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+*** START OF THE PROJECT GUTENBERG EBOOK 13906 ***
+
+CONCEPTION CONTROL AND ITS EFFECTS ON THE INDIVIDUAL AND THE NATION
+
+by
+
+FLORENCE E. BARRETT, C.B.E., M.D., M.S., B.Sc.
+
+Consulting Obstetric and Gynæcological Surgeon to the Royal Free
+Hospital. President of the Federation of Medical Women.
+
+With a Foreword by His Grace the Archbishop of Canterbury.
+
+1922
+
+
+
+
+
+
+
+PREFACE
+
+This small book has been written in response to many requests for some
+statement regarding the individual and national effects of the
+widespread practice of conception control.
+
+It is not intended to give medical advice on the subject for, in my
+judgment, that is best given to the individual by his or her medical
+adviser, and will vary in different circumstances.
+
+The question as to whether control of conception shall or shall not be
+practised is a decision ethical and not medical in character when
+husband and wife are healthy, and in the last resort will be decided
+by the individual pair for themselves; but they will be wise to
+discuss the question with their medical attendant in order to realise
+all that is involved in their decision.
+
+Space forbids anything like a full discussion of the national issues,
+but that aspect of the subject demands quite as careful study as
+personal needs or desires.
+
+     F.E.B.
+
+     31, DEVONSHIRE PLACE, W.1.
+     September, 1922.
+
+
+
+
+FOREWORD
+
+
+The Archbishop of Canterbury allows me to use the following letter as
+a Foreword to this little book.
+
+DEAR LADY BARRETT,
+
+I have read with great interest the manuscript of your pamphlet. Very
+many of us who have daily to do with the problems and perplexities of
+our social life and to give counsel to the anxious or the penitent or
+the perturbed will thank you for these clear and cogent chapters. To
+arguments based on moral and religious principle you add the weight of
+ripe experience and of technical scientific knowledge. Your words will
+gain access to the commonsense of many who would perhaps regard the
+opinions of clergy as likely to be prejudiced or uninformed. I am of
+course not qualified to express an independent judgment upon the
+medical or physiological aspects of this delicate problem, but I
+desire on moral and religious as well as on social and national
+grounds to support your general conclusions, and to express the hope
+that your paper may have wide circulation among those who are giving
+attention to what is becoming an urgent question in thousands of
+English homes.
+
+     I am,
+     Yours very truly,
+     RANDALL CANTUAR.
+
+     LAMBETH PALACE, S.E.
+     3rd August, 1922.
+
+
+
+
+CONTENTS
+
+
+     CHAPTER I
+     THE PROBLEM OF TO-DAY
+
+     CHAPTER II
+     THE DEMAND FOR KNOWLEDGE AND FROM WHOM TO OBTAIN IT
+
+     CHAPTER III
+     METHODS
+
+     CHAPTER IV
+     THE EFFECT OF WIDESPREAD CONCEPTION CONTROL ON NATIONAL EFFICIENCY
+
+     SUMMARY OF CONCLUSIONS
+
+
+
+
+CHAPTER I
+
+THE PROBLEM OF TO-DAY
+
+
+In the late seventies of last century a pamphlet entitled _The Fruits
+of Philosophy_ was republished by Mrs. Annie Besant and Mr. Charles
+Bradlaugh, in their desire to mitigate the suffering of poor women who
+were overburdened by work and further weakened by frequent
+child-bearing. They resolved to face public obloquy and even legal
+prosecution in order to bring to these women knowledge of how to
+prevent conception, which, in their opinion, would give the relief
+they so sorely needed. As is well known, the later pamphlet on the
+same subject written by themselves was withdrawn from publication by
+Mrs. Besant in 1886 on religious grounds.
+
+During the last few years the idea of the need for conception control
+has again become prominent, partly as a revolt against the bondage of
+women in child-bearing, partly accentuated by the difficulties and
+uncertainties of an adequate livelihood, and the desire to have a few
+children well educated and cared for rather than many who shift more
+or less for themselves.
+
+But also the claim is made that marriage exists at least as much for
+the fulfilment of happiness in union with the beloved as for the
+procreation of children; and that it should be possible for a married
+pair to have the fullest gratification without fear of children unless
+they desire them.
+
+Others, but these are extremists, go so far as to claim that apart
+altogether from marriage vows, sexual intercourse should be the
+experience of all, and that knowledge of how to avoid the birth of
+illegitimate children should be given to all.
