Reproduction, contraception and eugenics

1. Medicine, Disease and Society in Britain, 1750 - 1950 Reproduction, contraception and eugenics Lecture 16

2. Lecture Themes and Outline Overall theme – attempts at controlling reproduction Continued Themes • demography, medical science, VD, national efficiency, class Structure • Revisit population debates • Fertility decline – reproduction • Contraception • Eugenics

3. Estimated Population Totals and Percentage Growth Rates Population totals (millions) 1550 1680 1820 1900 England 3.0 4.9 11.5 30.5 France 17.0 21.9 30.5 38.5 Germany 12.0 12.0 18.1 43.6 Western Europe 61.1 71.9 116.5 201.4 Percentage growth rates 1550-1680 1680-1820 1820-1900 England 64% 133% 166% France 29% 39% 26% Germany 0% 51% 142% Western Europe 18% 62% 73%

4. Historians have explained the acceleration of population growth in one of two ways: • It was a consequence of the Industrial and Agricultural Revolutions through an improved standard of life (the Malthusian view) • Rising birth rate • Changes in marriage • Reduced death rate • It was the result of various medical innovations independent of these Revolutions (McKeown) • Control of disease • Better nutrition

5. Thomas McKeown: steep falls in infectious diseases, e.g. diphtheria, measles and whooping cough, occurred before the introduction of vaccination. Indeed, death rates had fallen by as much as 95% in the pre-vaccine era. He attributes this mainly to better and less-crowded living conditions, improved nutrition and clean water. From: The Role of Medicine by Thomas McKeown, 1979.

6. Reasons for decline in the birth rate: Parents have fewer children as more survive infancy. Easier access to contraception. Greater willingness to use contraception. Children perceived to ‘cost’ more so parents want less.

7. Methods of Contraception Non-mechanical • Coitus interrputus (or withdrawal) • Abstinence • Abortion Mechanical • Male – condom (sheath, French letter) • Female – douche • Cocoa pessaries • Intra-uterine caps

8. Herbal Abortificants

9. “For females of all ages these Pills are Invaluable, as a few a doses of them carry off all humours, and bring about all that is required. No female should be without them. There is no medicine to be found to equal BEECHAM'S PILLS for removing any obstruction or Irregularity of the system. If taken according to the directions given with each box, they will soon restore females of all ages to sound and robust health.” A nineteenth century advertisement for Beecham’s Pills.

10. Handbill to promote contraception, 1823 ‘This paper is addressed to the reasonable and considerate among you, the most numerous and most useful class of society. It is not intended to produce vice and debauchery, but to destroy vice, and put an end to debauchery... Do as other people do, to avoid having more children than they wish to have, and can easily maintain. What is done by other people is this. A piece of soft sponge is tied by a bobbin or penny ribbon, and inserted just before the sexual intercourse takes place, and is withdrawn again as soon as it has taken place. Many tie a piece of sponge to each end of the ribbon, and they take care not to use the sponge again until it has been washed. If the sponge be large enough, that is, as large as a green walnut, or a small apple, it will prevent conception, and thus, without diminishing the pleasures of married life, or doing the least injury to the health of the most delicate women, both the woman and her husband will be saved from all the miseries which having too many children produces’. (quoted in Joan Lane, Social History of Medicine, pp.42-43).

11. Robert Roberts, The Classic Slum (Harmondsworth: Penguin, 1990), pp. 51-52: ‘in the ordinary working-class bed, while coitus interruptus remained permissible, any artificial interference with the work of God aroused nothing but abhorrence. Still, among the ‘low’, certain homely safeguards against conception had been known for generations, especially the small piece of oiled sponge with tapes hopefully attached adopted by women. Common, too, was the home-made pessary, a compound of lard (later margarine) and flour.’

