Woman of Valor (51 page)

Earlier that year, in fact, when an official of the Farm Security Administration in charge of migratory labor camps in the South admitted to Hazel Moore that women were expressing interest in birth control, arrangements had quietly been made through the National Committee to equip FSA workers with privately funded supplies. Difficult to fund and to administer, the program there failed but did continue in California, where several nurses remained on duty through World War II.
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At the same time, Margaret sent Edna McKinnon from one government administrator to another to argue for an official change of policy on the basis of the
One Package
decision and the recent recognition of birth control by the American Medical Association. A representative of the American Birth Control League made the same rounds, but neither was successful. Without direct intervention from the White House, caution prevailed in federal agencies.

The policy constraint became most noticeable when maternal and child health services were first funded by the federal government under the Social Security Act. These funds, in turn, were administered by the Children's Bureau of the Department of Labor. For years the bureau's formidable director, Katherine Lenroot, a career civil servant, resolutely refused to be associated with the controversial birth control issue. Lenroot confessed outrage that people who were poor should not be allowed to have children—an idea she believed implicit in the suggestion that families on relief be given contraception. Margaret, in response to this allegation, pointedly distinguished the injunction to plan and space childbearing from absolute prohibition. Lenroot would not even consent to refer letters of inquiry about birth control to the American Birth Control League or any other voluntary agency, as was the policy of her colleague, Mary Anderson, director of the Woman's Bureau, and of several other federal administrators. Lenroot's position, however, was born less of concern for individual rights than of her commitment to the view that population decline was a principal element of the country's economic woes.

Beyond the nation's best interests, Lenroot also betrayed a transparent concern for protecting her own agency turf. These infant years of federal funding for health and social welfare, before the consolidation of services under one department, saw considerable jockeying among agencies for programs. Bureaucratic rivalry was particularly intense between the Children's Bureau and the U.S. Public Health Service at the Department of the Interior. The daughter of a Congressman and a savvy politician in her own right, Lenroot jealously courted the constituencies she needed to maintain her own power. In 1938, for example, she convened a National Conference on Better Care for Mothers and Babies and invited a representative of the American Birth Control League. Margaret could not attend but Hannah Stone did and was ruled out of order when she tried to turn the group's discussion to birth control. Lenroot maintained that some of the groups represented would not have participated had they known that the birth control issue was to' be considered, and she subsequently excluded any birth controllers from participating in the permanent committees that grew out of the conference.

These committees were established to help plan for Title V of the Social Security Act, which in 1938 provided some $5 million in new funds for maternal and child health services to be administered by the states. According to Martha May Eliot, M.D., who served as Lenroot's deputy at this time, the Children's Bureau encountered enormous resistance from Catholic lobbyists over Title V, because it decentralized a great deal of policy authority, the issue over which John Ryan broke with his superiors. Eliot, who drafted much of the measure herself, met with a delegation of bishops while the language of the bill was still being debated, ostensibly to work out a mechanism that would better protect the autonomy of Catholic agencies from the potential of arbitrary actions by state bureaucrats. A compromise was reached over general language, but the director of the Bureau of Catholic Charities then confronted Eliot directly with the question of whether the bureau would allow states to provide birth control through publicly funded facilities and programs. Much to his dissatisfaction she explained that this particular matter would be left to local discretion, but Lenroot herself then intervened, and no official statement of any willingness on the part of the Children's Bureau to let funds be used for such purposes was issued for the time being.
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Few states outside the South expressed interest in birth control in any event, and even there substantial resistance was encountered from private physicians, who objected on the grounds that birth control was just an example of socialized medicine in disguise. Eager for a statistically valid field investigation of a cheap contraceptive, Clarence Gamble in 1936 had sent a social worker to distribute a chemical jelly contributed by the Ortho pharmaceutical company among poor Appalachian women in Logan County, West Virginia. These women were enrolled in a public health project sponsored by the American Friends Service Committee, a Quaker philanthropy based in Philadelphia. The three-year study was also supported by Dickinson, the Milbank Memorial Fund, and the American Birth Control League. It recruited 1,345 women, out of a potential population three times that size, and achieved a 41 percent fertility decline among those who kept up with the method. But more than half of the participants expressed dissatisfaction and dropped out of the study, a rate worse than what had been achieved through the clinic-diaphragm regimen. This left only cost as a factor for recommending use of the jelly, and though it was cheaper, the expenditure required was still beyond the reach of existing public health budgets at the time. The Logan County study estimated that the cost of integrating contraception into existing public health programs would be from $2.00 to $3.00 a year, but the total yearly allowance per family on public health in Logan County was then only $1.25, a figure that incorporated just about all medical services available to the rural poor. Bringing contraception to the area would require a vastly expanded public commitment to health and social welfare, and since the effectiveness of mass marketing contraception could not really be proved, it was not even made a priority. Care of the malnourished and the sickly poor came first. Birthrates in the South for both whites and blacks were declining, but at a far less substantial rate than elsewhere in the country, and, of course, the region's levels of poverty, malnutrition, and disease remained disproportionately high.
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Nor could the problem of racism in the South be entirely overlooked. In 1937, the Sanger clinic in New York sent several field researchers to Miami to study Lydia DeVilbiss's use of a sponge and spermicidal foam powder that she was promoting as a resolution to the search for a cheap, effective, and democratic contraceptive. The problem they discovered was that DeVilbiss herself was hardly a democrat. Anxious about the high birthrates of the unemployed in Florida, she had earlier written Margaret proclaiming matter-of-factly, “It's either birth control and eugenic sterilization, or it is ‘curtains.'” She then apparently calmed down somewhat as the overall demographic picture in Miami became clear, but she was unashamed of the number of women she sent from her clinic for sterilization at local hospitals on grounds of mental deficiency or psychiatric impairment under the state's eugenic law. She also admitted to Margaret that she routinely gave pregnant women capsules containing tiny portions of arsenic and other chemicals, which she encouraged them to take with quinine over a four day period, in order to produce an abortion.