+
+The discussion of this subject has taken place under the title of
+Birth Control, but the control or regulation of births is not really
+the point under discussion. A very big factor in the diminution of
+births comes under the heading of abortions, whether voluntary or
+through conditions which might be remedied. That subject is not
+touched upon in this paper, but only methods which avoid conception,
+which is, of course, a very different subject from the larger one of
+avoiding births.
+
+At first sight it might seem a comparatively simple thing, in view of
+the knowledge which already exists of the physiological processes
+involved in conception, to advise a method which shall prevent
+conception at will without harmful effect upon man or woman and yet
+leave intercourse unimpaired. But even at first sight it is obvious
+that whatever knowledge may be available, and whatever methods may be
+devised, it would not be easy to convey this knowledge rightly to the
+individual it is hoped to benefit without doing harm to others.
+Further thought shows that the national problems involved are so
+important and far reaching in effects that they might well arrest the
+attention of the most careless advocate of indiscriminate conception
+control.
+
+This is a subject, therefore, which requires careful consideration
+from the point of view of the individual, of public morality, and of
+national welfare--and the more closely it is studied the more apparent
+are the far reaching issues involved. It is improbable that the
+practice of using contraceptives will continue for even a generation
+without revealing the harmful effects which must to some extent ensue.
+
+In the whole discussion of this subject it is important to keep in
+mind that the physical is only one aspect of the sex relation.
+
+In the evolution which sex has shared with all else, the psychic side
+appears even in the higher animals. In them the desire is not for mere
+indiscriminate physical satisfaction, but the element of choice comes
+in, a factor which sometimes upsets the plans of breeders. In man this
+aspect of the relation is all important. The higher side of sex, or
+what we may call the psychical secondary sex characters, seem to
+extend through the whole range of mental and spiritual activities.
+Because of this there is freshness of contact in mental and spiritual
+intercourse between men and women which differs somewhat from that
+between individuals of the same sex, and very much of the joy of life
+springs from the impact of these differing yet completing selves the
+one upon the other.
+
+Where the whole being enters into the union of the sexes the complete
+joy of marriage is realised, the characteristic of which is that it
+does not fade, but becomes ever deeper and more fully realised, a sure
+indication that the highest pleasure of sex union is only attained
+when it consummates a love which involves mutual sympathy and
+consideration. Physical union alone produces dissatisfaction the more
+quickly in proportion as it is physical only; on the other hand, when
+all parts of the nature find their counterpart in another, the joy of
+such intercourse pervades the whole life, and frequent repetition of
+physical intercourse is not essential to its highest development.
+
+This is well known to all true lovers who have for varied reasons
+exercised some voluntary self-control in regard to the physical side
+of sex in marriage, either in deference of the one to the desire of
+the other, or to avoid too frequent child-bearing, or in special
+seasons such as Lent.
+
+On the other hand it has been observed by most people that many
+marriages which seem to promise well, quickly lose even to the eye of
+the outsider all the romance of the days of courtship. Is not too
+frequent physical indulgence sometimes the cause?
+
+Even the time of courtship is spoiled by unrestrained demonstration of
+affection, and the beauty of the higher side of love is apt to lose
+its delicate bloom by over accentuation of the physical in marriage;
+husband and wife sadly admit to themselves that disillusionment has
+come--the real truth being that in seeking only physical satisfaction
+in each other, their eyes have become blinded to those higher
+qualities which each glimpsed in the other during the happier days of
+courtship, and the "road of the loving hearts," which they hoped to
+tread through life, has been missed because they have forgotten that
+"man is a spirit and doth not live by bread alone."
+
+To many the introduction of this aspect of the question may seem
+beside the mark. For them the practical question in a world of sense
+is how to avoid having children when for any reason they are not
+wanted, and yet leave unimpaired facilities for married life. It is
+true the problem is not always stated so bluntly. The uses of
+contraceptives are explained, together with a recommendation for
+moderation in physical intercourse; but as will be shewn below, if
+such moderation is really practised, it is possible to live a natural
+married life such as renders unnecessary the use of artificial
+contraceptives with all their attendant evils and yet limit the size
+of the family.
+
+But it is necessary to consider more carefully the claim made to-day
+that contraceptives are both necessary and harmless, and that public
+propaganda on the subject is desirable.
+
+There are several different groups for whom relief is claimed:--
+
+1. Women who are suffering from chronic or from temporary ill-health
+are frequently not in a condition to bear the strain of child-bearing,
+and indeed it may become a real danger to their future health, either
+mental or physical.
+
+2. There are cases of inherited disease, mental or physical, which
+ought to prohibit child-bearing.
