to stop the unending stream of unwanted babies. We cannot sweep back the tide with the broom of organized charity or palliative legislation. We have to stop it at the source by safe and sound information to control birth.

Another question concerns us. Child labor. Most of us believe there is no such thing. We think children are protected by the laws of this country from work. But that is not true. For fifty years the Child Labor Commission has been trying to do away with Child Labor. They have not been successful. There are seven million children under 14 years of age who are engaged in gainful occupations. Have any of you seen children in the Southern mills going to work before the sun is up and returning after sunset? If you knew the conditions where these children are, you would know they are doomed to it. Fathers in many cases remain at home, doing much of the housework because he cannot get an adult man’s pay. Little ones of 6 or 7 are standing on boxes or benches because the machinery was made for their parents; here you find these little ones crowding so closely into the family that it is absolutely necessary for each of them as soon as they can to get out and compete with father and mother just for their daily existence. The same applies to children toiling in the fields, for instance, of Colorado. I went myself into the wheat fields of Colorado and it was astounding to me that we cannot have a little more fundamental attitude toward child labor; children of three and four were crawling on the ground like animals, putting fruit into baskets, their little backs permanently bent. To look into the faces of the parents of these twelve or fifteen children was to know that they were not capable of taking care of themselves, to say nothing of a large family,-- which should never have been brought into the world. I’d like to see the Society for the Prevention of Cruelty to Children begin a little further back and prevent the cruelty of children being born in misery and disease. I should like to see the time when the United States Government would have to guarantee a passport of health for every child born in this country.

If we could imagine it I think the children would like to take a look at their parents before being born and to ask them a few questions. If parents had to apply for children as they do for cooks and chaffeurs, the children might ask them for their health certificate. They might say: “What is the idea of having me? How do you live? What kind of table do you set? What are your plans for bringing me up? Am I to spend my childhood in a factory or a playground?” It might even say: “Ah, Mr. Father, I am a potential genius: what do you know about the development of a genius? What kind of society have you constructed for my gifts to adorn?” It might ask how many children there were already and if the answer was eight in two rooms and on twenty dollars a week, we can fancy it would say “I’ll stay where I am” and interview the next applicant.

The Government is concerned about the kind of people who come here from outside. Up to 1914 Uncle Sam was rather negligent about the kind of folk who emigrated here; he was like the parents who, although they scarcely know what they will do if their family is increased, yet do nothing to prevent it. Not until 1914 did the U.S. Government do anything much. We did not encourage emigration but did nothing to stop it. Not until 1924 was it necessary to recognize that there was a population problem and that SOMETHING must be done for the future of the country. So bars were put up at the entrance of the United States. Le mt read you what the Government thinks likely to be a menace and source of disease to her people, to the happiness and wellbeing of her population. Feeble-minded persons, epileptics, idiots, imbeciles, insane people, tubercular, those with any loathsome or contagious disease, paupers, professional beggars, those likely to become a public charge, criminals, prostitutes, or for purposes of prostitution in any form; illiterates, those over 16 years unable to read English or any other language-- all are refused admission and procedure for the enforcement of these measures is mandatory. I think it is good legislation. Unfortunately it is merely negative and not selective legislation.

If it is necessary to keep such types out of the country why is it not just as important to stop their breeding? it seems to me a very short-sighted procedure to make laws to keep them out and laws that increase and multiply them within. Immigration throughout the world is causing a good deal of stir; the countries of Europe have looked upon America for years as the solution of their problems. There is a good deal of bitterness at the United States taking this attitude and concern as to what they shall do. Europe claims that she has sent into the United States some of her best stocks, equipped us with artisans, with man made ready material. She claims she has depleted her own stocks by so doing, also that in order to do this in the past she has now made an enemy ↑and a rival↓ more powerful than all Europe combined. Many of the countries, like England, are trying to solve their over-population problem by sending them into the Colonies; but the Colonies in turn say they cannot use the slum population which England wants to get rid of; they must have men of health, vigor and initiative-- so say New Zealand, Australia and Canada. The slum population England has sent has been sent back and England today has over a million unemployed. I am glad to say nevertheless that the British Government has been thinking seriously about the birth control; two years ago the House of Lords went on record and passed a resolution asked the Government to instruct mothers throughout the British Empire in methods of contraception at Infant Welfare Stations. It is an astounding thing that it was the Labor Party that refused to endorse that legislation.

Germany has also attempted to attack this question. When I was in Berlin I was astonished to find there was legislation going on, backed up by aggressive organization both labor and medical, as well as womens organizations, trying to terminate pregnancy, up to the third month. They have already endorsed sterilization. Women interrupted pregnancy and then remained to be sterilized. Out of 80 women who came, 75 remained, asking to be sterilized. These women had already had two or more children. In almost all cases something was wrong with their health of the mother, heart, kidneys or other troubles. Sterilization on a large scale is taking place in Germany. I consider that rather harsh and there may be some regret later on but nevertheless Germany is face to face with the problem of the future and she feels that is the only emergency she can at present attack.

Italy is making a great deal of increasing population. Mussolini has said: No babies, no votes. I do no know that the women particularly mind that; they might retort: No votes, no babies. I think Mussolini needs babies more than the women need votes. Italy is over-crowded. Everyone in Europe knows that. Italy cannot take care of her own population. Just two years ago six hundred thousand Italians and sixty thousand Poles went into France-- and France herself has begun to consider population and immigration, as we have the last ten years. Anyone can go into France regardless of their condition. Not even today does France bar out of her country even persons with a transmissible disease. I think only one is not admitted-- traucoma.

