Reader’s Companion to American History – -BIRTH CONTROL(转载)

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“Birth control“ was an early-twentieth-century slogan, but it has become the generic for all forms of control of reproduction. In popular usage it refers particularly to contraception, but in fact its historical practice cannot be separated from that of abortion. Attempts to control reproduction have characterized virtually every society of which we have records. In ancient societies these methods ranged from the magical to the highly effective and included coitus interruptus, spermicidal douches, homemade pessaries designed to obstruct the opening of the cervix, and abortions. With the spread of agriculture and the economic advantages of large families, religious and in some cases secular law increasingly restricted birth control, with the result that there appears to have been an increase in reliance on abortion while contraceptive technology and use declined. Both practices were legal in the United States until the mid-nineteenth century.
　　Starting in the 1830s, a state-by-state drive to prohibit abortion developed and was largely successful by 1880. It was spurred by a backlash against the women’s rights movement that reflected anxieties about women deserting their conventional position as mothers, and by professionalizing physicians eager to restrict their competition from “irregular“ practitioners, many of them offering abortion services. Then in 1873 all birth-control information was specifically included within the definition of the obscene and was therefore barred from interstate commerce by the federal Comstock Act. Nevertheless the steady decline of the U.S. birthrate in the nineteenth century suggests that some traditional birth-control methods were widely used despite legal prohibition, notably, abortion, coitus interruptus, and douches.
　　Although birth control is ancient, political movements for birth control are modern, arising in opposition to the prohibitions that began in the early nineteenth century. There were several movements. The first, neo-Malthusianism, appearing in England in the early nineteenth century, sought to increase the standard of living among the poor by reducing births. But the common view that America was underpopulated gave neo-Malthusianism little support in the United States.
　　Stronger in the United States were birth-control programs rooted in antebellum reform movements, both secular and religious. They advocated birth control to control population, to prevent the spread of hereditary disease, to improve the hereditary “stock“ (early versions of eugenics), to liberate women from reproductive drudgery, and sometimes to permit greater sexual freedom. In the 1820s, neo-Malthusian ideas were integrated into the experimental socialism associated with Robert Dale Owen and feminist Frances Wright. These secular socialists were soon joined by religious radicals who also promoted birth control, but in different forms. The Second Great Awakening had given rise to a “perfectionist“ mode of thought梙eretical in relation to orthodox forms of Protestantism because it emphasized the possibility of perfecting earthly life. Also committed to improving women’s condition and public health generally, these religious socialists rejected contraception as artificial and instead tried to effect birth control by changing the nature of sexual activity itself. For example, the Oneida community in the 1840s, ruled autocratically by John Humphrey Noyes, practiced male continence, a regimen in which men refrained from ejaculation altogether, and reproductive sex was practiced only by couples appointed by Noyes for the purpose of breeding superior people. He and his supporters believed that male continence not only built self-discipline but heightened sexual pleasure. In the second half of the century, “Free Lovers“ further developed these noncontraceptive forms of birth control, recommending withdrawal or sexual activity other than intercourse. Feminist socialist physician Alice Stockham designed a sexual system called “Karezza“ that required both men and women to avoid orgasm and, she believed, intensified and prolonged pleasure.
　　Women’s rights advocates shared the view that the discipline and self-control required by noncontraceptive birth control was in itself liberating. By the 1870s, a flourishing feminist movement transformed this tradition of thought into a new political demand, with the slogan “voluntary motherhood.“ Nineteenth-century feminists continued to oppose contraception and abortion, which, they feared, would further license predatory male sexual aggression. Instead they recommended abstinence. Their proposals and rhetoric have been considered prudish, and there is some truth in this characterization, since they were expressing many women’s negative experiences of heterosexual sex; yet viewed in their historic context, they can also be characterized as spokeswomen for women’s sexual liberation. They understood that women could not find and defend their own sexual desires until they gained the power to reject men’s. At the Free Love edges of the feminist movement, some advocated greater sexual experience and pleasure for women, whereas more mainstream women’s rights advocates tended to emphasize the dangers of licentious sexuality. Their arguments for abstinence as a form of birth control thus had two meanings: one was voluntary motherhood, opposition to coercive childbearing; the other was voluntary sex, opposition to men’s traditional prerogatives of demanding sexual submission from wives. Moreover, some voluntary motherhood advocates developed a critique of male sexuality, prefiguring much that late-twentieth-century feminists argued regarding the obsessiveness and dominance embedded in much of what men experience as sexual desire. Unlike their neo-Malthusian predecessors, voluntary motherhood advocates were not concerned with population size or with working-class power; they were resolutely pro-motherhood and, far from challenging the Victorian romanticization of motherhood, they manipulated it to increase women’s power.
　　At the turn of the century a conservative reaction against voluntary motherhood agitation set in, focused on the “race suicide“ alarm popularized by President Theodore Roosevelt. Race suicide moralists propagandized against the “selfishness“ of women who avoided their maternal duties by using birth control, deploying racist fears (in a period of heavy immigration) that “WASP“ dominance would be undermined by the high birthrates of those of “inferior stock.“
　　In the first decades of the twentieth century a renewed birth-control movement arose among feminists associated particularly with the Socialist party and the Industrial Workers of the World (IWW) and took a militant turn in demanding the legalization of contraception. As urban radicals grew more daring sexually, they discovered the use of vaginal diaphragms in Europe. Emma Goldman of the IWW and Margaret Sanger of the Socialist party visited clinics in Holland where women were fitted with diaphragms. When these two women adopted civil disobedience as a means of dramatizing the issue in the United States, distributing prohibited leaflets about contraception and opening illegal birth-control clinics, the Left leadership remained uninterested, but rank-and-file women responded with enthusiasm. Between 1914 and 1918 birth-control leagues developed in every major city of the United States. When these activists offered contraceptive information and services, they were deluged with clients. When they were arrested, their political defenses publicized contraception and created an even more avid demand for it.
