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CONCEPTION CONTROL AND ITS EFFECTS ON THE INDIVIDUAL AND THE NATION

by

FLORENCE E. BARRETT, C.B.E., M.D., M.S., B.Sc.

Consulting Obstetric and Gynæcological Surgeon to the Royal Free
Hospital. President of the Federation of Medical Women.

With a Foreword by His Grace the Archbishop of Canterbury.

1922







PREFACE

This small book has been written in response to many requests for some
statement regarding the individual and national effects of the
widespread practice of conception control.

It is not intended to give medical advice on the subject for, in my
judgment, that is best given to the individual by his or her medical
adviser, and will vary in different circumstances.

The question as to whether control of conception shall or shall not be
practised is a decision ethical and not medical in character when
husband and wife are healthy, and in the last resort will be decided
by the individual pair for themselves; but they will be wise to
discuss the question with their medical attendant in order to realise
all that is involved in their decision.

Space forbids anything like a full discussion of the national issues,
but that aspect of the subject demands quite as careful study as
personal needs or desires.

     F.E.B.

     31, DEVONSHIRE PLACE, W.1.
     September, 1922.




FOREWORD


The Archbishop of Canterbury allows me to use the following letter as
a Foreword to this little book.

DEAR LADY BARRETT,

I have read with great interest the manuscript of your pamphlet. Very
many of us who have daily to do with the problems and perplexities of
our social life and to give counsel to the anxious or the penitent or
the perturbed will thank you for these clear and cogent chapters. To
arguments based on moral and religious principle you add the weight of
ripe experience and of technical scientific knowledge. Your words will
gain access to the commonsense of many who would perhaps regard the
opinions of clergy as likely to be prejudiced or uninformed. I am of
course not qualified to express an independent judgment upon the
medical or physiological aspects of this delicate problem, but I
desire on moral and religious as well as on social and national
grounds to support your general conclusions, and to express the hope
that your paper may have wide circulation among those who are giving
attention to what is becoming an urgent question in thousands of
English homes.

     I am,
     Yours very truly,
     RANDALL CANTUAR.

     LAMBETH PALACE, S.E.
     3rd August, 1922.




CONTENTS


     CHAPTER I
     THE PROBLEM OF TO-DAY

     CHAPTER II
     THE DEMAND FOR KNOWLEDGE AND FROM WHOM TO OBTAIN IT

     CHAPTER III
     METHODS

     CHAPTER IV
     THE EFFECT OF WIDESPREAD CONCEPTION CONTROL ON NATIONAL EFFICIENCY

     SUMMARY OF CONCLUSIONS




CHAPTER I

THE PROBLEM OF TO-DAY


In the late seventies of last century a pamphlet entitled _The Fruits
of Philosophy_ was republished by Mrs. Annie Besant and Mr. Charles
Bradlaugh, in their desire to mitigate the suffering of poor women who
were overburdened by work and further weakened by frequent
child-bearing. They resolved to face public obloquy and even legal
prosecution in order to bring to these women knowledge of how to
prevent conception, which, in their opinion, would give the relief
they so sorely needed. As is well known, the later pamphlet on the
same subject written by themselves was withdrawn from publication by
Mrs. Besant in 1886 on religious grounds.

During the last few years the idea of the need for conception control
has again become prominent, partly as a revolt against the bondage of
women in child-bearing, partly accentuated by the difficulties and
uncertainties of an adequate livelihood, and the desire to have a few
children well educated and cared for rather than many who shift more
or less for themselves.

But also the claim is made that marriage exists at least as much for
the fulfilment of happiness in union with the beloved as for the
procreation of children; and that it should be possible for a married
pair to have the fullest gratification without fear of children unless
they desire them.

Others, but these are extremists, go so far as to claim that apart
altogether from marriage vows, sexual intercourse should be the
experience of all, and that knowledge of how to avoid the birth of
illegitimate children should be given to all.

The discussion of this subject has taken place under the title of
Birth Control, but the control or regulation of births is not really
the point under discussion. A very big factor in the diminution of
births comes under the heading of abortions, whether voluntary or
through conditions which might be remedied. That subject is not
touched upon in this paper, but only methods which avoid conception,
which is, of course, a very different subject from the larger one of
avoiding births.

