The concept of "cultural diffusion" begs all the important questions of how ideas and practices get transmitted from one class or group to another and how those ideas get accommodated and transformed under different circumstances. "Cultural" theorists of fertility trends assume that techniques get introduced among elite groups and then, by means never quite specified, make their way down the social hierarchy.83 We have seen, however, that effective methods of "family limitation"—including abandonment and abortion—were widely practiced among the poor and working class in preindustrial France, for reasons growing out of their economic and social conditions. Family limitation, both as an ideology and as a set of practices, was never exclusive to the dominant classes nor imposed by them unilaterally and coercively on the poor. Some demographers argue that the high incidence of abandonments in the late eighteenth century is itself evidence that birth control methods were not available to these parents. Yet this assumption is puzzling, given other evidence that various "potions of sterility" and abortifacients were, available in towns and villages, purveyed through the local midwives and crones.84 Indeed, a central part of Moheau’s complaint is that the law making abortion and infanticide punishable by death (which dated from 1556) could not be enforced and that the lives of fetuses, in the countryside as well as the cities, were jeopardized because "their mothers form homicidal motives against them."85 A survey of French physicians from all over the country found the commonly held view that "charlatans and empirics contribute to the country’s depopulation…" and that "the matrons and ‘so-called wise women’" were particularly responsible.86 The occasion for the distribution of "drugs and. . . balms,. . . purgative pills, poultices, herbs" was often the small-town fair or market—in other words, meeting places frequented by ordinary folk. Even allowing for the biases of physicians, who campaigned against "charlatans" and midwives throughout the late eighteenth and nineteenth centuries, there is no reason to believe these reports are false.
Aside from anecdotal evidence, there is another, more inductive way to think about the importance of abortion to declining preindustrial fertility rates. For we cannot account for a decline that is national in scope by referring to cultural mentalites and habits that affected only a small segment of the population or to a method as notoriously ineffective as coitus interruptus. McLaren makes the compelling argument that even in the absence of direct evidence, we must assume the importance of abortion in preindustrial contexts where marital fertility is known to have been low. For the premodern contraceptive methods most likely to have been used, especially coitus interruptus, have very high failure rates. A "rise in contraceptive practices" and a decline in fertility in such situations must have been "accompanied by an increase in abortion" used as a "back-up method."87 The evidence is that abortion was traditionally, and remains today, a more "female" method of fertility control and a more popular method than many forms of contraception. The relative importance of abandonment among the poor in late-eighteenth-century France may be exaggerated because foundling homes collected the evidence, whereas abortions were lost to history. At the same time, abortion use appears to have been specific to particular conditions; it was not uniformly available in all regions or among all occupational groups. It is the nature of this specificity we must try to understand.
By the late nineteenth century, a now vigilant and powerful medical profession provides us with more systematic reports about contraceptive and abortion use. A number of reasonably effective mechanical methods of contraception—sponges, pessaries, rubber condoms, sheaths—were used among middle-class couples. Most sources, however, tell us that these methods, and the private physicians who distributed them, were too expensive for poor and working-class women; besides, they often had husbands who were hostile to contraception.88 French working-class women, whose birthrate continued to decline in this period, had little choice but to rely on abortion:
If there was no education to provide or fortune to pass on, family size restriction would be primarily the woman’s concern, especially if she controlled the family budget. And to control fertility, she did not wait passively for new information, but took advantage of whatever means were already at her disposal including inducement of miscarriage.89
The question of the health dangers posed by various abortifacients common among poor and working-class women is ambiguous. On the one hand, it seems clear that such women were forced to rely on "home remedies" and "quack cures"—drugs that sometimes contained poisons (such as the lead-based Diachylon), knitting needles and quills, or injections of harsh substances such as Lysol into the womb—because they had no access to physicians and antiseptics (even after antiseptics were in common use for other purposes).90 Nevertheless, it is not certain that such home remedies are always dangerous; drugs in small doses or even a sharp implement—if sterile, used carefully, and in an early stage of pregnancy—were apparently effective without serious injury to the pregnant woman.91 A survey of one hundred patients by a Berlin doctor in 1919 regarding their birth control and abortion methods contains references to many "folk" methods reported to have been effective abortifa — cients, apparently without dire consequences: hot baths, jumping off chairs and stools, douching with soapy water or Lysol, using a commercial "period remedy," drinking various drugs and teas, and "[poking] around with a quill a little bit until blood came and then a doctor scraped me out."92