+
+3. There are over-worked women whose daily work, added to
+child-bearing, destroys their health and vitality. These people are
+found not only among the so-called working classes; the same
+conditions with somewhat different types of strain are found in wives
+of professional men with very slender incomes.
+
+4. Some parents wish to "space" their children, that greater attention
+may be given to each, or they wish to limit the number of their family
+on account of financial and other difficulties.
+
+With these and other considerations in view, the widespread teaching
+of methods of preventing conception is advocated because it is
+claimed:--
+
+(a) That except for general propaganda, the greatest sufferers, viz.,
+poor women with constantly recurring pregnancies, would otherwise
+never learn of any method of relief.
+
+(b) That many young people who for various reasons, such as housing or
+financial difficulties or inherited disease, feel themselves unable to
+have a family, would if such knowledge were available marry much
+earlier, and their natural desires would be satisfied, while apart
+from marriage they might resort to promiscuous intercourse.
+
+(c) That homes where the growing difficulties and strain of a
+continually increasing family are leading to estrangement between
+husband and wife, are restored to happiness when saved from the
+difficult choice between continence, which they have never trained
+themselves to practice, or many children with which they cannot cope.
+
+There are, however, serious fallacies in these contentions.
+
+The propagandists of conception control appear to take it for granted
+that after preventive measures in early youth, children may be
+conceived at will whenever they are desired; and, moreover, it is
+assumed that apart from such precautions every woman will conceive
+annually and will continue to do so until 10-12 children have been
+born.
+
+Neither of these suppositions is supported by facts. On the contrary,
+there are large numbers of married couples who would give anything to
+have children, but have postponed it until circumstances should seem
+quite desirable, and then, to their grief, no children are given to
+them. It is very unfair to teach people that they may safely postpone
+the natural tendency to bear children in youth and rely upon having
+them later in life. Probably gynæcologists are consulted more often by
+women who desire children but do not have them, than by those who
+wish to avoid having them--the truth being that the tendency among
+people in comfortable surroundings is towards relative sterility
+rather than towards excessive fertility.
+
+Those who are interested in this aspect of the question will find the
+facts admirably set forth in Mr. Pell's book on _The Law of Births and
+Deaths_, being a study of the variation in the degree of animal
+fertility under the influence of environment.
+
+He finds that the all-important factor which determines fertility is
+the amount of nervous energy of the organism, and that nervous energy
+is produced or modified by three specially influential factors, viz.,
+Food, both quantity and quality; Climate, hot or cold--moist or dry;
+and, lastly, all those varied conditions which make for greater or
+lesser mental and physical activity.
+
+Fertility, broadly speaking, varies in inverse proportion to the
+degree of nervous energy or what we may call vitality.
+
+Conditions, therefore, which lower the general vitality below the
+normal produce abnormal fertility. This excessive child-bearing under
+present conditions still further lowers the standard of life and the
+health of the mother, hence a vicious circle is set up, the only
+escape from which will come by such consideration of the laws of
+health relating to work, housing, food and recreation as shall ensure
+the maximum of vitality to the workers. This is the true method of
+conception control.
+
+There comes a point in the development of nervous energy which is
+productive of sterility. It is true that principles based on so many
+varying factors will necessarily appear to fail in individual cases.
+Environment with its influence on the nervous energy of the individual
+will be modified by the inherited tendency of that individual towards
+fertility or the reverse. We find, therefore, isolated cases of large
+families among the well-to-do and small families among those whose
+vitality is below the normal, but if the general principle is true we
+should expect to find a larger number of _sterile_ marriages among the
+well-to-do than among those whose lives are more full of hardship, and
+this undoubtedly is the case.
+
+This aspect of the problem is deserving of careful study. The desire
+for children in so many homes where every advantage could be given,
+may be gratified when more knowledge of how wisely to modify the
+environment of the rich is within our grasp.
+
+It may be that the more simple life among those who have much will
+give to them the prize of children which they covet more than things
+which wealth can buy.
+
+But let us return for a moment to the false expectation that children
+will come to all unless prevented.
+
+The results of this assumption are really serious. They involve the
+training of large numbers of people in unnatural practices, which in
+many cases are unnecessary, even if they were desirable. They rob many
+families of the children who would have been the delight of their
+parents through middle and later life.
+
+Moreover, it is obvious that advice which may be quite necessary in
+cases of ill-health or special conditions, may be fundamentally wrong
+to give broadcast to all individuals, for apart from the fact that
+when given to all it is largely unnecessary, there are other serious
+objections, as follows:--
+
+1. A public opinion at the present time is being gradually produced
+which takes it for granted that as a matter of good form young people
+should not have children for a few years after marriage, and it is
+becoming a common practice to start married life with sordid and
+unnatural preparations for a natural act; yet many of these young
+people, men and women alike, are most anxious to have children, and
+only seek to know how to prevent them because they believe it to be
+"the thing to do."
