Woman of Valor (20 page)

Paradoxically, the more conservative Dennett held out adamantly for total repeal of the obscenity statutes on free speech grounds. In so doing, she also rejected Margaret's conviction that the most appropriate system of delivery for contraception was the clinical, medical model pioneered in Holland. Margaret had begun to promote a bold vision of a democratic network of birth control facilities staffed by doctors and nurses who would guarantee the health, well-being, and solidarity of working-class women. When she finally framed her own legislative initiative, she took the position that reforming the statutes to allow doctors (at first, she also included midwives) the right to prescribe contraceptives not only made sense as public policy, but also had a better chance of winning support than a bill for total repeal. Dennett, to the contrary, insisted that such a compromise would only perpetuate an existing medical monopoly over contraception and serve established special interests. She could never reconcile deference to medicine with Margaret's political and social radicalism.
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In fact, Margaret's position derived from the larger vision of a socialized public health system she took from Ellis in England and from her own observations in the Netherlands. When she first visited there in 1915, the imperious Dr. Aletta Jacobs, who had founded the country's network of birth control clinics, would not deign to meet her, because even though she traveled with Ellis's introduction, she was not herself a doctor. She was received respectfully, however, by Dr. Johannes Rutgers, the second in command at the clinic in The Hague, whom she impressed in turn. Rutgers called
Family Limitation
“a brilliant pamphlet” and applauded her success in awakening American public opinion in favor of birth control.

What Margaret learned from him left an indelible impression, if little sense of the potential conflicts she would encounter trying to work with American doctors. By Rutgers's account, a committee of Dutch Neo-Malthusians had enlisted a “democratic” membership of 6,376 people in their organization. They then divided their small country of some 5 million inhabitants into twenty-four local subdivisions and, where they did not have a physical presence, identified individuals as “correspondents” who dispensed birth control and other gynecological and obstetrical information to women. They employed forty-eight trained nurses who, even with the distraction of war in 1917, were able to fit some 1,700 first-time users with diaphragms. However small this operation, it constituted a substantial health presence in the gynecological and obstetrical fields and was widely credited for the country's superior maternal and infant mortality statistics. In Margaret's view, it offered a useful paradigm for health-care delivery at home.
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As she traveled the country she kept repeating:

Following her lectures she was often sought out in her hotel room by women eager to know of more effective birth control methods, and their intense hunger for personal communication and instruction also convinced her of the superiority of a clinical distribution mechanism under scientific supervision. She soon discovered what contemporary family planning workers generally acknowledge—that individual counseling helps to establish client rapport and results in more successful use of contraceptive technology.
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Through her travels in the United States, she also found substantial interest in birth control on the part of a public health constituency that was gaining influence in most of the country's major cities. With advances in bacteriological science in the late nineteenth century, public officials came to recognize that they could intervene to stop the spread of diseases communicated by unsanitary conditions and human contact. This led, in turn, to the development by many states and municipalities of an urban health apparatus intended to educate in matters of personal and social hygiene, as well as to treat disease preventively. The more progressive communities took on the additional obligation of providing medical and nursing services to those too poor to afford the cost, through dispensaries or clinics paid out of the municipal treasury or by voluntary charities.

By 1915, there were 500 tuberculosis clinics in the United States and an equal number of facilities serving infants and children. Many areas of the country, especially in the South and West, offered only the most rudimentary services, but New York City's public health machinery was internationally acclaimed. Still, a survey on the city's Lower East Side found more than half of the population in need was getting no treatment. This tremendous overburdening of services, coupled perhaps with the virtual obsession of progressive social hygiene reformers about the problems of prostitution and rampant venereal disease, had turned professional and public attention to the issue of contraception. One of the most prominent physicians who endorsed Margaret's victory in
The Woman Rebel
case, in fact, was Herman Biggs, the widely esteemed commissioner of the New York State Board of Health.
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As a result of these gestures of support, the possibility of building a network of clinics to serve the health and contraceptive needs of women in this country was not altogether unthinkable. To that end, indeed, S. Adolphus Knopf, M.D., the leading private physician in New York City's public health efforts, addressed the American Public Health Association in October of 1916 on the “medical, social, economic and moral aspects” of birth control, citing the Dutch example and endorsing Margaret's recent victory against her federal prosecutors.

