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II.
THE ORIGIN AND RESULTS OF BIRTH CONTROL

In tracing the course of reproduction we have so far been concerned with what are commonly considered the blind operations of Nature in the absence of conscious and deliberate volition. We have seen that while at the outset Nature seems to have impressed an immense reproductive impetus on her creatures, all her energy since has been directed to the imposition of preventive checks on that reproductive impetus. The end attained by these checks has been an extreme diminution in the number of offspring, a prolongation of the time devoted to the breeding and care of each new member of the family, in harmony with its greatly prolonged life, a spacing out of the intervals between the offspring, and, as a result, a vastly greater development of each individual and an ever better equipment for the task of living. All this was slowly attained automatically, without any conscious volition on the part of the individuals, even when they were human beings, who were the agents. Now occurred a change which we may regard as, in some respects, the most momentous sudden advance in the whole history of reproduction: the process of reproductive progress became conscious and deliberately volitional.

We often fancy that when natural progress becomes manifested in the mind and will of man it is somehow unnatural. It is one of the wisest of Shakespeare's utterances in one of the most mature of his plays that

 
"Nature is made better by no mean
But Nature makes that mean …
This is an art
Which does mend Nature, change it rather, but
The art itself is Nature."
 

Birth control, when it ceases to be automatic and becomes conscious, is an art. But it is an art directed precisely to the attainment of ends which Nature has been struggling after for millions of years, and, being consciously and deliberately an art, it is enabled to avoid many of the pitfalls which the unconscious method falls into. It is an art, but

"The art itself is Nature."

It is always possible for the narrow-eyed fanatic to object to the employment of birth control, precisely as he might object to the use of clothes, as "unnatural." But, if we look more deeply into the matter, we see that even clothes are not truly unnatural. A vast number of creatures may be said to be born in clothes, clothes so naturally such that, when stripped from the animals they belong to, we are proud to wear them ourselves. Even our own ancestors were born in clothes, which they lost by the combined or separate action of natural selection, sexual selection, and the environment, which action, however, has not sufficed to abolish the desirability of clothes.⁸⁰ So that the impulse by which we make for ourselves clothes is merely a conscious and volitional form of an impulse which, in the absence of consciousness and will, had acted automatically. It is just the same with the control and limitation of reproductive activity. It is an attempt by open-eyed intelligence and foresight to attain those ends which Nature through untold generations has been painfully yet tirelessly struggling for. The deliberate co-operation of Man in the natural task of birth-control represents an identification of the human will with what we may, if we choose, regard as the divinely appointed law of the world. We can well believe that the great pioneers who, a century ago, acted in the spirit of this faith may have echoed the thought of Kepler when, on discovering his great planetary law, he exclaimed in rapture: "O God! I think Thy thoughts after Thee."

As a matter of fact, however, it was in no such spirit of ecstasy that the pioneers of the movement for birth control acted. The Divine command is less likely to be heard in the whirlwind than in the still small voice. These great pioneers were thoughtful, cautious, hard-headed men, who spoke scarcely above a whisper, and were far too modest to realise that a great forward movement in natural evolution had in them begun to be manifested. Early man could not have taken this step because it is even doubtful whether he knew that the conjunction of the sexes had anything to do with the production of offspring, which he was inclined to attribute to magical causes. Later, although intelligence grew, the uncontrolled rule of the sexual impulse obtained so firm a grip on men that they laughed at the idea that it was possible to exercise forethought and prudence in this sphere; at the same time religion and superstition came into action to preserve the established tradition and to persuade people that it would be wicked to do anything different from what they had always done. But a saner feeling was awakening here and there, in various parts of the world. At last, under the stress of the devastation and misery caused by the reproductive relapse of the industrial era, this feeling, voiced by a few distinguished men, began to take shape in action.