+
+One or two illustrations which have come to my personal knowledge will
+perhaps show the kind of idea which is conveyed to the mind of young
+people by books and speeches on this subject, though such results may
+not have been desired by the authors or speakers.
+
+A young bride came to her mother on returning from her honeymoon and
+said, "Mother, how long must we wait before having children--is it
+really necessary to prevent them for a year or two? We are both dying
+to have babies."
+
+A young couple on the eve of marriage consulted a gynæcologist
+regarding the question of using the cap pessary to prevent the
+possibility of having children for a few years.
+
+The bride, who was greatly distressed, produced the pessary which she
+had purchased, and said she could not possibly use it; her fiancé,
+however, had been advised that she could, and ought to do so, hence
+the first serious dispute had arisen between them, clouding the
+future.
+
+She was told by her doctor that it was quite impossible for her, and
+this fully satisfied the future husband.
+
+The next point was if this method were impossible what should be used.
+
+They were a splendid young couple, with ample means to support a
+family, and the doctor naturally asked--"But for what purpose do you
+need any methods to prevent children at all?" They hesitated and
+looked at each other, and then said--"I don't know, but we thought it
+was the thing to do."
+
+They left with the whole nightmare put aside, determined not to spoil
+the perfect consummation of their happiness.
+
+Many similar cases might be quoted where young people, without any
+considered motive, are acting in accordance with the vogue of the
+moment.
+
+2. The use of contraceptives does not encourage self-control, yet the
+cultivation of self-control is a far higher gain to the individual and
+the nation than any apparent advantages obtained by its abandonment.
+
+By no means unimportant is the influence that wide diffusion of the
+knowledge of how to prevent conception would have in causing more
+irregular unions and greater promiscuity in sex relations. The effect
+of this would not only loosen, rather than strengthen, the marriage
+tie, but would inevitably lead to an extension of venereal disease.
+Many people seem to think that contraceptives prevent venereal disease
+at the same time that they prevent conception. But this is not so. The
+use of methods of prevention by women is no protection to them from
+infection.
+
+3. We have, moreover, to take a wider view, and consider who will
+receive and act upon the advice given, and hence what the result will
+be on the differential birth-rate of the community.
+
+It is quite obvious that the educated classes can most easily follow
+instructions which result in protection from conception, and since
+such knowledge most easily circulates among the more highly endowed
+classes, it has been claimed that it is important to make efforts to
+let the knowledge be so widespread that it may reach all. The result,
+however, could only be that the practice of conception control would
+spread throughout the upper, middle and more intelligent of the
+working classes, and this would involve a very serious reduction in
+the births of those who furnish the leaders and efficient workers in
+all branches of life, and in those only.
+
+For the birth-rate amongst the least intelligent, least efficient and
+the mentally deficient will be unaffected. It must be apparent that
+after a very few generations of such weeding out of the best, with the
+continuous multiplication of the worst type of citizen, the general
+standard of efficiency, enterprise and executive skill of the nation
+would be seriously impaired. Such, briefly stated, is the problem
+before the public at the present time.
+
+
+
+
+CHAPTER II
+
+THE DEMAND FOR KNOWLEDGE AND FROM WHOM TO OBTAIN IT
+
+
+Even the brief survey given in the first chapter will have suggested
+to the reader that the people who ask for knowledge seek it for
+various reasons. Indeed, the first thing that strikes anyone who gives
+consideration to the subject is the difference in type and
+circumstance of the people for whom relief is claimed. We begin to
+realise at once that the subject of conception control is an intimate
+and individual one, and can only really be dealt with by advice which
+is given to the individual and not to the public at large.
+
+This is perhaps most obvious in the first group mentioned on page 17,
+where the woman is suffering from chronic or acute disease, and the
+necessity for preventing conception is clear to her medical adviser.
+If disease renders child-bearing a danger to the life and health of
+the mother, it becomes a positive duty of her doctor to prevent such a
+catastrophe--but the method advised will differ according to the
+special nature of the case.
+
+Again, where in the case of husband or wife there is a serious
+inheritance of mental or physical disease, and especially when the
+same weakness exists in both families, it is justly regarded as a duty
+by the married pair not to bring children into the world. It may be
+contended that men and women with such an inheritance should not
+marry, but that is a matter for the decision of the individuals
+concerned. It not infrequently happens that marriage has taken place
+before they know of the inherited tendency. In such cases clearly the
+advice of the family doctor should be given as to the best course to
+pursue in order to avoid conception.
