Gynaplaques and contraceptives available in India

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The Margaret Sanger Papers
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March 28, 2011, 10:51 a.m. (view history)

Sanger gave Indian doctors 15 gynaplaques, 3-dimensional models of the female reproductive system which could be used to demonstrate use of contraceptive methods.

She mentions going after the big rubber company in Trivandrum to make sponges and pessaries.

Handwritten at top: "Each place they were left might be considered a clinic."

Phillips distributed 5 in Bombay (names are there); Pillay was given 6 to deliver; Phillips was "pretty sure" of three others. 7others were mailed out, sometimes people got more than one. Four others were left at clinics and medical groups; one in Penang, -- this would only be the ones given out by Sanger, not How-Martyn.  Accounts for about 25 of them, spread in 15 cities.

"It is very difficult to use a Mensinga pessary in India. Because most of the women here are not willing to go clinics & get the instructions of fitting pessary even from a lady doctor. The same case with douch. They find very tiresome to take it. Hence we are advising them Rubber spong size of 2 1/2" diameter & 3/4 1.2" thickness to insert before coitu, after removing it to clean the vagina from inside and outside with another piece of spong rubber. The [side] is smeared with contraceptive jelly & the wash is given by foam forming lotion."

"We are not getting rubber  sizes of 1 1/2 " diameter 1/2" thickness; so we cut them from bath cakes of rubber sponge. But it is a tedious business we don't get caked to satsifaction & always find the difficulty of getting good sizes can we get it from any rubber sponge manufacturers from America. If he will send two gross (288) for sample through his agent here I will pay him the money   or I will send it through a Bank."

" Foam Powder We are preparing foam powder by mixing tartaric acid and with Sodium Bicarb but some women find it irritating to the mucous membrane of vagina. "  Asks for a recipe for foaming powder lotion.

Mentions the oil of the seeds of the Neem tree (Media Uzadeitachta/Margosa Tree) has been used in villages. "They  dip a cotton tampoon in the oil & insert it in the vagina before coitus. The oil has very bitter & nauseating smell. Does the oil tampoon only act as a mechanical [illegible] or Has it got any spermicidal power?"

Letterhead of the Miraj Social Service Centre.

Notes earlier letters to Journal of Contraception and their request for the JOC's impressions of "spermbar" the contraceptive that they have made. They sent a box and the recipe.

They wanted Abraham Stone to test the contraceptive, get an American evaluation, and offered to pay for the test.

"At present good many quacks are selling their pills & powders under the name of contraceptive & hundreds of people are  cheated by them. Our spermicidal jelly is prepared according to the formula published in the Journalf of Contraception & we are sure that theer will be no doubt about it efficasy.  The certaificates from your Journal & American medical association will have impress the minds of the people of India & they will be saved from cheating."

Says they also sent to Pillay, who promised to let them know once the test results are in.

Sanger asked her to write to Murti because she is very busy. Wants to meet him when she comes to Hyderabad, est. Jan. 21-22, "and perhaps after hearing her speak you will find that she has given you the way to make your work reach the mothers of the lower and lower middle classes who are most in need of birth control advice.

Mrs. Sanger has been trying to have the Bombay Surgical Company, and Charni road, Bombay; Lynch, the chemist, in Calcutta, and several other companies in India put on the market a new foam powder which has successfully tried out in the United States and which is cheap enough for even the villagers of India." Asks him to write to Bombay Surgical Co. later to see whether they have been able to stock it.

Another list of Indian doctors names, some of these are the same as the Palmer list, but notes that A. P. Pillay also delivered  some to a list of 9 doctors and social workers. Includes Kapila Khandvala , J. Mehta of KEM Hospital in Bombay.  Notes that MS kept one with her, they in her handwriting the fact that she gave plaque and supplies to Naidu of Hyderabad.

Notes also that foam powder was sent to three doctors in Calcutta, Allahabad, and New Delhi.

"The main difficulty in the way of contraception in India is of getting contraceptive pessaries. Most of the pessaries sold in the market are made in England and Germany. The [first] custom duty is the profit of merchants make the contraceptive costly & hence the poor people cannot afford to purchase them. Because the price of each soluble pessary is equal to their daily income. If the pessaries will be prepared here they will be cheaper & the poor can easily purchase them. So please send me a book which will give in detail the process of preparing soluble & other pessaries."

[342] "The number of educated Indians, who are practising birth control, is probably growing but even then they find it difficult to get advice from qualified doctors or the necessary clinical assistance. Practical interest in the subject is increasing among them but facilities for satisfying the demand for expert advice, which is the direct result thereof, are almost non-existent. The books of Dr. Marie Stopes and several other books on the subject, including some vernacular books written by authors of very doubtful authority, are finding a large and steady sale. They serve a useful purpose; but cannot take the place of expert advice and on that account failures, in spite of the use of contraceptives, are more common than they need to be and in some cases are followed by distressing results. Use of these methods without competent guidance cannot but be harmful in a large number of cases and it likely to retard further progress of the movement or strengthen the case against it. And of course it has not touched the masses at all. They are ignorant of the fact that avoidance of unwanted children is possible and have neither the desire not the knowledge and means to prevent their being born.

