Woman of Valor (85 page)

13: DOCTORS AND BIRTH CONTROL

1.
Autobiography
, pp. 290-297. M.S., “Clinics the Solution,”
Birth Control Review
4:7 (July 1920), pp. 6-7. M.S. to Samuel Untermyer, Dec. 31, 1920, asks his advice on whether the law must be changed before a dispensary license can be granted. There is no surviving response. Responses to Sanger's hospital questionnaire are detailed in a Jan. 1, 1923 memo marked “Birth Control Clinical Research Department, Private, Confidential to Council Members only,” MS-LC.

2.
Transcript of the Evening Medical Session, First American Birth Control Conference, 1921, MS-SS, pp. 7-35, Meyer quote, pp. 32-33. For historical context, suggesting just how forthright and unusual this discussion was for its time, see Sophie D. Aberle and George W. Corner,
Twenty-Five Years of Sex Research: History of the National Research Council Committee for Research in Problems of Sex, 1922-47
(Philadelphia: 1953). The book speaks of the courage it took to sponsor sex research in 1921 and credits the birth control and feminist movements for helping to advance interest in and tolerance of the study of the physiology of sex. See especially p. 3. Also see Regina Markell Morantz, “The Scientist as Sex Crusader: Alfred C. Kinsey and American Culture,”
American Quarterly
29:5 (Winter 1977).

3.
Janet F. Brodie, “Family Limitation in American Culture,” doctoral dissertation, University of Chicago, 1982, p. 182. On the patent medicine trade, also see, for example, George Creel, “Poisoners of Public Health,”
Harper's Weekly
60:3028 (Jan. 2, 1915), pp. 4-6, and “Suffering Women,”
Harper's Weekly
60:3029 (Jan. 9, 1915), pp. 28-30. For examples of Lysol ads, see the
Ladies Home Journal
, 32:3 (Mar. 1915), p. 58;
LHJ
36:7 (July 1919), p. 73;
LHJ
42:9 (Sept. 1925), p. 136; and for the “Wearever Fountain Syringe,”
LHJ
32:2 (Feb. 1915), p. 31. The final quotes are from an ad in
McCall's
(July 1933), p. 85, cited in Norman Himes,
Medical History of Contraception
(Baltimore: 1936), p. 329. Ellen Chesler, Interview with Sarah Marcus, M.D., Schlesinger-Rockefeller Oral History Project, Schlesinger Library, Cambridge, Mass., p. 17; Dr. Marcus talks about the popularity of Lysol. Several physicians in the early 1920s complained that the
Birth Control Review
, in order to make money, also carried advertisements for some of these questionable products. See, ABCL Minutes for 1922, PPFA-SS. A discussion of the hazards of douching is also in
Moneysworth: The Consumer Newsletter
5:5 (Dec. 9, 1974).

4.
Transcript of the Evening Medical Session, First ABCL Conference, MSSS. (The sterilization material is separate from the main body of the transcript, see esp. pp. 4-5.) On IUDs and abortion, see R. S. Siddal, M.D., “The Intrauterine Contraceptive Pessary--Inefficient and Dangerous,”
American Journal of Obstetrics and Gynecology
, July 8, 1924, pp. 76-79; Maraget Sanger,
Happiness in Marriage
(Elmsford, N.Y.: 1969), pp. 210, 214, and also, David Kennedy,
Birth Control in America: The Career of Margaret Sanger
(New Haven: 1970), pp. 184-85 and Janet F. Brodie, “Family Limitation,” p. 182. On Mary Halton and IUDs, also see James Reed, The
Birth Control Movement and American Society: From Private Vice to Public Virtue
(Princeton: 1984), p. 275.

5.
Robert Latou Dickinson, M.D., “A Program for American Gynecology,” Presidential Address to the American Gynecological Society, reprint from
The American Journal of Obstetrics and Gynecology
1:1 (Oct., 1920). Also see Dickinson, “The Business of Preventive Gynecology,” reprint from
The Long Island Medical Journal
, Jan. 1908, and “Office Gynecology,” reprint from
Practical Lectures Delivered under Auspices of Medical Society of the County of Kings
(New York: 1925). The reprints are in the library of the New York Academy of Medicine. Dickinson analyzed his own case records in R. L. Dickinson and Lura Beam,
A Thousand Marriages: A Medical Study of Sex Adjust
ment
(Baltimore: 1953). The papers of Robert Latou Dickinson are in the Countway Library of Medicine, Harvard University, hereinafter, RLD-CL. My thanks to James Reed for sharing his research on Dickinson with me. The best biographical information on Dickinson and the best analysis of his relationship with Sanger is in Reed,
Birth Control Movement
, pp. 143-80. Reed convincingly disputes David Kennedy's view that Sanger's erratic personality was to blame for the problems she encountered from the establishment medical community in New York, an interpretation which misrepresents the class and gender bias she endured and thus misreads her reluctance to compromise the autonomy of her clinic by acquiescing to medical authority. See Kennedy,
Birth Control
, pp. 172-217.