The pioneers were English. Among them Malthus occupies the first place. That distinguished man, in his great and influential work, The Principle of Population, in 1798, emphasised the immense importance of foresight and self-control in procreation, and the profound significance of birth limitation for human welfare. Malthus relied, however, on ascetic self-restraint, a method which could only appeal to the few; he had nothing to say for the prevention of conception in intercourse. That was suggested, twenty years later, very cautiously by James Mill, the father of John Stuart Mill, in the Encyclopedia Britannica. Four years afterwards, Mill's friend, the Radical reformer, Francis Place, advocated this method more clearly. Finally, in 1831, Robert Dale Owen, the son of the great Robert Owen, published his Moral Physiology, in which he set forth the ways of preventing conception; while a little later the Drysdale brothers, ardent and unwearying philanthropists, devoted their energies to a propaganda which has been spreading ever since and has now conquered the whole civilised world.

It was not, however, in England but in France, so often at the head of an advance in civilisation, that birth control first became firmly established, and that the extravagantly high birth-rate of earlier times began to fall; this happened in the first half of the nineteenth century, whether or not it was mainly due to voluntary control.⁸¹ In England the movement came later, and the steady decline in the English birth-rate, which is still proceeding, began in 1877. In the previous year there had been a famous prosecution of Bradlaugh and Mrs. Besant for disseminating pamphlets describing the methods of preventing conception; the charge was described by the Lord Chief Justice, who tried the case, as one of the most ill-advised and injudicious ever made in a court of justice. But it served an undesigned end by giving enormous publicity to the subject and advertising the methods it sought to suppress. There can be no doubt, however, that even apart from this trial the movement would have proceeded on the same lines. The times were ripe, the great industrial expansion had passed its first feverish phase, social conditions were improving, education was spreading. The inevitable character of the movement is indicated by the fact that at the very same time it began to be manifested all over Europe, indeed in every civilised country of the world. At the present time the birth-rate (as well as usually the death-rate) is falling in every country of the world sufficiently civilised to possess statistics of its own vital movement. The fall varies in rapidity. It has been considerable in the more progressive countries; it has lingered in the more backward countries. If we examine the latest statistics for Europe (usually those for 1913) we find that every country, without exception, with a progressive and educated population, and a fairly high state of social well-being, presents a birth-rate below 30 per 1,000. We also find that every country in Europe in which the mass of the people are primitive, ignorant, or in a socially unsatisfactory condition (even although the governing classes may be progressive or ambitious) shows a birth-rate above 30 per 1,000. France, Great Britain, Belgium, Holland, the Scandinavian countries and Switzerland are in the first group. Russia, Austro-Hungary, Italy, Spain and the Balkan countries are in the second group. The German Empire was formerly in this second group but now comes within the first group, and has carried on the movement so energetically that the birth-rate of Berlin is already below that of London, and that at the present rate of decline the birth-rate of the German Empire will before long sink to that of France. Outside Europe, in the United States just as much as in Australia and New Zealand, the same great progressive movement is proceeding with equal activity.

The wide survey of the question of birth limitation here taken may seem to some readers unnecessary. Why not get at once to matters of practical detail? But, if we think of it, our wide survey has been of the greatest practical help to us. It has, for instance, settled the question of the desirability of the adoption of methods of preventing conception and finally silenced those who would waste our time with their fears lest it is not right to control conception. We know now on whose side are the laws of God and Nature. We realise that in exercising control over the entrance gate of life we are not only performing, consciously and deliberately, a great human duty, but carrying on rationally a beneficial process which has, more blindly and wastefully, been carried on since the beginning of the world. There are still a few persons ignorant enough or foolish enough to fight against the advance of civilisation in this matter; we can well afford to leave them severely alone, knowing that in a few years all of them will have passed away. It is not our business to defend the control of birth, but simply to discuss how we may most wisely exercise that control.

