In Honor of Women’s History Month, We Remember Hannah Stone

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birth control, birth control methods, history, margaret sanger, reproductive rights, women

When we remember the birth control movement, we must commemorate the extraordinary women who willingly risked so much for the advancement of such a controversial movement. For these activists, giving all women new access and opportunities to contraceptives meant more than their own potential individual  advancements. Dr. Hannah Mayer Stone embodied this type of dedication. Chosen by Margaret Sanger in 1925 to be the head physician of the Clinical Research Bureau, Dr. Hannah Stone would prove to be dedicated not just to the cause, but also to the over 100,000 patients she saw during her time at the clinic.

Hannah M. Stone

While she defied the norm with her passionate involvement with the movement, Dr. Hannah Stone surpassed traditional 20th century women’s roles all her life. Born in New York City in 1893 as the daughter of a pharmacist, she went on to receive a degree in pharmacy from Brooklyn College in 1912. Following this, she attended New York Medical school, receiving her MD in 1920. In 1921, she attended the first American Birth Control Conference, where she met Margaret Sanger. Sanger opened the Clinical Research Bureau in 1923, and two years later she needed a new physician.Dr. Stone was already a member of the medical advisory board for the Clinical Research Bureau when Margaret Sanger offered her the position of physician. As she had this prior involvement, her interest in the birth control movement was known. Dr. Hannah Stone would work at the Clinical Research Bureau, which was later renamed Birth Control Clinical Research Bureau in 1928, for 16 years without receiving compensation.

The main purpose behind the establishment of the Clinical Research Bureau was to do more than just administer birth control to patients; it was to also prove the effectiveness of different types of contraceptives through detailed record keeping. Dr. Stone handled both tasks methodically. By the end of her time at the clinic in 1941, she had helped over 100,000 patients and she had maintained a record for each one. But aside from just being thorough, Dr. Stone was compassionate and understanding with her patients. Her demeanor led her become known as the “Madonna of the Clinic.” In her writing, Sanger expressed her adoration of Dr. Stone. She commented on her attributes, listing  “her infinite patience, her attention to details, her understanding of human frailties, her sympathy, her gentleness” as reasons that she was invaluable to the work of the clinic. Dr. Stone understood the value of her work at the clinic, not just in her interactions with patients, but also with her responsibility of compiling data about her patients. During her 16 years of service to the Birth Control Clinical Research Bureau, Dr. Hannah Stone was able to leave a profound impact. Her detailed records helped the movement discover that the most effective method of birth control was the diaphragm used with spermicide. She later published some of her findings in “Therapeutic Contraceptives.” This article was one of the first involving birth control to be published within a medical journal.

Her passion for helping women extended past the realm of birth control. Dr. Stone and her husband, Dr. Abraham Stone counseled couples with relationship and sexual problems from within the clinic as well. This began casually, but it developed into the more formal Marriage Consultation Center which was ran out of the clinic and a community church. Through this work Dr. Stone again acted as a trailblazer, as these marriage counseling sessions had not been done in this manner before. In 1935, Dr. Stone and her husband were able to publish their counseling techniques in a book entitled A Marriage Manual.

From left: Sigrid Brestwell, Antoinette Field, Elizabeth Pissort, Margaret Sanger, Hannah Mayer Stone, and Marcella Sideri

Dr. Stone’s association with birth   control often caused her to put the movement’s progression ahead of her own career, as her work at the clinic cost her many opportunities. She had been working at the Women’s Lying-In Hospital when she first started to work for Margaret Sanger at the Research Bureau Clinic. Her new work at the clinic caused a conflict with her the Women’s Hospital and they asked her to give up her newly acquired position. She refused this request, and as a result she was asked to resign from the Women’s Lying-In Hospital. This would only be the first of many times where her work at the clinic would prove to be a detriment to her career. Later, in 1929, Dr. Stone was arrested with four others when the Research Bureau Clinic was raided. Although the charges that were brought against her were later dismissed, the picture that was taken of her in handcuffs permanently damaged her record. Dr. Stone felt the full impact of this when she applied to admission to the New York Medical Society in 1932, and her application was tabled. She continued to take risks for the movement, including her involvement with the test case US v. One Package, when a package of Japanese pessaries were shipped to her and later seized. This case ended up being monumental, as it was the first step in legalized birth control. Despite her involvement with the birth control movement, and the clinic itself proving to be a detriment to the furthering of her medical career, Dr. Stone’s dedication to the cause never faltered.