"This is the crux of the birth control problem in India. So far the movement has met with very little opposition; but it cannot be assumed that it can become a mass movement without stirring up dormant prejudices and have arrayed against it dogmas and authority of the priests of every religious community in India. The major communities do not profess allegiance to any religious head like the Pope whose damnation of the movement might create insuperable difficulties along the way. But India is still a priest-ridden country and the priesthood cannot be left out of account as a factor potentially hostile to the [343] movement if an attempt is made to carry its message to the masses and convert them into being its supporters. To reach them in order to win their sympathy and active co-operation is itself an extremely difficult task. They cannot read any literature on the subject because of their illiteracy, and the powerful political organizations like the Congress and the Muslim League, which have influence over and access to the masses, will not lend support to the movement. In no country of the world have the politicians openly associated themselves with birth control. Its advocacy is a bad political strategy and results in the loss of votes. In India the confidence of the masses is even more difficult to win and retain, and at a time like this  when the struggle for political freedom and power is in progress, no political party or politician of any consequence will risk the loss of supporters, who otherwise might be with them, by advocacy of a cause like birth control...."

"But an even more serious difficulty in making birth control a practical proposition in India for the masses is that of suggesting a suitable contraceptive and providing an agency for teaching them how to use it. A perfect contraceptive is still to be found. The contraceptives in use in other countries are not absolutely infallible and call for intelligent co-operation on the part of the users. They are also open to criticism owing to their requiring a certain measure of preparation in advance and therefore interfering with the spontaneity  and un-premeditation of the sexual union. A simple, absolutely certain, fool-proof and aesthetically satisfactory contraceptive has not been made available yet. In India the people are [344] ignorant, their conditions of live primitive in the extreme and of course poverty-stricken. A contraceptive that will be acceptable to them an can be popularized must be within their means, should not be complicated in the least and should be effective and satisfactory otherwise. In spite of the fact that the birth control movement has been in existence for over sixty years in the West and has produced revolutionary results, all birth controllers agree that the methods now in use are imperfect and must be improved upon."

[76] Chapter on "Birth Control--Technical Aspects." He divides them by male or female used.

Male: Says that coitus interruptus is probably still the most widely used today, "because it requires no apparatus or preparation, costs nothing, and is always available." Says it works for those who are disciplined in approach, but some question its effect on health and mental health.  [77] "Some go to the extent of dismissing this method as being the easiest way to make husbands and wives nervous wrecks."

[78]Karezza, or coitus reservatus  is based on prevention of orgasm during sex, popularized by Alice Stockham and the Oneida community. Says that there is division over whether this too is unhealthy, but all agree that it requires "men of sound and well balanced nervous systems."

[79] Sheath, extensively deployed for venereal disease prevention, Chandrasehkar calls it a "satisfactory, reliable and harmless method. But the sheaths may be of an inferior quality or defective. Sometimes the method may cause physical discomfort or interfere with normal sexual response."

General objection to all these methods is that "they make the woman dependent on the man for protection in a matter that affects her own health most vitally. Should the husband be indifferent or careless or in an irresponsible position, the wife subjects herself to grave risks. This is one of the reasons wh methods [80] for the prevention of conception which can be used by the wife are generally considered to be the methods of choice today.

Chemical methods: Notes that there are contraceptive jellies, which while "effective in preventing conception, it is not absolutely reliable.  In fact there is no chemical contraceptive which is completely reliable and effective."

Best method prescribed in England and US is the diaphragm and jelly, individually fitted to the woman, requires gynecological visit for proper fit; easy to teach, and "highly reliable and satisfactory method." Does not interfere with marital life; doesn't impair future fertility. [81] "But the difficulties of this method in Indian conditions can be readily seen. As the method involves an individual medical examination and instruction, requiring a competent doctor within the reach of [82] rural and urban mothers, the cost in setting up the necessary clinics and providing them with doctors and equipment would be prodigious. Even after this initial expenditure, there is no guarantee that needy mothers could afford the cost of the necessary equipment, even if the clinic consultation were free.  Shocking as it may seem, in many rural areas the cost of having a baby would be cheaper than the price of birth control equipment. Unless and until the Government is prepared not only to give free clinical advice but also to supply equipment free of cost this particular method cannot be acceptable to the average rural mother in India."

[82] Sterilization is the cheapest and safest method of birth control today. Both men and women can be sterilized; male surgery (vasectomy) is simpler, but the women's (salpingectomy) is relatively major operation.  Doesn't impact sex instinct or pleasure. Superstition in the country that there is a "un-sexing effect on the male. This of course is not true."  Any father of 2 or 3 (or any man) can undergo the operation; should he lose his children, of course, he could not have more. But the fact that he has decided to have only 2 or 3 [83] enhances their survival chances. If his wife dies and he remarries, he cannot have children with the new wife. But again, this will be less likely to happen if women are not constantly bearing children. It should be chosen voluntarily by men who want a technique of permanent  conception control, as it is usually impossible to undo. In "cases of epilepsy, insanity, leprosy or mental defectiveness, the state might explore the possibility of compulsory sterilization as an eugenic measure. This would prevent the transmission of undesireable genes and the quality of the population could thus eventually be raised."

Biological Contraceptives Research being done on a biological contraceptive, [84] which would work on "the prevention of either ovulation, spermatogenesis, fertilization or the implantation of the fertilized egg. Also work done on "inducing temporary sterility in the female through hormonal control." Animal studies are underway. Also work done on Native American plant (lithosperm) that seems to control fertility. Pill is under study in the U.S., "It has to be taken for twenty days of the menstrual cycle. Secondly, the pill is very expensive. It is not realistic to expect mothers in India and other underdeveloped countries to be able to afford these pills even if they were available, or to have the necessary discipline to take them regularly." They need  a cheap pill  "which need be taken only once or twice for the desired conception control."

[97] The Trivandrum Rubber Works - "This factory situated in Trivandrum was the first of its kind in India. The Rubber Factory was opened as the Travancore Government Rubber Factory under the full management of the Government of Travancore on August, 17, 1935."