6.
M.S. to Dorothy Bocker, Oct. 17, 1922; J.N.H.S. to Bocker, Jan. 1, 1923; Bocker's réesumé, dated 1922; budget for Clinical Research Fund, Jan. 1 to Dec. 31, 1923, shows contributions from Chance and Straight, along with smaller donations that brought the total to almost $8,000; all in MS-LC. Also see Clinton and Janet Chance to M.S., Nov. 3, 1922, telegram, MS-SS. A memo dated Jan. 27, 1932, explains the choice of the Research Bureau name to circumvent the problem of a dispensary license, MS-SS. Also see Reed,
Birth Control Movement
, p. 113.

7.
Dorothy Bocker, M.D.,
Birth Control Methods
(New York: 1924), copy in MS-SS. Slee paid to print the report privately. Also see Bocker, “Summary of 2000 Cases Treated from Jan. 1, 1923, to 1924,” MS-LC; Robert L. Dickinson, “Contraception: A Medical Review of the Situation,” First Report of the Committee on Maternal Health of New York,
American Journal of Obstetrics and Gynecology
8:5 (Nov. 1924), pp. 583-88;
The Question of Birth Control, Authoritative Medical Report on Birth Control Methods
, one in a series of fliers published by the National Catholic Welfare Conference, 1925, copy in MS-LC. In a response Margaret graciously thanked Dickinson for his interest but called his findings “tainted with bias.” See
Birth Control Review
9:1, (Jan. 1925), pp. 20-21. Also see Reed,
Birth Control Movement
, p. 115 and pp. 168-69.

8.
Minutes of the Committee on Maternal Health for Dec. 7, 1923, Dec. 11, 1924, Dec. 10, 1925, Jan. 12, Mar. 9, and Mar. 12, 1926, and Oct. 11, 1927, cited in Reed,
Birth Control Movement
, pp. 172-75. R.L.D. to M.S., Nov. 6, 1929, and M.S. to R.L.D., Nov. 26, 1929, MS-SS. Beyond the rubber spring diaphragm, Sanger had also amassed a collection of other vaginal contraceptives made in Germany, which Dickinson coveted. She lent them to him when they became allies in 1929, and he published the first comparative study to appear in an American medical journal. For Kosmak's early views, see George W. Kosmak, M.D., “Birth Control: What Shall Be the Attitude of the Medical Profession Toward the Present-Day Propaganda?”
Medical Record
91:17 (Feb. 1917), pp. 268-73.

9.
Biographical material on Davis is from
Notable American Women, 1607-1950: A Biographical Dictionary
, edited by Edward T. James and Janet Wilson James (Cambridge, Mass.: 1971), pp. 439-41. On the early research work of the Bureau of Social Hygiene, also see Havelock Ellis, “The Sex Life of Married Women,”
Birth Control Review
7:10 (Oct. 1923), pp. 266-69. A detailed account of the Rockefeller contributions to birth control exists in the John D. Rockefeller, Jr. papers, Rocky RG 2 and 3.
The Rockefeller staff prepared extensive memos on the internal workings of the birth control movement in the 1920s and 1930s, including what appear to be quite accurate assessments of various institutional and personality conflicts. Sanger emerged as a favorite of the staff and of John D. Rockefeller, Jr., and his two wives, Abby Aldrich and Martha Beard Rockefeller.
See, for example, Katherine Bement Davis's memo for the Rockefeller staff on Sanger's request for funding, June 10, 1924; John D. Rockefeller, Jr., to Davis, June 17, 1924; Raymond Fosdick to John D. Rockefeller, Jr., June 13, 1924, and Rockefeller to Fosdick, June 17, 1924; Fosdick to R.L.D., July 17, 1924; memo on the American Birth Control League, Inc., Apr. 16, 1925; M.S. to K.B. Davis, “The Homestead, Hot Springs, Virginia,” n.d. (1925); M.S. to Davis, Sept. 24, 1925, enclosing a request for up to $50,000 to fund an expansion budget, which was turned down. Also see Sanger to Davis, Oct. 11, 1926, and memos on the ABCL annual requests for funding prepared for the advisory group, dated 12/3/25, 12/9/26, n.d.(1927), and 12/13/28. Annual reports of the advisory committee show total levels of funding during these years in the $700,000 range, all of it in contributions of $10,000 or less. A memo dated Feb. 27, 1926, sets forth the principles of the advisory committee with the proviso that contributions to current expenditures not exceed 5 to 10 percent of the total budget. All in Rocky-RG2.

10.
M.S. to Dorothy Bocker, Nov. 18, 1924; memo from Bocker to M.S., Nov. 24, 1924; M.S.to Bocker, n.d. (Dec. 1924); M.S. to George Kirchway, Esq., about Bocker, all in MS-LC. Journal entry for Jan. 1, 1925, MS-SS, refers to her shock over the “betrayal of trust.”