Japan has seven or eight hundred thousand new souls born every year. Crowded into a territory the size of California is a population equal to half of our population. All countries, except South America, have put up the bars against the Japanese. South America alone has the open door for Japan’s surplus population. Japan, to me, is like the chick inside the shell. Something has got to happen. As we all know, expansive populations of the world have caused wars over and over again. The economists of Europe are convinced that the peace of the world can never be solved until each country takes up the question of population. Until this is solved intelligently they may as well throw their peace treaties in the waste basket. This question of birth control is not only an individual, a national, and a racial problem but international. Many people believe that we who advocate birth control do not believe in having any children at all. It is not necessary to deny that to this audience; you know it is not true. Nevertheless, there are conditions in which it would be better for children not to be born at all. I maintain there are seven conditions underwhich children should never be born.

First: Not of parents with a transmissible disease; with insanity, feeble-mindedness, syphilis or epilepsy.

Second: Not of mothers with heart or kidney disease, until such disease is cured.

Third: Not of parents who already have a sub-normal child.

Fourth: I claim there should be an interval of two to three years between children. The mother should have an opportunity to recover from the ordeal of one birth, to enjoy her new baby and a period of time to prepare herself mentally and physically for the coming of the next child.

Fifth: No woman should have children until she has finished her adolescent period, from 14 to 23 years. While we all know many fine children born of young mothers I maintain that is no longer necessary. There should be an ideal time for parenthood and that should be at the close of the adolescent period, when the physical, nervous and mental organism is developed but not yet interlocked.

Sixth: There should not be more children than can be brought up decently and properly provided for. We have people for ten years who have been dependent upon social agencies, not only for the maintenance of themselves and the children they had years ago but for an increasing number ever since. I maintain that this is immoral in every sense of the word-- to have children they cannot take care of and to make their neighbors and others bear the consequences of their acts.

Seventh: I maintain children should not be born until the young couple have have, say, two years of married life. I would like to see young people take two or three years to play together, to build up and develop their common interests before parenthood. I believe it is harder today for two young people to become adjusted to each other than it ever was in the past. We imagine they are going to live happy ever after, but we know their problems have just begun. It is not, after all, an easy thing for love to grow into the fine thing which it can be. It is not easy to strengthen the bond of love and to submit to that bond of marriage, unless there is time for mutual adjustment. If couples had two years alone together I maintain there would be more happy homes, fewer divorces and the possibility of the girl developing her womanhood before taking the responsibility of motherhood. We really see very little of the love-life of individuals. They are married-- and the next year become parents. The girl goes away on her honeymoon and comes back pregnant, physically and mentally disturbed. The husband has never an opportunity to know her as a woman; he knows her as a girl and then as a mother. I believe it would make for more happy marriages and more permanent ones if the fear of pregnancy could be removed or delayed, and parenthood invited instead of being an unwelcome accident.

There are three groups of methods of preventing conception. The first is continence. The only organized religious body that opposes Birth Control does not condemn continence, but regards it as the only permissible method of birth control. The second is sterilization. The third, mechanical means of preventing conception. In our studies of the past five years we have found that continence cannot be a means of general application. Self-control, or continence, is a matter of one’s evolution. Sterilization is bound to play an important part, especially where there are transmissible diseases. This remedy is largely in the hands of the medical profession.

It is about four years since we had the first birth control clinic in this country. To date, more than ten thousand women, whose histories we have on record, have come to us. Today we can say we know something about birth control. Ten years ago we could not say that. We could only say it had been practiced in Holland and amongst the well-to-do in almost every country, but we had no positive information. We can today say that birth control clinics are doing a splendid thing, not only in giving children a better chance of life but in protecting mothers and reducing the enormous number of abortions. In our records we have 85 percent of the families going upward in the social scale. We know if we can get a woman before she has her fourth child there is every possibility of the husband bettering himself and the children going up the scale, instead of applying for work certificates before the age of fourteen. We know today, on a small scale (for, after all, ten thousand is a small scale) what birth control can do. There are twenty-five clinics in the United States, two in Germany, twenty in England. As to California, there are two in Los Angeles, one in Pasadena.

In the past thirteen years I have received over a million letters, written mostly by women, sometimes on scraps of wrapping paper. They have found my name somewhere and written to beg for information and help. I have recently taken a cross section of these letters and put them in a book called “Motherhood in Bondage.” If, after reading those letters, you still do not believe in birth control, I think such a person would be hopeless of reason. These are mothers who are asking for means to control the size of their families. And what, after all, are they asking for? For the right to live. For the right to life, liberty and the pursuit of happiness. For the right to know their children and to bring them up decently. For the right also to understand their husbands and to help him, too. These letters tell strange and dramatic stories of life in America, a side of life that is full of suffering and difficulty and that does not reach the public. And have not we paid a tremendous price for their ignorance? Have not these poor mothers paid a price that is staggering? Yet where is the information they need? We are paying for their ignorance in child labor, in infant and maternal mortality, in feeble-mindedness and with the large numbers of the unfit. I think it is time for us to wake up, to make it a right and easy thing for these mothers to obtain information and help of the right kind. We want women to have a chance to develop their own personalities, to rest from incessant child-bearing, to live with the fear of pregnancy removed from marriage. We want children to be born of love and conscious desire and given a heritage of sound bodies and sane minds. We want them to have and to have ourselves bodies that are beautiful, holy, fit instruments for progress towards perfection, temples in which the soul may take its place in the mystery of material being.

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