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If the Committee should decide to adopt either of these
methods, considerable additional expense to the existing services
would be involved, in that a further part-time Medical Officer
would be necessary as well as two trained nurses to attend at each
session.
F. GARLAND COLLINS,
October 5th, 1934. Medical Officer of Health.
Some Notes on Artificial Contraception.
1. In recent years Local Authorities have been urged by the
advocates of artificial contraception to provide facilities for its
practice, and it may be convenient again to offer some brief notes
for their consideration.
2. It should not be forgotten that this claim is preferred at a
time of a falling birth rate, and when the provision for maternity
and the treatment of conditions incidental thereto is receiving more
skilled attention than formerly, in institutions under Local Authorities,
in private medical practice, and in voluntary hospitals. The
birth rate which was 35.4 per thousand persons living in 187,11880
has now fallen to 14.4 in 1933. On the other hand, unemployment
has increased owing to widespread industrial depression,
bringing increased poverty; and social habit and aspiration
in regard to large families are undergoing profound changes. In
some sections of the population there is, from one cause or another,
a growing disinclination or economic inability to have children,
and a rapidly progressive disposition to find medical relief for the
disabilities of childbirth.
3. Yet it must not be assumed that "birth control" is a novel
idea. Intentional and purposive contraception has existed from
the earliest times in human history. Recently, however, its practice
has become more conscious and concrete, more talked about,
and more artificial in method. This change is not necessarily evil,
nor does it necessarily raise new moral issues. It is the means
which have changed, and which are advertised and publicly discussed.
The fact that the means have brought to a large number
of persons definite relief from immediate and practical difficulties
and burdens, financial as well as physical, must not be overlooked.
The Tightness or wrongness of the use of those means, the expediency
or inexpediency of their application, should always be
estimated without prejudice and on the plane of their motive and
occasion. The means to be adopted and their usage is, however,
another question, and the advocacy of indiscriminate and unskilled
artificial contraception has some substantial disadvantages
which should be recognised:—
(a) Organised popular instruction in this subject is
liable to become propagandist and pseudo-authoritative in
presentation and impression; it leads also to a commercial
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