Birth control and the state

The pioneer battles on behalf of Birth Control, as everybody knows, have been fought in this country by Dr Marie Stopes, who has largely borne the brunt of that abuse which is meted out to all popular exponents of ideas that do not harmonize with traditional morality. The fact that Dr Stopes has been criticized, and at times attacked by the medical profession (which until recently refused to acknowledge that the subject of Contraception fell within its sphere) on the grounds that she does not possess a medical degree, and the fact that she has retaliated with vigour—and continues to do so in most of her public utterances, have led to a breach between her and the more orthodox elements of the profession, which to a certain extent, has impeded the [vi] realization of her ultimate aim, namely the undertaking by the State of the work she performs on a small scale in her privately-run clinique.

In what follows I have drawn attention to drawbacks attending the dissemination of knowledge of Contraception by General Propaganda. I have done so, however, fully realizing that this propaganda was, in the first instance, necessary to override the barrier of prejudice presented by orthodox morality, and equally realizing that if it had not been for Dr Stopes and her propaganda this book would probably never have been written. In its essential plea that advice on Contraception, now obtainable only at private institutions, be made generally available by the Ministry of Health at the centres under its control, this book is at one with the wider aim expressed by Dr Stopes in the words that commemorate the founding of her first private clinique.

I know that in the past it has proved nearly impossible in a single book to [vii] appeal effectively both to the general public, and to the medical profession. Yet I have attempted to do that here. The task has been made perhaps less difficult than usual by the fact that until recently the subject of contraception has been completely ignored by the medical profession, which as a whole seems to remain as uninformed of its wider implication as does the general public. It will be found that the book ends with a practical suggestion taking the form of an appeal to the medical profession.

The substance of the first part of what follows originally appeared as a series of articles in The Saturday Review, to which I am indebted for permission to publish the book in its present form.

Since the War, the subject of Birth Control has been widely discussed, and much has been written about it. By some of its advocates it has been extolled to the point where any criticism, however tentative, is resentfully repudiated. By its enemies it has been represented as a pernicious and unnatural practice leading to the degeneracy and, ultimately, to the extinction of the race. So wholeheartedly felt, and yet so profoundly opposed are these views, that it has been difficult for the average person to find his bearings on any other basis than that of his own sentiment.

It is clear that the implications of Birth Control, or, rather, what is generally, though not logically understood [2] by the term, of the practice of contraception, are far reaching. It profoundly affects the life of the individual; it reacts upon the internal economy of the community; and it has a most important bearing upon the international future of the country wherein it is practised. It is therefore incumbent upon all serious students of contemporary world-problems to realize clearly what is to be said on both sides, and to form thereon, as far as lies in their power, an unbiassed opinion. This obligation weighs especially heavily on medical men since, if the practice is to be tolerated at all, it is by them that it should be administered and controlled.

It is a general survey of this sort that is attempted here. The book will begin with a consideration of the more important arguments that have been advanced on each side. These will then be discussed, and there will follow a conclusion as to the bearing of the practice upon the future of civilization.

It will be convenient first to review the more serious arguments used against Birth Control, the problem being considered throughout both as a world-problem and as one with a special significance for this country. They fall into two distinct categories concerning (A) the Race and (B) the Individual.

A. 1. The ‘military’ argument finds exponents among Nationalists, who are convinced that the essential merit of a country lies in its powers of offence and defence, or who are persuaded that future wars are, by the constitution of human nature, inevitable, and that it is therefore necessary for the country to which they belong to be fully equipped. By such persons, Birth Control is opposed in so far as it would impair their country’s man power.

2. An argument allied to the above, yet one which must be distinguished carefully from it, deserves close scrutiny. It is to the effect that quite apart from military considerations the practice of [4] Birth Control in a country is capable of acquiring in a short time such universality that the population may decrease, and eventually dwindle to proportions which would place that country, whatever its status, in a position of a second or third-rate power. From history the approximate generalization can be made that prolific races get the better of infertile races in the struggle, first for existence, and then at a later stage, for power. This generalization is likely to hold good in an economic sphere. Thus a graphic picture has been drawn of what will happen to England, in the matter of its population, if it follows in the wake of France. It will come to assume the proportions of an insignificant little island in the North Sea, the possessor, actually, of a mighty past, but in the present counting for nothing beside the densely peopled territories of Southern and Eastern Europe, Asia and America. Birth Control uncontrolled means race suicide.

3. There is an ‘economic’ argument against Birth Control, which itself takes two forms.

In the first place it is felt, in under-populated countries like New Zealand, Australia, and perhaps to a less extent the United States, that since it is desirable in the general interests that the population should increase, it is to be preferred that this increase be effected from native-born stock rather than through the process of accretion by often undesirable aliens. Hence in most under-populated countries, Birth Control is opposed.

In the second place it is probably felt (though probably not admitted) by the Governments of those capitalistic countries confronted with a labour problem, which are at the same time desirous of limiting immigration, that the unrestricted multiplication of their working classes, by causing a competition for wages, will create a cheap labour market. It is highly unlikely that this view has much weight here, [6] though it may easily be otherwise in the United States, where the labour problem is acute and where it is universally desired to limit coloured immigration and immigration from South-Eastern Europe.

4. There is an argument against Birth Control, which has special reference to the position of this country as the original founder of a great Empire. Since most of the Dominions are still under-populated and wish their numbers to increase, and since the increase of native stock, even though fully encouraged, is unable to supply the demand for labour, it is contended that Great Britain should always be able to turn out a numerical surplus to send to the Dominions each year, which in addition to satisfying a need for better-class immigrants would serve to consolidate the racial and cultural bonds that keep the Empire together.

B. The above arguments concern the race. The remainder which follow refer primarily to the individual.

5. A ‘medical’ argument has been heard to the effect that the actual practice of Birth Control or, more precisely, the use of contraceptives, is inimical to health, being capable of causing both local disease and more general constitutional disorders. Emotional instability and various neuroses have been quoted as such products. No woman making use of a contraceptive for the first time can escape a feeling of revulsion at such a callous interference with a process that above all others should be spontaneous and instinctive. No woman can then fail to experience a sense of aversion from such a deliberate thwarting of Nature’s most fundamental purpose.

6. Very potent also, is a ‘conventional’ objection which in practice is often associated with the religious argument next to be considered, though in reality it is distinguishable from it. On these grounds it is felt that all that pertains to the [8] province of sex is indecent, disgusting, and unfit for discussion. The topic of Birth Control is thus stigmatized as ‘immoral’ by many people of no deep religious conviction.

7. The ‘religious’ objection nowadays finds its chief exponents among the Japanese and Roman Catholics, though it is also strongly upheld by many Anglicans and others. By the Japanese, Birth Control is condemned on grounds that seem to be, partly at any rate, nationalistic. The Japanese religion, intimately connected as it is with Ancestor Cult, holds that it is the duty of every man to marry young, and to produce the largest possible number of children, especially males, who may carry on the tradition of the family and at the same time grow up into soldiers capable of fighting for the Mikado in war. By the Japanese, the Mikado is believed to be a Deity incarnate, not in the symbolical sense in which some people have thought of the divine right of kings, but in a real and [9] vital sense, as ‘the occupant of a sacred throne which was established at the time when the heavens and the earth became separated.’ To die for him in war is the most supreme, the most glorious duty. The objection to Birth Control here would thus seem closely allied to the ‘military’ objection first advanced.