Dr. Hannah Stone died suddenly of a heart attack in 1942 at the age of 48. Her loss was deeply felt at the clinic, as she had dedicated so much of her time to assisting the patients. She was replaced by her husband, who carried on her legacy and dedication to the cause. Dr. Stone is remembered for her kindness, and her groundbreaking work. She was well respected for her tremendous knowledge on administering effective contraceptives. Thousands of medical students and doctors alike came to the Research Bureau Clinic to learn her methods. Even though Dr. Stone was recognized for her greatness, Margaret Sanger wrote extensively on her humility. She did not crave attention or recognition, and often others took responsibility for her advancements.

As a doctor, Hannah Stone was a trailblazer. As a woman, she exceeded the expectations society had for her at the time. But it is her selflessness that is most inspiring. Dr. Hannah Stone dedicated nearly her entire career to serving women and the birth control movement, and despite her vast achievements she never sought recognition for them.

Sanger and the Ever Elusive Male Birth Control

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birth control methods

From pills, to implants, to patches, Sanger would be awestruck at the variety of birth control methods available to women today. Many women are now able to choose the birth control method that best fits their needs and lifestyles. For Sanger, who believed that “no woman can call herself free who does not control her own body,” this would have been a huge feat, despite the drawbacks of these methods. Birth control can be expensive and comes with an array of side effects, ranging from mood swings to heart attacks. In fact, for many women today, there is still a great deal to be done in terms of access to safe and effective birth control.

One avenue that has been largely unexplored until recent years is male birth control. Early advocates of birth control, including Sanger, were not very enthusiastic about male-controlled methods, which at the time, included condoms and withdrawal. Sanger felt that these methods “placed the burden of responsibility solely upon the husband – a burden which he seldom assumed.” Instead, the women who came to her were seeking “self-protection she could herself use, and there was none.” In other words, women did not feel comfortable trusting their husbands with birth control, and sought a way in which they could, in a sense, arm themselves from unwanted pregnancies. Thus, the emphasis of female birth control methods has its roots in the early years of the birth control movement. Female-controlled methods such as diaphragms became popularized by the birth control movement because they gave women agency in their reproductive lives.

A condom made out of caecal, or animal gut membrane, c. 1910. (Courtesy of the Science Museum, London)

Additionally, there is reason to believe that Sanger’s focus on female-controlled methods was a strategic move on her part. Women who relied on condoms for birth control did not need to visit birth control clinics. Sanger would have seen this as an immeasurable loss, because birth control clinics were often the only way women became adequately educated on their health and sexuality. The need for clinics also helped legitimize birth control as a public concern that was deserving of acceptance and state-sponsored support.

However, now that is has been over a century since Sanger’s first publication of “Family Limitation,” the issues women face when it comes to reproductive rights have evolved. Enter male birth control. Specifically, Vasalgel. According to the Parsemus Foundation‘s website, Vasalgel is a “long-acting, non-hormonal contraceptive similar to vasectomy but with one significant advantage: it is likely to be more reversible.” It involves injecting a gel into the vas deferens in order to stop the flow of sperm. Vasalgel can be flushed out through a second injection if one wishes to restore their sperm flow. Although it could be a while until Vasalgel passes clinical trials and makes it way on to the market, the public’s increasing interest in this type of birth control shows us that we have come a long way since the start of the birth control movement.