Because of insufficient evidence, it is probably impossible to make a definitive judgment about risks and mortality in the days of illegal abortions. But the extent of risk is not my point. Rather, two things seem clear about abortion in the nineteenth century. First, the cause of fatalities had less to do with medical technology than with medical politics and economics—the distribution of knowledgable and decent care. Second, whatever the risks, women wanted and sought abortions. Far from being pushed on women by quacks and hucksters (although some ineffective or useless methods undoubtedly were), abortifacients were "diffused" among women because women demanded them, often knowing there was danger. It is simply incorrect to assume that, prior to the availability of safe (i. e., antiseptic) methods, abortion was an infrequent mode of fertility control.93
This is dramatically illustrated in accounts about working-class women in the 1890s and during World War I in England who took pills containing lead or deliberately exposed themselves to lead in factories in order to induce miscarriage or sterility. Such examples call for detailed examination because they reveal something important about "cultural diffusion" among working-class women. An outbreak of lead poisoning in Sheffield, owing to contamination of the local water supply, gave women the information that small amounts of lead acted as an abortifa — cient. The knowledge spread rapidly from one town to another—"a home remedy passed on by word of mouth"—and was easily put to use, since the lead compound Diachylon was already "at hand in every working — class home" for various healing purposes.94 This suggests two important theoretical possibilities about how birth control and abortion information gets transmitted on a mass scale: (1) The process occurs effectively because the idea and the practice of fertility control are already embedded in popular ways of life; and (2) it occurs, not vertically (from the elites to the masses), but horizontally, from one working-class woman to another (her neighbor, coworker, or kin) or from one factory or shop to another or from one working-class town to another. This is of course a hypothesis, and needs to be tested through precise data comparing patterns of abortion use among different women’s communities and different occupational groups, towns, and regions. Yet it seems borne out by the fragments of information we have regarding abortion practices in nineteenth-century England, France, and the United States. These suggest that where there are strong and cohesive women’s communities, either through shared neighborhood cultures or shared work, and where women have access to local "wise women" or midwives or active communication networks, abortion practices flourish.95
Studies showing that declines in working-class fertility in late-nine — teenth-century England were greatest among particular occupational sectors, especially among families where wives worked and most especially in the textile industry, confirm this view of the "cultural diffusion" process. For women socialized into networks of со workers or workers’ wives (e. g., among better-paid skilled workers), not only were fertility rates consistently lower than for other working-class groups but abortion was apparently well known and widely practiced.96 The explanation for this lies in their obvious need for effective fertility control and in the socialized nature of their conditions, which made it possible to meet that need. In other words, I am assuming that women who work in factories have a particularly viable social basis for information sharing and self-help. A look at the communities in northern England where lead-based abortifa — cients were widely used in the 1890s confirms this line of argument. Nottingham, Leicester, Burnley, and Sheffield were precisely the towns where married women’s employment was high and thus where women were brought into regular contact with one another in factories and workshops.97 That regular birth control and abortion practice was a longstanding part of working-class life in such towns seems evident. A variety of herbal and other folk remedies had been rooted in popular health culture since preindustrial times.98 Moreover, as early as the 1830s the radical birth control pamphlets and handbills of Francis Place, Richard Carlile, and Charles Knowlton enjoyed "a quite large circulation," aimed "specifically towards the working classes" in the northern industrial districts.99
McLaren’s study of abortion in France in the late nineteenth and early twentieth centuries similarly emphasizes the importance among the working classes of women’s "self-help," community, and cross-generational networks in the diffusion of abortion methods. Medical and government sources report casual and unashamed conversations among female neighbors about where to find the local midwife or purveyor, what to take that will be safe, or how to elude abusive husbands.100 Similarly, in the German survey from 1913, mentioned earlier, where women noted an "accomplice" or helper in their abortions, it was either a midwife, a coworker, or in one case "the wife of a coworker of my husband’s [who] has helped the whole block."101 While these accounts involve urban women, the phenomenon of women’s communities and networks that act as conduits of abortion lore is not limited to towns. Mohr suggests that such sharing of abortion information among female kin and neighbors characterized the rise of abortion rates in the nineteenth-century United States not only in the towns but also on the frontier.102
That abortion flourished where women’s ties to one another were strongest does not mean that husbands were uninvolved in or always hostile to their wives having abortions. Sometimes husbands assisted or procured the drugs, although very often, as among the Berlin women, there was a strong desire to keep the abortion secret from husbands, a sense that he "must know nothing." But in most cases, regardless of husbands’ attitudes or role, the source of the woman’s knowledge about methods and her sense of abortion as a legitimate, accepted practice was other women.103