By Roman Catholics it is held to be a mortal sin to employ any chemical or mechanical means to prevent conception, the only permissible form of control being voluntary abstinence from each other on the part of both parents. The abstinence of one parent against the will of the other is also considered a mortal sin on the part of the refractory parent. An exception to this rule is now made which permits parents not desiring children to make use of a moment in the periodic life of the mother during which conception is less likely to take place than at other times—the so-called ‘safe’ period. It is, however, generally agreed [10] nowadays that the ‘safety’ pertaining to this period is in many cases quite illusory and devoid of serious physiological or medical basis. Opponents of the Roman Catholic Church have represented its insistence on this prohibition as dictated by a desire to extend her spiritual empire throughout the world, since obedience to it must bring about a greater relative increase of believing Roman Catholics than of adherents to other religious denominations tolerating Birth Control. But its attitude would further appear to express a conviction (manifested elsewhere in the insistence upon celibacy among Catholic priests and in its systems of penances and abstinences) that sexual indulgence is somehow incompatible with devotion to a purely spiritual life, and when excessive produces a demoralizing effect upon human nature, tending to make it weak, lazy, selfish and often vicious. Probably the Catholic Church feels that the use of devices to prevent conception would [11] abolish the necessity for salutary self-restraint, and would promote promiscuous and excessive indulgence. The effect of this prohibition is that most Catholics who are conscientious about not using contraceptives have large families. There are some, however, particularly in France, who do not take the prohibition very seriously.

At the bottom, however, of the religious objection, would appear to lie the conviction that excessive sexual indulgence, dissociated from the sequel of procreation and rendered possible by the use of contraceptives, is morally harmful to the individual.

8. An objection of a pseudo-political nature is sometimes heard which envisages a bureaucratic extension of Birth Control. The phrase is here understood to imply a ‘National Control of Births’ and not a ‘Voluntary Regulation of Births’, its more usual acceptance. Such a bureaucratic interference in people’s private lives is held to constitute an infringement of the [12] liberty of the individual—in this case his liberty to have as many children as he likes, when he likes. The principle of individual liberty, the corner-stone of nineteenth century Liberalism, still has a certain number of adherents.

9. The last outstanding argument is to the effect that the popularization of Birth Control will lead to a general increase in promiscuity, both among married and unmarried people. The temptation to illicit indulgence would be made greater, the process of seducing an innocent girl would be made easier, the ever-present lure of prostitution to the underpaid girl worker would be made more difficult to resist, if an assurance could be felt that the subsequent birth of a child—hitherto a generally prevalent and effective deterrent—could be prevented by the exercise of a popularly known technique. The restraint imposed by fear may not be one of a high moral order, yet the end which it serves is here, by common consent, socially desirable. [13] In face of the absence of any authoritative source of information on Birth Control, and of the indifference of the medical profession with regard to it, certain popular works on the subject have acquired an immense vogue and have enjoyed an enormous sale. Though not intended for this purpose, they are purchased and read extensively by young persons in much the same spirit that improper literature in general is read. Further, the sale to adults of these works containing as they do a magnification and eulogy of the sexual act per se (to be conceived, expressly, apart from its normal biological sequel of child-birth as a salutary and health-giving process), and containing also minute instructions as to the technical use of contraceptives, has not been confined to married persons. Such works have been held to inflame and pervert the imagination of the young, and on pseudo-medical grounds, to incite adults to promiscuity. It is to be noted, however, that the above [14] is an argument directed not so much against Birth Control itself as against the method by which knowledge of it is communicated to the public.

These appear to be the most important arguments currently advanced against Birth Control.

It will be noted that several have been omitted from consideration. The one based upon biblical condemnation is too futile to merit restatement. The argument that contraception is ‘unnatural’ is equally undeserving of repetition. The contention that it is anti-biological will be discussed later.

Arguments on the other side will now be considered. They divide themselves into three groups, which may arbitrarily be designated as International, Social, and Individual arguments.

( a ) International. —The connexion between over-population and war is [15] nowadays fairly obvious and is particularly manifest in those countries which are both industrially organized and consciously nationalist in spirit. In the absence of these two conditions over-multiplication need not be followed by war. India and China, for instance, are very densely populated countries where over-multiplication frequently takes place. This process does not, however, give rise to much danger of international disturbance, in that both countries are, from the nature of their organization, incapable of conducting war on modern lines, and neither has a generally-felt, or a unifying national consciousness. Excessive increase is here frequently checked by famines, which, though causing incalculable suffering, do not readily generate wars.

Within recent years two countries have demonstrated the relation between over-population and war, or the threat of war, namely Germany and Japan.

In Germany before the war, where [16] the ‘military’ objection to Birth Control, first advanced, was prevalent, there existed an ethical code by which German mothers were persuaded that they were fulfilling the highest spiritual purpose of which their sex was capable by producing male children destined to be soldiers, prepared to fight for their country in a victorious war. It is now generally recognized here that it was this attitude of mind, involving an expectation and a glorification of war, associated with the distinctively German powers of efficient organization centred in implicit obedience to the Kaiser, which served to produce that exultant pride of power and aggressive national consciousness which precipitated, if it did not actually cause, the late war. The increase in the population of Germany was advocated and extolled without regard to that country’s capacity to support her swelling populations. To-day, though Birth Control is largely practised by the upper and middle classes in [17] Germany as it is in this country, the old ideal still lingers on, and to it is attributable that fear of Germany which, until recently, has so conspicuously directed French policy since the Armistice.

In Japan the connexion between numerical increase and a possible war is now coming to be recognized here. Australia, New Zealand and the United States are already definitely conscious of it. The Japanese religion, based upon piety towards ancestors (to whom every man is bound to perpetuate his family), and upon loyalty to the Mikado who, as Emperor God, is held to be divine, imposes upon all faithful subjects the duty of marrying young and of producing many children. This injunction is again promulgated irrespective of the native resources of Japan, and in the past has necessitated a considerable annual emigration to other countries. The recent restrictions imposed by America upon Japanese immigration, themselves prompted by [18] motives common to most English-speaking races, have led directly and inevitably to the existing tension between America and Japan. As things stand at present, it appears that this tension is likely to increase and may easily eventuate in a war, in which there would be a greater probability of our being involved than there was, initially, of America being involved in the late war. Both the Americans and Japanese are sensitive and proud people. After further tension has accumulated, a trivial incident—the possible murder of an American official in Japan by some irresponsible person—might lead to the despatch of a curtly-worded note or to the formulation of an abrupt ultimatum out of which a second world war might, like the last, suddenly flare up, to reduce modern civilization to ruins and ashes.

Stress is laid on this particular aspect of the population problem partly because it is felt that few nations now hold the desirable ideal of adapting [19] their numbers to their particular economic optimum, and partly because it would seem that in face of this nationally encouraged increase of population and of certain apparently unalterable race antipathies, no amount of international pacifism, or of condemnation of violence, or of genuine humanitarian goodwill can prevent war.

Germany and Japan display the connexion between numerical increase and wars most clearly to-day. It is possible that in the future other nations may become conspicuous in this respect. Thus America, where the teaching of contraception is illegal (in so far as anything is), may, in another 50 or 100 years, develop an aggressive foreign policy. And now that restrictions have been imposed on the entry of Italians into America, it is conceivable that Italy may at some time discover an Imperialist mission on the shores of the Mediterranean.

( b ) Social. —This aspect of Birth Control has been much discussed and is concerned with the dimensions and quality of the population of these islands. The argument, in the form in which it is usually advanced, distinguishes a quantitative and a qualitative point of view, the latter further possessing two aspects.