+
+The case of the overworked and burdened mother with a large and
+increasing family is nearly allied to that of a woman with disease,
+though in her case the causes for ill-health are more complicated.
+
+While it is true that ill-health and premature ageing in working women
+are the result of many causes, yet where child-bearing still further
+injures health it is essential that she should consult her medical
+adviser on this point, for she not only needs treatment to restore her
+health, but also advice specially suitable to her own case, as to the
+best method to avoid conception for the time being, and such advice
+will vary according as the disability is temporary or permanent.
+
+It is, happily, as possible for the poor woman to obtain advice in all
+matters of health as it is for the rich. The mothers of the country
+are in touch everywhere with maternity clinics, where doctors advise
+them on all questions of health relating to pregnancy, and treat each
+woman as a separate individual.
+
+But the case of the poor working woman overburdened with work which
+she cannot accomplish--yet with the added burden of bearing more
+children than her more fortunate sisters, deserves some further
+consideration.
+
+What is it that prematurely ages so many of these women of the
+slums--is it child-bearing alone?
+
+The answer to that is immediately in the negative, for women in
+comfortable circumstances may have large families, with no sign of
+weariness and dejection. No, the causes of ill-health and debility
+are diverse, and to pretend to solve the question by conception
+control is a mockery, for it salves the conscience of the community
+without really dealing with the question of the disabilities of the
+working woman, or the true cause of her excessive fertility.
+
+Ill-health in working-class mothers often has its origin in inherited
+weakness and lack of care in childhood. It is further accentuated by
+overwork, with no labour-saving devices; lack of suitable food; too
+few, if any, hours of recreation, and hence very little out-door
+exercise. Badly ventilated homes deprive the mother of necessary
+supplies of oxygen, and insufficient sleep is often the last straw
+which breaks down the patient burden bearer. A true and haunting
+picture is given in a recently published book called _The Woman in the
+Little House_ (which first appeared in a series of articles in the
+journal "Time and Tide"), describing the anxiety of a working woman at
+night to keep her baby quiet that the husband may sleep.
+
+Now it is quite true that a small family instead of a large one will
+diminish the work and anxieties of such a mother, but it will not give
+her the remedies which she needs, nor will it diminish the excessive
+sexual demands made upon her.
+
+Everyone who knows these women intimately realises what an exhausting
+feature is this habit of excess due to lack of knowledge or
+self-restraint on the part of the husband.
+
+I believe if facilities were provided whereby the woman could do her
+laundry with modern appliances outside her own home, if family meals
+were arranged in service rooms equivalent to the arrangements in
+service flats, and if there were crêche rooms where children might be
+left for an hour or two in safety while necessary work was done--we
+should find a greatly increased standard of comfort even in existing
+homes, and a great improvement in dietary for the whole family. Such
+relief, added to teaching both to husband and wife as to the times of
+conception, would revolutionise the life of women more than any
+teaching of artificial birth control, and would lift it up to a higher
+level instead of degrading it to the grossly physical.
+
+We come to very different considerations in group 4, p. 18, where
+choice rather than necessity impels the parents to limitation of the
+family. The teaching now being advocated by certain books and
+pamphlets advises deliberate delay in child-bearing for a period after
+marriage, and the spacing of certain periods between the births of
+such children as are allowed to come into the world, with limitation
+of the number in each family.
+
+Teaching on these lines, if followed, would involve an artificial mode
+of sex life always--natural spontaneous union would find no place.
+Already young wives are seeking advice for some relief from methods of
+preparation which they say have destroyed in them all spontaneous
+desire. The tragedy of it all is that even to attain the end in
+view--moderation in the size of families--such methods are to a large
+extent unnecessary. Not to every young married couple does a child
+arrive at the end of a year. Some, using no artificial checks, wait
+two or three years before the first baby comes. Even if it does come,
+however, at the end of a year, there are many advantages to
+counterbalance the small means and perhaps hard living of the young
+pair. For when people are young they can put up with small means,
+because they are strong enough to work hard and help each other;
+indeed, the demand for little work and many luxuries in youth is not a
+healthy one, it is a sign of decadence in the race.
+
+Moreover, even though an early family involve real hardship for
+awhile, it has the great advantage that parents and children later on
+are still young together, and that means far more to the child in
+understanding friendship and helpfulness during the most critical
+period of life than extra comforts or pleasures would have meant to
+the parents, and if young parents realised this, would they not put
+the child first?