At first sight it might seem a comparatively simple thing, in view of
the knowledge which already exists of the physiological processes
involved in conception, to advise a method which shall prevent
conception at will without harmful effect upon man or woman and yet
leave intercourse unimpaired. But even at first sight it is obvious
that whatever knowledge may be available, and whatever methods may be
devised, it would not be easy to convey this knowledge rightly to the
individual it is hoped to benefit without doing harm to others.
Further thought shows that the national problems involved are so
important and far reaching in effects that they might well arrest the
attention of the most careless advocate of indiscriminate conception
control.

This is a subject, therefore, which requires careful consideration
from the point of view of the individual, of public morality, and of
national welfare--and the more closely it is studied the more apparent
are the far reaching issues involved. It is improbable that the
practice of using contraceptives will continue for even a generation
without revealing the harmful effects which must to some extent ensue.

In the whole discussion of this subject it is important to keep in
mind that the physical is only one aspect of the sex relation.

In the evolution which sex has shared with all else, the psychic side
appears even in the higher animals. In them the desire is not for mere
indiscriminate physical satisfaction, but the element of choice comes
in, a factor which sometimes upsets the plans of breeders. In man this
aspect of the relation is all important. The higher side of sex, or
what we may call the psychical secondary sex characters, seem to
extend through the whole range of mental and spiritual activities.
Because of this there is freshness of contact in mental and spiritual
intercourse between men and women which differs somewhat from that
between individuals of the same sex, and very much of the joy of life
springs from the impact of these differing yet completing selves the
one upon the other.

Where the whole being enters into the union of the sexes the complete
joy of marriage is realised, the characteristic of which is that it
does not fade, but becomes ever deeper and more fully realised, a sure
indication that the highest pleasure of sex union is only attained
when it consummates a love which involves mutual sympathy and
consideration. Physical union alone produces dissatisfaction the more
quickly in proportion as it is physical only; on the other hand, when
all parts of the nature find their counterpart in another, the joy of
such intercourse pervades the whole life, and frequent repetition of
physical intercourse is not essential to its highest development.

This is well known to all true lovers who have for varied reasons
exercised some voluntary self-control in regard to the physical side
of sex in marriage, either in deference of the one to the desire of
the other, or to avoid too frequent child-bearing, or in special
seasons such as Lent.

On the other hand it has been observed by most people that many
marriages which seem to promise well, quickly lose even to the eye of
the outsider all the romance of the days of courtship. Is not too
frequent physical indulgence sometimes the cause?

Even the time of courtship is spoiled by unrestrained demonstration of
affection, and the beauty of the higher side of love is apt to lose
its delicate bloom by over accentuation of the physical in marriage;
husband and wife sadly admit to themselves that disillusionment has
come--the real truth being that in seeking only physical satisfaction
in each other, their eyes have become blinded to those higher
qualities which each glimpsed in the other during the happier days of
courtship, and the "road of the loving hearts," which they hoped to
tread through life, has been missed because they have forgotten that
"man is a spirit and doth not live by bread alone."

To many the introduction of this aspect of the question may seem
beside the mark. For them the practical question in a world of sense
is how to avoid having children when for any reason they are not
wanted, and yet leave unimpaired facilities for married life. It is
true the problem is not always stated so bluntly. The uses of
contraceptives are explained, together with a recommendation for
moderation in physical intercourse; but as will be shewn below, if
such moderation is really practised, it is possible to live a natural
married life such as renders unnecessary the use of artificial
contraceptives with all their attendant evils and yet limit the size
of the family.

But it is necessary to consider more carefully the claim made to-day
that contraceptives are both necessary and harmless, and that public
propaganda on the subject is desirable.

There are several different groups for whom relief is claimed:--

1. Women who are suffering from chronic or from temporary ill-health
are frequently not in a condition to bear the strain of child-bearing,
and indeed it may become a real danger to their future health, either
mental or physical.

2. There are cases of inherited disease, mental or physical, which
ought to prohibit child-bearing.

3. There are over-worked women whose daily work, added to
child-bearing, destroys their health and vitality. These people are
found not only among the so-called working classes; the same
conditions with somewhat different types of strain are found in wives
of professional men with very slender incomes.