As a popular method of conscious fertility control, abortion among poor and working-class women never abates but increases with time. In addition to cost, accessibility, and the desire to avoid methods requiring the husband’s cooperation, there is a very practical reason why abortion, even when risky, may be the most useful method of fertility control for working-class women: "In allowing the working class couple to postpone the decision of controlling pregnancy to a later date in the reproductive cycle, abortion gave the family living at subsistence level time to assess whether they could support an additional child."104 "Planning" clearly involves different constraints and timetables for different social groups. It is thus not surprising that abortion was by all estimates extremely widespread among working-class and poor women in England and America in the late nineteenth and early twentieth centuries, when it was everywhere illegal. "In the 1890s, doctors were estimating two million abortions a year" in America, probably an underestimate.105 Caroline Hadley Robinson, who surveyed U. S. birth control clinics in the 1920s, found that 47 percent of the clientele of one clinic in Chicago, who were all poor Jews on welfare, were "already practicing abortion" before they came to the clinic and estimated that "one half to nine tenths of all interruptions of pregnancy in the general population are voluntary, illegal acts."106
Conscious ideologies legitimating abortion do not always accompany or fit neatly with its widespread practice. What of the consciousness of working-class women in the nineteenth century? Did they articulate an idea of abortion as "a woman’s right"? Here again, there seems to be agreement among historians writing about France, Britain, and the United States. Perhaps differently from middle-class feminists, working-class women in all three countries commonly believed that, regardless of the law, there was no baby, hence nothing "wrong" in ending a pregnancy, prior to "quickening."107 Numerous medical and state observers, in England and France, were dismayed at working-class women’s casual attitude about abortion and their widespread assumption that it was only "a perfectly legitimate measure" and not a question of "killing" anything. Rather, for many, who openly came to doctors for help, abortion was a question of making themselves, their own bodies, "regular": "Until animation they perceived themselves, not as pregnant, but as ‘irregular’; they took drugs, not to abort, but to restore the menses."108 Thus, between the collectively shared norms of these women and the medical scrutinizers who recorded those norms, the very meaning of "abortion" was contested.
Working-class women in the nineteenth and early twentieth centuries defended their right to abortion on at least two grounds, reflecting two different ideologies of fertility control. On the one hand, there is the strong and impassioned plea for women’s own lives and humanity, an end to constant childbearing and physical exhaustion. "It is not right," says one Englishwoman in 1915, "it is wicked that a woman should be killed by having children at this rate."109 Indeed, the idea "that the woman must have the freedom of her body" was apparently not unknown to European working-class women at that time. But, like the feminist proponents of "voluntary motherhood," the freedom these women were seeking was a (negative) freedom from unwanted sex and unwanted childbearing, from what they saw as sexual and biological abuse of their bodies; it was not a (positive) freedom to seek sexual fulfillment.
On the other hand, by the late nineteenth century there is ample evidence, at least among the wives of skilled workers in England and possibly among the poor as well, that the Malthusian ethic of "fewer and better" and having no more children than one could afford had taken hold. In fact, the "economic" morality seems to have gotten entangled and hung in an uneasy suspension with the "feminist" morality defending women’s bodily integrity. A poignant, though rather late, example of this confusion is a letter sent to Dr. Marie Stopes, the English sex counselor and birth control reformer, in 1922:
Could you be kind enough to tell me the safest Means for Prevention of Children as my age is 37 I have had 14 children nine living. . . we are very poor People I have my last at the Maternity home the Matron and Dr. told me I have a very Weak Heart if і have any more it might prove fatal my inside is quite exhausted I have Prolapsed Womb, its wicked to bring children into the world to Practicly starve and be a burden to the ratepayers as that is what it Means in my case as my Husband is only a jobing Gardener his work is most uncertain I cannot feed baby myself I realy must try something as my Husband is not a careful man in that respect I dont want any more if I should sink with having another what would become of all the other little ones my nerves are getting quite bad worrying from one month to another. . . .no
In fact, by the 1870s in England, especially with the enactment of compulsory elementary schooling, conditions were created that would transform working-class culture and working-class family life and would make them more amenable to neo-Malthusian ideas. As a result of compulsory education, which abolished the value of children as potential wage earners, higher wages, and a consumption-oriented living standard among the more privileged sectors, and because of the influence of social reformers, charity workers, public investigators, and public health agents, "the [working class] home was to become increasingly central to the life of the worker and the question of restricting the number of children it housed ever more important/’111 This process was not one of bourgeois values merely "trickling down," but of those values being externally imposed and internally transformed.
