Annotation: Margaret Sanger was a woman’s activist focusing on women’s health. Sanger witnessed her mother's slow death, rundown after 18 pregnancies and 11 live births. She also worked as a nurse and midwife for the poor in New York City. She saw women deprived of their health and ability to care for children already born. So, Margaret founded the National Birth Control League which eventually became the Planned Parenthood Federation of America. In this chapter from her autobiography, Sanger relates how her social conscience was awakened by the plight of poverty-stricken young women who endured - and often eventually died from - the "chronic condition" of pregnancy.
Document: During these years in New York trained nurses were in great demand. Few people wanted to enter hospitals; they were afraid they might be "practiced" upon, and consented to go only in desperate emergencies. Sentiment was especially vehement in the matter of having babies. A woman's own bedroom, no matter how inconveniently arranged, was the usual place for her lyingin. I was not sufficiently free from domestic duties to be a general nurse, but I could ordinarily manage obstetrical cases because I was notified far enough ahead to plan my schedule. And after serving my two weeks I could get home again.
Sometimes I was summoned to small apartments occupied by young clerks, insurance salesmen, or lawyers, just starting out, most of them under thirty and whose wives were having their first or second baby. They were always eager to know the best and latest method in infant care and feeding. In particular, Jewish patients, whose lives centered around the family, welcomed advice and followed it implicitly.
But more and more my calls began to come from the Lower East Side, as though I were being magnetically drawn there by some force outside my control. I hated the wretchedness and hopelessness of the poor, and never experienced that satisfaction in working among them that so many noble women have found. My concern for my patients was now quite different from my earlier hospital attitude. I could see that much was wrong with them which did not appear in the physiological or medical diagnosis. A woman in childbirth was not merely a woman in childbirth. My expanded outlook included a view of her background, her potentialities as a human being, the kind of children she was bearing, and what was going to happen to them.
. . . As soon as the neighbors learned that a nurse was in the building they came in a friendly way to visit, often carrying fruit, jellies, or gefilte fish made after a cherished recipe. It was infinitely pathetic to me that they, so poor themselves should bring me food. Later they drifted in again with the excuse of getting the plate, and sat down for a nice talk; there was no hurry. Always back of the little gift was the question, "I am pregnant (or my daughter, or my sister is). Tell me something to keep from having another baby. We cannot afford another yet. "
I tried to explain the only two methods I had ever heard among the middle classes, both of which were invariably brushed aside as unacceptable. They were of no certain avail to the wife because they placed the burden of responsibility solely upon the husband-a burden which he seldom assumed. What she was seeking was selfprotection she could herself use, and there was none.
Below this stratum of society was one in truly desperate circumstances. The men were sullen and unskilled, picking up odd jobs now and then, but more often unemployed, lounging in and out of the house at all hours of the day and night. The women seemed to slink on their way to market and were without neighborliness.
These submerged, untouched classes were beyond the scope of organized charity or religion. No labor union, no church, not even the Salvation Army reached them. They were apprehensive of everyone and rejected help of any kind, ordering all intruders to keep out; both birth and death they considered their own business. Social agents, who were just beginning to appear, were profoundly mistrusted because they pried into homes and lives, asking questions about wages, how many were in the family, had any of them ever been in jail. Often two or three had been there or were now under suspicion of prostitution, shoplifting, purse snatching, petty thievery, and, in consequence, passed furtively by the big blue uniforms on the corner.
. . . Pregnancy was a chronic condition among the women of this class. Suggestions as to what to do for a girl who was "in trouble" or a married woman who was "caught" passed from mouth to mouth-herb teas, turpentine, steaming, rolling downstairs, inserting slippery elm, knitting needles, shoehooks. When they had word of a new remedy they hurried to the drugstore, and if the clerk were inclined to be friendly he might say, "Oh, that won't help you, but here's something that may." The younger druggists usually refused to give advice because, if it were to be known, they would come under the law; midwives were even more fearful. The doomed women implored me to reveal the "secret" rich people had, offering to pay me extra to tell them; many really believed I was holding back information for money. They asked everybody and tried anything, g but nothing did them any good. On Saturday nights I have seen groups of from fifty to one hundred with their shawls over their heads waiting outside the office of a fivedollar abortionist.
These were not merely "unfortunate conditions among the poor" such as we read about. I knew the women personally. They were living, breathing, human beings, with hopes, fears, and aspirations like my own, yet their weary, misshapen bodies, "always ailing, never failing, " were destined to be thrown on the scrap heap before they were thirty-five. I could not escape from the facts of their wretchedness; neither was I able to see any way out. My own cozy and comfortable family existence was becoming a reproach to me. . . . . . . No matter what it might cost, I was finished with palliatives and superficial cures; I was resolved to seek out the root of evil, to do something to change the destiny of mothers whose miseries were vast as the sky.