This is the first comprehensive history of the struggle to win public acceptance of contraceptive practice. James Reed traces this remarkable story from its beginnings, carefully documenting the roles of the diverse interests that supported birth control, including feminists, eugenicists, and physicians, and providing a unique account of the struggles of such pioneers as Margaret Sanger, Robert Dickinson, and Clarence Gamble to win the support of organized medicine, to change laws, to open birth control clinics, and to improve birth control methods. Originally published in 1984. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. The Birth Control Movement and American Society From Private Vice to Public Virtue By James Reed PRINCETON UNIVERSITY PRESS Copyright © 1983 James W. Reed All rights reserved. ISBN: 978-0-691-02830-9 Contents Preface, ix, Preface to the Princeton Edition, xv, Acknowledgments, xxiv, PART I BIRTH CONTROL BEFORE MARGARET SANGER, 1 Contraceptive Technology in the Nineteenth Century, 3, 2 The Rise of the Companionate Family, 19, 3 The Suppression of Contraceptive Information, 34, 4 The Anarchists, 46, 5 Permissiveness with Affection: A Sexual Standard for an Affluent Society, 54, PART II THE WOMAN REBEL: MARGARET SANGER AND THE STRUGGLE FOR CLINICS, 6 The Burden of Domesticity, 67, 7 European Models, 89, 8 Competition for Leadership, 97, 9 Providing Clinics, 106, 10 Woman and the New Race, 129, PART III ROBERT L. DICKINSON AND THE COMMITTEE ON MATERNAL HEALTH, 11 The Medical Man as Sex Researcher, 143, 12 Clinical Studies, 167, 13 Publisher and Clearing House, 181, PART IV THE PROSPECT OF DEPOPULATION, 14 Birth Control in American Social Science: 1870–1940, 197, 15 Birth Control Stalled, 211, 16 The Parents' Information Bureau, 218, PART V BIRTH CONTROL ENTREPRENEUR: THE PHILANTHROPIC PATHFINDING OF CLARENCE J. GAMBLE, 17 A Recruit for Birth Control, 225, 18 Policing the Marketplace, 239, 19 Experiments in Population Control: Logan County, West Virginia, and the North Carolina Public Health Department, 247, 20 Conflict and Isolation, 257, PART VI PROPAGANDISTS TURNED TO PROPHETS: BIRTH CONTROL IN A CROWDED WORLD, 21 The Population Explosion, 281, 22 Margaret Sanger from Exile: The Founding of the International Planned Parenthood Federation, 289, 23 The Failure of Simple Methods: The IUD Justified, 294, PART VII THE PILL, 24 The Prospects for Hormonal Sterilization, 311, 25 A Life in Experimental Biology, 317, 26 The Lady Bountiful, 334, 27 The Product Champion, 346, PART VIII THE TROUBLE WITH FAMILY PLANNING, Abbreviations Used in the Notes, 383, Notes, 385, Bibliographical Essay, 439, Index, 448, CHAPTER 1 Contraceptive Technology in the Nineteenth Century A DEMOGRAPHIC revolution took place in the United States between 1800 and 1940. The high birth rates and high mortality characteristic of a pre-modern society were replaced by a new vital economy of fewer births and fewer deaths. The course of the demographic transition in the United States greatly differed, however, from the model developed by demographers intent on discovering the dynamics of economic development in the Third World. Americans began having fewer children before large-scale industrialization or urbanization took place, and dramatic declines in fertility preceded by at least a century the late nineteenth century advances in public health that gave the infant a good chance of surviving childhood. Thus, Americans began having smaller families in the absence of two factors that social scientists have often assumed to be determining — rapid industrialization and declining infant mortality. In 1800, American white women were having many more children than the women of Western Europe; by 1900 they were relatively infertile compared with their European sisters. Although early nineteenth century birth rates must be constructed from inadequate sources, the projections available indicate that in 1800 American women were bearing an average of 7.04 children; 5.21 in i860; and 3.56 in 1900. This downward secular trend would continue until the 1930s, when the birth rate briefly fell below the level required to maintain the existing population. The low fertility of the 1930s is often viewed as a result of the Great Depression, but it should be seen as the culmination of a trend that had begun by 1800. More than half of the decline in fertility between 1800 and 1940 occurred during the nineteen