Knopf's remarks were considered of such significance that they were immediately reprinted in
The New York Medical Journal
and in
The Survey
, a magazine prominent in the progressive social welfare community. Attention was also called to the recent publication in the United States of books endorsing the public benefit of contraception and small families by C. V. Drysdale, the British Neo-Malthusian who had so warmly received Margaret, and by Dr. William J. Robinson, a popular writer on health who had long advocated birth control. The Drysdale book was featured in a full page story in the Sunday
New York Times Magazine
, and the Robinson book included an introduction by his friend, Abraham Jacobi, the physician and venerated former president of the American Medical Association who had first raised the issue of contraception without any visible fanfare in his annual address to that body back in 1912. After Margaret's indictment called attention to the issue, however, Jacobi's continued support of scientific contraception received ample press attention, and in 1915, while she was in exile, a committee of the New York Academy of Medicine actually met at his urging to consider the birth control problem, though without any visible result.
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There was then legitimate cause for optimism about doctors, yet Margaret either did not understand, or chose to ignore, parallel developments in the medical profession that certainly did not bode well. The machinery of public health had, in fact, grown significantly, but the major professional thrust of the times was toward narrow scientific and technological developments. Orthodox physicians were consolidating their authority through reforms that improved the quality of medical education, reduced the number of doctors, and fostered specialization in practice areas, and these putative advances were producing a conservative professional elite intent on maintaining its own scientific hegemony, wealth, and social status. The stature of the public health component of American medicine would actually diminish after 1920, and support would erode for the kind of comprehensive clinical health facilities serving the working class and the poor that Margaret so optimistically envisioned. Public confidence in social solutions to health problems would actually decline, and the sovereignty of private practitioners would be institutionalized.

In this respect, the situation recapitulated the experience of the 1870s. In 1916, a committee of the New York County Medical Society again condemned the commercial sale of contraceptive products, because they were “absurd, frequently dangerous, filthy and usually unsatisfactory,” and also suggested that licensing such practices would undermine “personal morality and national strength.” At the same time, Dr. Robert Latou Dickinson, who would later be elected president of the American Gynecological Society and would ultimately become the most prominent medical ally of the birth control movement, advised a group of his colleagues in Chicago that same year to take hold of the matter of contraception, “not let it go to the radicals, and not let it receive harm by being pushed in any undignified or improper manner.”
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Dickinson flatly turned Margaret down when she approached him with an offer of cooperation shortly thereafter, but this did not stand in the way of her determination to open a birth control clinic modeled on the Dutch facilities. She had first thought of getting started in a western state, where local law did not prohibit contraception, where a more hospitable attitude toward suffrage and women's rights had been demonstrated, and where there was less of a threat of religious opposition from politically influential Catholics. She had fewer contacts out West, however, and she recognized that no other location had the publicity potential of New York. What is more, Dr. Robinson advised her in a private letter that the local medical society would be unlikely to interfere if she staffed her facility with a licensed physician. Suggesting that she make a direct challenge on First Amendment grounds to the state's Comstock prohibitions on contraception, he reminded her of New York's “venereal disease” clause, the amendment to the state's original Comstock act that exempted doctors from prosecution for prescribing condoms to prevent the spread of disease. This, in his view, presented the possibility of a judicial reinterpretation that would sanction the prescription of contraception on broader medical grounds.

With a $50 contribution from a woman who had heard her lecture in California, Margaret found a sympathetic landlord in Brooklyn and rented space for a clinic. She later claimed to have first written the local district attorney advising him of what she proposed to do, but then never received any response. She moved ahead anyway and in so doing unilaterally determined the future course of the birth control movement in this century. Independent, not-for-profit medical facilities became the model for the distribution of contraception in the United States and throughout the free world, a development that occurred, not with the further cooperation of leaders in American medicine, but largely in spite of them.
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O
n October 16, 1916, Margaret Sanger opened the first birth control clinic in America, behind the curtained windows of a storefront tenement on Amboy Street near the corner of Pitkin Avenue in the Brownsville district of Brooklyn. Handbills, advertising the location in English, Yiddish, and Italian, promoted the benefits of contraception over abortion:

The women of Brownsville patiently stood in line for service—there were 464 recorded clients during the several weeks the facility remained open. Surviving photographs show them handsomely attired in shirtwaists and billowing skirts. Draped in a shawl to protect against the autumn chill, one young mother hovers over a graceful wicker baby carriage in a romantic tableau that conceals the full dimension of the neighborhood's dispiriting poverty.
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Margaret had been advised “to proceed slowly and carefully in the matter of the clinic” and “avoid all unnecessary antagonisms.” She may have intended to follow Dr. Robinson's advice and staff the clinic with a doctor, but failing to find a willing recruit, gave authority to her sister, Ethel Byrne, who was still working as a registered nurse at Mt. Sinai Hospital. Assisting with client intake and record keeping were Fania Mindell, a volunteer from Chicago who spoke three languages, and Elizabeth Stuyvesant, a social worker with Associated Charities of New York, who was apparently acting without institutional endorsement. That the presence of a doctor would have saved the clinic from attack was not clear, but in the interests of caution, Margaret and Ethel ostensibly agreed to provide only contraceptive information and sex education, rather than themselves dispense condoms and suppositories or fit the cervical appliances they advocated as a preferred birth control method. They charged 10 cents for each consultation. A device called the Mizpah Pessary was available at local pharmacies as a womb support for multiparous women who suffered from the then commonly diagnosed condition of prolapsed or distended uterus, which results when multiple or strenuous pregnancies weaken the vaginal muscles that hold the uterus in place. This pessary could also be effective as a contraceptive, and boxes of them were part of the clinic's inventory.
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On day nine of the clinic's operation, a modishly attired woman, identifying herself as a “Mrs. Whitehurst,” arrived and immediately aroused suspicion. When she left, according to Margaret, the $2 bill she had paid for a 10-cent sex education pamphlet was pinned to the wall with a note that read “received from Mrs. Whitehurst of the Police Department as her contribution.” The following day she returned with three plainclothesmen from the department's vice squad and arrested Margaret and Fania Mindell. The police impounded pamphlets, furnishings, and supplies, along with the case histories that had been compiled as a record of the clinic's activities.
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Provoked by this confrontation, Margaret threw all caution to the winds, betraying her radical roots. The afternoon edition of the
Brooklyn Daily Eagle
on October 26, 1916, described the scene:

According to the story, Sanger and Mindell were then “half-dragged, half carried” to a patrol wagon. With a gaggle of Brownsville mothers defiantly following behind them, they were taken to the local station house, where they were arraigned and released on $500 bail. But they chose to reap the publicity value of remaining overnight in a cold, vermin-infested jail. Several weeks later Margaret reopened the clinic, pending action by the courts, but it was closed down once again, and she was charged this time with maintaining a public nuisance.
⁴

Though Margaret managed the publicity surrounding her arrest much like an old-fashioned Wobbly, her choice of counsel reflected a new and determined political savvy. Jonah J. Goldstein was a young liberal Democrat, who had grown up on the Lower East Side under the tutelage of Lillian Wald and Mary Simkovitch, progressive reformers in the local settlement houses. He became a lawyer in private practice and began his political life as an aide to Al Smith, then majority leader of the New York State Assembly. Later he would become a distinguished judge and family law theorist. He clearly knew his way around the courts and, through a variety of preliminary legal maneuverings, was able to keep postponing the case until January, allowing for an orderly preparation of his defense and giving Margaret plenty of time to pursue her own public relations strategy. Though he failed to win her the jury trial she desired, he did manage—after impassioned testimony from Margaret herself during the pre-trial hearings—to remove from the three-man panel that heard the case in Brooklyn's Court of Special Sessions the judge who had convicted her husband and was known for his extreme bias on the birth control issue.
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Goldstein's actual courtroom strategy, however, was not so successful. Ethel Byrne had not been there when the clinic was raided, but she was arrested shortly thereafter, and the charges brought against her came up first, on the court calendar of January 4, 1917. In pretrial arguments he had argued for dismissal on the grounds that the Comstock statutes were unconstitutional because they interfered with the free exercise of conscience and the pursuit of happiness; that they were arbitrary and unduly oppressive, because they allowed for no exceptions; that they failed to promote the health, welfare, and morals of the community; that they were so unreasonable as to place the life of women in jeopardy, thereby violating the equal protection provisions of the Fourteenth Amendment. His various entreaties failed, however, and during the trial itself, he took still a different approach, telling the judges that Section 1145 of New York's Comstock law, which provided a medical exception, infringed the constitutional rights of the poor, denying them the right to choose how many children they would have, a right enjoyed by middle-class citizens who could afford the services of private physicians.

