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decision of the Authority to provide facilities for birth control
advice within the limits laid down in the Memorandum. He is of
opinion that this work should not be regarded as falling within
the scope of the normal duties of the medical officers of a Local
Authority, who should be free to undertake it or decline it.
Circular 1408. Ministry of Health, Whitehall, London, S.W.I.
Sir, BIRTH CONTROL. 31st May, 1934.
1. I am directed by the Minister of Health to refer to
Memorandum 153/M.C.W. dated March, 1931, and Circular 1208
of the 14th July, 1931, and more particularly to paragraph 4 of
the Memorandum and paragraph 3 of the Circular which deal
with the provision under the Public Health Acts of clinics for
women suffering from gynaecological conditions. It was stated
in paragraph 4 of the Memorandum that the Government had decided
that any Departmental sanction which might be necessary
to the establishment of such clinics should be given only on condition:—
(1) that the clinics will be available only for women who
are in need of medical advice and treatment for gynaecological
conditions, and (2) that advice on contraceptive methods will
be given only to married women who attend the clinics for such
medical advice or treatment, and in whose cases pregnancy
would be detrimental to health.
2. The Authority will be aware that the Departmental Committee
on Maternal Mortality and Morbidity, in their Final Report
published in 1932, called special attention to the importance of the
avoidance of pregnancy by women suffering from organic disease
such as tuberculosis, heart disease, diabetes, chronic nephritis,
etc., in which childbearing is likely seriously to endanger life. The
Committee considered that advice and instruction in contraceptive
methods should be readily available for such women.
3. It was pointed out in the Memorandum and Circular of
1931 that the powers which the Public Health Acts confer upon
Local Authorities for the provision of clinics limit their availability
to sick persons, but the Minister is advised that there is nothing
to prevent the Local Authority from rendering such a clinic available
for women suffering from forms of sickness other than
gynaecological conditions. After careful consideration of the recommendation
made by the Departmental Committee, the Minister
is of opinion that where a Local Authority has provided a clinic
at which medical advice and treatment are available for married
women suffering from gynaecological conditions, and at which
contraceptive advice is afforded to married women so suffering in
whose cases pregnancy would be detrimental to health, it would
be proper also for married women who are suffering from other
forms of sickness, physical or mental, such as those mentioned in
the Report of the Departmental Committee, which are detrimental
to them as mothers, to be afforded contraceptive advice at the
clinic if it is found medically that pregnancy would be detrimental
to health. 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.
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