Family Planning In Practice

Mauritius Times – 60 Years

“There is no prospect,” declared the Royal Commission on Population 10 years ago, “that men and women, having acquired control over the number of children they will have, will abandon it. Nor is it desirable that they should,” for it is “one of the first conditions of their own and the community’s welfare.”

The advent of voluntary parenthood is both cause and consequence of a growth of personal responsibility and partnership in marriage — of husbands towards wives and of both towards their children. Comparing the quality of working-class family life in Bethnal Green today and in late Victorian times, two sociologists have recently found “the rise in the status of the young wife and of the children” to be “the great transformation of our time.” This transformation they find most dramatically expressed in the reduced size of families brought about by deliberate planning.

Social disaster

Family planning originated in the desire for family limitation. This association of planning with restriction of human reproduction became inevitable when, in the nineteenth century, the reduction of child mortality transformed the family which survived the hazards of childhood from a small into a large unit. It remains inevitable because, without birth control, the very progress of death control would produce social disaster. Without family limitation, according to the royal commission, “unless famine, disease or wars multiplied our death rates, the nineteenth century size of family would double the population in less than 30 years.”

But it is from its contribution to personal welfare rather than from its demographic advantages that the family planning movement derives its growing strength. The movement has long since come to stress not the need for mere restriction of births but the positive enrichment of marital relations, parenthood, maternal health, and child welfare which follows from the ability to decide when to have wanted children, whether few or numerous. It is as much concerned to help the barren into parenthood (though is draws the line at artificial insemination save by the husband) as it is to help the fruitful plan their parenthood.

The prevailing attitude to voluntary parenthood was found good by last year’s Lambeth Conference of the Anglican bishops. Their resolution stated “that the responsibility for deciding upon the number and frequency of children has been laid by God upon the conscience of parents everywhere: that this planning, in such ways as are mutually acceptable to husband and wife in Christian conscience is a right and important factor in Christian family life.” Their encyclical letter added that family planning was right and important also because “procreation of children is not the sole purpose of Christian marriage. Implicit within the bond between husband and wife is the relationship of love with its sacramental expression in physical union.”

Catholic attitude

With one exception, there is now no important religious group in Britain which is prepared as a matter of doctrine to condemn contraception as a method of family planning. The exception is the Roman Catholic Church. Family limitation is nearly as prevalent among Roman Catholics in this country as among those of other faiths, and their leaders do not condemn responsible family planning. But they do insist on “natural” methods of birth control – complete abstinence or reliance on the so called ‘‘safe period.”

They forbid contraception because, as Pius XI stated in 1930,”the conjugal act is of its very nature designed for the procreation of offspring… Those who, in performing it, deliberately deprive it of its natural power and efficacy act against nature and do something which is shameful and intrinsically immoral.” Yet, inspite of this disagreement about methods, it is noteworthy that the Roman Catholic journal Universe should have remarked recently that, in other respect, “there is a positive and praiseworthy aspect of the work” of the Family Planning Association, and this body’s forthcoming “Good Cause” appeal on the BBC marks “the full circle of respectability” for family planning.

By their behaviour, the bulk of Britons today show that they assent to the royal commission’s conclusion that “there is nothing inherently wrong in the use of mechanical methods of contraception.” The commission went on to argue that the long-run interests of the family and of society both require that “voluntary parenthood should become universal and that women should have the maximum freedom in the ordering of their lives,” and “that children, whether in large or small families, are wanted children and not the result of ignorance.”

Ignorance of elementary sexual matters as well as of family planning, is still widespread. Only in the past two decades has contraception replaced coitus interruptus as the main birth control method; and among those not averse from contraception, inefficient methods are still common The consequences include some 50,000 to 100,000 illegal abortions annually (chiefly, it seems, among married women); a sizable proportion of stillbirths, premature births, and infant deaths which sensible spacing of pregnancies could have prevented; and a great amount of needless ill-health.

A quick remedy

Seeking a quick remedy, the royal commission would have obliged the health service to provide advice both on contraception and infertility to “married persons who want it.” Governments so far have preferred to let the situation remedy itself without forcing the pace. Publicly praised by Cabinet Ministers with vice-presidents who include two bishops and the current presidents of the three royal medical colleges and of the College of General Practitioners, the Family Planning Association is medically impeccable and eminently respectable. It operates 299 clinics, four in every five on health service premises, and is opening new clinics at the rate of nearly one a fortnight.

Hoping the barren is an integral and important part of the associations’ work, though one which is increasingly — and rightly — passing to the hospitals, about 150 FPA clinics are equipped for preliminary advice and investigation of barrenness in couples who want children. The simpler cases they can remedy themselves where the difficulty is appreciable and it is the wife who needs treatment, she is usually referred to a hospital for further help, though there are six F.P.A. centres equipped to deal with female infertility at consultant level. If it is the husband who is infertile, hospital facilities are still very haphazard, and he is likely to find his way to the association’s own national centre for male infertility. Though no longer unique, this centre remains the leading institution of its kind.

In 1955 the Minister of Health told the association: “I believe that you do an admirable work… However, there are many thousands of your countrymen and women who hold different views… and in all we do we must consider these most deeply held convictions, even if we do not share them.” Respect for minority views justifies keeping the clinics under voluntary control, while not forbidding the health service to refer patients to them Yet there is no reason why the health service should not be required to refer for contraceptive advice any married persons who want it, provided it allows complete freedom for medical and other conscientious objectors to dissociate themselves from this particular service. Official policy, however, stops far short of this. The health services may arrange contraceptive advice only for women for pregnancy may be medically dangerous; and even this is not obligatory. And the British Pharmacopoeia still ignores contraceptives, the only impartial testing of which is still done in the association’s own laboratories. 

Simple instruction

Family planning clinics are increasingly frequented by women — and men too — whose main need is not birth control information but simple sex instruction or advice on marital or social difficulties. Yet, although marriage guidance and premarital preparation for married life are officially favoured, there is still no trend in the social services towards bringing all these related facilities together into comprehensive marriage welfare centres. Here, too, the association is pioneering. Seven of its leading centres already approximate to the comprehensive standard.

The Times, UK, 17th July 1959

Mauritius Times ePaper Friday 29 December 2023