{"collection":"philosophy-ethics","full_text_available":true,"graph_url":"https://unchartedknowledge.5gfusion.net/v2/api/page/gutenberg_13906/graph","html_url":"https://unchartedknowledge.5gfusion.net/v2/page/gutenberg_13906","id":"gutenberg_13906","license":"Public Domain (US)","rights_basis":"gutenberg_metadata_copyright_false","source":"gutenberg","source_url":"https://www.gutenberg.org/ebooks/13906","summary":null,"tags":["Category: Health & Medicine","Category: Parenthood & Family Relations","Category: Philosophy & Ethics","Contraception","Sociology"],"text":"CONCEPTION CONTROL AND ITS EFFECTS ON THE INDIVIDUAL AND THE NATION\n\nby\n\nFLORENCE E. BARRETT, C.B.E., M.D., M.S., B.Sc.\n\nConsulting Obstetric and Gyn\u00e6cological Surgeon to the Royal Free\nHospital. President of the Federation of Medical Women.\n\nWith a Foreword by His Grace the Archbishop of Canterbury.\n\n1922\n\n\n\n\n\n\n\nPREFACE\n\nThis small book has been written in response to many requests for some\nstatement regarding the individual and national effects of the\nwidespread practice of conception control.\n\nIt is not intended to give medical advice on the subject for, in my\njudgment, that is best given to the individual by his or her medical\nadviser, and will vary in different circumstances.\n\nThe question as to whether control of conception shall or shall not be\npractised is a decision ethical and not medical in character when\nhusband and wife are healthy, and in the last resort will be decided\nby the individual pair for themselves; but they will be wise to\ndiscuss the question with their medical attendant in order to realise\nall that is involved in their decision.\n\nSpace forbids anything like a full discussion of the national issues,\nbut that aspect of the subject demands quite as careful study as\npersonal needs or desires.\n\n     F.E.B.\n\n     31, DEVONSHIRE PLACE, W.1.\n     September, 1922.\n\n\n\n\nFOREWORD\n\n\nThe Archbishop of Canterbury allows me to use the following letter as\na Foreword to this little book.\n\nDEAR LADY BARRETT,\n\nI have read with great interest the manuscript of your pamphlet. Very\nmany of us who have daily to do with the problems and perplexities of\nour social life and to give counsel to the anxious or the penitent or\nthe perturbed will thank you for these clear and cogent chapters. To\narguments based on moral and religious principle you add the weight of\nripe experience and of technical scientific knowledge. Your words will\ngain access to the commonsense of many who would perhaps regard the\nopinions of clergy as likely to be prejudiced or uninformed. I am of\ncourse not qualified to express an independent judgment upon the\nmedical or physiological aspects of this delicate problem, but I\ndesire on moral and religious as well as on social and national\ngrounds to support your general conclusions, and to express the hope\nthat your paper may have wide circulation among those who are giving\nattention to what is becoming an urgent question in thousands of\nEnglish homes.\n\n     I am,\n     Yours very truly,\n     RANDALL CANTUAR.\n\n     LAMBETH PALACE, S.E.\n     3rd August, 1922.\n\n\n\n\nCONTENTS\n\n\n     CHAPTER I\n     THE PROBLEM OF TO-DAY\n\n     CHAPTER II\n     THE DEMAND FOR KNOWLEDGE AND FROM WHOM TO OBTAIN IT\n\n     CHAPTER III\n     METHODS\n\n     CHAPTER IV\n     THE EFFECT OF WIDESPREAD CONCEPTION CONTROL ON NATIONAL EFFICIENCY\n\n     SUMMARY OF CONCLUSIONS\n\n\n\n\nCHAPTER I\n\nTHE PROBLEM OF TO-DAY\n\n\nIn the late seventies of last century a pamphlet entitled _The Fruits\nof Philosophy_ was republished by Mrs. Annie Besant and Mr. Charles\nBradlaugh, in their desire to mitigate the suffering of poor women who\nwere overburdened by work and further weakened by frequent\nchild-bearing. They resolved to face public obloquy and even legal\nprosecution in order to bring to these women knowledge of how to\nprevent conception, which, in their opinion, would give the relief\nthey so sorely needed. As is well known, the later pamphlet on the\nsame subject written by themselves was withdrawn from publication by\nMrs. Besant in 1886 on religious grounds.\n\nDuring the last few years the idea of the need for conception control\nhas again become prominent, partly as a revolt against the bondage of\nwomen in child-bearing, partly accentuated by the difficulties and\nuncertainties of an adequate livelihood, and the desire to have a few\nchildren well educated and cared for rather than many who shift more\nor less for themselves.\n\nBut also the claim is made that marriage exists at least as much for\nthe fulfilment of happiness in union with the beloved as for the\nprocreation of children; and that it should be possible for a married\npair to have the fullest gratification without fear of children unless\nthey desire them.\n\nOthers, but these are extremists, go so far as to claim that apart\naltogether from marriage vows, sexual intercourse should be the\nexperience of all, and that knowledge of how to avoid the birth of\nillegitimate children should be given to all.\n\nThe discussion of this subject has taken place under the title of\nBirth Control, but the control or regulation of births is not really\nthe point under discussion. A very big factor in the diminution of\nbirths comes under the heading of abortions, whether voluntary or\nthrough conditions which might be remedied. That subject is not\ntouched upon in this paper, but only methods which avoid conception,\nwhich is, of course, a very different subject from the larger one of\navoiding births.