Many ways of preventing conception have been devised since the method which is still the commonest was first introduced, so far as our certainly imperfect knowledge extends, by a clever Jew, Onan (Genesis, Chap. XXXVIII), whose name has since been wrongly attached to another practice with which the Mosaic record in no way associates him. There are now many contraceptive methods, some dependent on precautions adopted by the man, others dependent on the woman, others again which take the form of an operation permanently preventing conception, and, therefore, not to be adopted save by couples who already have as many children as they desire, or else who ought never to have children at all and thus wisely adopt a method of sterilisation. It is unnecessary here, even if it were otherwise desirable, to discuss these various methods in detail. It is even useless to do so, for we must bear in mind that no method can be absolutely approved or absolutely condemned. Each may be suitable under certain conditions and for certain couples, and it is not easy to recommend any method indiscriminately. We need to know the intimate circumstances of individual cases. For the most part, experience is the final test. Forel compared the use of contraceptive devices to the use of eyeglasses, and it is obvious that, without expert advice, the results in either case may sometimes be mischievous or at all events ineffective. Personal advice and instruction are always desirable. In Holland nurses are medically trained in a practical knowledge of contraceptive methods, and are thus enabled to enlighten the women of the community. This is an admirable plan. Considering that the use of contraceptive measures is now almost universal, it is astonishing that there are yet so many so-called "civilised" countries in which this method of enlightenment is not everywhere adopted. Until it is adopted, and a necessary knowledge of the most fundamental facts of the sexual life brought into every home, the physician must be regarded as the proper adviser. It is true that until recently he was generally in these matters a blind leader of the blind. Nowadays it is beginning to be recognised that the physician has no more serious and responsible duty than that of giving help in the difficult path of the sexual life. Very frequently, indeed, even yet, he has not risen to a sense of his responsibilities in this matter. It is as well to remember, however, that a physician who is unable or unwilling to give frank and sound advice in this most important department of life, is unlikely to be reliable in any other department. If he is not up to date here he is probably not up to date anywhere.

Whatever the method adopted, there are certain conditions which it must fulfil, even apart from its effectiveness as a contraceptive, in order to be satisfactory. Most of these conditions may be summed up in one: the most satisfactory method is that which least interferes with the normal process of the act of intercourse. Every sexual act is, or should be, a miniature courtship, however long marriage may have lasted.⁸² No outside mental tension or nervous apprehension must be allowed to intrude. Any contraceptive proceeding which hastily enters the atmosphere of love immediately before or immediately after the moment of union is unsatisfactory and may be injurious. It even risks the total loss of the contraceptive result, for at such moments the intended method may be ineffectively carried out, or neglected altogether. No method can be regarded as desirable which interferes with the sense of satisfaction and relief which should follow the supreme act of loving union. No method which produces a nervous jar in one of the parties, even though it may be satisfactory to the other, should be tolerated. Such considerations must for some couples rule out certain methods. We cannot, however, lay down absolute rules, because methods which some couples may find satisfactory prove unsatisfactory in other cases. Experience, aided by expert advice, is the only final criterion.

When a contraceptive method is adopted under satisfactory conditions, with a due regard to the requirements of the individual couple, there is little room to fear that any injurious results will be occasioned. It is quite true that many physicians speak emphatically concerning the injurious results to husband or to wife of contraceptive devices. Although there has been exaggeration, and prejudice has often been imported into this question, and although most of the injurious results could have been avoided had trained medical help been at hand to advise better methods, there can be no doubt that much that has been said under this head is true. Considering how widespread is the use of these methods, and how ignorantly they have often been carried out, it would be surprising indeed if it were not true. But even supposing that the nervously injurious effects which have been traced to contraceptive practices were a thousandfold greater than they have been reported to be—instead of, as we are justified in believing, considerably less than they are reported—shall we therefore condemn contraceptive methods? To do so would be to ignore all the vastly greater evils which have followed in the past from unchecked reproduction. It would be a condemnation which, if we exercised it consistently, would destroy the whole of civilisation and place us back in savagery. For what device of man, since man had any history at all, has not proved sometimes injurious?