Quantitatively, it has been pointed out that in the last hundred years, the increase in the population of this country has been excessive. Because England was the pioneer of the Industrial Revolution, she enjoyed initially an unprecedented national prosperity, unharassed by competitors and with the world as her market. Though the conditions of many of the early factory-workers were unquestionably appalling, the wealth and economic importance of this country increased so rapidly that she was enabled to support immensely greater numbers than at any previous period of her history.

Thus in 1821 the population of England and Wales was just over 12 millions; in 1921 it had risen to nearly 38 millions. That is to say that in a hundred years our population had more than trebled.

When, however, at the beginning of this century other countries began to enter into competition with us, and to produce manufactured goods on a large scale often underselling British goods, our hitherto unchallenged industrial supremacy gradually commenced to suffer eclipse. But our numbers have not adapted themselves to our diminished power of employing labour thus created. On the contrary, the population has continued steadily to increase, with the result that by slow degrees the unemployment problem which, at present, looms so large on our political horizon began insidiously to disclose itself. The present formidable figure of nearly a million and a quarter of unemployed, together with a large number [22] of workers on short hours, testifies to the fact that at the present time in relation to existing economic conditions, this country seems to be over-populated.

From the point of view of quality it has been pointed out that there are two factors which now tend to impoverish the race. They might be distinguished and arbitrarily named as ‘Dysgenic’ and ‘Economic’ respectively.

The dysgenic factor may be propounded as follows: Though the Birth-rate in England has fallen from 36 per 1000 in 1877 to 20 per 1000 or less to-day, this decrease has not been accompanied by a decrease in the population, since the Death-rate has dropped correspondingly. This has taken place by reason of the complete suspension, if not the actual reversal, in civilized countries to-day of the principle of Natural Selection, operative [23] amongst animals and primitive peoples.

There are three outstanding reasons to which this suspension is attributable. They are the advances in sanitation and medical science, the increase in humanitarianism, and the method of obtaining votes which prevails in democratic countries.

The advances in sanitation and medical science made in the last 60 years have resulted in an enormous reduction of infant mortality in large towns, and also in an average prolongation of life. Epidemics of smallpox, cholera, typhus, diphtheria, scarlet fever, etc., which took such a heavy toll in the past, are now effectively controlled by the existing system of isolation hospitals, and of efficient public health supervision. To-day it is possible for the medical student to traverse his six laborious years of training without seeing a single case of typhoid fever—a disease which in the times of his elders used to be one of the commonplaces of a [24] hospital. These improvements in sanitation, the progress made in aseptic surgery, in prophylactic medicine, and in the general treatment of disease, have been largely responsible for the lowering of the death-rate already mentioned.

The increase of humanitarianism in civilized countries has resulted in the creation of an enormous number of philanthropic institutions and charity organizations, through the channels of which much relief is brought to the impoverished classes. This spirit now makes it difficult for those endowed with a superfluity, or even a sufficiency of wealth, to contemplate with indifference the misery and degradation of less fortunately placed fellow human beings.

And lastly, since the entry to power of any given political party is conditioned by the acquisition by that party of a sufficient number of votes, given by a mainly proletarian electorate, it follows that politics are likely to be [25] framed in such a way as to commend themselves to such an electorate. It would seem unfair to omit this fact from consideration, though it has been over-emphasized by a school of political cynics who deny the participation of humanitarian feelings in politics (outside the realm of speech-making), and who attribute to political expediency an excessive if not an exclusive rôle in improving the lot of the very poor.

In virtue, then, of these factors it would nowadays be very difficult for any individual, however worthless, actually to starve, and many people of defective stock and bad physique who, in the ordinary course of nature would perish, are now artificially kept alive to perpetuate their kind.

The ‘economic’ factor tending to produce deterioration in the race, presupposes the dysgenic.

Among uncivilized peoples it is the biologically superior type which is most [26] prolific. In advanced civilized countries, which are democratic in social organization, the reverse obtains. Thus among most primitive people, the Chief— i.e. the man with most courage, initiative, resourcefulness and power of leadership—enjoys the possession of most wives, and therefore produces most offspring. The analogue of the drunken unemployable of to-day would probably not be permitted to marry.

In England now, however, the drunken unemployable finds his nearest approach to an occupation in endowing his ill-fated wife with a stream of children, the regular succession of which is only eventually interrupted by the breakdown, age, or premature death of the wife, or by the death of the husband. And the only discouragement extended to such a man is forthcoming from the strictures passed upon him by his slum neighbours. None is forthcoming from the Government, and none from the hospital, which gratuitously delivers [27] the wife of her children. In fact, information as to how she may arrest this devastating succession of children is deliberately withheld from her by nearly all hospitals, because it is felt that the condition of public opinion, upon which the hospitals largely depend for their finances, is averse from her being enlightened in this respect.

The organization for relief in this country is now so comprehensive and far-reaching that every necessity can be obtained gratis by those who cannot afford to pay for it. Thus the wife of the poor man is delivered of her children free of charge; the children are educated for nothing; if employment is not available for them at the time of leaving school, they are supplied with doles and relief free of obligation. And when they become senile, they are given old age pensions gratuitously. The funds necessary for the administration of these works are levied from the middle and upper classes, in rates and taxes.

Now the Englishman possesses a strong sentiment for institutions. A man who has himself received a certain kind of education, and who has been brought up according to a certain tradition, likes to provide the same education and the same tradition for his children. And if in the face of the increase in taxation, the rise in the cost of living, and the expenses of education, he cannot afford this, sooner than have children to whom he must deny what he considers a good start in life, he prefers to limit his family. This obtains of the man who suffers from a sense of obligation towards his children. The opposite holds good of the unemployed man at the other end of the social scale. He feels that he has sunk as low as is possible for him while still remaining out of prison. Insidiously his ambition and his self-respect become sapped by the soul-killing experience of finding himself a useless parasite upon the community. Frequently, as prison reports [29] show, he takes to crime or drink. And slowly he is overcome by that sense of irresponsibility, of bitterness, of carelessness of the future, of improvident fatalism that takes possession of those living under continuously adverse circumstances.

It is a matter of indifference to him how many children are born to him since with each one his dole is increased. None of the restraints which enter into the longer view of the future held by the middle classes is felt by him. And so he goes ahead, and has as many children as time and the health of his wife (of which last he does not always show excessive consideration) will permit.

The following figures clearly illustrate this state of things. Whereas the number of children produced annually by a thousand teachers is 95, by Church of England ministers is 101, by doctors is 103, the average number produced by general labourers is 231. And among these general labourers [30] it is the least desirable individuals—those, with least self-restraint, least foresight and with least consideration for their wives or the future of their children—who have largest families. And the undesirability may be of another kind. Mental defectives generally are very prolific. Girls of this condition, if left unwatched, are constantly becoming pregnant, there being apparently no shortage of men prepared to take advantage sexually of such unfortunate victims. It is to be noted that the economic situation following war is especially favourable to this discrepancy of fertility between classes. It would seem that the recent experience of the significance of war, the existing sense of social instability, the universal prevalence of unrest, hatred and international discord, make the more considerate parents feel that the world is not a very desirable place to bring children into. And this feeling is emphasized if they have to pay in taxation four times [31] what they had to pay before, after which what money remains is worth about sixty-five per cent. of its previous value. But these considerations hardly affect the classes whose occupation is manual labour, or who have accustomed themselves to no occupation at all.

Thus from a social point of view it is to be observed that quantitatively, in relation to the present resources of the country, England is at the present day considerably over-populated; and qualitatively that many persons of all classes possessing inferior physique are now artificially kept alive to perpetuate their stock, while at the same time those elements of the population who, by lack of intelligence or thrift or steadiness, or who by possession of other defects have been reduced to the lowest level of the social structure, to-day constitute the most fertile strain in the country.