Image courtesy of the Parsemus Foundation

The possibility of safe, effective, and long-term male contraception reveals a cultural shift in the way that we see birth control. It is no longer solely the woman’s burden to prevent unwanted pregnancies. Vasalgel shows us that men are starting to be held accountable as well. Although Sanger was against male-controlled contraceptives in the early years of the birth control movement, one could argue that products such as Vasalgel and what they tell us about how far we have come in terms of reproductive rights would certainly impress her.

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For more information on Sanger’s stance on male birth control, check out these sources:

• Margaret Sanger, “A Parents’ Problem or Woman’s?,” March 1919
• Margaret Sanger Papers Project Newsletter, “The Lowly Condom–Sanger’s Missed Opportunity?,” 1997

#SayVagina: Legislating Women’s Bodies, 1932

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Abortion, birth control methods, documents, Politics

Our Facebook feed this week has been overflowing with jokes and outrage about the Michigan State Congress where Rep. Lisa Brown was banned from speaking on the floor after saying “vagina” in a debate over an abortion bill. Brown’s sound response: “It’s an anatomically correct term for woman’s anatomy. It actually exists in Michigan statutes in three different places. This bill was about abortion. That doesn’t happen without a vagina.” Unsurprisingly, male lawmakers’ discomfort about speaking openly about the very bodies they are attempting to regulate is not new. In 1932, Margaret Sanger went to Washington to lobby against a provision in the Comstock Law that categorized birth control information as obscene and punished those who distributed it, including health care professionals (seriously). Below are two passages from her papers that illustrate some of the all-to-familiar attitudes she encountered there.

Sanger lobbying Congress, 1932

American Woman’s Association Award Speech, April 20, 1932:
“We found that the great difficulty was misunderstanding. We further found that the great majority of these men were both badly informed and misinformed. Of course, we found that the younger men, some of the newer ones, knew something of the pros and cons of birth control. One could easily know that by the size of their own families. But when it came to asking for a law to allow others to have the same privileges that they had, the subject became a serious one that had to have their due consideration.”

Letter to Mary Hope Macaulay, May 21, 1932:
“But Mary dear their arguments grow weaker, they put up a very poor case this time never have we so thoroughly aroused the people as this year. Thousands wrote to Congressmen and oh Mary such letters!! Many of them classics. Just to arouse people to ask, to demand this right makes me feel the victory is near. And oh Mary you would love to see the look on the men’s faces… when I replied to pertinent questions & talked about “douches” — Their faces were scarlet! Poor darlings they wanted to escape but they had to sit & listen to what women endure. I read letter from Mothers & their old tired eyes were moist & I knew they understood & were moved.”

The “Tech” of Safer Sex and Reproductive Technology

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birth control methods, Saturday Night Live

This video has been making the rounds since the weekend. It depicts an advertisement for “Lil Poundcake,” whose hair smells like frosting and who comes with accessories like a cell phone and earrings that her human friends can wear too. She is also equipped to administer the three shots over a six-month period that make up the HPV vaccine.

Shockingly (or perhaps not, if you speak satire/happened to watch Saturday Night Live this week), Lil Poundcake is a parody, designed to poke fun at the “HPV wars” that have been taking place during the Republican campaign for the Presidential nomination. It’s a humorous way of drawing attention to the hysteria surrounding the HPV vaccine and proposals (or legislation, where such legislation exists) to make it mandatory for all students – sometimes just female students, sometimes female and male – of a certain age.

One of the more striking things about the video is just how much it highlights the fact that when it comes to safer sex and reproductive health technologies, the delivery methods may have advanced (lower doses of pills than in my mother’s generation, condoms that “feel as though you aren’t using one,” silicone rings administering the same synthetic hormones in birth control pills) but the basic building blocks are the same. Even though there are advances being made (the much buzzed-about “male birth control” comes to mind), when it comes to contraception there are precious few options to choose from – and I recognize that I, living comfortably and legally in a medium-sized city, in a country with accessible health care provided by the provincial government, am coming from a place of serious privilege. If Margaret Sanger were to walk through a sexual health centre, she would most likely recognize most of the devices and methods on display as current – rather than former – birth control methods.

