In every woman"s ovaries are imbedded millions of ovules or eggs. They are in every female at birth, and as the girl develops into womanhood, these ovules develop also. At a certain age, varying slightly with the individual, the ripest ovule leaves the nest or ovary and comes down one of the tubes connecting with the womb and pa.s.ses out of the body.
When this takes place, it is said that the girl is at the age of p.u.b.erty. When it reaches the womb the ovule is ready for the process of conception--that is, fertilization by the male sperm.
At the time the ovule is ripening, the womb is preparing to receive it. This preparation consists of a reinforced blood supply brought to its lining. If fertilization takes place, the fertilized ovule or ovum will cling to the lining of the womb and there gather its nourishment.
If fertilization does not take place, the ovum pa.s.ses out of the body and the uterus throws off its surplus blood supply. This is called the menstrual period. It occurs about once a month or every twenty-eight days.
In the male organs there are glands called testes. They secrete a fluid called the s.e.m.e.n. In the s.e.m.e.n is the life-giving principle called the sperm.
When intercourse takes place, if no preventive is employed, the s.e.m.e.n is deposited in the woman"s v.a.g.i.n.a. The ovule is not in the v.a.g.i.n.a, but is in the womb, farther up, or perhaps in the tube on its way to the womb. As steel is attracted to the magnet, the sperm of the male starts on its way to seek the ovum. Several of these sperm cells start, but only one enters the ovum and is absorbed into it. This process is called fertilization, conception or impregnation.
If no children are desired, the meeting of the male sperm and the ovum must be prevented. When scientific means are employed to prevent this meeting, one is said to practice birth control. The means used is known as a contraceptive.
If, however, a contraceptive is not used and the sperm meets the ovule and development begins, any attempt at removing it or stopping its further growth is called abortion.
There is no doubt that women are apt to look upon abortion as of little consequence and to treat it accordingly. An abortion is as important a matter as a confinement and requires as much attention as the birth of a child at its full term.
"The immediate dangers of abortion," says Dr. J. Clifton Edgar, in his book, "_The Practice of Obstetrics_," "are hemorrhage, retention of an adherent placenta, sepsis, teta.n.u.s, perforation of the uterus. They also cause sterility, anemia, malignant diseases, displacements, neurosis, and endometritis."
In plain, everyday language, in an abortion there is always a very serious risk to the health and often to the life of the patient.
It is only the women of wealth who can afford the best medical skill, care and treatment both at the time of the operation and afterwards.
In this way they escape the usual serious consequences.
The women whose incomes are limited and who must continue at work before they have recovered from the effects of an abortion are the great army of sufferers. It is among such that the deaths due to abortion usually ensue. It is these, too, who are most often forced to resort to such operations.
If death does not result, the woman who has undergone an abortion is not altogether safe from harm. The womb may not return to its natural size, but remain large and heavy, tending to fall away from its natural position. Abortion often leaves the uterus in a condition to conceive easily again and unless prevention is strictly followed another pregnancy will surely occur. Frequent abortions tend to cause barrenness and serious, painful pelvic ailments. These and other conditions arising from such operations are very likely to ruin a woman"s general health.
While there are cases where even the law recognizes an abortion as justifiable if recommended by a physician, I a.s.sert that the hundreds of thousands of abortions performed in America each year are a disgrace to civilization.
The effects of such operations upon a woman, serious as they may be, are nothing as compared to the injury done her general health by drugs taken to produce the same result. Even such drugs as are prescribed by physicians have harmful effects, and nostrums recommended by druggists are often worse still.
Even more drastic may be the effect upon the unborn child, for many women fill their systems with poisonous drugs during the first weeks of their pregnancy, only to decide at last, when drugs have failed, as they usually do, to bring the child to birth.