( c ) Individual. —The argument has frequently been heard that it is desirable [32] to communicate knowledge of Birth Control to the poorer classes in the interests of the mother and the children.

It is difficult to know what percentage of the unwanted children born in the poorer quarters of our large towns are conceived as the result of a culpable aggression on the part of the husband upon his wife—as when he returns home drunk on Saturday night and threatens her with physical violence if she refuses to submit to his conjugal rights—or as the result of an ignorance of Birth Control methods which are familiar to the more educated classes. Certain it is that a large percentage of the children born are unwanted, and equally certain that among the very poor ignorance of contraception is such as to appear incredible to those who have not had personal experience of it.

Thus in the Autumn of 1924 a group of seven externs, working in the district covered by Guy’s Hospital, [33] made inquiries of the mothers whose confinements they attended as to whether the child just born had been wanted or not. The inquiries were made, when possible, on the tenth day, when the patients were last visited, in such a way that their answers were more likely to be favourably influenced by fondness for the child than unfavourably by recollection of the pains of labour. Furthermore, where any doubt existed, as for instance when a woman replied that she had not particularly desired the baby before it was born, but would not part with it for the world now, she was given the benefit of the doubt and the baby was counted as wanted. In all, inquiries were made in the case of seventy-eight children born. Out of these, forty-seven were definitely not wanted, and thirty-one wanted; and the writer can vouch for the fact that if these figures erred at all, they did so on the side of moderation. Thus, in at least one poor quarter of London, well over [34] half of the children born were emphatically not wanted.

The hardships imposed on the mother by such conditions are sometimes very cruel. Numerous cases have been quoted by advocates of Birth Control in their propaganda which there is not space to reproduce here. The reader can, however, picture to himself the experience of a woman suffering from the sickness, shortness of breath, emotional instability, and deformity of pregnancy, having to maintain life in some squalid slum, house-keeping, cooking, cleaning and tending the children without change of air or scene and without holidays, up till the incidence of the final labour pains. And no sooner is a child born than the husband reasserts his “rights,” and the same dismal cycle repeats itself without prospect or hope of change, or of relief from a body that has ceased to know the easy freedom and self-forgetfulness of good health.

Indifference to the children appears. [35] They are looked after out of a stern sense of duty. The native impulse of spontaneous maternal fondness is killed by the deadly routine, and when, as frequently happens, the child dies, after a few pangs of grief, an easy reconciliation (perhaps not without a deep-seated sense of inward gratitude), is made to what is acknowledged as the “Will of the Almighty.” Sometimes, the mother makes no secret of her relief. But no man who has come for any length of time in contact with these working-class mothers can fail to admire the patience, the stoicism and the grim fortitude with which they face their dreary lot.

Their ignorance of Birth Control, in face of the publicity the subject is now given in the Press, is almost incredible. The same quality of fatalism and resignation felt by the soldier in the war before the prospect of wounds or death, is still evinced by these women in the matter of child-birth. [36] One frequently meets with a sentiment that “we must take what comes without grumbling,” that “what is fated must be,” and even that “we must not fly in the face of the Almighty.” There further exists a superstition that any object requiring internal adjustment, like a pessary, runs the risk of being lost in the woman’s inside.

A further aspect of the problem is the prevalence under the existing system of the practice of abortion. It is difficult, of course, to give any trustworthy figures in this connexion, since in many cases the fact that the mother has attempted to induce an abortion is not revealed to the medical man who attends her, or to the hospital authorities who take her in. The methods usually resorted to are of an amazing crudity. They vary from the pregnant mother jumping three or four times consecutively off a table on to the floor or throwing herself downstairs, to her swallowing [37] large quantities of lead, ergot, quinine and other substances as well as nocuous doses of emetics, irritants and purgatives.

Frequently the woman practises local violence upon herself, or engages the services of a professional abortionist, a class more numerous than is generally supposed. Such a person, after practising his art, is in the habit of instructing the woman as soon as she feels the pain or notices any haemorrhage, to report herself to a medical man or present herself at a hospital where she is taken in as an ordinary case of threatened abortion. The responsibility for what may subsequently happen to the woman is thus effectively removed from the abortionist’s shoulders, it being in the interest of everyone concerned to preserve silence as to the part he has played.

The damage done to the health of many poor women by such practices is enormous, and might largely be [38] avoided by a judicious instruction in Birth Control.

When the effects of all this upon the children are considered, it is at once found that the question of Birth Control is intimately connected with the housing problem. The overcrowding in large slum families is notorious. At an early age the day is passed by these children in the street, where, filthy and untended, they receive little by way of notice from their elders except hard words or blows. Their nights are spent packed, in a fetid atmosphere, several together in the same bed from which they may witness their parents in sexual intercourse, sometimes their mother in labour, and where they are free to indulge in what, later in life, would be called incestuous practices with one another. The writer has on more than one occasion attended a woman in confinement while several children were watching her from a bed in the same room, there being, in the urgency of the situation, no time to dispose of [39] them and nowhere immediately available to send them.

Before proceeding to discuss the arguments heretofore propounded, it is necessary to emphasize the fact that from the technical point of view a really satisfactory contraceptive does not yet exist .

The chief disadvantage attaching to the contraceptive used by the man is that it is quite impossible to induce the type of individual whose procreation we would wish to restrict to use any contraceptive at all.

The child is usually begotten by such a parent when he is drunk, and everyone who has had experience of the conditions prevailing in bad slums will know that it is futile to expect to achieve anything along these lines through the man. The problem must [40] be met through the woman who, unlike the man, has to put up with the discomfort and the pain of repeated pregnancies, and has to shoulder the main burden of large families. Were it not for this elementary human fact all attempts to teach Birth Control to the very poor and destitute would fail completely.

Essentially, contraceptives which the woman can use are of two sorts, and involve two principles—namely, a mechanical or occlusive, and a chemical or spermicidal principle.

The objections to the first are two, namely that they are far from being fool-proof, and that unless sanctioned by a doctor their use can be followed by serious harm. It will be clear to any medical man that for a patient suffering from gonorrhœal cervicitis, or indeed from any condition involving a chronic cervical discharge, the use of an occlusive pessary may lead to disastrous consequences. The broadcasting of promiscuous advice as to the utilization [41] of these objects in the absence of an examination by a competent medical man or woman is therefore to be strongly condemned.

The drawback, to all existing spermicidal suppositories is simply their uncertainty, though they are as nearly fool-proof as anything of the kind can be. It is possible that by further research a suppository, physically harmless but of certain action may be discovered, in which case, from its practical and sociological aspect, the problem of birth control will be greatly simplified. It remains, however, a little doubtful whether the chemical principle, however actively spermicidal, will ever dispense with the necessity of some occlusive device. But this is a sphere in which later research may prove of great value, and nothing but a tentative statement is now possible. The statement may, however, be made that if there is one method of Birth Control as to whose harmfulness there is little room for doubt, it is the method of coitus [42] interruptus. In both sexes it gives rise to a condition of chronic anxiety which, nowadays, is far from uncommon. In the absence of local disease any of the above methods of contraception is preferable to this one.

The effectiveness of those women’s contraceptives now in vogue is difficult to estimate. There is little doubt that an unduly high estimation of their success has been formed in certain quarters, based on the assumption that in cases of failure, the working woman will promptly report the event to the centre where the contraceptive was obtained. The writer is persuaded that this is often a mistaken assumption, and that many cases of failure pass in consequence unnoted. There is also difficulty in knowing whether the instructions in the adjustment of the occlusive pessary have been adequately followed out. This process is not always easy, and as has been said above, is far from fool-proof.