4. Some parents wish to "space" their children, that greater attention
may be given to each, or they wish to limit the number of their family
on account of financial and other difficulties.

With these and other considerations in view, the widespread teaching
of methods of preventing conception is advocated because it is
claimed:--

(a) That except for general propaganda, the greatest sufferers, viz.,
poor women with constantly recurring pregnancies, would otherwise
never learn of any method of relief.

(b) That many young people who for various reasons, such as housing or
financial difficulties or inherited disease, feel themselves unable to
have a family, would if such knowledge were available marry much
earlier, and their natural desires would be satisfied, while apart
from marriage they might resort to promiscuous intercourse.

(c) That homes where the growing difficulties and strain of a
continually increasing family are leading to estrangement between
husband and wife, are restored to happiness when saved from the
difficult choice between continence, which they have never trained
themselves to practice, or many children with which they cannot cope.

There are, however, serious fallacies in these contentions.

The propagandists of conception control appear to take it for granted
that after preventive measures in early youth, children may be
conceived at will whenever they are desired; and, moreover, it is
assumed that apart from such precautions every woman will conceive
annually and will continue to do so until 10-12 children have been
born.

Neither of these suppositions is supported by facts. On the contrary,
there are large numbers of married couples who would give anything to
have children, but have postponed it until circumstances should seem
quite desirable, and then, to their grief, no children are given to
them. It is very unfair to teach people that they may safely postpone
the natural tendency to bear children in youth and rely upon having
them later in life. Probably gynæcologists are consulted more often by
women who desire children but do not have them, than by those who
wish to avoid having them--the truth being that the tendency among
people in comfortable surroundings is towards relative sterility
rather than towards excessive fertility.

Those who are interested in this aspect of the question will find the
facts admirably set forth in Mr. Pell's book on _The Law of Births and
Deaths_, being a study of the variation in the degree of animal
fertility under the influence of environment.

He finds that the all-important factor which determines fertility is
the amount of nervous energy of the organism, and that nervous energy
is produced or modified by three specially influential factors, viz.,
Food, both quantity and quality; Climate, hot or cold--moist or dry;
and, lastly, all those varied conditions which make for greater or
lesser mental and physical activity.

Fertility, broadly speaking, varies in inverse proportion to the
degree of nervous energy or what we may call vitality.

Conditions, therefore, which lower the general vitality below the
normal produce abnormal fertility. This excessive child-bearing under
present conditions still further lowers the standard of life and the
health of the mother, hence a vicious circle is set up, the only
escape from which will come by such consideration of the laws of
health relating to work, housing, food and recreation as shall ensure
the maximum of vitality to the workers. This is the true method of
conception control.

There comes a point in the development of nervous energy which is
productive of sterility. It is true that principles based on so many
varying factors will necessarily appear to fail in individual cases.
Environment with its influence on the nervous energy of the individual
will be modified by the inherited tendency of that individual towards
fertility or the reverse. We find, therefore, isolated cases of large
families among the well-to-do and small families among those whose
vitality is below the normal, but if the general principle is true we
should expect to find a larger number of _sterile_ marriages among the
well-to-do than among those whose lives are more full of hardship, and
this undoubtedly is the case.

This aspect of the problem is deserving of careful study. The desire
for children in so many homes where every advantage could be given,
may be gratified when more knowledge of how wisely to modify the
environment of the rich is within our grasp.

It may be that the more simple life among those who have much will
give to them the prize of children which they covet more than things
which wealth can buy.

But let us return for a moment to the false expectation that children
will come to all unless prevented.

The results of this assumption are really serious. They involve the
training of large numbers of people in unnatural practices, which in
many cases are unnecessary, even if they were desirable. They rob many
families of the children who would have been the delight of their
parents through middle and later life.

Moreover, it is obvious that advice which may be quite necessary in
cases of ill-health or special conditions, may be fundamentally wrong
to give broadcast to all individuals, for apart from the fact that
when given to all it is largely unnecessary, there are other serious
objections, as follows:--

1. A public opinion at the present time is being gradually produced
which takes it for granted that as a matter of good form young people
should not have children for a few years after marriage, and it is
becoming a common practice to start married life with sordid and
unnatural preparations for a natural act; yet many of these young
people, men and women alike, are most anxious to have children, and
only seek to know how to prevent them because they believe it to be
"the thing to do."

