BIRTH CONTROL
                             AND THE STATE




                             BIRTH CONTROL
                             AND THE STATE

                         A PLEA AND A FORECAST


                                  BY
                             C. P. BLACKER
                    M.C., M.A., M.R.C.S., L.R.C.P.


                            [Illustration]


                               NEW YORK
                        E. P. DUTTON & COMPANY
                           681 FIFTH AVENUE




                            Copyright, 1926
                       By E. P. DUTTON & COMPANY

                         _All Rights Reserved_


                PRINTED IN THE UNITED STATES OF AMERICA




                               FOREWORD

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
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 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.

                                                            C. P. B.




                      BIRTH CONTROL AND THE STATE

                         A PLEA AND A FORECAST


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 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 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,
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 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 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 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 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 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.
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 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
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 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 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 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 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 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 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 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 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 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 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 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 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 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 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, 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 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. 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. 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 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 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 them and nowhere immediately available to send them.

                   *       *       *       *       *

Substantially this is what has been said on each side of this complex
question.

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 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 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 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 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 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. 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 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 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 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 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 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 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 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, 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 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 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 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
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 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 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 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 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 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 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 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. 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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.

                   *       *       *       *       *




 Transcriber’s Notes:

 ――Text in italics is enclosed by underscores (_italics_).

 ――Punctuation and spelling inaccuracies were silently corrected.

 ――Archaic and variable spelling has been preserved.

 ――Variations in hyphenation and compound words have been preserved.