The arguments above advanced will now be considered in their relation to ( a ) the Individual and ( b ) the Race.

( a ) The Individual. —The arguments relating to the individual are divisible into those applicable to (1) married, and (2) unmarried persons.

(1) It is to be noted that some of the contentions advanced on each side apply to the different phases of the married life of the woman.

Thus the revulsion of feeling against the use of contraceptives is experienced chiefly by the woman who has had either no children or few children. On the other hand, the woman who has the greatest need for a knowledge of Birth Control is the one who has had many children and desiring no more would probably feel little or no aversion from taking precautions against conceiving them. It appears to the writer that there is no adequate objection to communicating to such [44] a multiparous mother this much needed information.

The difficulty in the case of the newly-married woman is of another type. The discrepancy between the ages at which human beings reach sexual maturity and at which they find themselves capable of maintaining a family, raises a number of exceedingly difficult problems. Seeing that the sexual requirements of man constitute a factor varying very greatly from individual to individual, and to a large extent depending, as is now realized, upon a very complex balance of glandular functions, it is more difficult than most popular moralists seem to realize to lay down general rules applicable impartially to every body.

Questions such as the following are raised: Can it reasonably be expected of every man to live ten or more years of his sexually adult life in complete continence? If not, is it better for him to marry young and [45] probably unequipped to support children, having remained continent till that time, or to marry later, probably better equipped financially to become a father, yet having had promiscuous experience of women before marriage? And if he does marry young, can he be expected to remain continent in his married life till he and his wife feel that they can satisfactorily maintain a family? If he finds he cannot do this, should he proceed to have children whom he cannot properly support, or is it better for the couple to overcome their dislike of contraceptives—a feeling which it is idle for advocates of Birth Control to ignore—and thus avoid having children till they are wanted? These are a few of the general questions which are raised in this connexion to which no comprehensive answer can possibly be given.

Much controversy has revolved round the question of the desirability of self-control as a means of regulating births, and of its universal practicability. [46] It is here contended that where possible this is immeasurably the best means of regulating births. At the same time, it is futile to advance a counsel of such perfection and difficulty that a highly probable failure to observe it will be followed by socially disastrous results. Everyone would acknowledge that the Medical Officer of a military unit who refused to instruct the soldiers under his supervision in the precautions they should take against contracting venereal disease, on the high moral grounds that they should never expose themselves to such risk, would be carrying his idealism to socially harmful lengths. Yet it is a much more difficult task for two people in love with each other and living together in the intimacies of married life to exercise continuous self-denial over long periods extending to years, than it is for the soldier to abstain from occasional promiscuity. In both cases it is clear that the correct course is to start by putting the case [47] for restraint as clearly and forcibly as possible, and then to explain what steps must be taken in the event of that restraint proving too great a task. In the Army and Navy such appeals, when tactfully made, have met with a response which justifies the view that, within limits, more can be done in this way than might be supposed. As a general rule, then, it would appear desirable that contraceptives should be used as little as possible, especially in the early years of married life.

It also seems to the writer that in the case of normal married people, too much has been made of the demoralizing effect of the ‘excessiveness’ of that indulgence which is supposed to be permitted by the practice of contraception and which forms the basis of the ‘moral’ objection advanced in this country. This argument frequently emanates from ecclesiastical sources, where knowledge of the sexual aspect of human nature as well as of the technical side of contraception is apt to [48] be restricted and biassed. In effect, the man who is sufficiently provident and considerate of his wife to encourage the necessary precautions (which—a point too often ignored by prejudiced critics—from the immediately selfish point of view both parties would far sooner forego), is not the kind of man to indulge in reprehensible excesses. Actually, demoralization seems rather to be produced in those men who insist on gratifying themselves regardless of their means, or of the welfare of the children they so abundantly procreate, or of the feelings and health of their wives.

(2) The case of unmarried persons clearly falls into a different category. There can be little doubt that the publicity given to the subject of Birth Control has kindled the imagination of many young people and led to various transgressions. The requirement here is to discover a method by which at the same time this publicity may be diminished and information [49] made selectively more available. Both these results could be achieved if the subject were taken up by the Ministry of Health, and facilities created for the appropriate giving of knowledge thereon by responsible qualified persons. By such means the particular advice suited to each individual case could be privately given, precisely where it is required, and steps might be taken to stop the journalistic broadcasting of information and discussion which has brought the subject into such discredit.

The effects of this measure would be comparable to the arrest of the literature upon the subject of venereal diseases, and to the reduction of their incidence that has been brought about by the institution of special departments for the treatment of these diseases in the large towns.

It is clear, however, that all arguments relating to the individual are limited in their appeal to those in whose minds the conception of morality [50] is somehow related to that of individual harmony and happiness and to the ideal of the general good. To those for whom the word ‘morality’ has an ulterior meaning, unconnected with the affairs of this world and relevant, solely, to the destiny of the individual soul—I refer, here to those who enlist the ‘Will of God’ of which they are the self-constituted interpreters, on their side—no argument can be of any avail. Since the subject is thus removed from the sphere of practical controversy, no further discussion is possible, and the only thing to hope is that with the passage of time such persons will become less numerous.

Consideration of the arguments bearing upon the individual, it is submitted, points to the desirability of (1) the Ministry of Health giving the subject recognition and sanction, and (2) limiting the publicity that now attaches to it.

( b ) The Race. Turning now from the individual to the race, we enter on a more difficult part of the subject. Adhering to our original conception of the question we find that the solution (if it is to be accepted as such) of the quantitative difficulty, and of the qualitative problem described as ‘economic’ in nature, are one and the same. The remedy for that aspect of the qualitative problem distinguished as ‘dysgenic’ is different and must be considered separately.

The quantitative difficulty reduces itself to this. Admitting the greater fertility to-day of those whose occupations are manual, or who have no occupation at all (in other words, of the less select type) and admitting that at the present moment the country is overpopulated, how are we to be certain that we are not within sight of more prosperous times when unemployment will disappear? And how are we to feel assured that the dissemination of knowledge of Birth Control [52] will not, in the long run, lead to a disastrous decline in the birth rate, producing an irretrievable diminution in our numbers?

The practical difficulty is here to prophesy what will be the optimum population (i.e., that at which average return of labour per individual would be greatest) for a given country fourteen years ahead—at the time, that is, when the children born to-day would enter the labour market. And here we are in the realm of almost pure guesswork, and probably no economist could be found who would venture upon more than a tentative speculation. What the optimum is at the moment remains even a disputed question. There is reason to suppose that unemployment returns are not necessarily a trustworthy guide to the figure. A consensus of opinion however exists (including that of Mr. Baldwin) that at the moment our numbers are above their optimum, though expectations vary almost infinitely as to what [53] the optimum will be in a few years. Those who hope for a boom in trade are satisfied with the present condition. Others who do not anticipate such an event, would more willingly see an alteration brought about. In the absence of any definite knowledge, the best we can do is not to try to look too far ahead but to consider the solution of our problems as we find them to-day. At the moment the indisputable facts of the problem in this country are that we are over-populated, that contraception is practised too much by the upper and middle classes—perhaps even by the skilled working classes—and not enough by the improvident unskilled masses at the bottom of the social edifice.

The outstanding question is whether, as a result of a reduction of our numbers to a point somewhere in the neighbourhood of the economic optimum for this country—by which reduction the existing burden of taxation, an increasing element of which is now devoted to [54] charity and relief, will be correspondingly diminished—our upper and middle classes would be enabled to produce more children, and to continue to produce enough to maintain our numbers in the neighbourhood of their optimum.