One or two illustrations which have come to my personal knowledge will
perhaps show the kind of idea which is conveyed to the mind of young
people by books and speeches on this subject, though such results may
not have been desired by the authors or speakers.

A young bride came to her mother on returning from her honeymoon and
said, "Mother, how long must we wait before having children--is it
really necessary to prevent them for a year or two? We are both dying
to have babies."

A young couple on the eve of marriage consulted a gynæcologist
regarding the question of using the cap pessary to prevent the
possibility of having children for a few years.

The bride, who was greatly distressed, produced the pessary which she
had purchased, and said she could not possibly use it; her fiancé,
however, had been advised that she could, and ought to do so, hence
the first serious dispute had arisen between them, clouding the
future.

She was told by her doctor that it was quite impossible for her, and
this fully satisfied the future husband.

The next point was if this method were impossible what should be used.

They were a splendid young couple, with ample means to support a
family, and the doctor naturally asked--"But for what purpose do you
need any methods to prevent children at all?" They hesitated and
looked at each other, and then said--"I don't know, but we thought it
was the thing to do."

They left with the whole nightmare put aside, determined not to spoil
the perfect consummation of their happiness.

Many similar cases might be quoted where young people, without any
considered motive, are acting in accordance with the vogue of the
moment.

2. The use of contraceptives does not encourage self-control, yet the
cultivation of self-control is a far higher gain to the individual and
the nation than any apparent advantages obtained by its abandonment.

By no means unimportant is the influence that wide diffusion of the
knowledge of how to prevent conception would have in causing more
irregular unions and greater promiscuity in sex relations. The effect
of this would not only loosen, rather than strengthen, the marriage
tie, but would inevitably lead to an extension of venereal disease.
Many people seem to think that contraceptives prevent venereal disease
at the same time that they prevent conception. But this is not so. The
use of methods of prevention by women is no protection to them from
infection.

3. We have, moreover, to take a wider view, and consider who will
receive and act upon the advice given, and hence what the result will
be on the differential birth-rate of the community.

It is quite obvious that the educated classes can most easily follow
instructions which result in protection from conception, and since
such knowledge most easily circulates among the more highly endowed
classes, it has been claimed that it is important to make efforts to
let the knowledge be so widespread that it may reach all. The result,
however, could only be that the practice of conception control would
spread throughout the upper, middle and more intelligent of the
working classes, and this would involve a very serious reduction in
the births of those who furnish the leaders and efficient workers in
all branches of life, and in those only.

For the birth-rate amongst the least intelligent, least efficient and
the mentally deficient will be unaffected. It must be apparent that
after a very few generations of such weeding out of the best, with the
continuous multiplication of the worst type of citizen, the general
standard of efficiency, enterprise and executive skill of the nation
would be seriously impaired. Such, briefly stated, is the problem
before the public at the present time.




CHAPTER II

THE DEMAND FOR KNOWLEDGE AND FROM WHOM TO OBTAIN IT


Even the brief survey given in the first chapter will have suggested
to the reader that the people who ask for knowledge seek it for
various reasons. Indeed, the first thing that strikes anyone who gives
consideration to the subject is the difference in type and
circumstance of the people for whom relief is claimed. We begin to
realise at once that the subject of conception control is an intimate
and individual one, and can only really be dealt with by advice which
is given to the individual and not to the public at large.

This is perhaps most obvious in the first group mentioned on page 17,
where the woman is suffering from chronic or acute disease, and the
necessity for preventing conception is clear to her medical adviser.
If disease renders child-bearing a danger to the life and health of
the mother, it becomes a positive duty of her doctor to prevent such a
catastrophe--but the method advised will differ according to the
special nature of the case.

Again, where in the case of husband or wife there is a serious
inheritance of mental or physical disease, and especially when the
same weakness exists in both families, it is justly regarded as a duty
by the married pair not to bring children into the world. It may be
contended that men and women with such an inheritance should not
marry, but that is a matter for the decision of the individuals
concerned. It not infrequently happens that marriage has taken place
before they know of the inherited tendency. In such cases clearly the
advice of the family doctor should be given as to the best course to
pursue in order to avoid conception.