Goldstein had intended to introduce the testimony of an expert medical witness, Margaret's own doctor, Morris Kahn, who was to explain the compelling medical, social, and economic indications for birth control use. Criminal defendants are normally allowed wide latitude in introducing evidence, and there was also some precedent at this time for judicial rulings that relied on socioeconomic arguments. The Brooklyn judges, however, allowed Goldstein only fifteen minutes for his presentation and ruled Kahn's remarks inadmissable, though they did not interrupt when any number of wild and unsupported extralegal charges were brought by witnesses for the prosecution. In the kind of racist accusation that would continue to haunt her sister, Ethel Byrne was accused by the prosecution of intending “to do away with the Jews” by dispensing contraception in an immigrant ghetto, and of hoping to make money in the process, because she had charged a small fee. She was found guilty of violating the statutory prohibition on giving birth control information and was sentenced to one month's imprisonment in the workhouse on Blackwell's Island. Goldstein applied to the State Supreme Court and to the Federal District Court to void her sentence pending an appeal, but he was denied by both.
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Disappointed by the failure of their legal strategy but emboldened by the sudden spate of publicity they were receiving, Sanger and Byrne embarked on an audacious course. They announced that Mrs. Byrne would undertake a hunger strike in jail in the manner of the British suffragists. Newspapers throughout the country bannered her vow to “die, if need be, for my sex.” A farewell dinner of turkey and “plenty of ice cream” sustained the theatrics on the eve of her incarceration, and for the entire week that followed, news from prison of her deteriorating physical and emotional status vied for front-page headlines with stories of German belligerence against American ships in the seas of Europe. Ethel kept her fast for four days, giving rise to allegations, which were later denied, that she was drinking water when not observed. When the New York City corrections commissioner announced that forcible feeding of the prisoner through a tube inserted into the esophagus would begin, for the first time in United States penal history, the national wire services literally went wild. Even the normally sensation-shy
New York Times
carried the story on its front page for four days in a row, alternating reports from prison officials that Mrs. Byrne's response was “passive” to her thrice-daily feedings of a mixture of milk, brandy, and eggs, with overstated claims from Sanger that her sister could not resist because she was extremely weak and near death.
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Throughout this ordeal, Ethel and Margaret enjoyed the support of a group of women from the National Birth Control League, who called themselves the Committee of 100 and included Mary Ware Dennett, Rose Stokes, Jessie Ashley, Crystal Eastman, and Elsie Clews Parsons, along with others willing to associate themselves with Sanger's direct action. Their chairwoman was Gertrude Pinchot, who had earlier given the Sangers the money to keep their children in school, and their official credo was drafted by the prepossessing Juliet Barrett Rublee, an heiress from Chicago who would become Margaret's intimate friend and whose husband, George, served on the Federal Trade Commission as a Wilson appointee. The document, though not elegantly phrased, emphatically announced their purpose:

Margaret had impressed these women when she first appeared at one of what they called their “parlor meetings,” and by dominating the media after the clinic raid, she persuaded them to support her activities along with their preferred legislative solution to the birth control problem. As a measure of their effectiveness and power, moreover, they raised $700 for birth control work by just informally passing around a hat, and pledged part of it for her legal expenses.
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When Ethel was sentenced, the Committee of 100 called a protest rally at Carnegie Hall. Falling right in the middle of her sensationalized hunger strike, the event attracted 3,000 supporters, most of them women, and raised another $1,000. Admission to the upper galleries was only 25 cents, and according to the newspapers, the seats were filled with poor working women, offering a sharp contrast to the “richly dressed” society types who adorned the boxes below. Margaret was, of course, the featured speaker of the evening, and her impassioned oratory elicited sustained cheers. She began:

At her suggestion, a group of Brownsville mothers were given “places of honor” on the platform behind her “to let everybody see what kind of women we are fighting for,” and by all accounts this dramatic touch was extremely effective. One observer likened the spirit of the evening to that of the abolition days.
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Several days after the event, a well-connected delegation of the Committee of 100, upset that Ethel's militancy was getting out of hand and truly endangering her life, took Margaret to meet with New York Gov. Charles Whitman. Their intent was to win commutation of Ethel's sentence and to secure a pledge from the governor to appoint a commission to investigate birth control. Whitman was willing to pardon Byrne only if she pledged never to break the law again, a condition Margaret declared unacceptable, and no investigation ever took place. Through his intervention, however, Margaret was granted a pass to visit her sister in jail, which she had previously been denied. On discovering what appeared to be a genuinely alarming physical deterioration, she decided to accept the terms of the pardon on her sister's behalf. Given the extraordinary public interest in the situation, prison officials were only too happy to be rid of their charge, and Ethel was carried prostrate from the workhouse, wrapped in the fur coat of one her rich new benefactors.
¹⁰

Once recovered, Ethel told Margaret that “I couldn't have lived or fought through anything if I hadn't known and loved you,” and Margaret assured her in response that she had fought “the finest fight ever made by any woman in the U.S.A.” Later, Margaret would gallantly identify the hunger strike as the most significant act of “self-sacrifice in the history of the birth control movement.” Yet it effectively ended Ethel's participation in birth control activities and regrettably cast a permanent pall on relations between the two sisters. An undercurrent of rivalry had long festered beneath their deep and abiding affection, and these extraordinary events brought it to the surface. Ethel greatly resented Margaret's ambitious pursuit of the new social and political connections their sudden celebrity had wrought. They argued as well over Ethel's apparent sympathy for Bill Sanger, with which Margaret had little patience.