Every one of even the most useful and beneficent of human inventions has either exercised subtle injuries or produced appalling catastrophes. This is not only true of man's devices, it is true of Nature's in general. Let us take, for instance, the elevation of man's ancestors from the quadrupedal to the bipedal position. The experiment of making a series of four-footed animals walk on their hind-legs was very revolutionary and risky; it was far, far more beset by dangers than is the introduction of contraceptives; we are still suffering all sorts of serious evils in consequence of Nature's action in placing our remote ancestors in the erect position. Yet we feel that it was worth while; even those physicians who most emphasise the evil results of the erect position do not advise that we should go on all-fours. It is just the same with a great human device, the introduction of clothes. They have led to all sorts of new susceptibilities to disease and even tendencies to direct injury of many kinds. Yet no one advocates the complete disuse of all clothing on the ground that corsets have sometimes proved harmful. It would be just as absurd to advocate the complete abandonment of contraceptives on the ground that some of them have sometimes been misused. If it were not, indeed, that we are familiar with the lengths to which ignorance and prejudice may go we should question the sanity of anyone who put forward so foolish a proposition. Every great step which Nature and man have taken in the path of progress has been beset by dangers which are gladly risked because of the advantages involved. We have still to enumerate some of the immense advantages which Man has gained in acquiring a conscious and deliberate control of reproduction.

III.
BIRTH CONTROL IN RELATION TO MORALITY AND EUGENICS

Anyone who has followed this discussion so far will not easily believe that a tendency so deeply rooted in Nature as Birth Control can ever be in opposition to Morality. It can only seem to be so when we confuse the eternal principles of Morality, whatever they may be, with their temporary applications, which are always becoming modified in adaptation to changing circumstances.

We are often in danger of doing injustice to the morality of the past, and it is important, even in order to understand the morality of the present, that we should be able to put ourselves in the place of those for whom birth control was immoral. To speak of birth control as having been immoral in the past is, indeed, to underestimate the case; it was not only immoral, it was unnatural, it was even irreligious, it was almost criminal. We must remember that throughout the Christian world the Divine Command, "Increase and Multiply," has seemed to echo down the ages from the beginning of the world. It was the authoritative command of a tribal God who was, according to the scriptural narrative, addressing a world inhabited by eight people. From such a point of view a world's population of several thousand persons would have seemed inconceivably vast, though to-day by even the most austere advocate of birth limitation it would be allowed with a smile. But the old religious command has become a tradition which has survived amid conditions totally unlike those under which it arose. In comparatively modern times it has been reinforced from unexpected quarters, on the one hand by all the forces that are opposed to democracy and on the other by all the forces of would-be patriotic militarism, both alike clamouring for plentiful and cheap men.

Even science, under primitive conditions, was opposed to Birth Control. Creation was regarded as a direct process in which man's will had no part, and knowledge of nature was still too imperfect for the recognition of the fact that the whole course of the world's natural history has been an erection of barriers against wholesale and indiscriminate reproduction. Thus it came about that under the old dispensation, which is now for ever passing away, to have as many children as possible and to have them as often as possible—provided certain ritual prescriptions were fulfilled—seemed to be a religious, moral, natural, scientific, and patriotic duty.

To-day the conditions have altogether altered, and even our own feelings have altered. We no longer feel with the ancient Hebrew who has bequeathed his ideals though not his practices to Christendom, that to have as many wives and concubines and as large a family as possible is both natural and virtuous, as well as profitable. We realise, moreover, that the Divine Commands, so far as we recognise any such commands, are not external to us, but are manifested in our own deliberate reason and will. We know that to primitive men, who lacked foresight and lived mainly in the present, only that Divine Command could be recognisable which sanctified the impulse of the moment, while to us, who live largely in the future, and have learnt foresight, the Divine Command involves restraint on the impulse of the moment. We no longer believe that we are divinely ordered to be reckless or that God commands us to have children who, as we ourselves know, are fatally condemned to disease or premature death. Providence, which was once regarded as the attribute of God, we regard as the attribute of men; providence, prudence, self-restraint—these are to us the characteristics of moral men, and those persons who lack these characteristics are condemned by our social order to be reckoned among the dregs of mankind. It is a social order which in the sphere of procreation could not be reached or maintained except by the systematic control of offspring.