The case of the overworked and burdened mother with a large and
increasing family is nearly allied to that of a woman with disease,
though in her case the causes for ill-health are more complicated.

While it is true that ill-health and premature ageing in working women
are the result of many causes, yet where child-bearing still further
injures health it is essential that she should consult her medical
adviser on this point, for she not only needs treatment to restore her
health, but also advice specially suitable to her own case, as to the
best method to avoid conception for the time being, and such advice
will vary according as the disability is temporary or permanent.

It is, happily, as possible for the poor woman to obtain advice in all
matters of health as it is for the rich. The mothers of the country
are in touch everywhere with maternity clinics, where doctors advise
them on all questions of health relating to pregnancy, and treat each
woman as a separate individual.

But the case of the poor working woman overburdened with work which
she cannot accomplish--yet with the added burden of bearing more
children than her more fortunate sisters, deserves some further
consideration.

What is it that prematurely ages so many of these women of the
slums--is it child-bearing alone?

The answer to that is immediately in the negative, for women in
comfortable circumstances may have large families, with no sign of
weariness and dejection. No, the causes of ill-health and debility
are diverse, and to pretend to solve the question by conception
control is a mockery, for it salves the conscience of the community
without really dealing with the question of the disabilities of the
working woman, or the true cause of her excessive fertility.

Ill-health in working-class mothers often has its origin in inherited
weakness and lack of care in childhood. It is further accentuated by
overwork, with no labour-saving devices; lack of suitable food; too
few, if any, hours of recreation, and hence very little out-door
exercise. Badly ventilated homes deprive the mother of necessary
supplies of oxygen, and insufficient sleep is often the last straw
which breaks down the patient burden bearer. A true and haunting
picture is given in a recently published book called _The Woman in the
Little House_ (which first appeared in a series of articles in the
journal "Time and Tide"), describing the anxiety of a working woman at
night to keep her baby quiet that the husband may sleep.

Now it is quite true that a small family instead of a large one will
diminish the work and anxieties of such a mother, but it will not give
her the remedies which she needs, nor will it diminish the excessive
sexual demands made upon her.

Everyone who knows these women intimately realises what an exhausting
feature is this habit of excess due to lack of knowledge or
self-restraint on the part of the husband.

I believe if facilities were provided whereby the woman could do her
laundry with modern appliances outside her own home, if family meals
were arranged in service rooms equivalent to the arrangements in
service flats, and if there were crêche rooms where children might be
left for an hour or two in safety while necessary work was done--we
should find a greatly increased standard of comfort even in existing
homes, and a great improvement in dietary for the whole family. Such
relief, added to teaching both to husband and wife as to the times of
conception, would revolutionise the life of women more than any
teaching of artificial birth control, and would lift it up to a higher
level instead of degrading it to the grossly physical.

We come to very different considerations in group 4, p. 18, where
choice rather than necessity impels the parents to limitation of the
family. The teaching now being advocated by certain books and
pamphlets advises deliberate delay in child-bearing for a period after
marriage, and the spacing of certain periods between the births of
such children as are allowed to come into the world, with limitation
of the number in each family.

Teaching on these lines, if followed, would involve an artificial mode
of sex life always--natural spontaneous union would find no place.
Already young wives are seeking advice for some relief from methods of
preparation which they say have destroyed in them all spontaneous
desire. The tragedy of it all is that even to attain the end in
view--moderation in the size of families--such methods are to a large
extent unnecessary. Not to every young married couple does a child
arrive at the end of a year. Some, using no artificial checks, wait
two or three years before the first baby comes. Even if it does come,
however, at the end of a year, there are many advantages to
counterbalance the small means and perhaps hard living of the young
pair. For when people are young they can put up with small means,
because they are strong enough to work hard and help each other;
indeed, the demand for little work and many luxuries in youth is not a
healthy one, it is a sign of decadence in the race.

Moreover, even though an early family involve real hardship for
awhile, it has the great advantage that parents and children later on
are still young together, and that means far more to the child in
understanding friendship and helpfulness during the most critical
period of life than extra comforts or pleasures would have meant to
the parents, and if young parents realised this, would they not put
the child first?