The role of social workers and public health clinicians in communicating the dominant bourgeois values of "rational," child-focused mothering and restricted childbearing for the sake of higher consumption seems particularly important. It raises major questions about the cultural diffusion theory, suggesting that, at least in part, such "diffusion" occurs through the deliberate imposition of values rather than by osmosis. The idea that "maternal duty" involved rational planning and budgeting, of children as well as household economies, was clearly geared to the economics of the capitalist market in labor and goods; it was also transmitted by agents of the bourgeois state. From whom but social workers and preachers does a poor woman learn that "its wicked to bring children into the world to Practicly starve and be a burden to the ratepayers"? Yet the "modem" ideology of fertility control is not simply transposed mechanically or wholesale from one class to another, like a lesson taught in Sunday school. The conditions of working-class life, which are not the same as those of the middle class, result in an accommodation of that ideology to a new situation. The language of neo-Malthusian thinking takes on a different sense within a working-class context. For example, letters from working-class women in England written in 1913-14, and published by the Women’s Cooperative Guild, to the extent that they explicitly approve of birth control and abortion, do so in terms resonant with the middle-class idea that fewer children mean giving "more advantages," that children deserve certain "advantages" as a precondition to being born:
. . . that we would only have what little lives we could make happy, and give a chance in life.
I have not had children as fast as some. . . not because I do not love them, but because if I had more I do not think I could have done my duty to them under the circumstances.
. . . as to mechanical prevention of family, I know it is a delicate subject, but it is an urgent one, as it is due to low-paid wages and the unearthly struggle to live respectably. All the beautiful in motherhood is very nice if one has plenty to bring up a family
on, but what real mother is going to bring life into the world to be pushed into the drudgery of the world at the earliest possible moment because of the strain on the family exchequer. . . .112
The emphasis on "maternal duty" here, on the value of fewer children who must be provided with a certain "standard of living," reflects both sides of the double bourgeois ideology of fertility control: the definition of children as "consumption goods" rather than "production goods"113 and the definition of motherhood as intensive and exclusive. Moreover, the letters written to the Guild were mostly not from the poorest women but from the (unemployed) wives of skilled workers, who were literate and saw their children as having some possibility of "moving up." Yet even here, and certainly among women less privileged, there is a class — specific meaning to the idea of limiting births to give children "a chance in life." Margaret Llewelyn Davies interprets the birthrate decline in the late nineteenth and early twentieth centuries among better-paid workers in England in terms that imply resistance more than accommodation: a "refusal to have children," "a kind of strike against large families," which grew out of the transcendence of fatalism and the growing consciousness "that there are other things in life besides poverty and work," "something better than bare existence."114
We have to distinguish between the origins of an idea and the social context in which it is applied. Words like "respectability," "drudgery," and even "maternal duty" have concrete meanings depending on the circumstances of those espousing them, the "life chances" specific to them. It is one thing to hope children will acquire professions (or professional husbands); it is another to hope they will grow up—and maybe go to school. At the same time, a distinctly patriarchal standard of "woman’s place" in domesticity and childrearing permeates the working-class variant of Malthusianism, just as it does the working-class ideology of the "family wage," to which it is closely related. When a working-class wife argues that birth control will give her "better health to serve my husband and children, and more advantages to give them,"115 she is utilizing the bourgeois ideology of upward mobility and "true motherhood" to justify her decision to use birth control. Yet, while accommodating bourgeois patriarchal assumptions, her statement also embodies a determination, for herself and her children, to push beyond the limits of their lives.
We have journeyed far into the complexities of history and theory to reach some fairly simple conclusions: Abortion has nearly always been a crucial form of fertility control for women; its availability and practice are in some ways a measure of the position of different groups of women in society; and a scientific understanding of fertility trends has to encompass these facts. We have also found that the extent to which abortion and other forms of birth control are available to women is specific to certain social conditions. Where women are connected by strong ties of work and community, where they have access to nondomestic sources of support and livelihood, where mothering is not the only work culturally valued for them or their sense of their autonomy over "domesticity" is bolstered by feminist bonds, and where alternative systems of reproductive health care thrive because they are supported by vital women’s communities—there, and mainly there, does a culture of fertility control, including abortion, develop. If these have been the historical conditions in which abortion as a popular practice exists, then it becomes clear that political efforts to suppress abortion are aimed not only at women’s control over their fertility and their sexuality but at the social and economic roots of their collective power.