There are no statistics, of course, by which we may compute the amount of suffering to mother and child from the use of such drugs, but we know that the total of physical weakness and disease must be astounding. We know that the woman"s own system feels the strain of these drugs and that the embryo is usually poisoned by them. The child is likely to be rickety, have heart trouble, kidney disorder, or to be generally weak in its powers of resistance. If it does not die before it reaches its first year, it is probable that it will have to struggle against some of these weaknesses until its adolescent period.
It needs no a.s.sertion of mine to call attention to the grim fact that the laws prohibiting the imparting of information concerning the preventing of conception are responsible for tens of thousands of deaths each year in this country and an untold amount of sickness and sorrow. The suffering and the death of these women is squarely upon the heads of the lawmakers and the puritanical, masculine-minded person who insist upon retaining the abominable legal restrictions.
Try as they will they cannot escape the truth, nor hide it under the cloak of stupid hypocrisy. If the laws against imparting knowledge of scientific birth control were repealed, nearly all of the 1,000,000 or 2,000,000 women who undergo abortions in the United States each year would escape the agony of the surgeon"s instruments and the long trail of disease, suffering and death which so often follows.
"He who would combat abortion," says Dr. Hirsch, "and at the same time combat contraceptive measures may be likened to the person who would fight contagious diseases and forbid disinfection. For contraceptive measures are important weapons in the fight against abortion.
"America has a law since 1873 which prohibits by criminal statute the distribution and regulation of contraceptive measures. It follows, therefore, that America stands at the head of all nations in the huge number of abortions."
There is the case in a nutsh.e.l.l. Family limitation will always be practiced as it is now being practiced--either by birth control or by abortion. We know that. The one means health and happiness--a stronger, better race. The other means disease, suffering, death.
The woman who goes to the abortionist"s table is not a criminal but a martyr--a martyr to the bitter, unthinkable conditions brought about by the blindness of society at large. These conditions give her the choice between the surgeon"s instruments and the sacrificing of what is highest and holiest in her--her aspiration to freedom, her desire to protect the children already hers. These conditions--not the woman--outface society with this question:
"Contraceptives or Abortion--which shall it be?"
CHAPTER XI
ARE PREVENTIVE MEANS CERTAIN?
There are several means of preventing conception which are both certain and harmless. What those means are the state laws forbid me to say. If I should defy the state laws and name those contraceptives, the federal laws would forbid this book"s going through the mails. Nor can I, without coming into conflict with the laws, tell _why_ these means are reliable. It is difficult to discuss the subject without using franker language than the statutes permit, and I do not wish to violate the law in this particular book.
"Can I rely upon this? Is it certain? Will it prevent absolutely?"
Such questions, always asked by women who seek advice concerning contraceptives, testify both to their fear of involuntary motherhood and their doubt as to any and all means offered for their deliverance.
Doubt as to the certainty of contraceptives arises from two sources.
One is the uninformed element in the medical profession. A physician who belongs to this element may object to birth control upon general grounds, or he may repeat old-fashioned objections to cover his ignorance of contraceptives. For, strange as it may seem, there is an amazing ignorance among physicians of this supremely important subject. The uninformed objector often a.s.sumes to speak with the voice of authority, a.s.serting that there are no thoroughly dependable contraceptives that are not injurious to the user.
The other source of distrust is the experience of the woman herself.
Having no place to go for scientific advice, she gathers her information from neighbors and friends. One offers this suggestion, another offers that, each urging the means that she has found successful and condemning others. All this is very confusing and extremely disturbing to the woman who, for one reason or another, is living in constant fear of pregnancy.
It is not at all surprising that such a state of affairs exists. There has been so much secrecy about the whole subject and so much dependence upon amateurish and nonprofessional advice that it is almost impossible for anyone to procure reliable information or to recognize it when given. This is especially true in the United States where there are both federal and state laws to punish those who disseminate knowledge of birth-control methods.
Even under present conditions, however, there is a certain amount of reliable information concerning methods of birth control. We know that there are several methods of prevention which are not only dependable, but which can be used without injury either to the man or the woman.
Knowledge of what these methods are and how to apply them should be available to every married man and woman. It is safe to predict that in a very few years they will be available.