\n\nAt first sight it might seem a comparatively simple thing, in view of\nthe knowledge which already exists of the physiological processes\ninvolved in conception, to advise a method which shall prevent\nconception at will without harmful effect upon man or woman and yet\nleave intercourse unimpaired. But even at first sight it is obvious\nthat whatever knowledge may be available, and whatever methods may be\ndevised, it would not be easy to convey this knowledge rightly to the\nindividual it is hoped to benefit without doing harm to others.\nFurther thought shows that the national problems involved are so\nimportant and far reaching in effects that they might well arrest the\nattention of the most careless advocate of indiscriminate conception\ncontrol.\n\nThis is a subject, therefore, which requires careful consideration\nfrom the point of view of the individual, of public morality, and of\nnational welfare--and the more closely it is studied the more apparent\nare the far reaching issues involved. It is improbable that the\npractice of using contraceptives will continue for even a generation\nwithout revealing the harmful effects which must to some extent ensue.\n\nIn the whole discussion of this subject it is important to keep in\nmind that the physical is only one aspect of the sex relation.\n\nIn the evolution which sex has shared with all else, the psychic side\nappears even in the higher animals. In them the desire is not for mere\nindiscriminate physical satisfaction, but the element of choice comes\nin, a factor which sometimes upsets the plans of breeders. In man this\naspect of the relation is all important. The higher side of sex, or\nwhat we may call the psychical secondary sex characters, seem to\nextend through the whole range of mental and spiritual activities.\nBecause of this there is freshness of contact in mental and spiritual\nintercourse between men and women which differs somewhat from that\nbetween individuals of the same sex, and very much of the joy of life\nsprings from the impact of these differing yet completing selves the\none upon the other.\n\nWhere the whole being enters into the union of the sexes the complete\njoy of marriage is realised, the characteristic of which is that it\ndoes not fade, but becomes ever deeper and more fully realised, a sure\nindication that the highest pleasure of sex union is only attained\nwhen it consummates a love which involves mutual sympathy and\nconsideration. Physical union alone produces dissatisfaction the more\nquickly in proportion as it is physical only; on the other hand, when\nall parts of the nature find their counterpart in another, the joy of\nsuch intercourse pervades the whole life, and frequent repetition of\nphysical intercourse is not essential to its highest development.\n\nThis is well known to all true lovers who have for varied reasons\nexercised some voluntary self-control in regard to the physical side\nof sex in marriage, either in deference of the one to the desire of\nthe other, or to avoid too frequent child-bearing, or in special\nseasons such as Lent.\n\nOn the other hand it has been observed by most people that many\nmarriages which seem to promise well, quickly lose even to the eye of\nthe outsider all the romance of the days of courtship. Is not too\nfrequent physical indulgence sometimes the cause?\n\nEven the time of courtship is spoiled by unrestrained demonstration of\naffection, and the beauty of the higher side of love is apt to lose\nits delicate bloom by over accentuation of the physical in marriage;\nhusband and wife sadly admit to themselves that disillusionment has\ncome--the real truth being that in seeking only physical satisfaction\nin each other, their eyes have become blinded to those higher\nqualities which each glimpsed in the other during the happier days of\ncourtship, and the \"road of the loving hearts,\" which they hoped to\ntread through life, has been missed because they have forgotten that\n\"man is a spirit and doth not live by bread alone.\"\n\nTo many the introduction of this aspect of the question may seem\nbeside the mark. For them the practical question in a world of sense\nis how to avoid having children when for any reason they are not\nwanted, and yet leave unimpaired facilities for married life. It is\ntrue the problem is not always stated so bluntly. The uses of\ncontraceptives are explained, together with a recommendation for\nmoderation in physical intercourse; but as will be shewn below, if\nsuch moderation is really practised, it is possible to live a natural\nmarried life such as renders unnecessary the use of artificial\ncontraceptives with all their attendant evils and yet limit the size\nof the family.\n\nBut it is necessary to consider more carefully the claim made to-day\nthat contraceptives are both necessary and harmless, and that public\npropaganda on the subject is desirable.\n\nThere are several different groups for whom relief is claimed:--\n\n1. Women who are suffering from chronic or from temporary ill-health\nare frequently not in a condition to bear the strain of child-bearing,\nand indeed it may become a real danger to their future health, either\nmental or physical.\n\n2. There are cases of inherited disease, mental or physical, which\nought to prohibit child-bearing.\n\n3. There are over-worked women whose daily work, added to\nchild-bearing, destroys their health and vitality. These people are\nfound not only among the so-called working classes; the same\nconditions with somewhat different types of strain are found in wives\nof professional men with very slender incomes.\n\n4. Some parents wish to \"space\" their children, that greater attention\nmay be given to each, or they wish to limit the number of their family\non account of financial and other difficulties.