We may realise the difference between the morality of to-day and the morality of the past when we come to details. We may consider, for instance, the question of the chastity of women. According to the ideas of the old morality, which placed the whole question of procreation under the authority (after God) of men, women were in subjection to men, and had no right to freedom, no right to responsibility, no right to knowledge, for, it was believed, if entrusted with any of these they would abuse them at once. That view prevails even to-day in some civilised countries, and middle-class Italian parents, for instance, will not allow their daughter to be conducted by a man even to Mass, for they believe that as soon as she is out of their sight she will be unchaste. That is their morality. Our morality to-day, however, is inspired by different ideas, and aims at a different practice. We are by no means disposed to rate highly the morality of a girl who is only chaste so long as she is under her parents' eyes; for us, indeed, that is much more like immorality than morality. We are to-day vigorously pursuing a totally different line of action. We wish women to be reasonably free, we wish them to be trained in the sense of responsibility for their own actions, we wish them to possess knowledge, more especially in that sphere of sex, once theoretically closed to them, which we now recognise as peculiarly their own domain. Nowadays, moreover, we are sufficiently well acquainted with human nature to know, not only that at best the "chastity" merely due to compulsion or to ignorance is a poor thing, but that at worst it is really the most degraded and injurious form of unchastity. For there are many ways of avoiding pregnancy besides the use of contraceptives, and such ways can often only be called vicious, destructive to purity, and harmful to health. Our ideal woman to-day is not she who is deprived of freedom and knowledge in the cloister, even though only the cloister of her home, but the woman who, being instructed from early life in the facts of sexual physiology and sexual hygiene, is also trained in the exercise of freedom and self-responsibility, and able to be trusted to choose and to follow the path which seems to her right. That is the only kind of morality which seems to us real and worth while. And, in any case, we have now grown wise enough to know that no degree of compulsion and no depth of ignorance will suffice to make a girl good if she doesn't want to be good. So that, even as a matter of policy, it is better to put her in a position to know what is good and to act in accordance with that knowledge.

The relation of birth control to morality is, however, by no means a question which concerns women alone. It equally concerns men. Here we have to recognise, not only that the exercise of control over procreation enables a man to form a union of faithful devotion with the woman of his choice at an earlier age than would otherwise be possible, but it further enables him, throughout the whole of married life, to continue such relationship under circumstances which might otherwise render them injurious or else undesirable to his wife. That the influence thus exerted by preventive methods would suffice to abolish prostitution it would be foolish to maintain, for prostitution has other grounds of support. But even within the sphere of merely prostitutional relationships the use of contraceptives, and the precautions and cleanliness they involve, have an influence of their own in diminishing the risks of venereal disease, and while the interests of those who engage in prostitution are by some persons regarded as negligible, we must always remember that venereal disease spreads far beyond the patrons of prostitution and is a perpetual menace to others who may become altogether innocent victims. So that any influence which tends to diminish venereal disease increases the well-being of the whole community.