The answer to this question depends on a further question. To what extent is the relative sterility of the professional and skilled working classes attributable to the heavy taxation now imposed on them, and to the rise in the cost of living due to the war, and to what extent is it the result of a preference shown by many people for a more or less luxurious life, with few or no children, to a simpler life with several children? In other words, to what extent is it attributable to an economic factor and to what extent to motives of selfishness?

To what extent does that quality of self-interest play a part which prompts a woman to refuse to breastfeed her baby because she is afraid of the effects thereof upon her figure, [55] which causes her to abstain from having children because she dislikes the discomfort and deformity preliminary to, and the actual pains of, childbirth, or which makes her value amusements and expensive forms of pleasure and recreation more highly than the experience of maternity? To what extent is the relative infertility of the upper and middle classes accounted for by the kind of egotism which induces the husband to go in for entertaining, for a motor, and a house with several servants, and generally to live in comparative affluence rather than do without his superfluities and bring up a family of children? This attitude nowadays certainly plays a part. Dissatisfaction with the elementary pleasures of life, the craving after artificial stimuli and new sensations, have always been, and probably will always remain, the surest way to decadence in a race, and as such should be combated. It is more in the interest of the race that the professional and artisan classes should [56] produce plenty of good children than that the families of the very poor should be restricted. The argument is sometimes advanced by complacent and wealthy individuals that the working classes should be encouraged to reproduce freely in order to keep up the country’s numbers. The dirty work is thrown, so to speak, on the shoulders of those least qualified to discharge it. It must appeal to the sense of justice of everyone that if the maintenance of numbers of the race is to be conceived as a burden (which of course it should not), the burden should be borne equally by all classes.

The writer, who has had occasion to witness the results of over-multiplication among the very poor, feels that it is only in fairness to them that they should be equipped with every possible means of improving their lot. At present one of the most important of such means is the creation of facilities by the Ministry of Health for the giving of information to those mothers [57] who need it about how they may limit their families and space their children. The immediate social results of such a measure would unquestionably be good. The remote results are more open to doubt. And it is this doubt which renders it of the utmost importance to add that every form of pressure and persuasion be brought to bear on the other classes, to make them realize that it is morally incumbent on them, in the interests of the country and of the race, to have as many children as they can possibly afford, even at the expense of the minor luxuries of life.

Up till now no such pressure has been exerted, and most people regard it as a matter of moral indifference, whether, when married, they have children or not. The problem as to whether the general public, once it has been educated to realize the national importance of the question of having children, would act upon it and thereby avert the threat of a [58] dwindling population is again one of great difficulty. Admittedly, the example set us by France is not encouraging. What is the likelihood of our following in her footsteps? It is a delicate and important question. The writer is of the opinion that our national character differs from that of the French in a way that would make us more responsive to such an appeal for children than the French have shown themselves to be. But again we are in the realm of conjecture, and each person is entitled to his opinion.

The fact remains, however, that as long as the advertisement now given to Birth Control is permitted to continue, its practice will become yearly more prevalent. Its spread will certainly not be limited by an attitude of official negativism towards it while the propaganda is allowed to continue unchecked.

There remains the other process above distinguished as ‘dysgenic,’ the [59] effect of which upon the quality of the race is probably as detrimental as the one just considered, namely, the nurture and perpetuation of the morally and physically unfit. This tendency can only possibly be met by some form of Eugenic legislation. The existing opposition to anything of the sort in this country probably springs from a deep-seated dislike of bureaucratic interference in people’s private lives, and is associated with a failure to realize the harmful consequences of the existing order. It is of interest, however, to observe that in America, where, in practice if not in theory, individual liberty is valued less highly than in this country, various enactments have been passed with a definitely Eugenic object. Thus in the State of Nebraska marriage is forbidden to anyone afflicted with venereal disease, and all applications for marriage licenses have to be accompanied by affidavits of freedom from such disease. Nobody acquainted with [60] the nature of the infant mortality produced by congenital syphilis can fail to approve of this measure.

In 1895 the State of Connecticut forbade the marriage of epileptics and feeble-minded persons, under penalty of three years’ imprisonment. Everyone possessing knowledge of the Neurological Out-patients’ Department of any large hospital must realize the existing prevalence of epilepsy and appreciate how this hereditary disease may incapacitate and stultify its victims. Montana provides for the sterilizing of idiots, epileptics, feeble-minded and insane persons, which measure must again commend itself to those aware of how prolific such types can be if left unwatched. In males, sterilization can be effected by a very minor operation, the use of X-rays for this purpose being a procedure with regard to which there is still medical controversy.

The principle might even be extended to individuals who, by a record of crime or misdemeanour, prove themselves [61] to belong to a type which the nation does not want perpetuated. The sterilization of the male leaves quite undisturbed his sexual function, though it destroys his power of reproduction. The infringement which it therefore involves of the liberty of the individual is far less than that made by the State when it takes it upon itself to hang a man. Yet the social benefit arising from the two measures cannot be compared. Though it is difficult at this stage to define the details of Eugenic legislation it seems likely that the physical and moral standard of the race could broadly be raised by such a qualitative Birth Control.

The number of emigrants which we are in a position to send to the Dominions each year is limited by difficulties of transport, and could never amount to more than a fraction of our present unemployment figure. There is further the important consideration that the Dominions themselves [62] do not relish the idea of our regarding them as dumping grounds for our superfluous undesirables. The type of emigrant they want is a courageous, hardworking, physically healthy type, capable of initiative, of withstanding hardships without grumbling, and of making a good citizen. Such do not tend to become unemployed here, though, under very adverse circumstances, they often may. A decrease of our population need not therefore be opposed to our Imperial interests if, in the process, we raise the standard of the race and improve our national stock.

What will be the bearings of such enlightened Birth Control upon the future? It will affect the Individual directly in his immediate relation to his family, and it will influence him indirectly through its effect upon the community as well as through the international relationships of the country to which he belongs. The [63] international implications will be considered first, since they are the most far-reaching.

The most obvious of these is the connexion between unrestricted increase of population and wars. To what extent was the late war due to this cause, and to what extent has the world learnt from it the necessity of regulating such increase?

The causes of the late war were complex and are not yet wholly understood. A fact however stands out clearly now that we contemplate it in retrospect and now that changes in international feelings have forced upon us a consideration of the point of view of our late enemies. It is that the causes now recognized are essentially different from what those causes were represented to be in the war propaganda of the various belligerents.

It is to the interests of each belligerent to place the whole blame for a war upon its enemies and completely to exculpate itself. Thus in the late [64] war both sides were convinced that they were fighting for Righteousness, Liberty, Justice, Law and Order, Civilization, etc., against enemies inspired by cruelty, subtlety, insatiable greed, jealousy and lust for world-power. When, however, we contemplate the war after a lapse of several years through an aftermath of much suffering and disillusionment, we realize that it was the product of historical causes and racial antipathies and of certain social and economic phenomena rather than of any unequal partition of moral qualities.

Before the war, Great Britain was the most powerful nation in the world and was naturally jealous of any other nation that coveted, or aspired to usurp, her enviable status.

Russia found herself in a condition of acute social instability, momentarily threatened by the event which in 1917 cast her beyond the pale of western civilization. To Russia the war came as a happening which could dissipate the [65] revolutionary ferments, mobilize her refractory workers into the army, and, through the tremendous appeal of a national crusade, sidetrack the forces of anarchy in precisely the way that those forces were sidetracked in Ireland in 1914. Had the war been won quickly—as there were grounds for hoping when it began—the Czar would probably still be on the throne of an enlarged and yet more powerful Russia.