\n\nWith these and other considerations in view, the widespread teaching\nof methods of preventing conception is advocated because it is\nclaimed:--\n\n(a) That except for general propaganda, the greatest sufferers, viz.,\npoor women with constantly recurring pregnancies, would otherwise\nnever learn of any method of relief.\n\n(b) That many young people who for various reasons, such as housing or\nfinancial difficulties or inherited disease, feel themselves unable to\nhave a family, would if such knowledge were available marry much\nearlier, and their natural desires would be satisfied, while apart\nfrom marriage they might resort to promiscuous intercourse.\n\n(c) That homes where the growing difficulties and strain of a\ncontinually increasing family are leading to estrangement between\nhusband and wife, are restored to happiness when saved from the\ndifficult choice between continence, which they have never trained\nthemselves to practice, or many children with which they cannot cope.\n\nThere are, however, serious fallacies in these contentions.\n\nThe propagandists of conception control appear to take it for granted\nthat after preventive measures in early youth, children may be\nconceived at will whenever they are desired; and, moreover, it is\nassumed that apart from such precautions every woman will conceive\nannually and will continue to do so until 10-12 children have been\nborn.\n\nNeither of these suppositions is supported by facts. On the contrary,\nthere are large numbers of married couples who would give anything to\nhave children, but have postponed it until circumstances should seem\nquite desirable, and then, to their grief, no children are given to\nthem. It is very unfair to teach people that they may safely postpone\nthe natural tendency to bear children in youth and rely upon having\nthem later in life. Probably gyn\u00e6cologists are consulted more often by\nwomen who desire children but do not have them, than by those who\nwish to avoid having them--the truth being that the tendency among\npeople in comfortable surroundings is towards relative sterility\nrather than towards excessive fertility.\n\nThose who are interested in this aspect of the question will find the\nfacts admirably set forth in Mr. Pell's book on _The Law of Births and\nDeaths_, being a study of the variation in the degree of animal\nfertility under the influence of environment.\n\nHe finds that the all-important factor which determines fertility is\nthe amount of nervous energy of the organism, and that nervous energy\nis produced or modified by three specially influential factors, viz.,\nFood, both quantity and quality; Climate, hot or cold--moist or dry;\nand, lastly, all those varied conditions which make for greater or\nlesser mental and physical activity.\n\nFertility, broadly speaking, varies in inverse proportion to the\ndegree of nervous energy or what we may call vitality.\n\nConditions, therefore, which lower the general vitality below the\nnormal produce abnormal fertility. This excessive child-bearing under\npresent conditions still further lowers the standard of life and the\nhealth of the mother, hence a vicious circle is set up, the only\nescape from which will come by such consideration of the laws of\nhealth relating to work, housing, food and recreation as shall ensure\nthe maximum of vitality to the workers. This is the true method of\nconception control.\n\nThere comes a point in the development of nervous energy which is\nproductive of sterility. It is true that principles based on so many\nvarying factors will necessarily appear to fail in individual cases.\nEnvironment with its influence on the nervous energy of the individual\nwill be modified by the inherited tendency of that individual towards\nfertility or the reverse. We find, therefore, isolated cases of large\nfamilies among the well-to-do and small families among those whose\nvitality is below the normal, but if the general principle is true we\nshould expect to find a larger number of _sterile_ marriages among the\nwell-to-do than among those whose lives are more full of hardship, and\nthis undoubtedly is the case.\n\nThis aspect of the problem is deserving of careful study. The desire\nfor children in so many homes where every advantage could be given,\nmay be gratified when more knowledge of how wisely to modify the\nenvironment of the rich is within our grasp.\n\nIt may be that the more simple life among those who have much will\ngive to them the prize of children which they covet more than things\nwhich wealth can buy.\n\nBut let us return for a moment to the false expectation that children\nwill come to all unless prevented.\n\nThe results of this assumption are really serious. They involve the\ntraining of large numbers of people in unnatural practices, which in\nmany cases are unnecessary, even if they were desirable. They rob many\nfamilies of the children who would have been the delight of their\nparents through middle and later life.\n\nMoreover, it is obvious that advice which may be quite necessary in\ncases of ill-health or special conditions, may be fundamentally wrong\nto give broadcast to all individuals, for apart from the fact that\nwhen given to all it is largely unnecessary, there are other serious\nobjections, as follows:--\n\n1. A public opinion at the present time is being gradually produced\nwhich takes it for granted that as a matter of good form young people\nshould not have children for a few years after marriage, and it is\nbecoming a common practice to start married life with sordid and\nunnatural preparations for a natural act; yet many of these young\npeople, men and women alike, are most anxious to have children, and\nonly seek to know how to prevent them because they believe it to be\n\"the thing to do.