The so-called advantages of a few years between one child and the next
so that the parents may give fuller care and attention to each, are
far outweighed from the child's point of view by the advantages of
playmates in the nursery of nearly its own age, who are a source of
education in the give and take of life such as no adult can supply. If
parents wish to have only three or four children, it is to the
advantage of the mother as well as of the children, to have the little
family early in life--they are then all in the nursery together, and
later all at school, and her life work is in this way so arranged
that she may give most service to the world in addition to carrying on
the race.

Our conclusion is that for mothers and children it is very desirable
that no contraceptives should be used in the early years of married
life.

In the vast majority of families where no restrictions or unnatural
means are used and where mothers nurse their children for eight or
nine months, children only come every two years. Even if a young
couple decide that they cannot afford to bring up more than four
children, they have first to prove that four children will be given
them--in many cases they will not have so many, and as years go by the
fertility of the mother becomes progressively less, so that if
child-bearing is postponed till after thirty, in a certain number of
families no children are born. There are many men and women who
bitterly regret having let the years go by in which children might
have been born to them, and it is only fair that young couples of
to-day should fully understand this risk.




CHAPTER III

METHODS


There are certain points in regard to methods of preventing conception
which should be made clear.

It is, of course, obvious that conception can be voluntarily
controlled by abstention from intercourse except when children are
desired. This has been called a counsel of perfection. It could only
rightly be so described where such a method of life was both desired
and approved by both husband and wife. It would not be a fair thing
for either to enforce a practically celibate life on the other without
the fullest understanding and consent before the marriage vows were
taken.

But conception can also be controlled by avoidance of those parts of
the monthly cycle in which conception most commonly takes place. That
in the great majority of women there is a time in the monthly cycle
when no conception occurs has been noted for a long time. The
rough-and-ready method of reckoning the date of birth in relations to
the last menstrual period is an example of the assumption that
conception will probably have taken place a week later, and the
frequency with which such reckoning is justified shows that it is not
altogether unfounded. During the war it was possible to make some more
exact observations owing to the short leave granted to soldiers to
visit their homes. Seigel has published a paper in the "Münchener
Medizinische Wochenschrift," 1916, in which he gives information
regarding the conception of between two and three hundred children
born during the war. He finds that the likelihood of fertilisation
increases from the first day of menstruation, reaching the highest
point six days later, the fertile period remains almost at the same
height till the 12th or 13th day, and then declines gradually until
the 22nd day, after which there is absolute sterility.

This suggests that conception control can be attained without
artificial methods if intercourse is confined to one week in the
month.

Such control of conception, though natural, does not make it any more
desirable to space the births unduly so that the children are brought
up in separate units instead of in a happy family group in which they
can share games and interests--but it does avoid the risks which are
associated with artificial methods of conception control.

It is not proposed to discuss in detail artificial methods in this
pamphlet, because no advice can be wisely given on this subject in a
general way. Those who after careful consideration choose to use
artificial means to prevent child-bearing will be wise if they consult
their medical attendant as to those methods which are least harmful
for their individual case, and ask for careful instruction in their
use.

Most of the methods so widely advertised are productive of diseased
conditions, whether from the nature of the method itself or from the
way in which it is used, and all of those recommended to women
interfere with normal physiological processes. The object aimed at in
methods recommended to women, is either to produce, by drugs or
otherwise, conditions in the vagina inimical to the life of the male
cell, or to prevent by mechanical means the reception of the semen
into the uterus. Owing to the uncertainty in the results of either of
the above methods of prevention, the later editions of books which
teach conception control now advocate the use of both methods at the
same time in order to approximate more closely to certainty of result.

All these artificial preparations for intercourse demand from the
woman an investigation of and interference with her own internal
organs, which is revolting to all decent women, and such teaching is
directly opposed to the advocacy of cleanliness and non-interference
with the genital organs, which is the natural habit of healthy-minded
women.

The effects, however, go further than this. Nature has provided in the
healthy vaginal secretions an antidote to infection which quickly
destroys harmful germs. If the natural secretions are altered it is
difficult to restore them to their natural quality.

