From its inception a century ago, the birth control and family planning movement has presented Jekyll and Hyde faces. The movement's contribution to the liberation of women from perpetual childbearing, families from mistimed children, and societies from rising fertility beyond what environments could absorb must be regarded as one of the crowning achievements of health science and politics. A truly optimistic trend has been the "demographic transition," in which rising prosperity produces falling birth and death rates, promising a safer, less starvation-edged future.
The sinister face of family planning and birth control is eugenics—that is, efforts to improve a society's "population stock" by preventing the births of babies of disfavored populations. "Negative eugenics" is defined by Merriam-Webster's Medical Dictionary as the "improvement of the genetic makeup of a population by preventing the reproduction of the obviously unfit." "Positive eugenics" consists of encouraging the fit to breed.
Early family planning leaders expressed eugenics goals. "Birth control must lead ultimately to a cleaner race," declared Margaret Sanger, pioneering contraception advocate and founder of Planned Parenthood, in the early 1920s. "Eugenics is ... the most adequate and thorough avenue to the solution of racial, political and social problems." Planned Parenthood points out that Sanger also affirmed "the principles that a woman's right to control her body is the foundation of her human rights," "created access to birth control for low-income, minority, and immigrant women," fought the repressive
Comstock laws banning information about sexuality and contraception, and established the first family planning networks. As for Sanger's advocacy for eugenicist policies,
Planned Parenthood Federation of America finds these views objectionable and outmoded. ... However, attempts to discredit the family planning movement because its early twentieth-century founder was not a perfect model of early twenty-first-century values is like disavowing the Declaration of Independence because its author, Thomas Jefferson, bought and sold slaves.3
By the same token, it is doubtful that all but the most extreme conservatives today would identify with their famous puritan forbear, Anthony Comstock, who boasted of destroying millions of books and causing suicides. Sanger's work ultimately was endorsed by such African-American elder statesmen as W. E. B. Dubois and Martin Luther King.4
Sanger's views were very much in line with progressive scientific thinking of the early twentieth century that embraced new medical technologies and intelligence testing as tools to improve the quality of the American population through selective immigration, education, and family planning policies. Many intellectuals and professionals then held what we now would consider racist views on eugenics alongside liberal views on sexuality. American Psychological Association president H. H. Goddard spearheaded a movement to deport "mentally defective" immigrants and demanded that the "feeble minded" as demonstrated by psychometric testing be forcibly prevented from breeding. In particular, Goddard deplored the fiscal "charges upon the state and community"—that is, the "social costs"—caused by allowing "inferior" parents to bear children and perpetuate "the menace of moronity" from generation to generation.
The dominant scientific view of the time held that sexuality education, contraceptive provision, abortion, and sterilization could reduce or eliminate reproduction among lower-class and "feeble-minded" populations at the same time it optimized the timing of fertility for middle- and upper-class couples. Family planning could improve human stock across populations, within races, and within families. The Supreme Court even endorsed negative eugenics in its famous "three generations of imbeciles are enough" decision (Buck v. Bell, 1927), upholding a Virginia law requiring sterilization of the mentally "unfit" for "the protection and health of the state."6
The next half century brought a withering attack on eugenicist notions of branding entire classes of people and their babies as inferior. Nazi Germany's experiments in medical genocide added to the discrediting of negative eugenics. Voluntary family planning remained an entirely different issue; medical advances in contraception and legalized abortion would help individual couples time pregnancies and reduce childbearing risks. However, the notion of deploying family planning to cleanse the population of inferior children based on broad demographic classifications was rightly seen as too vulnerable to temporary political prejudices supported by bad science.
Or was it? Fast-forward 50 years. By the 1980s, groups promoting family planning that included adolescent health had expanded substantially across the country. Every major urban area and many smaller ones provided access to accurate information and confidential, high-quality reproductive health services. At first, family planning advocates measured success in terms of reducing poor health outcomes. Indeed, maternal and infant mortality, babies' complications, and other sexual health problems had declined rapidly as services improved.
By the mid-1980s, however, an uglier trend was emerging in some segments of the movement, employing the same prejudicial language and grossly biased "science" of early-century eugenicists. New eugenics lobbies (which certainly do not term themselves as such) at the state and national levels began emphasizing the "social costs" of teenage motherhood. This chapter explores the misuse of research and the political deception involved in selectively exploiting social-cost notions to produce arguments against teenage child-bearing that are virtually identical to the nineteenth century's racialized eugenicist arguments. New eugenicists do not mention race directly, but it looms large when the demography of the group targeted is considered.
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