Some methods are more dependable than others, just as there are some more simple of adjustment than others. Some are cheap and less durable; others are expensive and last for years. There are some which for a quarter of a century have stood the test of certainty in Holland, France, England and the United States among the wealthier cla.s.ses, as the falling birth rate among these cla.s.ses indicates. And just as the reliable, primitive wheelbarrow is antiquated beside the latest airplane, so, as scientific investigators turn their attention more and more to this field, will the awkward, troublesome methods of the past give way to the simpler, more convenient methods of the morrow.
Although the law forbids information concerning reliable means of contraception, it is hardly likely that it can be invoked to prevent warnings against widely practiced methods which are NOT reliable. The employment of such methods leads not only to disappointment but often to ill health.
One of the most common practices of this kind is that of nursing one baby too long in the hope of preventing the birth of the next. The "poor whites" of the South and many of the foreign-born women of the United States pin their hopes to this method. Often they persist in nursing a child until it is eighteen months old--almost always until they become pregnant again.
Prolonged nursing hurts both child and mother, it is said. In the child it causes a tendency to brain disease, probably through disordered digestion and nutrition. In the mother it causes a strong tendency to deafness and blindness. If a child is nursed after it is twelve months old, it is generally pale, flabby and unhealthy, often rickety, one authority points out, while the mother is usually nervous, emaciated and hysterical. If pregnancy occurs under these conditions, the mother not only injures her own health but that of the next child, often developing in it a weakness of const.i.tution which it never overcomes.
Moreover, prolonged nursing has been found to be unreliable as a contraceptive. We know this upon good authority. It should not be depended upon at all.
In the same cla.s.s is the so-called "safe period" referred to in another chapter. For many women there is never any "safe period."
Others have "safe periods" for a number of years, only to find themselves pregnant because these periods have ceased without warning.
One of the most frequent of all the mistakes made in recommending contraceptives is the advice to use an antiseptic or cold-water douche. This error seems to be surprisingly persistent. I am particularly surprised to hear from women that such douches have been prescribed by physicians. Any physician who knows the first rudiments of physiology and anatomy must also know that necessary and important as an antiseptic douche is as a cleanser and hygienic measure, it is a.s.suredly not to be advised as a means of preventing conception.
A woman may, and often does, become pregnant before she can make use of a douche. This is particularly likely to happen if her uterus is low. And the woman who does much walking, who stands for long hours or who uses the sewing machine a great deal is likely to have a low uterus. It is then much easier for the spermatazoa to enter almost directly into the womb than it would otherwise be, and the douche, no matter how soon it is used, is likely to be ineffective. The tendency of the uterus to drop under strain goes far to explain why some women who have depended upon the douche for years suddenly find themselves pregnant. Do not depend upon the douche. As a cleansing agent, it is a necessary part of every woman"s toilet, but it is not a preventive.
Even if the douche were dependable, the absence of sanitary convenience from households in remote districts and the difficulty of using a douche in crowded tenements would prevent many women from making use of it.
Despite the unreliability of some methods and the harmfulness of some others, there _are_ methods which are both harmless and certain. This much the woman who is seeking means of limiting her family may be told here. _In using any method_, whatsoever, all depends upon the care taken to use it properly. No surgeon, no matter how perfect his instruments, would expect perfect results from the simplest operation did he not exercise the greatest possible care. Common sense, good judgment and taking pains are necessary in the use of all contraceptives.
More and more perfect means of preventing conception will be developed as women insist upon them. Every woman should make it plain to her physician that she expects him to be informed upon this subject. She should refuse to accept evasive answers. An increasing demand upon physicians will inevitably result in laboratory researches and experimentation. Such investigation is indeed already beginning and we may expect great progress in contraceptive methods in the near future.
We may also expect more authoritative opinions upon preventive methods and devices. When women confidently and insistently demand them, they will have access to contraceptives which are both certain and harmless.