Professor Arthur Thomson, F.R.C.S., has shewn ("British Medical
Journal," January 7th, 1922) from observations of the lining of the
womb in animals and in women that "the weight of evidence goes to
prove that its function is more likely to be absorbent than excretive,
and that as such it plays an important part in the animal economy."

After describing at length the evidence that the male secretion
consists largely of the secretions from special glands as well as the
sex cells, he refers to the fact that these are all largely received
into and absorbed by the glands of the womb, and he discusses the
probability that such absorption profoundly and beneficially affects
the physiological reaction in the woman. He points out that the use of
artificial checks "while preventing fertilisation may also be the
means of depriving the female of certain secretions which may exercise
a far reaching influence on her economy"; and he concludes, "As a rule
we cannot interfere with the normal course of nature without some
consequent evil result. May this not be an instance in which for some
apparent gain in one direction, the woman pays the penalty?"




CHAPTER IV

THE EFFECT OF WIDESPREAD CONCEPTION CONTROL ON NATIONAL EFFICIENCY


In every nation individual capacity varies within wide limits. We have
men and women of brilliant attainments, and of all grades of
intelligence ranging downwards to the mentally defective. There is no
doubt that all grades of intelligence can be improved by education,
but there appears to be a limit to the capacity of development of each
individual. Lower intelligence, therefore, is not only due to lack of
opportunity, but to an inborn constitutional defect.

Further study has shewn this defect to be hereditary--the parents or
grandparents of such people shew defective intelligence, and their
offspring are likely to do the same; indeed, if two mentally defective
people marry it is fairly certain that their children will all be
mentally defective.

There are, however, no sharply defined classes of intelligence; just
as the mentally defective are in many grades, so ordinary men and
women vary from low or average intelligence up to outstanding cases of
genius or capacity.

By the newer methods of mental testing it has been shewn that children
of various classes of the community, as well as men and women of
different races, can be grouped according to their intellectual
capacity, and that no educational facilities will develop that
capacity beyond a certain point.

Professor W. McDougall, F.R.S., in his most useful and interesting
book on _National Welfare and National Decay_, reaches the important
conclusion "that innate capacity for intellectual growth is the
predominant factor in determining the distribution of intelligence in
adults, and that the amount and kind of education is a factor of
subordinate importance." He claims that the evidence is overwhelming
as to the validity of the results obtained by mental testing.

A few examples of experimental work given in Professor McDougall's
book will suffice to show the trend of these results.

Tests of intelligence were carried out on recruits for the American
Army, white and coloured, and they shewed marked superiority of the
white race.

A special test was carried out in Oxford by Mr. H.B. English, who
compared the capacity of boys in a school attended by children of the
intellectual classes with that of boys in a very good primary school,
whose fathers were shop-keepers, skilled artisans, etc., coming from
homes which were good, with no sort of privation. The result showed
marked superiority of the sons of intellectual parents. Mr. English
concludes that the children of the professional classes, between 12
and 14 years of age, exhibit very marked intelligence, and he is
convinced that the hereditary factor plays an altogether predominant
part.

In another experiment, Miss Arlitt, of Bryn Mawr College, tested 342
children from primary schools in one district, who were divided into
four groups:--

     Group 1.   Professional.
     Group 2.   Semi-professional and higher business.
     Group 3.   Skilled labour.
     Group 4.   Semi-and unskilled labour.

Marked differences between the groups were shewn. The intellectual
capacity was represented by figures as follows:--

     Group 1     125
     Group 2     118
     Group 3     107
     Group 4      92

A further research of 548 children, grouped according to the
occupation of their father, gave its results in terms of the
percentage of children in each group who scored a mark higher than the
median for the whole 548. They are as follows:--

     Professional group      85%
     Executive group         68%
     Artisan group           41%
     Labour group            39%

In the "Journal of Educational Psychology," Vol. IX, 1916, Mr. A.W.
Kornhauser gives evidence from the examination of 1,000 children drawn
from five schools in Pittsburgh.

Schools A and B were attended by children of unskilled manual workers.

Schools C and D by children of skilled artisans and small shopkeepers.

School E by children of parents in very comfortable circumstances.

The results are tabulated as--

     Retarded, _i.e._, below average.
     Normal, _i.e._, average.
     Advanced, _i.e._, above average.