Apart from the relationship to morality, although the two are intimately combined, we are thus led to the relationship of birth control to eugenics, or to the sound breeding of the race. Here we touch the highest ground, and are concerned with our best hopes for the future of the world. For there can be no doubt that birth control is not only a precious but an indispensable instrument in moulding the coming man to the measure of our developing ideals. Without it we are powerless in the face of the awful evils which flow from random and reckless reproduction. With it we possess a power so great that some persons have professed to see in it a menace to the propagation of the race, amusing themselves with the idea that if people possess the means to prevent the conception of children they will never have children at all. It is not necessary to discuss such a grotesque notion seriously. The desire for children is far too deeply implanted in mankind and womankind alike ever to be rooted out. If there are to-day many parents whose lives are rendered wretched by large families and the miseries of excessive child-bearing, there are an equal number whose lives are wretched because they have no children at all, and who snatch eagerly at any straw which offers the smallest promise of relief to this craving. Certainly there are people who desire marriage, but—some for very sound and estimable reasons and others for reasons which may less well bear examination—do not desire any children at all. So far as these are concerned, contraceptive methods, far from being a social evil, are a social blessing. For nothing is so certain as that it is an unmixed evil for a community to possess unwilling, undesirable, or incompetent parents. Birth control would be an unmixed blessing if it merely enabled us to exclude such persons from the ranks of parenthood. We desire no parents who are not both competent and willing parents. Only such parents are fit to father and to mother a future race worthy to rule the world.

It is sometimes said that the control of conception, since it is frequently carried out immediately on marriage, will tend to delay parenthood until an unduly late age. Birth control has, however, no necessary result of this kind, and might even act in the reverse direction. A chief cause of delay in marriage is the prospect of the burden and expense of an unrestricted flow of children into the family, and in Great Britain, since 1911, with the extension of the use of contraceptives, there has been a slight but regular increase not only in the general marriage rate but in the proportion of early marriages, although the general mean age at marriage has increased. The ability to control the number of children not only enables marriage to take place at an early age but also makes it possible for the couple to have at least one child soon after marriage. The total number of children are thus spaced out, instead of following in rapid succession.

It is only of recent years that the eugenic importance of a considerable interval between births has been fully recognised, as regards not only the mother—this has long been realised—but also the children. The very high mortality of large families has long been known, and their association with degenerate conditions and with criminality. The children of small families in Toronto, Canada, are taller than those of larger families, as is also the case in Oakland, California, where the average size of the family is smaller than in Toronto.⁸³ Of recent years, moreover, evidence has been obtained that families in which the children are separated from each other by intervals of more than two years are both mentally and physically superior to those in which the interval is shorter. Thus Ewart found in a northern English manufacturing town that children born at an interval of less than two years after the birth of the previous child remain notably defective, even at the age of six, both as regards intelligence and physical development. When compared with children born at a longer interval and with first-born children, they are, on the average, three inches shorter and three pounds lighter than first-born children.⁸⁴ Such observations need to be repeated in various countries, but if confirmed it is obvious that they represent a fact of the most vital significance.

Thus when we calmly survey, in however summary a manner, the great field of life affected by the establishment of voluntary human control over the production of the race, we can see no cause for anything but hope. It is satisfactory that it should be so, for there can be no doubt that we are here facing a great and permanent fact in civilised life. With every rise in civilisation, indeed with all evolutionary progress whatever, there is what seems to be an automatic fall in the birth-rate. That fall is always normally accompanied by a fall in the death-rate, so that a low birth-rate frequently means a high rate of natural increase, since most of the children born survive.⁸⁵ Thus in the civilised world of to-day, notwithstanding the low birth-rate which prevails as compared with earlier times, the rate of increase in the population is still, as Leroy-Beaulieu points out, appalling, nearly half a million a year in Great Britain, over half a million in Austro-Hungary, and three-quarters of a million in Germany. When we examine this excess of births in detail we find among them a large proportion of undesired and undesirable children. There are two opposed alternative methods working to diminish this proportion: the method of preventing conception, with which we have here been concerned, and the method of preventing live birth by producing abortion. There can be no doubt about the enormous extension of this latter practice in all civilised countries, even although some of the estimates of its frequency in the United States, where it seems especially to flourish, may be extravagant. The burden of excessive children on the overworked underfed mothers of the working classes becomes at last so intolerable that anything seems better than another child. "I'd rather swallow the druggist's shop and the man in it than have another kid," as, Miss Elderton reports, a woman in Yorkshire said.⁸⁶