Contraception and eugenics

By Claudia Jessop

Lady Barrett was active in the Eugenics Society, and was appointed to its council in 1917. Eugenics – the desire to ensure the birth of ‘high quality’ human specimens by nurturing positive genetic inheritance and ‘weeding out’ negative genetic inheritance – was a common preoccupation of the period, throughout the political spectrum. Many of the most eminent establishment figures, including former Prime Minister Balfour, were members of the Eugenics Society, as well as radical medics like Marie Stopes, and in the arts, Virginia Woolf, T.S. Eliot and W.B.Yeats were all keenly interested in the subject. The First World War and the spread of Empire had concentrated establishment minds on the perceived need to nurture a good ‘breeding stock’ of healthy Britons. Indeed, several references made incidentally in The Mothers’ Hospital’s Annual Reports to ideas like the “future strength of the race”, reflect this element of the zeitgeist in a way distinctly uncomfortable for the modern reader – improving the health of mothers and babies is seen often as not only a benefit for the individuals involved, but a contribution to the nurture of a superior kind of human being. Twenty years before events in Nazi Germany had shown the horrors of taking such ideas to their arguably logical conclusions, it was acceptable to advocate attempts to ‘improve the race’ by encouraging the reproduction of the ‘more fit’ (i.e. the more healthy and intelligent) and discouraging that of the ‘unfit’ (those with poor health and low intellectual capabilities). Such views were becoming popular in certain sections of the church; Lady Barrett’s treatise on conception control had as its introduction an enthusiastic letter of recommendation written by the Archbishop of Canterbury, Randal Cantuar, and in 1930, a few years after its publication, no less a figure than William Ralph Inge, dean of St Paul’s Cathedral, spoke in favour of eugenics at the Church Congress “in the form of a reasoned statement which might have gone far enough to imply definitely the sterilisation of the unfit and the control of conception had the speaker so wished”, describing the idea of “racial hygiene” as being part of “the spirit of the age”. (The Manchester Guardian, 10 October 1930.)

Lady Barrett was a passionate believer in eugenics, but her approach to it was unorthodox in that she was not persuaded by the idea of conception control as its instrument. She disagreed vehemently with her fellow Eugenics Society member Marie Stopes on the subject; in 1922 her pamphlet Conception Control: its Effects on the Individual and the Nation set out her idea that the use of contraception would lead to a decline in the nation’s fitness as only the higher social classes would be sufficiently intelligent to know how to use it. This would result in “weeding out of the best” and “the continuous multiplication of the worst type of citizen.” Contraception would also encourage promiscuity and thus spread venereal disease. As a solution to the poor health and exhaustion suffered by working-class mothers of many children – much evidence of which she must have seen in her work at the Mothers’ – she proposed instead a publicly-funded improvement of diet and living conditions that still sounds radical today, including state provision of crèches, communal laundry facilities, “family meals arranged in service rooms equivalent to the arrangements in service flats” and provision of the new domestic labour saving devices. These recommendations show an intimate familiarity with and understanding of the practical stresses and strains that would have beset her working-class patients at the Mothers’: the unrelenting need to provide family meals, adequate clothing and hygienic living conditions on often totally inadequate budgets. But it is difficult not to feel that one of the biggest improvements to these women’s lives would necessarily have been an escape from continuous childbearing and a reduction in the number of mouths they had to feed and bodies to clothe. Lady Barrett also believed that lower class women were more fertile than their upper class counterparts, due to an unhealthy lifestyle leading to lowered “vitality” – paradoxically, fertility was believed to increase the less “vital” or healthily energetic a woman was.
 She was in favour of the prevention of conception for the mentally “defective”, advocating their segregation as the “hopelessly unfit”, and expressed the view that while the state had a duty to educate all children, it must be accepted that such education would never enable the lower classes to go beyond the naturally low, fixed limits of their intelligence. Her view of female sexuality seems strikingly repressive today, but was typical of the time: “All these artificial preparations for intercourse demand from the woman an investigation of and interference with her own internal organs, which is revolting to all decent women ... the advocacy of cleanliness and non-interference with the genital organs … is the natural habit of healthy-minded women.”

Where contraception was insisted upon, she advocated the use of the calendar method (recent research done into conceptions that took place during the brief leave periods of soldiers in the First World War had deepened understanding of the phases of the menstrual cycle when conception was and wasn’t possible). The condom was superior to the quinine pessary, which she criticised in an article in The Practitioner in 1923 for being dangerous. The best method of birth control, however, was self-control.

Lady Barrett was particularly unsympathetic to the newly fashionable idea that young married couples should postpone childbearing until their economic position had improved: “… the demand for little work and many luxuries in youth is ... a sign of decadence in the race.” Interestingly, another of her statements with regard to the possible disappointment of couples whose fertility had declined with age might have been used by Dr Susan Bewley of St Thomas’s Hospital and the other doctors who in 2005 controversially warned against the elective deferral of pregnancy to middle age: “It is very unfair to teach people that they may safely postpone the natural tendency to bear children in youth and rely upon having them later in life.” She did concede that “If disease renders child-bearing a danger to the life and health of the mother, it becomes a positive duty of her doctor to prevent such a catastrophe.”

One paragraph of this treatise reveals a perhaps surprisingly positive estimation of the new endeavour to improve public health provision for poor mothers: “It is, happily, as possible for the poor woman to obtain advice in all matters of health as it is for the rich. The mothers of the country are in touch everywhere with maternity clinics, where doctors advise them on all questions of health relating to pregnancy, and treat each woman as a separate individual.” Only a few years earlier, such a description would have been unthinkable.

Lady Barrett believed that the strength of the British people would be improved not only by ensuring that the “better specimens” reproduced as much as possible, but, a more benign endeavour, which still resonates today, that the working classes should be provided with opportunities for physical exercise, healthy recreation and self-improving ways to spend their leisure time. She was a co-signatory of a letter to The Times in November 1919, which urged the newly empowered Ministry of Health to make the provision of “an organised system of physical education” a priority. Again, modern echoes resound when the letter laments “inadequate playgrounds and relatively few clubs”. In it Lady Barrett summarised her general view of the importance of public welfare, and the reasons for this importance: “We are not making this appeal for the sake of the workers alone, for we believe that anything which helps to invigorate the population is of benefit to the whole country, in that it stimulates good work and increases production.” It emphasised the importance, after the exhausting years of the First World War, of improvement in public health: “For we cannot at any time afford a ‘C3’ population, least of all at the moment of our history when with the flower of our manhood cut off we are endeavouring to reconstruct a new and better kingdom.”

 Lady Barrett’s fellow signatories of this letter included Frederick Treves, the surgeon who had founded the British Red Cross (which the letter proposed should take overall responsibility for the public provision of physical education), best known for his association at the Royal London Hospital with Joseph Merrick ‘The Elephant Man’.

This interest in physical training continued throughout Lady Barrett’s life - in June 1935, she became one of the inaugural members of the Central Council for Recreative Physical Training, under the presidency of Lord Astor.