By the events of the last hundred years Germany had been elevated from a position of relative unimportance to that of the most highly organized and perfectly industrialized power in the world. In achieving this promotion she had earned the venomous hatred, born of her humiliation, of France, and the slowly growing, disquieting suspicion of Great Britain.

Conscious of her growing industrial strength, becoming restive within the frontiers which confined her swelling population, aware of the hostility of her neighbours, and never allowed to [66] forget that her kingdom had been built upon the sword, the youthful soul of Germany found, in her Emperor, a fitting symbol for her aspirations. He was the creation of her mood, and together with the party of which he was the mouthpiece led her to her downfall.

It would not be a fair statement to assert that population pressure in Germany was the cause of the war. It was unquestionably a part-cause and a predisposing cause, as it was of migration in prehistoric times and of most wars since. But it was here complicated by other factors both inside and outside Germany.

The universal desire to avert a similar catastrophe in the future has materialized in the League of Nations. It is hoped that through its agency many precipitating causes of war will be eliminated. By it provocation will be made more difficult and commitment more perilous. But the essential predisposing cause, that of over-multiplication, remains unassailed. [67] Like some dull-witted monster it is left to wax in strength and malignancy within its fetters, till at last, no longer to be denied, it will break all bounds, turn, and rend the world. From the late war no lesson as to the importance of population control has been learnt. Will another war be necessary to teach us this lesson?

Earlier in the book reference was made to the possibility of a war between Japan and either America or ourselves. Though this contingency is being thought out in detail by the naval authorities of all three countries, care is taken in diplomatic circles to assert that such practical measures as the equipment of Singapore imply no unfriendly or suspicious attitude toward Japan. Few people, however, are deceived by these utterances. The mutual fear and distrust is growing and will probably continue to grow. There is little doubt, that, if this war comes about, its essential cause, the increase of Japanese in excess of the [68] power of maintenance of their country, will be obscured by that outburst of vilification of the enemy and glorification of self which is now demanded by popular sentiment in the conduct of wars. Yet this cause will remain here incomparably the most important of the predisposing causes. After such a war will there remain any vestige of civilization to profit from the hard-won lesson?

The principal aim of Soviet Russia to-day is the spread of her communistic principles throughout the world. The chief obstacles to this are the firmly entrenched and powerful capitalism of the United States, and the more diffused and essentially more vulnerable capitalistic organisations of the British Empire. These last the Russians are doing their best to undermine now. A second world war would give them a long-coveted opportunity. Realizing that prolonged wars and the social unrest that follows them are the soil from which revolutions most readily spring, Russia [69] would probably associate herself with Japan. The secret treaty between the two countries whose aspirations and political ideals have otherwise little in common, gives a premonition of this. By the time a war comes it is possible that the exploitation of China by Japan will be more complete, and the effects of anti-foreign propaganda, carried on by Russia, more far-reaching. The increase of anti-British feeling in India, also stimulated by Russia, will co-operate to unify Asia and European Russia in a solid block, determined to shake off the yoke of the Western Powers and of America.

Such a war could never be conclusive, however prolonged. The vast length of the fighting front, the colossal numbers of active belligerents, and the enhanced destructiveness of war would probably lead, after initial successes, to a collapse of the organized fighting forces of the West. The seeds of revolution in Europe, by then more deeply sown, would germinate, and the present [70] social order would come to an end. The continent would then embark upon a new phase of its history, with the first chapter steeped in the bloodshed of revolution, and founded upon the ruins of our industrial civilization. The centre of civilization might then shift to the southern hemisphere where to-day there is less to destroy.

The fact remains that if the price that humanity will have to pay for learning to regulate its over-multiplication is to be a second world war—the much talked of war, this time, between East and West—it is doubtful if there will be left a civilization capable of learning the lesson. It seems worth while, therefore, to try to put the principle into effect before we are taught its necessity in such a way. To this there are at present two obstacles, namely the nature of certain religions and the criterion of national evaluation that is still prevalent.

The first obstacle rests in the fact that two powerful religions have not [71] adapted themselves to the changes of human relationships imposed by the unification through science of the human race. These religions remain with their eyes fixed either on the next world or on the exclusive welfare of the tribe.

By the Catholic Church a mode of behaviour is imposed calculated to achieve salvation in the next world irrespective of its effects on this one. Omitting from consideration, as probably unjust, the motive of wishing to increase the number of its adherents, with which the Roman Catholic Church has been charged by reason of its attitude towards Birth Control, there remains a motive arising from a theory of a relation between salvation in the next world and certain modes of behaviour in this. Contraception is condemned because it is held to incur damnation. It is not condemned because it leads to social injustice, to wars, to human suffering. The point is that it is still condemned in spite of its leading away from these [72] things. It is therefore devoutly to be hoped that in the event of the population of any Catholic country at any time in the future expanding to proportions that threaten the peace of the world, the Pope will see his way to modify the Church’s attitude in the matter before it is too late. Failure to do so would result in the depressing spectacle of the leader of the religion of ‘Peace and Goodwill’ among men deliberately refusing to take a step to avert war.

The second type of religion is represented in Japan and is tribal in the sense that it is avowedly concerned with the glorification of the Japanese, irrespective of the consequences to the world that this may involve. In its object of elevating Japan to the status of a first class power the cult of revived Shinto has succeeded admirably and has proved itself, in several wars, to be a splendid fighting creed. The present increase of the population of Japan by 700,000 a year is wholly in accordance [73] with its precepts. Again we may devoutly hope that it will not overreach itself and plunge Japan, as well as the rest of us, into a world war after which we would probably cease to exist as civilized countries. It is, of course, obvious that a modification of Japanese policy where Birth Control is concerned would be welcomed with inexpressible relief by the rest of the world.

The militancy of Mohammedanism will probably have little effect on the future of the world, because Mohammedan countries are at present poorly organized for extensive modern war. The Church of England is more concerned with the social and international implications of religion than any other, and the above remarks have little relevance to it.

If, therefore, the cataclysm above contemplated is to be averted the first necessity would seem to be a revision of the standards of existing religions, in consideration of the unification [74] of the human race, so as to accord with a formula of something of this sort: That is good and morally right which will promote the general happiness and goodwill of humanity, and the harmony of the world. It is clear that action leading to the limitation of over-multiplication would in this sense be good and in accordance with religion.

The second obstacle to the realization of a control of population is the standard by which the merit of a nation is now generally appraised, and to which most nations aspire. This merit is largely estimated in terms of power of offence and defence. This is a bad criterion and should be altered for a better one which will now be considered.

Earlier in the book reference was made to a biological argument against contraception, consideration of which was deferred. This argument holds that [75] in so far as reproduction is a primary biological function, a thwarting of that function is not only unnatural but anti-biological. This view has a certain plausibility but does not stand close scrutiny. The criterion of biological value or fitness is essentially racial, not individual. That is biologically good which will improve or benefit the race, that is bad which will harm or weaken it.

Under stable conditions of racial equilibrium there is a reasonable expectation that instincts and structures which have had survival value in the past will continue to have such value in the future. But during moments of crisis, at those turning points in the history of living things when new forms appear, such a presumption is quite unjustified. Thus if we picture to ourselves, allegorically, an event which probably took many thousands of years to accomplish, we might imagine the comments of a conservative [76] piscine critic upon the emergence of the first Dipnoid from some muddy river on to land.

