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1228 An American Dilemma
educational campaign be instigated to reach the masses with specific birth control advice.
The first is a legal question: The Comstock Law still stands on the federal statutes books
for all nonmedical people and would probably be involved if general advice—not
directed to specific cases investigated by a doctor—^were distributed through the mails.
Twenty-nine states also still have laws which prohibit nonmedical people from giving
birth control advice. But the birth control organizations are no longer fighting the
Comstock Law or the state laws (outside of those in Massachusetts and Connecticut,
which apply to doctors) . They are content to let them stand since they no longer apply
to doctors. The second problem is one of quackery: if nonmedical people were allowed
to give advice, there would be all sorts of dangerous or useless contraceptives put on the
market and advertised. But this is already happening, except that the mails are not
used, even in those states where it is illegal. People know that physicians can give
contraceptive information; to overcome quackery it is necessary to disseminate correct
information on a mass scale without waiting for people to consult physicians. Too, it is
possible to have laws which practically eliminate quackery. A third issue is the question
of what the popular reaction might be: birth control organizations are afraid of losing
the support of doctors and others of the “best people” and of being called “immoral.”
This is probably the decisive issue which prevents the birth control organizations from
giving concrete information to the masses of the people. But the question remains as to
whether there would be such a popular reaction, whether this reaction would nullify
all the small but positive gains that have been made, and whether an extensive publicity
campaign would not counterbalance any reaction.
Because of the tendency to work through physicians, even greater emphasis than
is necessitated by facts has been laid on the contraceptive techniques which require a
doctor’s advice; the pessary and the foam-and-sponge techniques. The simple methods
of the condom and coitus interruftus are deplored. Yet the leading medical authorities,
Dickinson and Morris, in a manual issued by the Birth Control Federation itself, have
the following to say about the condom:
“Properly tested, the condom provides protection as efficient as any method, and,
skillfully used, furnishes security, ... It ought to enjoy a much more favorable attitude
on the part of the clinician.” (Robert L. Dickinson and Woodbridge E. Morris,
Techniques of Conceftion Control [1941], p. 34,)
It may be that when all people know about birth control, and when the task is to get
its methods perfected and individualized, it will be wise to shift emphasis back again
from the condom to the pessary, since the latter is supposed to be the most efficient and
least annoying method. Since it happens that the condom and coitus interruftus methods
are for men, the pessary and other methods available to women should be spread so
that women, too, should have opportunity to control conception.
‘^^The public clinics now in existence disseminate information about birth control
solely by mentioning it to women who have come into the public health office for other
purposes, especially to women who have just had a child. Only indigent women use the
public clinic; others are referred to a private physician.
The demonstration projects sponsored by the Planned Parenthood Federation have
a similarly slow method of reaching the public. During two years of the project at
Nashville, only 638 patients were advised, and during 21 months of the project in
Berkeley County, South Carolina, only 1,008 patients were advised. (McCarroU, of, cit,,
pp. 7, II.) It should be recognized, however, that completeness and not extensive
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