11.
Autobiographical material on Hannah Stone is in AS-Countway. The East quote is from E. M. East to M.S. Feb. 1, 1929, MS-LC (copy also in PPLM-SS). Also see M.S. to East, Jan. 29, 1929, PPLM-SS. Hannah Stone to M.S., Mar. 27, 1932, recounts the ordeal of her membership hearing before the Academy of Medicine, MS-LC. The quotes on her “torture” are from the lawyer Morris Ernst, written for a memorial at her death, Oct. 28, 1941, MS-LC.

12.
Hannah M. Stone, “Report of the Clinical Research Department of the American Birth Control League for the Year of 1925,” MS-SS. In 1976, I also found scattered reports of Stone's follow-up work in uncataloged historical materials at the Margaret Sanger Center of Planned Parenthood of New York City. Linda Gordon,
Woman's Body, Woman's Right: A Social History of Birth Control in America
(New York: 1976), pp. 312-13, criticizes the failure to do more casework through home visits without fully considering the commitment of resources such visits required.
On the medical session at the 1925 conference, see R. L. Dickinson, “The Birth Control Movement,”
Medical Journal and Record
125: 10 (May 18, 1927), and Hannah M. Stone, “Therapeutic Contraception,”
Medical Journal and Record
126:6 (Mar. 21, 1928), pp. 8-17. Newspaper coverage highlighted the fact that Margaret was not permitted to attend, because she was not a physician. See “Doctors in Shut Meetings,”
The New York Times
, Mar. 30, 1925, 10:2.

13.
Committee on Maternal Health Memorandum, Mar. 12, 1925; CMH memorandum, “Proposed Standards for Medical Direction of Clinical Research Connected with the American Birth Control League,” Apr. 17, 1925; “Report of Conference of the Maternal Health Committee and the Clinic Committee of the American Birth Control League,” Nov. 29, 1925, all in MS-LC. M.S. to Adolf Meyer, May 28, 1925; C. C. Little to M.S., Oct. 26, 1925, and R.L. D. to M.S., Dec. 17, 1925, all in MS-LC. Also see Reed,
Birth Control Movement
, pp. 177-79.

14.
CMH, Apr. 17, 1925, memorandum, MS-LC; “Report of the Sub-Committee to the Public Health Committee on the Medical Work and Clinic of the American Birth Control League,” RLD-CL; and Kosmak to Dickinson, Feb. 16, 1925, both cited in Reed,
Birth Control Movement
, p. 177. A list of the official health indications for contraception is in “Report of Birth Control Clinical Research Bureau, January 1st 1929 to November 28th 1929,” MS-SS. Early clinic policy on child spacing and on referring women exhibiting “no health reasons” or NHRs, as they were called, is in James Cooper to Hannah Stone, Aug. 28, 1928, and in an internal memorandum dated “4/16/28,” which apparently came from Stone herself, though it is not signed, both in the uncataloged papers at the Margaret Sanger Center in New York. “Minutes of the Staff Meeting of the Clinical Research Bureau, Apr. 29, 1929,” MS-LC, revisits the issue and says “it is up to the doctor to prove that she gave information in good faith.”
Ella M. Hediger, M.D., to M.S., Apr. 22, 1928, MS-LC, complains that she had opened an office on West 9th Street to be convenient to the clinic but was not getting enough private patient referrals. Whatever the official policy, referrals continued to be made. A memorandum “To Staff Physicians,” dated Oct. 3, 1932, and signed by Hannah Stone with an “O.K. M.S.” at the bottom, reiterates the official prohibition on private referrals as a result of “recent infractions.” A second memo from Stone, dated Nov. 12, 1940, and titled “Policy Regarding Referral of Patients,” specifies that women should be referred back to their own private physician or to a local hospital clinic, or if neither exist, they were to be given the names of three doctors in their own neighborhoods. Both memos are in AS-Countway. Finally, see M.S. to Hannah Stone, June 26, 1929, MS-LC.
The willingness to treat patients exhibiting no health reasons became even greater during the Depression, when the clinic physicians were anxious to provide contraception on economic grounds. See Sigrid A. Brestwell (head nurse) to M.S., Nov. 10, 1932, MS-LC. By 1939, an official view was adopted that any married woman who wanted contraception should be given it, and to that end, “marital adjustment” was added to the list of health indications, and birth control was legitimized for its psychological benefit. See memorandum, “
DOCTORS MEETING
,” May 31, 1939, uncataloged papers at the Margaret Sanger Center in New York City.
To understand just how threatened George Kosmak was by the specter of “socialized” medical services for women and children, one should know as well that his testimony at Congressional hearings in 1929 on the Sheppard-Towner Act helped defeat this pioneering legislation. See Sheila Rothman,
Woman's Proper Place: A History of Changing Ideals and Practices, 1890 to the Present
(New York: 1978), p. 151.