12. Joseph A. Banks, Prosperity and Parenthood (London: Routledge and Kegan Paul, 1954), p. 202 : • Economic depression of the 1870s and 1880s undermined middle-class confidence in the future and encouraged the use of birth control to maintain living standards. • During the period 1870-1914 childrearing for most working-class families was increasingly subject to an array of perceived rising ‘costs’ • It was realised that smaller families enjoyed a better standard of living than their larger counterparts. • Middle and working class had rising aspirations

13. Simon Szreter, Fertility, Class and Gender in Britain, 1860-1940 (Cambridge: Cambridge University Press, 1996), p. 439: • Attempted abstinence, embracing coitus interruptus, were, overall, the most important forms of birth control before the Great War in Britain. • Abstinence was the English way of adjusting fertility in response to the perceived relative costs of having children. • The perception of the escalating ‘costs’ of childrearing provided the conscious motivation to control births. • But it was the anti-sexual culture which was both conducive to the use of abstinence as the method to achieve that goal and, also, essential, in providing married men and women with a legitimating, anti-sexual rationale, which enabled them to stick to their task. • The regime of attempted abstinence was probably at its most prevalent as a general practice during the period 1870-1920, but it cast a long cultural shadow extending until the 1960s.

14. Marie Stopes (1880 - 1958) was a campaigner for women's rights and a pioneer in the field of family planning. • 1918- Married Love and Wise Parenthood • 1921- Mothers’ Clinic for Birth Control – free contraceptive advice for married women • 1930 National Birth Control Council (later Family Planning Association) • 1930-16 clinics- 21,000 clients 1939- 65 clinics • 1948 – Not part of NHS

15. Norman Dennis, Fernando Henriques and Clifford Slaughter, Coal is our Life (London: Tavistock Publications, 1969), pp. 208-209: ‘When Mary and Jean were told repeatedly of the ease of birth control under modern clinical supervision, they reacted…in a manner illustrative of…the conditioning of women in Ashton to a narrow and traditional range of activity, ideas and personality. Jean was at first unreceptive to the idea of birth-control appliances. She had a feeling that there was something unnatural about it; she would feel awkward and embarrassed about going to the clinic. Secondly, and very significantly, she thought her husband would not favour the idea; once, she said, she had brought home some rubber sheaths sold to her by the chemist and her husband had thrown them on the fire, saying that they took all the enjoyment out of sex, and were no safer than withdrawal. She thought Stanley would ridicule the appearance of the appliance which was shown. She had no bathroom, and she would find it very awkward to use the equipment correctly.’

17. Anthropometrics Galton’s “lab” at International Exhibition, 1884

18. Francis Galton, anthropometric testing

20. ‘Civilised’ people interfered with natural selection. They do not let nature take its course- they allow the unfit – disabled, disturbed, to reproduce. How then can evolution take its course? Soft inheritance- transmission of natural (genetic) and acquired characteristics (culture and habits) (Darwin) Hard inheritance – transmission of natural attributes only (Galton) • Positive eugenics: ‘consist in watching for the indications of superior strains or races, and in favouring them that there progeny shall outnumber and gradually replace that of the old one’.E.g. Selected marriage • Negative eugenics: measures to dissuade the less fit from breeding.

23. Carlos Panton Blacker (1895-1975), physician and leader of the Eugenics Society from 1928

24. Achievements in eugenics before 2nd World War ‘Legislatures as well as demagogues enacted moderate eugenic measures, for the most part, hoping these would lead to favourable changes in the make-up of their populations. More people- not necessarily the - ‘unfit’- practised artificial birth control; more illegal abortions-not necessarily of the ‘unfit’- probably took place. More mothers –not necessarily the ‘fit’-raised more babies, and more families were probably healthier. More ‘unfit’ people were segregated in institutions to keep them from reproducing, and more were sterilized than ever before- about 5,000 Scandinavians up to 1940.’ (Brunton, Medicine Transformed, p.282.).

25. Conclusion • Focus on control of reproduction through contraception (non-mechanical and mechanical) and class-based eugenics • Result from concern over population growth, of “wrong stock,” national degeneration, disease, continued state intervention • Contraception accepted, eugenic programmes not for the most part – although certainly some measures today can still be seen as eugenic by attempting to control reproduction