The development of fore and hind limbs from fins, of lung from swim-bladder, and of instincts appropriate to the new medium, would strike all conservative fishes as highly immoral deviations from that biological tradition which had given stability to the glorious race of fishes. Nothing could seem more a-biological. Similarly with the development of fur and feathers and of the parental instinct, all of which were probably, in part at any rate, invested with survival value by the spell of cold which followed the Secondary period, and which perhaps conditioned the substitution of birds and mammals for the hitherto ubiquitous reptile as dominant vertebrates on the earth. From the point of view of the conservative reptile such changes would appear highly anti-biological. In moments of racial crisis, therefore, it is dangerous to generalize as [77] to what is biologically good from past experience alone. In the past a high degree of fertility has been, for most species, a biologically valuable asset. It does not follow that it will continue to be so for the human race. In fact there are good reasons for supposing that it will not.

The human race is now passing through a biological crisis unprecedented in the history of life. It has achieved a mastery over nature such that mankind is now economically unified throughout the world by the astounding feats of intercommunication and transport. But as yet the human race has achieved little ethical unification. It is directly in the interests of the race that such unification should take place, and all things which promote it may therefore be considered biologically good. And of those things a restriction of human fertility is one of the most important.

What then is to be our biological criterion of racial fitness and our standard [78] for judging of a nation’s merit?

It is clear that our biological criterion must be racial rather than individual. Division of labour and differentiation of function are carried to such lengths in civilized societies that it does not seem possible to hold up any individual type as an ideal of biological fitness. Qualities which, to the solitary animal, would irrevocably spell extinction may for the gregarious animal have the highest survival value. Thus no attribute would be more irremediably fatal to a non-social animal than sterility. Yet the sterility of 999 out of 1000 female bees in the community of the hive has endowed the species with a vitality and a biological importance such that it has largely conditioned the appearance on the planet of many kinds of entomophilous flowers. Our biological criterion must therefore, with our standard of merit, be social rather than individual, and the following general outline is suggested.

The population of each country [79] should be proportionate to its resources. The numerical adjustment should be such that there be no unemployment and that individual productivity be highest without idlers at either end of the social scale. The physical average of the race should be good with no congenital diseases of mind or body and with the minimum of other diseases, and of crime. There should be a high average standard of comfort, self-respect and happiness, and a high moral standard of honesty, tolerance, and kindliness. One would hope for a wide prevalence of that ‘joie de vivre’ and contentment which is doubtless largely temperamental in origin and which contributes more to an individual’s happiness than any number of worldly possessions can ever do. And the social cleavage between classes, and the now stupendous discrepancies between the very rich and the very poor should be reduced to a minimum. Such conditions all would wish generally distributed. It is a question [80] whether a uniformly high degree of intelligence should be equally ubiquitous. In every community, primitive or civilized, an immense amount of crude physical labour has to be done. The soil has to be tilled, someone has to dig coal and iron out of the ground, and endless other kinds of manual work have to be performed. It is doubtful whether the possession of a very high degree of intelligence would make such workers happier or more efficient. But whatever we may individually feel about this point, we would all wish such workers to be healthy, happy, well housed, contented with their lot, fond of their children, and both appreciated by, and on good terms with, the rest of the community.

And obviously it is a condition of this sort which an enlightened Birth Control could help to achieve.

The above is intended both to be a criterion of biological fitness for the human race, and a more satisfactory standard of national evaluation than the [81] one that is in vogue to-day. It will be noted that there is nothing in it about capacity for wars. If we could substitute some such standard in place of the armament standard by which to grade countries in an order of merit, we should be in a better position to avert the catastrophe of another world war than we are at present. According to such a standard the country most deserving of admiration, respect and imitation to-day would probably be Switzerland. Knowing that she cannot defend herself against her powerful neighbours, she does not aspire to large armies. When other countries can, by a simultaneous control of population, realize a similar security, it will be open to them to follow in her footsteps. The ideal may not appeal to the romantic, but much that passes for romance is frequently pernicious nonsense, like the sentiment by which war is glorified in the eyes of many women and elderly men who have never participated in it.

From an international equilibrium based upon a modification of religions as above suggested and upon an alteration in our standards of national evaluation, social harmony would follow fairly readily. It is unlikely that the antagonism between capital and labour will be much affected by a control of population beyond removing that source of social unrest which is furnished by a large body of unemployed. It remains doubtful, however, if the essential political issue will be much modified by a solution of the unemployment problem. The psychological forces which give the Labour party its driving power are not such as to produce the fullest economic prosperity in this country; but none the less they demand and must ultimately receive satisfaction. The best that can be hoped is that those forces will gradually be appeased, and will not lead to bloodshed, too great a dislocation of trade, or too drastic a loss of international status.

The gain to the individual following the general application of knowledge of Birth Control will be twofold. In the first place parents will be able to space their children in accordance with their physical and financial resources; in the second they will feel more confident of producing healthy well-balanced children, untainted by disease, than they can feel at present. Their children would further be welcomed by the community, and their future would be assured.

Such are the bearings of an enlightened Birth Control upon the future. It is obvious that such advantages could only be gained by slow and laborious degrees. The writer is far from the opinion that the application of his views will immediately transform the world into a Utopia. He is convinced however that if the existing form of civilization is to have any permanence, the necessity for controlling population [84] will have to be realized and striven for by all educated people.

In practice, the ‘plea,’ referred to in the sub-title, is that the Ministry of Health should give the subject of contraception its sanction. In May of 1924 a petition supported by twenty-two Labour members of Parliament was presented to the Minister of Health by a deputation of eighteen persons, some of them well known, requesting that official permission be accorded to doctors in charge of Welfare Centres to give information on Birth Control to such working women as desired it and were considered fit for it. Though the existing technique is not wholly satisfactory it is avowedly worth something, having already proved of great help to many women.

This permission was refused in deference, it seems, to ecclesiastical opinion, to certain reactionary political forces which, in the House, were opposed to it, and to popular prejudice. It is possible that by the time this book is [85] published the Ministry of Health may have changed its attitude. At present, however, information on contraception can only be obtained from a few private organizations such as those of the Malthusian League in Walworth and Kensington, of Dr Stopes in Holloway, and from another centre in the Edgware Road. The Malthusian League has worked quietly, unostentatiously, and, so far as its means allow, with the utmost effectiveness in one of the poorest quarters of London. For what it has done there can be nothing but praise.

But however valuable the work of these organizations, they cannot possibly meet the requirements of our large slums, where such information as exists is handed about by irresponsible midwives and gamps, often with the worst results. It also seems desirable to the writer to restrict the often vulgar publicity by which this subject is frequently attended, and to which attention was drawn when the objections [86] to Birth Control were reviewed. After the first blast of criticism which it would evoke from the baser organs of the press, such a sanction from the Ministry of Health would render further newspaper advertisement of Birth Control superfluous. If it does not cease of its own accord steps should be taken to suppress it. How best can this sanction be obtained?

Clearly through an appeal from the medical profession. An expression of unanimity, or relative unanimity, from doctors in this country as to the desirability of this sanction would constitute an argument which the Ministry of Health could not easily ignore. If the sanction were thus obtained it would be open to those medical men who had approved the measure in this country to invite their colleagues in other countries to follow in our footsteps. It would seem best to begin with Germany and America, where there is reason to suppose that such an appeal would meet with response. If support were [87] forthcoming from these countries, others might be approached—such as Japan, Italy and perhaps India, in which last the suffering caused by an excessive birth rate and a high early death rate is immense and almost wholly avoidable.

In this way the medical profession in whose hands the health of each community lies would take the first step in the direction of an international control of population, and would thereby lay the basis for a genuine and permanent world-peace.

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The Project Gutenberg eBook of Birth control and the state

BIRTH CONTROL
AND THE STATE

FOREWORD