By Amiel Lynch
Although contraception is taken for granted today, the history of the struggle for this right is complex. Birmingham played a central role in providing access to this right. Politically and legally birth control was contentious and the movement of contraception from the private sphere of influence to the public mirrored the changing role of women in society. Instead of engaging with the formal legal system, Birmingham Women’s Clinic, focused on the limits of soft law in providing access to specific groups of women. This highlights the struggle between desire for immediate gains and long-term legal progress.
The Birmingham Women’s Welfare Centre opened in 1926. It was the seventh clinic in the country and it was one of the main providers of contraception services in Birmingham up until 1973.[1] Initially it faced opposition from the local authorities. After the Ministry of Health’s statement in 1930 allowing local health authorities to provide contraceptive advice, the Birmingham clinic offered to act as agents for these authorities. However, grants to provide contraception as agents of the health authority were not given.[2] They clinic slowly gained acceptance by the local authorities in 1947 when the Lord Mayor took the chair for the clinic in the Council Chamber—a movement seen as a victory for the centre.[3]
The First World War led to changes in perspectives on gender equality. Ideas surrounding greater equality and genetic progress dominated the discourse around birth control.[4] Individual women like Marie Stopes opened family planning clinics for the first time and began to offer contraceptive services for women, mirroring this shift in perspective.[5] Previously, focus was mainly on political emancipation.[6] However, after the war, there was a shift to sexual and social emancipation in focusing on women’s rights to their own bodies. Contraception was the envisioned medium for this control.
There were no laws in the United Kingdom to criminalise the opening of birth control clinics nor were there any restrictions on the use or sale of forms of contraception.[7] Therefore, the movement towards freedom in birth control initially developed through ‘soft law’ measures. Soft law in this context included non-binding measures that were not directly legislated by Parliament but by a delegated body and thus did not carry the same weight or authority as primary legislation. For many years there was little recognition in primary law of the need for birth control or even an acknowledgement of restrictions. Local health authorities were authorized by the Ministry of Health to only give advice to women that would be medically ill-advised to have children.[8] Clinics often interpreted the memorandum to exclusively include married women since it was only socially acceptable for them to have children. The right to advice for unmarried women was not recognized in primary law for another 37 years.[9]
By only authorizing giving advice on contraception in a non-binding memorandum, the law reinforced that birth control is part of the ‘private’ sphere of family life. In feminist critical thought, women and their struggles are seen as part of the ‘private’ sphere of family life while men occupy the ‘public’ sphere of work.[10] The lack of desire to legislate and legitimize contraception in the ‘public’ sphere reveals that contraception was inherently part of a woman’s connection to the ‘private’ sphere. While birth control undoubtedly has private dimensions, to view contraception as a purely private issue ignores dimensions that are inherently public.[11] Within the debate on contraception there are debates on medicine, access across class lines, and public safety—all of which necessitate some form of recognition and access in the public sphere. The soft law measures provided flexibility so that organizations could choose to only provide contraception to those ‘proper’ legal subjects—those married women who could be trusted with the responsibility of their own sexuality. This meant access was conditional and those women who did not fulfil certain conditions lacked the freedom to use birth control. Consequently, the conceptualization of birth control as a ‘private’ issue legitimized the lack of access for many women.
Despite the need for engagement with the legality of birth control, the Birmingham clinic did not participate directly in activism after initially beginning their services.[12] Leathard criticizes them for merely providing access through establishing clinics; this short-term goal neglected the long-term aim of persuading the government to make contraception free for everyone[13]. However, in some respects the work they did carry out was fairly revolutionary. They were the first to offer contraception in Birmingham and the significance of this act in the face of opposition from local authorities should not be underestimated.[14] Yet, it is undeniable that the Birmingham clinic did not fulfil its potential to establish access to contraception for all women. Despite desire to provide unmarried women advice, this more ‘controversial’ service was outsourced to Brooks centres.[15] Leathard argues this was so that the FPA was not tainted by association with an aspect of contraception which was considered not ‘respectable’.[16]
Legal progress is not always carried out through controversial and ground-breaking means. While the Birmingham clinic did not directly provide advice for unmarried women, they carried out resistance indirectly. the Birmingham clinic twice sought relaxation of FPA guidelines and also allowed the use of its facilities for a Brooks advisory clinic.[17] This was despite adverse publicity and a legal campaign against the use of the premises for this purpose.[18] Thus while the indirect assistance was not ‘revolutionary’, it undoubtedly provided support for unmarried women to gain access to contraception. This is positive because it provided change for women and made the law easier to live under. The indirect support is open to criticism; in providing those services of their own volition, the Birmingham clinic may have helped transform social perceptions about what is the ‘acceptable’ means of contraception. Progress is not straightforward, however, the lack of engagement with real efforts to change law is problematic. While they did provide access to contraceptives, there was very little engagement with the political struggle that was occurring within the Labour party.[19] If one of the largest family planning organizations had lobbied for legal change, perhaps it would have taken less time to recognize rights in primary law.
