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function of such Centres systematically to give advice and instruc
tion in regard to the methods of artificial contraception or their
application. The use of the Centres for such a purpose would
be likely to damage their particular work. In certain cases in
which there are medical grounds for giving individual advice on
contraceptive methods to married women in attendance at the
Centres, it may be secured (see 4 above), but such advice should
be restricted to cases where further pregnancy would be detrimental
to health, and should be offered under conditions such as
will not disturb the normal and primary work of the centre.
(11) Whilst Local Authorities have no general statutory
power to establish "birth control clinics" as such, the Public
Health Acts confer upon Local Authorities the power to provide
clinics for sick persons. On May 3,1st, 1934, the Ministry of
Health issued a further Circular (1408) drawing attention to the
recommendation of the Departmental Committee and explaining
that such general clinics might properly deal with forms of sickness
other than gynaecological conditions in the narrow sense of
the term. Among such conditions directly or indirectly affecting
pregnancy are tuberculosis, heart disease, diabetes, chronic
nephritis, certain forms of anaemia, the toxaemias of pregnancy,
epilepsy, mental deficiency or amentia, hyperthyroidism, haemophilia,
grave malnutrition, or morbid conditions arising from the
incomplete recovery from pregnancy. A copy of the Circular is
printed below as an addendum.
(12) It should be added that under this and the previous Circulars
on birth control, arrangements have been made by some 75
or 80 Local Authorities for the provision of contraceptive advice
to mothers for whom further pregnancies would be detrimental to
health. Various voluntary societies, including the National Birth
Control Association, the Society for the Provision of Birth Control
Clinics and others have also established a number of clinics
on a voluntary basis. Experience shows that women attend such
Centres for various reasons. As in the ordinary clinics for the
ailments of school children, tuberculosis, venereal disease, etc.,
many patients attend for the purpose of diagnosis, who may find as
a result that they are in no need of medical advice or treatment;
some, who may have borne many children, for advice as to stopping
further child-birth on medical grounds; others for advice as
to the "spacing" of their prospective children; and not a few
for general or particular morbid conditions which they suspect,
rightly or wrongly, are detrimental to their health as mothers.
The purpose of such clinics, from first to last, should be the prevention
of disease or impairment in the mother or her offspring,
and the ensurement of the health of both. In these clinics, as in
other clinics, what is, or is not, medically detrimental to health
must be decided by the professional judgment of the registered
medical practitioner in charge of the clinic.
[Copy from Annual Report of The Chief Medical Officer of
the Ministry of Health for the year 1933.]
F. GARLAND COLLINS.
October, 1934.
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