+
+The so-called advantages of a few years between one child and the next
+so that the parents may give fuller care and attention to each, are
+far outweighed from the child's point of view by the advantages of
+playmates in the nursery of nearly its own age, who are a source of
+education in the give and take of life such as no adult can supply. If
+parents wish to have only three or four children, it is to the
+advantage of the mother as well as of the children, to have the little
+family early in life--they are then all in the nursery together, and
+later all at school, and her life work is in this way so arranged
+that she may give most service to the world in addition to carrying on
+the race.
+
+Our conclusion is that for mothers and children it is very desirable
+that no contraceptives should be used in the early years of married
+life.
+
+In the vast majority of families where no restrictions or unnatural
+means are used and where mothers nurse their children for eight or
+nine months, children only come every two years. Even if a young
+couple decide that they cannot afford to bring up more than four
+children, they have first to prove that four children will be given
+them--in many cases they will not have so many, and as years go by the
+fertility of the mother becomes progressively less, so that if
+child-bearing is postponed till after thirty, in a certain number of
+families no children are born. There are many men and women who
+bitterly regret having let the years go by in which children might
+have been born to them, and it is only fair that young couples of
+to-day should fully understand this risk.
+
+
+
+
+CHAPTER III
+
+METHODS
+
+
+There are certain points in regard to methods of preventing conception
+which should be made clear.
+
+It is, of course, obvious that conception can be voluntarily
+controlled by abstention from intercourse except when children are
+desired. This has been called a counsel of perfection. It could only
+rightly be so described where such a method of life was both desired
+and approved by both husband and wife. It would not be a fair thing
+for either to enforce a practically celibate life on the other without
+the fullest understanding and consent before the marriage vows were
+taken.
+
+But conception can also be controlled by avoidance of those parts of
+the monthly cycle in which conception most commonly takes place. That
+in the great majority of women there is a time in the monthly cycle
+when no conception occurs has been noted for a long time. The
+rough-and-ready method of reckoning the date of birth in relations to
+the last menstrual period is an example of the assumption that
+conception will probably have taken place a week later, and the
+frequency with which such reckoning is justified shows that it is not
+altogether unfounded. During the war it was possible to make some more
+exact observations owing to the short leave granted to soldiers to
+visit their homes. Seigel has published a paper in the "Münchener
+Medizinische Wochenschrift," 1916, in which he gives information
+regarding the conception of between two and three hundred children
+born during the war. He finds that the likelihood of fertilisation
+increases from the first day of menstruation, reaching the highest
+point six days later, the fertile period remains almost at the same
+height till the 12th or 13th day, and then declines gradually until
+the 22nd day, after which there is absolute sterility.
+
+This suggests that conception control can be attained without
+artificial methods if intercourse is confined to one week in the
+month.
+
+Such control of conception, though natural, does not make it any more
+desirable to space the births unduly so that the children are brought
+up in separate units instead of in a happy family group in which they
+can share games and interests--but it does avoid the risks which are
+associated with artificial methods of conception control.
+
+It is not proposed to discuss in detail artificial methods in this
+pamphlet, because no advice can be wisely given on this subject in a
+general way. Those who after careful consideration choose to use
+artificial means to prevent child-bearing will be wise if they consult
+their medical attendant as to those methods which are least harmful
+for their individual case, and ask for careful instruction in their
+use.
+
+Most of the methods so widely advertised are productive of diseased
+conditions, whether from the nature of the method itself or from the
+way in which it is used, and all of those recommended to women
+interfere with normal physiological processes. The object aimed at in
+methods recommended to women, is either to produce, by drugs or
+otherwise, conditions in the vagina inimical to the life of the male
+cell, or to prevent by mechanical means the reception of the semen
+into the uterus. Owing to the uncertainty in the results of either of
+the above methods of prevention, the later editions of books which
+teach conception control now advocate the use of both methods at the
+same time in order to approximate more closely to certainty of result.
+
+All these artificial preparations for intercourse demand from the
+woman an investigation of and interference with her own internal
+organs, which is revolting to all decent women, and such teaching is
+directly opposed to the advocacy of cleanliness and non-interference
+with the genital organs, which is the natural habit of healthy-minded
+women.
+
+The effects, however, go further than this. Nature has provided in the
+healthy vaginal secretions an antidote to infection which quickly
+destroys harmful germs. If the natural secretions are altered it is
+difficult to restore them to their natural quality.
+
+Professor Arthur Thomson, F.R.C.S., has shewn ("British Medical
+Journal," January 7th, 1922) from observations of the lining of the
+womb in animals and in women that "the weight of evidence goes to
+prove that its function is more likely to be absorbent than excretive,
+and that as such it plays an important part in the animal economy."