\"\n\nOne or two illustrations which have come to my personal knowledge will\nperhaps show the kind of idea which is conveyed to the mind of young\npeople by books and speeches on this subject, though such results may\nnot have been desired by the authors or speakers.\n\nA young bride came to her mother on returning from her honeymoon and\nsaid, \"Mother, how long must we wait before having children--is it\nreally necessary to prevent them for a year or two? We are both dying\nto have babies.\"\n\nA young couple on the eve of marriage consulted a gyn\u00e6cologist\nregarding the question of using the cap pessary to prevent the\npossibility of having children for a few years.\n\nThe bride, who was greatly distressed, produced the pessary which she\nhad purchased, and said she could not possibly use it; her fianc\u00e9,\nhowever, had been advised that she could, and ought to do so, hence\nthe first serious dispute had arisen between them, clouding the\nfuture.\n\nShe was told by her doctor that it was quite impossible for her, and\nthis fully satisfied the future husband.\n\nThe next point was if this method were impossible what should be used.\n\nThey were a splendid young couple, with ample means to support a\nfamily, and the doctor naturally asked--\"But for what purpose do you\nneed any methods to prevent children at all?\" They hesitated and\nlooked at each other, and then said--\"I don't know, but we thought it\nwas the thing to do.\"\n\nThey left with the whole nightmare put aside, determined not to spoil\nthe perfect consummation of their happiness.\n\nMany similar cases might be quoted where young people, without any\nconsidered motive, are acting in accordance with the vogue of the\nmoment.\n\n2. The use of contraceptives does not encourage self-control, yet the\ncultivation of self-control is a far higher gain to the individual and\nthe nation than any apparent advantages obtained by its abandonment.\n\nBy no means unimportant is the influence that wide diffusion of the\nknowledge of how to prevent conception would have in causing more\nirregular unions and greater promiscuity in sex relations. The effect\nof this would not only loosen, rather than strengthen, the marriage\ntie, but would inevitably lead to an extension of venereal disease.\nMany people seem to think that contraceptives prevent venereal disease\nat the same time that they prevent conception. But this is not so. The\nuse of methods of prevention by women is no protection to them from\ninfection.\n\n3. We have, moreover, to take a wider view, and consider who will\nreceive and act upon the advice given, and hence what the result will\nbe on the differential birth-rate of the community.\n\nIt is quite obvious that the educated classes can most easily follow\ninstructions which result in protection from conception, and since\nsuch knowledge most easily circulates among the more highly endowed\nclasses, it has been claimed that it is important to make efforts to\nlet the knowledge be so widespread that it may reach all. The result,\nhowever, could only be that the practice of conception control would\nspread throughout the upper, middle and more intelligent of the\nworking classes, and this would involve a very serious reduction in\nthe births of those who furnish the leaders and efficient workers in\nall branches of life, and in those only.\n\nFor the birth-rate amongst the least intelligent, least efficient and\nthe mentally deficient will be unaffected. It must be apparent that\nafter a very few generations of such weeding out of the best, with the\ncontinuous multiplication of the worst type of citizen, the general\nstandard of efficiency, enterprise and executive skill of the nation\nwould be seriously impaired. Such, briefly stated, is the problem\nbefore the public at the present time.\n\n\n\n\nCHAPTER II\n\nTHE DEMAND FOR KNOWLEDGE AND FROM WHOM TO OBTAIN IT\n\n\nEven the brief survey given in the first chapter will have suggested\nto the reader that the people who ask for knowledge seek it for\nvarious reasons. Indeed, the first thing that strikes anyone who gives\nconsideration to the subject is the difference in type and\ncircumstance of the people for whom relief is claimed. We begin to\nrealise at once that the subject of conception control is an intimate\nand individual one, and can only really be dealt with by advice which\nis given to the individual and not to the public at large.\n\nThis is perhaps most obvious in the first group mentioned on page 17,\nwhere the woman is suffering from chronic or acute disease, and the\nnecessity for preventing conception is clear to her medical adviser.\nIf disease renders child-bearing a danger to the life and health of\nthe mother, it becomes a positive duty of her doctor to prevent such a\ncatastrophe--but the method advised will differ according to the\nspecial nature of the case.\n\nAgain, where in the case of husband or wife there is a serious\ninheritance of mental or physical disease, and especially when the\nsame weakness exists in both families, it is justly regarded as a duty\nby the married pair not to bring children into the world. It may be\ncontended that men and women with such an inheritance should not\nmarry, but that is a matter for the decision of the individuals\nconcerned. It not infrequently happens that marriage has taken place\nbefore they know of the inherited tendency. In such cases clearly the\nadvice of the family doctor should be given as to the best course to\npursue in order to avoid conception.