When Marie Stopes died in 1958 at the age of 78 it was still the common belief that contraception was linked solely with the rights and freedoms of women in reproduction. The demographic aspect of contraception world-wide had yet to be appreciated. In fact world population has of course increased enormously since her death and now increases at a rate of one million extra every four days. Marie Stopes left a will of great complexity, leaving much to the Eugenics Society on account of her appreciation of Dr C P Blacker and his work as long time policy initiator of that Society.
So came to the Eugenics Society (now the Galton Institute), in possession and responsibility, the pioneer clinic in Whitfield Street, London, to be managed by the Marie Stopes Memorial Foundation, a subsidiary charitable company of the Society.
The task of the Foundation was held to be not only service to the public via the clinic but research as well, and as a visible Memorial, and that was how we began the seminal investigation and practice of Domiciliary Birth Control.
Marie Stopes had long recognised the efficacy of a mail order business in the sale of contraceptives, realising the importance then of privacy in such matters, and the then inadequate provision through chemists’ shops. In our new Foundation we realised that many in need were averse even to writing or were frankly ignorant. And here came immense good fortune in the zeal, availability and excellence of two most admirable pioneer women doctors, Mary Peberdy and Dorothy Morgan, the one in Newcastle and the other in Southampton. They had realised that in fact (then in the sixties) many women simply would not go to a clinic or chemist for contraceptive help or supplies, however close the facilities. So why not go to the houses of such people.
Thus it came about. The woman doctor of discernment started by going, humbly dressed, and sitting for hours on the doorsteps of large pavement blocks. After a while heads appeared at the windows and looked at the huddled figure down below.
On repetition, the next day, the heads began to talk. ‘‘Silly old woman, why are you sitting there?’’ And then the following day, ‘‘Silly old woman, come in and have some tea!’’ Once inside the house by invitation, the contraceptive subject was broached and willing ears were quickly pricked. Contraceptives were in the visitor’s bag and were found to be wonderfully welcome, and the news spread. We in the Foundation were able to subsidise (from Marie Stopes’ munificence) and provide free contraceptives, and they went like hot cakes. Then helpful paramedics were employed to keep up the good work after the initial phase had succeeded. One’s admiration for those first women doctors, who gained the entry, must be great indeed.
That was a demonstration of the acceptability of a domiciliary contraceptive service. So we then began to work with our heads and initiated a survey of what would now be called cost-effectiveness. We gathered information in detail as well as distributing the free contraceptive supplies and advice. I must stress that in all this activity others did the work: I was merely Chairman of the Managing Board. We were able, after a while, through our subsidised workers and researchers, to get figures which demonstrated a great deal. In essence we viewed a hundred women in mid-reproductive phase and found out how many children they had had in the last three years, and so sadly many of them not wanted at all. Then we found how many further children these same hundred had in the subsequent three years while we supplied them free with the means of limitation. The product was extremely few. Thus we were able in a way to calculate the number of children ‘saved’, that is to say who were not wanted and were not born at all because of our help. Then we made further investigations, and calculated the cost of the maternity benefits for the children born in the previous three years, the costs to the health service in after care, the cost as to the rate payers in taking so many into public care, to say nothing of education costs. And, I repeat, so many of those children had never been wanted. So here was real monetary saving when further children, with our help, were not born in the second period of three years. All the savings were balanced against the costs (originally provided by the MSMF) in the salaries of the pioneer medical women and then their follow-up social workers, and the wholesale costs of supplies. The true economic ‘saving’ was substantial indeed.
So at that stage we got in touch with the local health authorities and gradually the idea was sold. Then in several instances a local health authority (particularly Camden and Westminster) agreed to proceed itself (or use us as paid agent), making its own public savings by itself supplying the people and the contraceptives; and the unwanted children born were all the fewer. That was a job well done indeed. Our minor affluence had enabled us to be true pioneers: now others must keep up the good work.
In parallel our Clinic for long maintained the Stopes’ postal supply service; and we even were able (with kind volunteers) to undersell the chemists and yet make a profit to be turned back into the costs of demonstration and research.
The early Board membership in the MSMF and this special task, were Alan Wyborn as Marie Stopes’ Executor, Margaret Pyke of the Family Planning Association, Cedric Carter, (Lady) Helen Brook (later to lead the movement to help the younger women), Faith Cox (née Schenk) the administrator in the Eugenics Society, and myself, General Secretary of that Society as Chairman. John Peel came in at a slightly later stage.
This was a wonderful demonstration as to what a minor affluence can achieve in practice and research. At the same time, I fully believe, we were instrumental, via Margaret Pyke as its sometime President, in leading our Family Planning Association to the wider demographic importance of their good work.
It may be added that the MSMF archive is now in the safe keeping of the Wellcome Institute for Medical Research.
Colin Bertram