                                | Retarded. | Normal. | Advanced.
     A } Manual workers        {|  45.2     | 47.1    |   7.7
     B }                       {|  36.7     | 55.9    |   7.4
                                |           |         |
     C } Artisans, etc.        {|  29.4     | 50.2    |  20.7
     D }                       {|  28.8     | 50.2    |  19.5
                                |           |         |
     E Most comfortable         |  12.7     | 62.7    |  24.6[A]

[Footnote A: I am indebted to Professor McDougall's book for
information here given.]


These experiments all shew the trend of intelligence (and with it will
power or power of concentration, and what we may call general
capacity) to be more concentrated in the so-called higher grades of
society, and to be less and less evident as we descend in the scale
from skilled to unskilled workers. It would, of course, be clear to
all that the children of mentally deficient parents can only be a
burden on the State or can rarely contribute anything of value to the
common weal.

Now the teaching and advocacy of methods of conception control is most
easily assimilated and practised by the intelligent classes; indeed,
we may say with certainty that such methods can only be used
effectively by the intelligent members of the community, such as
leisured, professional and mercantile classes, skilled artisans and
better class workers, whereas the lowest type of casual labourers
whose home conditions render the use of preventive methods difficult
or impossible, and the mentally deficient and criminal classes, are
unaffected by such teaching.

The result in a few generations must be a marked decrease in the
numbers of the intellectual and efficient workers, while the
hopelessly unfit continue to produce their kind at the same rate as
before.

The figures given do not suggest that individuals with marked ability
are to be found in the upper classes only, but they do indicate that
there is a larger proportion of boys and girls in the more comfortable
classes whose inherited ability is above the average, though this may
be partly due to the more intellectual atmosphere in which their early
childhood has been passed.

The provision of education for all, with facilities for children of
every class to pass on to higher grades of work, is essential if the
latent powers in all, whatever they may be, are to be developed to the
utmost.

The point for our consideration at the moment, however, is that if the
production of all capable workers, whether mental or manual, is to be
curtailed and the numbers of the population maintained in greater
proportion from the mentally deficient or criminal classes, the result
must be national disaster. For in a very short time there will not be
enough leaders of real capacity to occupy positions of initiative and
responsibility in the various activities of the country at home and
abroad, nor will there be an adequate supply of good practical work: a
lowered standard of efficiency must result. From a national point of
view, therefore, we regard the propaganda in favour of conception
control to be a real and increasing danger.

The problem of the mentally deficient is of another order. In this
case another kind of control is urgently needed, but it is one which
can only be undertaken by the State, and not by the individual. It is
to put in force such a method of compulsory segregation as would
ensure the comfort and contentment of the mentally deficient, and
safeguard them and the nation from the reproduction of their kind.

The problem also of the insane and criminal classes in relation to
heredity is one which demands careful consideration by those competent
to give it.




SUMMARY OF CONCLUSIONS


1. There are certain women who for medical reasons should be prevented
from bearing children.

2. There are couples with undesirable inheritance who rightly decline
to bear children.

3. There are many women of the poorer classes in whom child-bearing is
sometimes the last straw in circumstances all of which tend to destroy
health and vitality.

4. Public teaching on contraceptives, like medical advice advertised
in newspapers, is generally applied to cases for which it is
unsuitable and applied in the wrong way.

It is therefore detrimental to public health as well as being
detrimental to public morality.

5. A public opinion in favour of small spaced families does not serve
the best interests of the children or of their mother.

6. Married love should express itself at once in the usual way without
the use of artificial contraceptives.

7. The diminishing fertility of the more capable classes is a national
peril.

To counteract this tendency every encouragement should be given to the
intelligent and efficient classes of the community to bear healthy
children.

The study of problems which give rise periodically to a propaganda in
favour of the practice of conception control reveal the fact that
excessive child-bearing is found in those classes who suffer the
greatest privation, and in whom large families are a real hardship,
while many couples among the well-to-do are childless though greatly
desiring children.

Such facts suggest that the true remedy for the general problem lies
in raising the standard of living among working-class mothers and
advising a more simple life to the more richly endowed.

8. It is desirable that the Government should make provision for
methods which will arrest the propagation of the mentally deficient,
insane and criminal classes.