\n\nThe case of the overworked and burdened mother with a large and\nincreasing family is nearly allied to that of a woman with disease,\nthough in her case the causes for ill-health are more complicated.\n\nWhile it is true that ill-health and premature ageing in working women\nare the result of many causes, yet where child-bearing still further\ninjures health it is essential that she should consult her medical\nadviser on this point, for she not only needs treatment to restore her\nhealth, but also advice specially suitable to her own case, as to the\nbest method to avoid conception for the time being, and such advice\nwill vary according as the disability is temporary or permanent.\n\nIt is, happily, as possible for the poor woman to obtain advice in all\nmatters of health as it is for the rich. The mothers of the country\nare in touch everywhere with maternity clinics, where doctors advise\nthem on all questions of health relating to pregnancy, and treat each\nwoman as a separate individual.\n\nBut the case of the poor working woman overburdened with work which\nshe cannot accomplish--yet with the added burden of bearing more\nchildren than her more fortunate sisters, deserves some further\nconsideration.\n\nWhat is it that prematurely ages so many of these women of the\nslums--is it child-bearing alone?\n\nThe answer to that is immediately in the negative, for women in\ncomfortable circumstances may have large families, with no sign of\nweariness and dejection. No, the causes of ill-health and debility\nare diverse, and to pretend to solve the question by conception\ncontrol is a mockery, for it salves the conscience of the community\nwithout really dealing with the question of the disabilities of the\nworking woman, or the true cause of her excessive fertility.\n\nIll-health in working-class mothers often has its origin in inherited\nweakness and lack of care in childhood. It is further accentuated by\noverwork, with no labour-saving devices; lack of suitable food; too\nfew, if any, hours of recreation, and hence very little out-door\nexercise. Badly ventilated homes deprive the mother of necessary\nsupplies of oxygen, and insufficient sleep is often the last straw\nwhich breaks down the patient burden bearer. A true and haunting\npicture is given in a recently published book called _The Woman in the\nLittle House_ (which first appeared in a series of articles in the\njournal \"Time and Tide\"), describing the anxiety of a working woman at\nnight to keep her baby quiet that the husband may sleep.\n\nNow it is quite true that a small family instead of a large one will\ndiminish the work and anxieties of such a mother, but it will not give\nher the remedies which she needs, nor will it diminish the excessive\nsexual demands made upon her.\n\nEveryone who knows these women intimately realises what an exhausting\nfeature is this habit of excess due to lack of knowledge or\nself-restraint on the part of the husband.\n\nI believe if facilities were provided whereby the woman could do her\nlaundry with modern appliances outside her own home, if family meals\nwere arranged in service rooms equivalent to the arrangements in\nservice flats, and if there were cr\u00eache rooms where children might be\nleft for an hour or two in safety while necessary work was done--we\nshould find a greatly increased standard of comfort even in existing\nhomes, and a great improvement in dietary for the whole family. Such\nrelief, added to teaching both to husband and wife as to the times of\nconception, would revolutionise the life of women more than any\nteaching of artificial birth control, and would lift it up to a higher\nlevel instead of degrading it to the grossly physical.\n\nWe come to very different considerations in group 4, p. 18, where\nchoice rather than necessity impels the parents to limitation of the\nfamily. The teaching now being advocated by certain books and\npamphlets advises deliberate delay in child-bearing for a period after\nmarriage, and the spacing of certain periods between the births of\nsuch children as are allowed to come into the world, with limitation\nof the number in each family.\n\nTeaching on these lines, if followed, would involve an artificial mode\nof sex life always--natural spontaneous union would find no place.\nAlready young wives are seeking advice for some relief from methods of\npreparation which they say have destroyed in them all spontaneous\ndesire. The tragedy of it all is that even to attain the end in\nview--moderation in the size of families--such methods are to a large\nextent unnecessary. Not to every young married couple does a child\narrive at the end of a year. Some, using no artificial checks, wait\ntwo or three years before the first baby comes. Even if it does come,\nhowever, at the end of a year, there are many advantages to\ncounterbalance the small means and perhaps hard living of the young\npair. For when people are young they can put up with small means,\nbecause they are strong enough to work hard and help each other;\nindeed, the demand for little work and many luxuries in youth is not a\nhealthy one, it is a sign of decadence in the race.\n\nMoreover, even though an early family involve real hardship for\nawhile, it has the great advantage that parents and children later on\nare still young together, and that means far more to the child in\nunderstanding friendship and helpfulness during the most critical\nperiod of life than extra comforts or pleasures would have meant to\nthe parents, and if young parents realised this, would they not put\nthe child first?