“Contraceptives or Abortion--Which Shall It Be?"

Apropos yesterday's Supreme Court opinion:

"When society holds up its hands in horror at the 'crime' of abortion, it forgets at whose door the first and principal responsibility for this practice rests.  Does anyone imagine that a woman would submit to abortion if not denied the knowledge of scientific, effective contraceptives?  Does anyone believe that physicians and midwives who perform abortions go from door to door soliciting patronage?  The abortionist could not continue his practice for twenty-four hours if it were not for the fact that women come desperately begging for such operations.  He could not stay out of jail a day if women did not so generally approve of his services as to hold his identity an open but seldom-betrayed secret.

"The question, then, is not whether family limitation should be practiced.  It is being practiced; it has been practiced for ages and it will always be practiced.  The question that society must answer is this: Shall family limitation be achieved through birth control or abortion?  Shall normal, safe, effective contraceptives be employed, or shall we continue to force women to the abnormal, often dangerous surgical operation?

"This question, too, the church, the state and the moralist must answer.  The knowledge of contraceptive methods may yet for a time be denied to the woman of the working class, but those who are responsible for denying it to her, and she herself, should understand clearly the dangers to which she is exposed because of the laws which force her into the hands of the abortionist.

"To understand the more clearly the difference between birth control by contraceptives and family limitation through abortion it is necessary to know something of the processes of conception.  Knowledge of these processes will also enable us to comprehend more thoroughly the dangers to which woman is exposed by our antiquated laws, and how much better it would be for her to employ such preventive measures as would keep her out of the hands of the abortionist, into which the laws now drive her.

"In every woman's ovaries are imbedded millions of ovules or eggs.  They are in every female at birth, and as the girl develops into womanhood, these ovules develop also.  At a certain age, varying slightly with the individual, the ripest ovule leaves the nest or ovary and comes down one of the tubes connecting with the womb and passes out of the body.  When this takes place, it is said that the girl is at the age of puberty.  When it reaches the womb the ovule is ready for the process of conception--that is, fertilization by the male sperm.

"At the time the ovule is ripening, the womb is preparing to receive it.  This preparation consists of a reinforced blood supply brought to its lining.  If fertilization takes place, the fertilized ovule or ovum will cling to the lining of the womb and there gather its nourishment.  If fertilization does not take place, the ovum passes out of the body and the uterus throws off its surplus blood supply.  This is called the menstrual period.  It occurs about once a month or every twenty-eight days.

"In the male organs there are glands called testes.  They secrete a fluid called the semen.  In the semen is the life-giving principle called the sperm.

"When intercourse takes place, if no preventative is employed, the semen is deposited in the woman's vagina.  The ovule is not in the vagina, but is in the womb, farther up, or perhaps in the tube on its way to the womb.  As steel is attracted to the magnet, the sperm of the male starts on its way to seek the ovum.  Several of these sperm cells start, but only one enters the ovum and is absorbed into it.  This process is called fertilization, conception or impregnation.

"If no children are desired, the meeting of the male sperm and the ovum must be prevented.  When scientific means are employed to prevent this meeting, one is said to practice birth control.  The means used is known as a contraceptive.

"If, however, a contraceptive is not used and the sperm meets the ovule and development begins, any attempt at removing it or stopping its further growth is called abortion.

"There is no doubt that women are apt to look upon abortion as of little consequence and to treat it accordingly.  An abortion is as important a matter as a confinement and requires as much attention as the birth of a child at its full term.

"'The immediate dangers of abortion,' says Dr. J. Clifton Edgar, in his book, 'The Practice of Obstetrics,' 'are hemorrhage, retention of an adherent placenta, sepsis, tetanus, perforation of the uterus.  They also cause sterility, anemia, malignant diseases, displacements, neurosis, and endometritis.'

"In plain, everyday language, in an abortion there is always a very serious risk to the health and often to the life of the patient.

"It is only the women of wealth who can afford the best medical skill, care and treatment both at the time of the operation and afterwards.  In this way they escape the usual serious consequences.

"The women whose incomes are limited and who must continue at work before they have recovered from the effects of an abortion are the greatest army of sufferers.  It is among such that the deaths due to abortion usually ensue.  It is theses, too, who are most often forced to resort to such operations.