+
+After describing at length the evidence that the male secretion
+consists largely of the secretions from special glands as well as the
+sex cells, he refers to the fact that these are all largely received
+into and absorbed by the glands of the womb, and he discusses the
+probability that such absorption profoundly and beneficially affects
+the physiological reaction in the woman. He points out that the use of
+artificial checks "while preventing fertilisation may also be the
+means of depriving the female of certain secretions which may exercise
+a far reaching influence on her economy"; and he concludes, "As a rule
+we cannot interfere with the normal course of nature without some
+consequent evil result. May this not be an instance in which for some
+apparent gain in one direction, the woman pays the penalty?"
+
+
+
+
+CHAPTER IV
+
+THE EFFECT OF WIDESPREAD CONCEPTION CONTROL ON NATIONAL EFFICIENCY
+
+
+In every nation individual capacity varies within wide limits. We have
+men and women of brilliant attainments, and of all grades of
+intelligence ranging downwards to the mentally defective. There is no
+doubt that all grades of intelligence can be improved by education,
+but there appears to be a limit to the capacity of development of each
+individual. Lower intelligence, therefore, is not only due to lack of
+opportunity, but to an inborn constitutional defect.
+
+Further study has shewn this defect to be hereditary--the parents or
+grandparents of such people shew defective intelligence, and their
+offspring are likely to do the same; indeed, if two mentally defective
+people marry it is fairly certain that their children will all be
+mentally defective.
+
+There are, however, no sharply defined classes of intelligence; just
+as the mentally defective are in many grades, so ordinary men and
+women vary from low or average intelligence up to outstanding cases of
+genius or capacity.
+
+By the newer methods of mental testing it has been shewn that children
+of various classes of the community, as well as men and women of
+different races, can be grouped according to their intellectual
+capacity, and that no educational facilities will develop that
+capacity beyond a certain point.
+
+Professor W. McDougall, F.R.S., in his most useful and interesting
+book on _National Welfare and National Decay_, reaches the important
+conclusion "that innate capacity for intellectual growth is the
+predominant factor in determining the distribution of intelligence in
+adults, and that the amount and kind of education is a factor of
+subordinate importance." He claims that the evidence is overwhelming
+as to the validity of the results obtained by mental testing.
+
+A few examples of experimental work given in Professor McDougall's
+book will suffice to show the trend of these results.
+
+Tests of intelligence were carried out on recruits for the American
+Army, white and coloured, and they shewed marked superiority of the
+white race.
+
+A special test was carried out in Oxford by Mr. H.B. English, who
+compared the capacity of boys in a school attended by children of the
+intellectual classes with that of boys in a very good primary school,
+whose fathers were shop-keepers, skilled artisans, etc., coming from
+homes which were good, with no sort of privation. The result showed
+marked superiority of the sons of intellectual parents. Mr. English
+concludes that the children of the professional classes, between 12
+and 14 years of age, exhibit very marked intelligence, and he is
+convinced that the hereditary factor plays an altogether predominant
+part.
+
+In another experiment, Miss Arlitt, of Bryn Mawr College, tested 342
+children from primary schools in one district, who were divided into
+four groups:--
+
+     Group 1.   Professional.
+     Group 2.   Semi-professional and higher business.
+     Group 3.   Skilled labour.
+     Group 4.   Semi-and unskilled labour.
+
+Marked differences between the groups were shewn. The intellectual
+capacity was represented by figures as follows:--
+
+     Group 1     125
+     Group 2     118
+     Group 3     107
+     Group 4      92
+
+A further research of 548 children, grouped according to the
+occupation of their father, gave its results in terms of the
+percentage of children in each group who scored a mark higher than the
+median for the whole 548. They are as follows:--
+
+     Professional group      85%
+     Executive group         68%
+     Artisan group           41%
+     Labour group            39%
+
+In the "Journal of Educational Psychology," Vol. IX, 1916, Mr. A.W.
+Kornhauser gives evidence from the examination of 1,000 children drawn
+from five schools in Pittsburgh.
+
+Schools A and B were attended by children of unskilled manual workers.
+
+Schools C and D by children of skilled artisans and small shopkeepers.
+
+School E by children of parents in very comfortable circumstances.
+
+The results are tabulated as--
+
+     Retarded, _i.e._, below average.
+     Normal, _i.e._, average.
+     Advanced, _i.e._, above average.
+
+                                | Retarded. | Normal. | Advanced.