\n\nThe so-called advantages of a few years between one child and the next\nso that the parents may give fuller care and attention to each, are\nfar outweighed from the child's point of view by the advantages of\nplaymates in the nursery of nearly its own age, who are a source of\neducation in the give and take of life such as no adult can supply. If\nparents wish to have only three or four children, it is to the\nadvantage of the mother as well as of the children, to have the little\nfamily early in life--they are then all in the nursery together, and\nlater all at school, and her life work is in this way so arranged\nthat she may give most service to the world in addition to carrying on\nthe race.\n\nOur conclusion is that for mothers and children it is very desirable\nthat no contraceptives should be used in the early years of married\nlife.\n\nIn the vast majority of families where no restrictions or unnatural\nmeans are used and where mothers nurse their children for eight or\nnine months, children only come every two years. Even if a young\ncouple decide that they cannot afford to bring up more than four\nchildren, they have first to prove that four children will be given\nthem--in many cases they will not have so many, and as years go by the\nfertility of the mother becomes progressively less, so that if\nchild-bearing is postponed till after thirty, in a certain number of\nfamilies no children are born. There are many men and women who\nbitterly regret having let the years go by in which children might\nhave been born to them, and it is only fair that young couples of\nto-day should fully understand this risk.\n\n\n\n\nCHAPTER III\n\nMETHODS\n\n\nThere are certain points in regard to methods of preventing conception\nwhich should be made clear.\n\nIt is, of course, obvious that conception can be voluntarily\ncontrolled by abstention from intercourse except when children are\ndesired. This has been called a counsel of perfection. It could only\nrightly be so described where such a method of life was both desired\nand approved by both husband and wife. It would not be a fair thing\nfor either to enforce a practically celibate life on the other without\nthe fullest understanding and consent before the marriage vows were\ntaken.\n\nBut conception can also be controlled by avoidance of those parts of\nthe monthly cycle in which conception most commonly takes place. That\nin the great majority of women there is a time in the monthly cycle\nwhen no conception occurs has been noted for a long time. The\nrough-and-ready method of reckoning the date of birth in relations to\nthe last menstrual period is an example of the assumption that\nconception will probably have taken place a week later, and the\nfrequency with which such reckoning is justified shows that it is not\naltogether unfounded. During the war it was possible to make some more\nexact observations owing to the short leave granted to soldiers to\nvisit their homes. Seigel has published a paper in the \"M\u00fcnchener\nMedizinische Wochenschrift,\" 1916, in which he gives information\nregarding the conception of between two and three hundred children\nborn during the war. He finds that the likelihood of fertilisation\nincreases from the first day of menstruation, reaching the highest\npoint six days later, the fertile period remains almost at the same\nheight till the 12th or 13th day, and then declines gradually until\nthe 22nd day, after which there is absolute sterility.\n\nThis suggests that conception control can be attained without\nartificial methods if intercourse is confined to one week in the\nmonth.\n\nSuch control of conception, though natural, does not make it any more\ndesirable to space the births unduly so that the children are brought\nup in separate units instead of in a happy family group in which they\ncan share games and interests--but it does avoid the risks which are\nassociated with artificial methods of conception control.\n\nIt is not proposed to discuss in detail artificial methods in this\npamphlet, because no advice can be wisely given on this subject in a\ngeneral way. Those who after careful consideration choose to use\nartificial means to prevent child-bearing will be wise if they consult\ntheir medical attendant as to those methods which are least harmful\nfor their individual case, and ask for careful instruction in their\nuse.\n\nMost of the methods so widely advertised are productive of diseased\nconditions, whether from the nature of the method itself or from the\nway in which it is used, and all of those recommended to women\ninterfere with normal physiological processes. The object aimed at in\nmethods recommended to women, is either to produce, by drugs or\notherwise, conditions in the vagina inimical to the life of the male\ncell, or to prevent by mechanical means the reception of the semen\ninto the uterus. Owing to the uncertainty in the results of either of\nthe above methods of prevention, the later editions of books which\nteach conception control now advocate the use of both methods at the\nsame time in order to approximate more closely to certainty of result.\n\nAll these artificial preparations for intercourse demand from the\nwoman an investigation of and interference with her own internal\norgans, which is revolting to all decent women, and such teaching is\ndirectly opposed to the advocacy of cleanliness and non-interference\nwith the genital organs, which is the natural habit of healthy-minded\nwomen.\n\nThe effects, however, go further than this. Nature has provided in the\nhealthy vaginal secretions an antidote to infection which quickly\ndestroys harmful germs. If the natural secretions are altered it is\ndifficult to restore them to their natural quality.