Eugenic Themes
A theme that underscores birth control is the idea of contraception as a eugenic tool. Eugenics was an idea that was widely held by some supporters of birth control as a means of improving the population in order to foster desirable characteristics and improve society. While the Birmingham clinic was not directly linked to the eugenics movement—unlike Marie Stopes and her clinics[20]¾many of their donors and supporters supported the movement. In 1927, the Bishop of Birmingham, in giving his support, referenced that ‘the alarming increase among the worse stocks should diminish’.[21] It is necessary to study the undercurrent of eugenics that pervades a topic as seemingly emancipatory as contraception because it illustrates the different experiences of women’s involvement with contraception. Carey argues that voluntary motherhood was supported only for a select few; while middle class, educated women might be capable of utilizing birth control eugenically, ‘ignorant’ women needed strong intervention and control of their sexuality[22].
The freedom that birth control offers can be interpreted in different ways and an intersectional approach recognizes that its availablility did not affect women equally. For working class women, it was often described as a means of control; their lack of control over their bodies in the private sphere combined with their husband’s inability to work in the public sphere, condemned them to poverty.[23] In conducting birth control trials Glenys Bond, the medical officer for the family planning clinic in Birmingham, wrote that pregnancy ‘could not be attributed to the failure of the tablets, but to the patient’s low IQ.’[24] Lower class women who often lacked the level of education that middle-class women possessed, were portrayed as needing stronger intervention in order to control their reproduction. As a result, responsibility was placed on women to be the gatekeepers of their own reproduction and sexuality; failure reduced the legitimacy of their freedom and the desirability for them to reproduce.
The characterization of ‘lower class’ women as ignorant and in need of stronger measures ignored the fact that they faced particular difficulties in using contraception such as lack of privacy, greater responsibilities in the home, and lack of money making birth control inconvenient and unaffordable.[25] The freedom that birth control offered many women could be viewed as a double-edged sword, offering freedom but with the condition of conforming to certain societal expectations. In light of this, birth control, especially with the advent of the pill, represented a welcomed development for women from across the spectrum of society. Many users of the clinic in Birmingham were grateful for the services they provided and the choice it empowered them with.
Later years
Decades later, Lella Florence was pioneering in establishing the first clinical trial of the pill in the United Kingdom by raising the funds and lobbying to have it conducted in Birmingham.[26] The efforts of the Birmingham clinic and its impact on contraception were undermined because it was subject to the authority of the Family Planning Association (FPA). Efforts to open clinics for unmarried women met significant challenges and the clinical trial of the pill was faced with serious opposition.[27] Eventually the clinics became agents of local health authorities as free family planning became available through the NHS.[28] Initially the services were merely for women whose doctors felt they would suffer emotionally, psychologically, or physically through pregnancy.[29] However in 1974, contraception became free under the NHS for all women and the FPA clinics were absorbed into the NHS ones.[30] By 1991, FPA services were completely terminated.[31]
Footnotes
[1] Audrey Court and Cynthia Walton, Birmingham Made a Difference: The Birmingham Women’s Welfare Centre – The Family Planning Association in Birmingham (Barn Books 2001) 6.
[2] ibid 14.
[3] ibid 22.
[4] Audrey Leathard, The Fight for Family Planning: The Development of Family Planning in Britain 1921-74 (Macmillan Press 1980) 9.
[5] ibid 12.
[6] ibid.
[7] ibid 22.
[8] Court and Walton (n 1) 12.
[9] National Health Service (Family Planning) Act 1967.
[10] Stephen Brooke, Sexual Politics: Sexuality, Family Planning, and the British Left from the 1880s to the Present Day (OUP 2011) 6.
[11] ibid.
[12] Court and Walton (n 1) 13.
[13] Leathard (n 10) 288.
[14] Court and Walton (n 1) 14.
[15] ibid 53-54.
[16] Leathard (n 10) 230.
[17] Court and Walton (n 1) 53-54.
[18] ibid.
[19] Leathard (n 10).
[20] ibid 228.
[21] Letter from Bishop Barnes to William R. Darby, 13 June 1927, Papers of Bishop Barnes.
[22] Jade Carey, ‘The Racial Imperatives of Sex: birth control and eugenics in Britain, the United States and Australia in the interwar years’ (2012) 21(5) Women’s History Review 754.
[23] Brooke (n 16) 141.
[24] P Eckstein and others, ‘The Birmingham Oral Contraceptive Trial’ (1961) 2(5261) British Medical Journal.
[25] Court and Walton (n 1) 29-30.
[26] ibid 47.
[27] ibid 53, 47.
[28] ibid 69.
[29] ibid 70.
[30] ibid 84.
[31] ibid 126.