Over at RH Reality Check, Kirsten Moore has a great post up about the differences in technological advancement between smartphones and contraceptives, arguing that if consumer demand for advancement in one mirrored that of the other, the safer sex and contraceptive product market would look quite different:

The opportunities for innovation in products and services are as varied as the women and men who need them. There is no one silver bullet (or pill, or condom) when it comes to contraception: each woman is different and has unique and changing life circumstances. As consumers, we need to talk about what we like, what we don’t like, and what we wish we had when it comes to birth control.

Keeping safer sex and reproductive health technologies out of the public discourse – except to demonize and discredit them – does nobody any favors.

Sanger worked throughout her entire life to improve the accessibility and caliber of birth control in the United States and globally, using methods as diverse as government lobbying for increased research efforts and, when necessary, smuggling. Why, then, should we assume that what we have is “good enough,” and stop asking for something better?

Without open discourse about what works, what doesn’t, and who likes to use what (and for which reasons), there is no room for innovation. There is no question that for many, many people, the barriers to accessing what is actually available are financial, physical, and social. It is, however, possible to improve access to what does exist without forgetting to keep an eye on what might be coming over the horizon.

We got the sheath

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birth control methods, condoms, Robert Latou Dickinson

Illustration from Norman Himes and Abraham Stone, "Practical Birth Contrtol Methods," (1942).

Before Kinsey, there was Robert Latou Dickinson, a prominent gynecologist and sex educator who, among other things,  founded the Committee on Maternal Health in 1923. This committee aimed to gather clinical research on contraception, sterility, and abortions–a true, if not precarious novelty given the time period– and then report their findings.

In the course of my research here at the Sanger Papers, I recently happened upon the committee’s first report, written by Dickinson himself and printed by The American Journal of Obstetrics and Gynecology in November of 1924. And while some of its contents are laughably outdated (someone seriously recommended tampons as a viable form of contraception) there are moments that still ring with relevancy.

Take for instance, this discussion of the condom, or what was then known as the “sheath”:

“The sheath maintains its conspicuous place as the best known and simplest measure [of contraception]. It is believed to be trustworthy under four stipulations. These are good quality; testing; lubrication; and a medicated douche (such as one-fourth vinegar) available in case of slip or break. It is very commonly refused by the feebly virile and the selfish” (italics are mine, 9).

Amen, Dr. Dickinson.

This sharp insight also reminds me of the most recent national survey of sexual health and behavior, conducted by a group of Indiana University Researchers, and published in early October of last year. Although the study was funded by the makers of Trojan (which means we ought to take the next bit of info. with the tiniest morsel of salt), it found that 60%-80% of teens used condoms during their most recent sexual encounter. A sign perhaps, that the “sheath” is on its way to the kind of reputation public health officials would like it to have.

The study also noted however, that while the kids are alright with condoms, their parents and grandparents remain way behind the times. In fact, the study showed that two-thirds of those 50 and older take no preventive measures against STDs. This is not what the good doctor ordered.

Margaret Sanger was not a big fan of the condom, or any other contraceptive method that left control in the hands of men.  In her 1920 Woman and the New Race, she argued:

“In an ideal society, no doubt, birth control would become the concern of the man as well as the woman. The hard inescapable fact which we encounter to-day is that man has not only refused any such responsibility, but has individually and collectively sought to prevent woman from obtaining knowledge by which she could assume this responsibility for herself.  She is still in a state of a dependent to-day because her mate has refused to consider her as an individual apart from his needs.  She is still bound because she has in the past left the solution of the problem to him. Having left it to him she finds that instead of rights, she has only such privileges as she has gained by petitioning, coaxing and cozening. Having left it to him, she is exploited, driven and enslaved to his desires.” (pp. 96-97)

(For further information on the IU study, see Shari Rudavsky’s “Major sex study reveals wide range of behaviors in USA” at http://www.usatoday.com/yourlife/sex-relationships/2010-10-04-sexsurvey04_ST_N.htm)