\n\nProfessor Arthur Thomson, F.R.C.S., has shewn (\"British Medical\nJournal,\" January 7th, 1922) from observations of the lining of the\nwomb in animals and in women that \"the weight of evidence goes to\nprove that its function is more likely to be absorbent than excretive,\nand that as such it plays an important part in the animal economy.\"\n\nAfter describing at length the evidence that the male secretion\nconsists largely of the secretions from special glands as well as the\nsex cells, he refers to the fact that these are all largely received\ninto and absorbed by the glands of the womb, and he discusses the\nprobability that such absorption profoundly and beneficially affects\nthe physiological reaction in the woman. He points out that the use of\nartificial checks \"while preventing fertilisation may also be the\nmeans of depriving the female of certain secretions which may exercise\na far reaching influence on her economy\"; and he concludes, \"As a rule\nwe cannot interfere with the normal course of nature without some\nconsequent evil result. May this not be an instance in which for some\napparent gain in one direction, the woman pays the penalty?\"\n\n\n\n\nCHAPTER IV\n\nTHE EFFECT OF WIDESPREAD CONCEPTION CONTROL ON NATIONAL EFFICIENCY\n\n\nIn every nation individual capacity varies within wide limits. We have\nmen and women of brilliant attainments, and of all grades of\nintelligence ranging downwards to the mentally defective. There is no\ndoubt that all grades of intelligence can be improved by education,\nbut there appears to be a limit to the capacity of development of each\nindividual. Lower intelligence, therefore, is not only due to lack of\nopportunity, but to an inborn constitutional defect.\n\nFurther study has shewn this defect to be hereditary--the parents or\ngrandparents of such people shew defective intelligence, and their\noffspring are likely to do the same; indeed, if two mentally defective\npeople marry it is fairly certain that their children will all be\nmentally defective.\n\nThere are, however, no sharply defined classes of intelligence; just\nas the mentally defective are in many grades, so ordinary men and\nwomen vary from low or average intelligence up to outstanding cases of\ngenius or capacity.\n\nBy the newer methods of mental testing it has been shewn that children\nof various classes of the community, as well as men and women of\ndifferent races, can be grouped according to their intellectual\ncapacity, and that no educational facilities will develop that\ncapacity beyond a certain point.\n\nProfessor W. McDougall, F.R.S., in his most useful and interesting\nbook on _National Welfare and National Decay_, reaches the important\nconclusion \"that innate capacity for intellectual growth is the\npredominant factor in determining the distribution of intelligence in\nadults, and that the amount and kind of education is a factor of\nsubordinate importance.\" He claims that the evidence is overwhelming\nas to the validity of the results obtained by mental testing.\n\nA few examples of experimental work given in Professor McDougall's\nbook will suffice to show the trend of these results.\n\nTests of intelligence were carried out on recruits for the American\nArmy, white and coloured, and they shewed marked superiority of the\nwhite race.\n\nA special test was carried out in Oxford by Mr. H.B. English, who\ncompared the capacity of boys in a school attended by children of the\nintellectual classes with that of boys in a very good primary school,\nwhose fathers were shop-keepers, skilled artisans, etc., coming from\nhomes which were good, with no sort of privation. The result showed\nmarked superiority of the sons of intellectual parents. Mr. English\nconcludes that the children of the professional classes, between 12\nand 14 years of age, exhibit very marked intelligence, and he is\nconvinced that the hereditary factor plays an altogether predominant\npart.\n\nIn another experiment, Miss Arlitt, of Bryn Mawr College, tested 342\nchildren from primary schools in one district, who were divided into\nfour groups:--\n\n     Group 1.   Professional.\n     Group 2.   Semi-professional and higher business.\n     Group 3.   Skilled labour.\n     Group 4.   Semi-and unskilled labour.\n\nMarked differences between the groups were shewn. The intellectual\ncapacity was represented by figures as follows:--\n\n     Group 1     125\n     Group 2     118\n     Group 3     107\n     Group 4      92\n\nA further research of 548 children, grouped according to the\noccupation of their father, gave its results in terms of the\npercentage of children in each group who scored a mark higher than the\nmedian for the whole 548. They are as follows:--\n\n     Professional group      85%\n     Executive group         68%\n     Artisan group           41%\n     Labour group            39%\n\nIn the \"Journal of Educational Psychology,\" Vol. IX, 1916, Mr. A.W.\nKornhauser gives evidence from the examination of 1,000 children drawn\nfrom five schools in Pittsburgh.\n\nSchools A and B were attended by children of unskilled manual workers.\n\nSchools C and D by children of skilled artisans and small shopkeepers.\n\nSchool E by children of parents in very comfortable circumstances.\n\nThe results are tabulated as--\n\n     Retarded, _i.e._, below average.\n     Normal, _i.e._, average.\n     Advanced, _i.e._, above average.\n\n                                | Retarded. | Normal. | Advanced.