　　Shortly after World War I the birth-control mass movement subsided, victim of the strongly conservative mood that followed the war. The leader of the main national birth-control organization, Margaret Sanger, shifted political strategies, downplaying the earlier association of reproductive control with women’s rights and seeking instead a compromise: legalizing contraception at physicians’ discretion. Birth-control leaders also emphasized the eugenic arguments popular for several decades, but now in more overtly racist ways, building on fears of high immigrant and black birthrates to support the case for legalization of contraception. The adoption of statutes providing for forcible sterilization of the feeble-minded, “degenerates,“ and some other groups by many states (with especial alacrity in the southern states) was also part of this redefinition of the function of birth control. This compromise was the basis for significant hostility to birth control among many twentieth-century African-Americans.
　　The World War II period produced two new birth-control movements: Planned Parenthood and population control. These were distinct but related. The Planned Parenthood organization, dating from 1942, renewed the campaign for the legalization and promotion of contraception, arguing primarily that birth control promoted family stability. Unlike the profamily backlash of the race suicide alarm, these family planning advocates asserted that marital adjustment must rest on a permissive attitude toward sex without fear of conception. Planned Parenthood, unlike the voluntary motherhood movement, endorsed unlimited marital sex and did not raise issues of women’s sexual exploitation. In its domestic campaigns, the organization promoted small families and planning. In its international aspects, it argued a renewed neo-Malthusianism: it advocated population control as a cure for poverty. By 1960 population control had become such an unchallenged ideology in the United States that many used the phrase interchangeably with the earlier birth control.
　　In the late 1960s the renewed women’s liberation movement again changed the terms of understanding of reproduction-control politics. The women’s movement viewed birth control as part of an overall campaign for women’s self-determination and began to distinguish that goal from those of family planning or population control. This orientation was influenced by the introduction of birth-control pills in 1960, which were mass-marketed so successfully that within a year 1 million women in the United States were using them. The “pill“ had a twofold effect: its availability accustomed a generation of women to sex without fear of reproduction, and feminist exposure of its health dangers and discomforts, some of them hidden by the great pharmaceutical companies that were reaping vast profits from this new market, decreased women’s trust in professionals and sparked a powerful women’s health movement.
　　Intrauterine devices (IUD) were mass-marketed from the late 1960s, and women’s experience with them further increased feminist conviction that the FDA, the agency responsible for reviewing the safety of drugs and medical devices, could not be relied on to protect women. The Dalkon Shield IUD caused at least twenty deaths and hundreds of thousands of severe infections and injuries, often creating permanent sterility or other damage. In a victorious class-action suit brought by the victims, its manufacturer, A. H. Robins, was shown to have ignored warnings of the dangers from its own staff. The result did not necessarily help the cause of birth control, however, as nearly all forms of IUD, including those with good safety records, were removed from the U.S. market.
　　The feminist campaign coalesced around the issue of abortion. The campaign for legal abortion in the 1960s began not with feminists but with civil libertarians and physicians, and the Supreme Court decision in Roe v. Wade in 1973 continued the tradition of defending physicians’ discretion. The women’s movement began to insist on a broader program, supporting reproductive self-determination and criticizing forced sterilization, unsafe contraception, and unnecessary hysterectomies and cesarean sections. This movement had considerable impact, forcing governments to adopt regulations for informed consent in sterilization procedures, for example.
　　In response a widespread antiabortion movement arose, organized first by the Catholic hierarchy but soon becoming more ecumenical and receiving support notably from fundamentalist Protestants. It remains a largely religious movement. Unlike the nineteenth-century antiabortion movement, which spoke explicitly of prohibiting abortion in order to enforce women’s domesticity, the late-twentieth-century movement, known by the slogan “right-to-life,“ defined itself as defending the rights of fetuses.
　　By 1990 abortion had become perhaps the most controversial political issue in the country. Some conservative courts and state legislatures had sharply limited the right to abortion, especially among the poor, by establishing or encouraging prohibitions on public funding. In its 1989 Webster decision the Supreme Court enlarged the area in which state legislatures were allowed to restrict abortion. A new and safer hormonal abortifacient developed in France, known as RU-486, had not found a U.S. marketer because of fear of antiabortionists’ retaliation.
　　Birth control was also implicated in a range of other controversial social and political issues in the 1980s, notably high teenage out-of-wedlock pregnancy rates and AIDS. Some responded to these problems by calling for increased public education about and availability of birth-control and prophylactic devices, and the antiabortion lobby continued to argue that the emphasis should be on chastity instead. The vision of midcentury civil libertarians that birth control might become a private issue in which no government action is necessary seems distant from the late-twentieth-century situation.
　　Linda Gordon, Woman’s Body, Woman’s Right: A Social History of Birth Control in America (1976; rev. ed., 1990); James Mohr, Abortion in America: The Origins and Evolution of National Policy (1978); Rosalind Pollack Petchesky, Abortion and Woman’s Choice: The State, Sexuality, and Reproductive Freedom (1984; 2nd ed., 1986).