Dubious about these procedures, Margaret privately undermined DeVilbiss's reputation in professional circles up North, but she continued to work with her and never challenged her publicly. She did, however, begin to recognize the severe limitations of “speakeasy” contraception—as she began to refer to the unregulated birth control clinics that sprouted up around the country during the Depression. In their place, she renewed her determination to legalize contraception and bring it under the closer scrutiny of public officials, who were at least legally accountable and responsible for the public's health and welfare. It was this motivation that sustained the last frustrating year of the National Committee's work, and with this intent, she also closed down the committee in 1937 and teamed up with Gamble and public health officials in the state of North Carolina to sponsor an official trial of DeVilbiss's foam powder there.
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Gamble agreed to pay Hazel Moore and Edna McKinnon of the National Committee to run a mass field distribution of sponges and foam. The two women worked with Dr. George M. Cooper, an enterprising official, though regrettably also a racist, in the State Board of Health, who incorporated the fieldwork directly into public programs. By 1940, three quarters of the county health stations in the state offered contraception, yet the programs were funded and administered so haphazardly that only a meager 4 percent of the eligible population was being served. Comparable demonstration projects were also tried with little success in five other Southern states, until a shortage of personnel during the war diminished interest altogether. Family planning programs in the South were not revitalized until new funding and new technology became available in the 1960s. Until then, when new appropriations were added under the Social Security Act for “special projects” in maternity and infancy, only thirteen states nationwide were providing any kind of publicly assisted birth control. And the Children's Bureau did not expressly commit funds until required to do so by the passage of the Child Health Act of 1967, which mandated that a fixed percentage of federal spending be allocated for family planning.
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In 1938, Margaret organized a Committee on Public Progress to keep constituent and journalistic pressure on federal agencies. At the same time, the American Birth Control League mounted a Citizen's Committee for Planned Parenthood. Both groups continued to lobby Congress for public funding of contraception through increases in the Social Security Act. Sen. Robert Wagner of New York, sponsor of the Title VI amendments of 1939, was apparently sympathetic to Margaret's view that birth control was essential to the kind of preventive public health initiatives he wished to promote. But, like others on the Hill, he was not prepared to stand up to Catholic opposition.

The patent absurdity of this situation became especially apparent when close to a million dollars in Social Security funds were channeled through the Public Health Service to fight syphilis. Millions more were explicitly authorized for this purpose through the National Venereal Disease Act of 1939, but all the money went into education and treatment, rather than outright prevention. Not a single dollar was allocated for condoms that contained the transmission of infection but were also self-evidently contraceptives. The U.S. Surgeon General, Dr. Thomas Parran, Jr., defended this policy on the grounds that the larger “scientific and social factors of birth control” were not sufficiently clarified to warrant government action. In response, Margaret circulated fact sheets demonstrating continued high rates of maternal death and disease in the country and emphasizing the spiraling incidence of abortion that was believed to account in large part for the persistence of the problem. She curtly reminded Dr. Parran that his responsibility was for public health and not for “conjectural considerations of population policy.”
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Following her trip to Japan in the fall of 1937, Margaret finally took the time to recuperate from her broken arm and from long-postponed surgery to remove the gallbladder that had been causing her distress. Having completed Cornell Medical School, Grant was serving his residency in surgery at Columbia-Presbyterian Hospital, where he arranged for his mother to be treated. The routine procedure went smoothly, and the most memorable moment of her hospital stay occurred when H. G. Wells made a surprise visit to her bedside, causing quite a stir among those on the medical staff who knew of his personal notoriety.

On the doctor's strict orders, she then finally agreed to settle down for an extended period of postoperative rest and as a retreat chose the hauntingly beautiful, but still raw, desert landscape of Tucson, Arizona, which had captivated her several years earlier during a trip out west to visit Stuart. Noah was nearing the age of eighty, and she certainly owed him some sustained attention and time. They rented a charming adobe-style house in the foothills of the Catalina Mountains just north of the city limits.

Still little more than a trading outpost—though its first downtown skyscrapers were in construction—the town of Tucson was steadily gaining recognition for its restorative, healthful climate. The now fabled Arizona Inn had recently been opened by the elegant and cultured Isabella Ferguson Greenway, Eleanor Roosevelt's childhood friend, who was then also representing Arizona in Congress. Several other hotels and sanitaria were beginning to cater to a rather cosmopolitan population of winter visitors, and they could be counted on to provide welcome diversion. One of the most prominent was the cosmetics pioneer Elizabeth Arden, who befriended Margaret and supplied her with the latest in diets, vitamin creams, and other fads for the preservation of youth and beauty.

For more intellectual stimulation, the University of Arizona's community of scholars was nearby, and for occasional personal inspiration there was Juliet Rublee, who still spent her winters in Mexico. Margaret also used the publication of
Movers and Shakers
, Mabel Dodge Luhan's vivid memoir of New York's prewar bohemia, as an occasion to renew the acquaintance of her old friend. The eccentric Dodge had long since retreated from the frenzied East and married Tony Luhan, a Pueblo Indian from Taos, New Mexico, with whom she was exploring an alternative life-style ostensibly dedicated to the needs of the community over those of the individual. Guests were always welcome at their villa, and in the summer of 1937, the two women exchanged cordial letters and a first visit, which brought Margaret great pleasure and inspired the comment: “So few people mean anything to anyone in life that it's a joy to touch the fringe of the life of one like yourself who does.”
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