"If death does not result, the woman who has undergone an abortion is not altogether safe from harm.  The womb may not return to its natural size, but remain large and heavy, tending to fall away from its natural position.  Abortion often leaves the uterus in a condition to conceive easily again and unless prevention is strictly followed another pregnancy will surely occur.  Frequent abortions tend to cause barrenness and serious, painful pelvic ailments.  These and other conditions arising from such operations are very likely to ruin a woman's general health.

"While there are cases where even the law recognizes an abortion as justifiable if recommended by a physician, I assert that the hundreds of thousands of abortions performed in America each year are a disgrace to civilization.

"The effects of such operations upon a woman, serious as they may be, are nothing as compared to the injury done her general health by drugs taken to produce the same result.  Even such drugs as are prescribed by physicians have harmful effects, and nostrums recommended by druggists are often worse still.

"Even more drastic may be the effect upon the unborn child, for many women fill their systems with poisonous drugs during the first weeks of their pregnancy, only to decide at last, when drugs have failed, as they usually do, to bring the child to birth.

"There are no statistics, of course, by which we may compute the amount of suffering to mother and child from the use of such drugs, but we know that the total of physical weakness and disease must be astounding.  We know that the woman's own system feels the strain of these drugs and that the embryo is usually poisoned by them.  The child is likely to be rickety, have heart trouble, kidney disorder, or to be generally weak in its powers of resistance.  If it does not die before it reaches its first year, it is probable that it will have to struggle against some of these weaknesses until its adolescent period.

"It needs no assertion of mine to call attention to the grim fact that the laws prohibiting the imparting of information concerning the preventing of conception are responsible for tens of thousands of deaths each year in this country and an untold amount of sickness and sorrow.  The suffering and the death of these women is squarely upon the heads of the lawmakers and the puritanical, masculine-minded person who insist upon retaining the abominable legal restriction.

"Try as they will they cannot escape the truth, nor hide it under the cloak of stupid hypocrisy.  If the laws against imparting knowledge of scientific birth control were repealed, nearly all of the 1,000,000 or 2,000,000 women who undergo abortions in the United States each year would escape the agony of the surgeon's instruments and the long trail of disease, suffering and death which so often follows.

"'He who would combat abortion,' says Dr. [Max] Hirsch, 'and at the same time combat contraceptive measures may be likened to the person who would fight contagious diseases and forbid disinfection.  For contraceptive measures are important weapons in the fight against abortion.

"'America has a law since 1873 which prohibits by criminal statute the distribution and regulation of contraceptive measures.  It follows, therefore, that America stands at the head of all nations in the huge number of abortions.'

"There is the case in a nutshell.  Family limitation will always be practiced as it is now being practiced--either by birth control or by abortion.  We know that.  The one means health and happiness--a stronger, better race.  The other means disease, suffering, death.

"The woman who goes to the abortionist's table is not a criminal but a martyr--a martyr to the bitter, unthinkable conditions brought about by the blindness of society at large.  These conditions give her the choice between the surgeon's instruments and the sacrificing of what is highest and holiest in her--her aspiration to freedom, her desire to protect the children already hers.  These conditions--not the woman--outface society with this question:

"'Contraception or Abortion--which shall it be?'"

--Margaret Sanger, Woman and the New Race (New York: Brentano's, 1920), pp. 121-29.

According to the receipt tucked into my copy of this book, I bought it for $5 back in March 1986, from a used book store in my hometown of Amarillo, Texas.  I was doing a research paper on Sanger for an undergraduate course in American history, and I was excited to find such an immediate primary source (first edition, third printing).  At that time, I was (and still am) wholly won over by Sanger's appeal to make birth control information available to the working women of our country: her accounts of their suffering in the tenements of New York were (and are) impossible to read without feeling how difficult (to put it mildly) it must have been for women when the Comstock Law (1873) was in force and disseminating (pun accidental, but apt) information about birth control was illegal.  By 1986, contraceptives had been legal and available even to unmarried persons since (I had to look this up in the Wikipedia article) 1972.  The Supreme Court gave its opinion on Roe v. Wade in 1973.  Sanger is now best-known as the founder of Planned Parenthood, according to its Wikipedia entry, "the largest single provider of abortions in the U.S."  Sanger defined birth control (see above) as preventing fertilization, whereas some now would define it as preventing implantation.  WWMSS (What would Margaret Sanger say) about drugs and devices that prevent implantation but not fertilization?  On such distinctions does our debate now hang.


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