+     A } Manual workers        {|  45.2     | 47.1    |   7.7
+     B }                       {|  36.7     | 55.9    |   7.4
+                                |           |         |
+     C } Artisans, etc.        {|  29.4     | 50.2    |  20.7
+     D }                       {|  28.8     | 50.2    |  19.5
+                                |           |         |
+     E Most comfortable         |  12.7     | 62.7    |  24.6[A]
+
+[Footnote A: I am indebted to Professor McDougall's book for
+information here given.]
+
+
+These experiments all shew the trend of intelligence (and with it will
+power or power of concentration, and what we may call general
+capacity) to be more concentrated in the so-called higher grades of
+society, and to be less and less evident as we descend in the scale
+from skilled to unskilled workers. It would, of course, be clear to
+all that the children of mentally deficient parents can only be a
+burden on the State or can rarely contribute anything of value to the
+common weal.
+
+Now the teaching and advocacy of methods of conception control is most
+easily assimilated and practised by the intelligent classes; indeed,
+we may say with certainty that such methods can only be used
+effectively by the intelligent members of the community, such as
+leisured, professional and mercantile classes, skilled artisans and
+better class workers, whereas the lowest type of casual labourers
+whose home conditions render the use of preventive methods difficult
+or impossible, and the mentally deficient and criminal classes, are
+unaffected by such teaching.
+
+The result in a few generations must be a marked decrease in the
+numbers of the intellectual and efficient workers, while the
+hopelessly unfit continue to produce their kind at the same rate as
+before.
+
+The figures given do not suggest that individuals with marked ability
+are to be found in the upper classes only, but they do indicate that
+there is a larger proportion of boys and girls in the more comfortable
+classes whose inherited ability is above the average, though this may
+be partly due to the more intellectual atmosphere in which their early
+childhood has been passed.
+
+The provision of education for all, with facilities for children of
+every class to pass on to higher grades of work, is essential if the
+latent powers in all, whatever they may be, are to be developed to the
+utmost.
+
+The point for our consideration at the moment, however, is that if the
+production of all capable workers, whether mental or manual, is to be
+curtailed and the numbers of the population maintained in greater
+proportion from the mentally deficient or criminal classes, the result
+must be national disaster. For in a very short time there will not be
+enough leaders of real capacity to occupy positions of initiative and
+responsibility in the various activities of the country at home and
+abroad, nor will there be an adequate supply of good practical work: a
+lowered standard of efficiency must result. From a national point of
+view, therefore, we regard the propaganda in favour of conception
+control to be a real and increasing danger.
+
+The problem of the mentally deficient is of another order. In this
+case another kind of control is urgently needed, but it is one which
+can only be undertaken by the State, and not by the individual. It is
+to put in force such a method of compulsory segregation as would
+ensure the comfort and contentment of the mentally deficient, and
+safeguard them and the nation from the reproduction of their kind.
+
+The problem also of the insane and criminal classes in relation to
+heredity is one which demands careful consideration by those competent
+to give it.
+
+
+
+
+SUMMARY OF CONCLUSIONS
+
+
+1. There are certain women who for medical reasons should be prevented
+from bearing children.
+
+2. There are couples with undesirable inheritance who rightly decline
+to bear children.
+
+3. There are many women of the poorer classes in whom child-bearing is
+sometimes the last straw in circumstances all of which tend to destroy
+health and vitality.
+
+4. Public teaching on contraceptives, like medical advice advertised
+in newspapers, is generally applied to cases for which it is
+unsuitable and applied in the wrong way.
+
+It is therefore detrimental to public health as well as being
+detrimental to public morality.
+
+5. A public opinion in favour of small spaced families does not serve
+the best interests of the children or of their mother.
+
+6. Married love should express itself at once in the usual way without
+the use of artificial contraceptives.
+
+7. The diminishing fertility of the more capable classes is a national
+peril.
+
+To counteract this tendency every encouragement should be given to the
+intelligent and efficient classes of the community to bear healthy
+children.
+
+The study of problems which give rise periodically to a propaganda in
+favour of the practice of conception control reveal the fact that
+excessive child-bearing is found in those classes who suffer the
+greatest privation, and in whom large families are a real hardship,
+while many couples among the well-to-do are childless though greatly
+desiring children.
+
+Such facts suggest that the true remedy for the general problem lies
+in raising the standard of living among working-class mothers and
+advising a more simple life to the more richly endowed.
+
+8. It is desirable that the Government should make provision for
+methods which will arrest the propagation of the mentally deficient,
+insane and criminal classes.
+
+*** END OF THE PROJECT GUTENBERG EBOOK 13906 ***