\n     A } Manual workers        {|  45.2     | 47.1    |   7.7\n     B }                       {|  36.7     | 55.9    |   7.4\n                                |           |         |\n     C } Artisans, etc.        {|  29.4     | 50.2    |  20.7\n     D }                       {|  28.8     | 50.2    |  19.5\n                                |           |         |\n     E Most comfortable         |  12.7     | 62.7    |  24.6[A]\n\n[Footnote A: I am indebted to Professor McDougall's book for\ninformation here given.]\n\n\nThese experiments all shew the trend of intelligence (and with it will\npower or power of concentration, and what we may call general\ncapacity) to be more concentrated in the so-called higher grades of\nsociety, and to be less and less evident as we descend in the scale\nfrom skilled to unskilled workers. It would, of course, be clear to\nall that the children of mentally deficient parents can only be a\nburden on the State or can rarely contribute anything of value to the\ncommon weal.\n\nNow the teaching and advocacy of methods of conception control is most\neasily assimilated and practised by the intelligent classes; indeed,\nwe may say with certainty that such methods can only be used\neffectively by the intelligent members of the community, such as\nleisured, professional and mercantile classes, skilled artisans and\nbetter class workers, whereas the lowest type of casual labourers\nwhose home conditions render the use of preventive methods difficult\nor impossible, and the mentally deficient and criminal classes, are\nunaffected by such teaching.\n\nThe result in a few generations must be a marked decrease in the\nnumbers of the intellectual and efficient workers, while the\nhopelessly unfit continue to produce their kind at the same rate as\nbefore.\n\nThe figures given do not suggest that individuals with marked ability\nare to be found in the upper classes only, but they do indicate that\nthere is a larger proportion of boys and girls in the more comfortable\nclasses whose inherited ability is above the average, though this may\nbe partly due to the more intellectual atmosphere in which their early\nchildhood has been passed.\n\nThe provision of education for all, with facilities for children of\nevery class to pass on to higher grades of work, is essential if the\nlatent powers in all, whatever they may be, are to be developed to the\nutmost.\n\nThe point for our consideration at the moment, however, is that if the\nproduction of all capable workers, whether mental or manual, is to be\ncurtailed and the numbers of the population maintained in greater\nproportion from the mentally deficient or criminal classes, the result\nmust be national disaster. For in a very short time there will not be\nenough leaders of real capacity to occupy positions of initiative and\nresponsibility in the various activities of the country at home and\nabroad, nor will there be an adequate supply of good practical work: a\nlowered standard of efficiency must result. From a national point of\nview, therefore, we regard the propaganda in favour of conception\ncontrol to be a real and increasing danger.\n\nThe problem of the mentally deficient is of another order. In this\ncase another kind of control is urgently needed, but it is one which\ncan only be undertaken by the State, and not by the individual. It is\nto put in force such a method of compulsory segregation as would\nensure the comfort and contentment of the mentally deficient, and\nsafeguard them and the nation from the reproduction of their kind.\n\nThe problem also of the insane and criminal classes in relation to\nheredity is one which demands careful consideration by those competent\nto give it.\n\n\n\n\nSUMMARY OF CONCLUSIONS\n\n\n1. There are certain women who for medical reasons should be prevented\nfrom bearing children.\n\n2. There are couples with undesirable inheritance who rightly decline\nto bear children.\n\n3. There are many women of the poorer classes in whom child-bearing is\nsometimes the last straw in circumstances all of which tend to destroy\nhealth and vitality.\n\n4. Public teaching on contraceptives, like medical advice advertised\nin newspapers, is generally applied to cases for which it is\nunsuitable and applied in the wrong way.\n\nIt is therefore detrimental to public health as well as being\ndetrimental to public morality.\n\n5. A public opinion in favour of small spaced families does not serve\nthe best interests of the children or of their mother.\n\n6. Married love should express itself at once in the usual way without\nthe use of artificial contraceptives.\n\n7. The diminishing fertility of the more capable classes is a national\nperil.\n\nTo counteract this tendency every encouragement should be given to the\nintelligent and efficient classes of the community to bear healthy\nchildren.\n\nThe study of problems which give rise periodically to a propaganda in\nfavour of the practice of conception control reveal the fact that\nexcessive child-bearing is found in those classes who suffer the\ngreatest privation, and in whom large families are a real hardship,\nwhile many couples among the well-to-do are childless though greatly\ndesiring children.\n\nSuch facts suggest that the true remedy for the general problem lies\nin raising the standard of living among working-class mothers and\nadvising a more simple life to the more richly endowed.\n\n8. It is desirable that the Government should make provision for\nmethods which will arrest the propagation of the mentally deficient,\ninsane and criminal classes.","title":"Conception Control and Its Effects on the Individual and the Nation","tradition":"philosophy-ethics","translated_text":null,"word_count":7248}