Infanticide (of female children, of course), abortion and contraception had been used since antiquity to limit population growth. Contraceptives and abortificients, many of dubious efficacy and safety, ranged from amulets, prayers, potions, and pessaries to surgery. Safe, effective, convenient contraceptives, such as silk condoms, were expensive and required the co-operation of the man. Inexpensive techniques which women could use, such as vinegar douches, were often only somewhat effective or dangerous. Often spurred more by Malthus's vision of an over-populated earth than by concern for the health and welfare of either a woman or her family, a few men openly advocated birth control beginning at the end of the 18th century. In her book, Contraception and Abortion in 19th Century America (Cornell University press, Ithaca and London, 1994), Janet Farrell Brodie thoroughly discuss dozens of men and women prominent in the 19th century birth control movement. Tracts were written, speeches given, techniques explained; but birth control continued to be associated with prostitution and illicit sex and to have a generally unsavory reputation. Feminist women supported celibacy, even in marriage, as the primary means of birth control. The issue of artificial birth control was awaiting someone of impeccable reputation and credentials to be its champion; Aletta Jacobs was just such a woman.

      Born the eighth of twelve children (six boys and six girls) to a physician father, Jacobs parents valued education in both their male and female children. Her father's favorite, as a child Jacobs only wanted to grow up to be a physician like her father and her eldest brother; she didn't set out to forge a path for other women to follow and she didn't set out to change the world. Yet, her drive for an education caused both her and her parents to challenge the system even while she was just a schoolgirl. In the nineteenth century, boys and girls had the same elementary education. Advanced education for girls included languages, art, music, handicrafts, and social skills to prepare them for a lifetime in the home, while a high school education for boys included mathematics, history, Greek, and Latin which prepared them for a college education. Although girls were not permitted to enroll in the boys' high school, Jacobs father convinced the local school master to allow her to audit his classes for boys, enabling her to learn the subjects which she would need to enter college. Eventually, this simple act led to high schools throughout the Netherlands being opened to girls.

      After leaving high school, Jacobs went to live with a pharmacist brother whose assistant taught her the trade. Passing her assistant pharmacist exam, Jacobs wrote Minister Thorbecke and asked him for special permission to enter the university in Gröningen. He granted her a one year temporary, probationary admittance to the university. In the spring of 1872, rumors began circulating that Thorbecke was seriously ill. Fearing that he would die and that the next minister would not be so accommodating to her wish to enter the university, Jacobs took the exams she felt she could pass, sent the results to Thorbecke, and petitioned him to make her a permenant student six months ahead of schedule. Jacobs writes, "Two days after Thorbecke's death, on June 5, 1872, I received the permission, complete with a funereal black border. It was dated May 30, 1872, and an accompanying letter informed me that the granting of this request had been one of the minister's last official acts." (p. 18)

      Jacobs passed her exams to become a Candidate in Mathematics and Physics (non sine laude - with honors), which is preparatory to the study of medicine and moved to Amsterdam to enter medical school in Oct 1876. She received medical degree on April 2, 1878. Although her earlier attempts at an education had been controversial, for the first time she encountered open opposition from her professors.

      Jacobs writes,"It was during this exam that I first encountered professors who openly opposed the idea of women doctors. Two gentlemen treated me in a way that was simply unfair. Fortunately, several other Utrecht professors as well as my teachers from Amsterdam actively protected me from these two examiners' remarks and behavior. Indeed, it was only because of this protection that I was able to complete the exam at all." (p. 28)

      Almost immediately Jacobs began to challenge tradition. Her first act was to go on a vacation to London were she met with neo-Malthusian birth control advocates, a subject that was not discussed in polite society. Upon arriving home, she set up practice in an era where women did not walk down the street after dark and did not walk on certain streets even during the afternoon. She took it for granted that she would be able to walk through the streets to visit her patients, her family, or friends at any hour of the day or night.

      Many of her patients were working class girls who clerked in shops. They suffered from lifelong gynecological problems because they were expected to remain on their feet from 8 am until 11 pm except for a brief 1/2 hour break for lunch. One of Jacobs first campaigns was to get stools for the girls to sit on when there were no customers. Believing that the store owners failed to provide stools for the girls because they were ignorant of the facts, she began a campaign to educate the owners. Her educational campaign failed and it was almost 20 years before a law was passed requiring shop keepers to provide stools for their employees to sit on.

      But the first major campaign in which she took part was the birth control movement. Here is the story in her own words.

      "When I was a student, and particularly when I worked at Amsterdam Hospital, I was haunted by the suffering caused by frequent pregnancies, which, for various reasons, can have a disastrous effect on a woman's life.

      In my long conversations with a variety of women in the delivery room, they explained to me that they found it impossible to prevent pregnancy when sexual abstinence was the only method available. Women who produced sickly babies or stillbirths, for whom birth meant yet another brush with death, kept on returning to the delivery room. Families that were already large enough considering the mother's physical condition and the parents' circumstances, simply continued to expand. I spent hours wrestling with this problem without any solution in sight. Sometimes I discussed the issue with my fellow students. "Yes," they would coolly reply, "that's what is called a woman's destiny" or "Thank God, there's no way of preventing pregnancy. If there were, then the whole world would soon collapse through underpopulation." (p. 46) . . .

      "The availability of contraception would prevent immeasurable suffering. I had learned that much from the pregnant women I had met in Amsterdam Hospital and from all the newborn babies whose births were greeted by anything but joy and whose very existence was a burden both to their families and to society in general. There remained only the question of which contraceptives were effective in preventing unwanted pregnancy. I felt unable to come up with any definitive answer. Doubting that the existing means were reliable or even suitable for use, I was uncertain as to whether they could damage users' health. In the end, I was forced to admit that I had reached an impasse. My contact was with groups that included the book's author and with others who described themselves as Neo-Malthusians because they followed Malthus's ideas yet chose to employ their own means to combat this social ill. Although they had provided me with much theoretical knowledge, I had no way of transforming theory into practice." (p. 47) . . .

      "During my search for a remedy for this state of affairs, I chanced upon an article in early 1882 in a German medical journal that had been written by Dr. Mensinga from Flensburg. He recommended the use of a pessary for the kinds of cases I was dealing with. This purely scientific article made such an impression on me that I immediately wrote to its author. A lengthy exchange of letters followed, in which Dr. Mensinga informed me fully about the way in which pessaries should be used. He also sent me a number of specimens. Although Dr. Mensinga had assured me that they were effective and in no way jeopardized users' health, I decided that I had to have them tested before I could provide any personal recommendation.

      For social, moral, and medical reasons, women from different social classes had often asked me for some form of contraception. I had always had to fend off these requests without providing adequate explanation or advice. Eventually I sent letters to a number of women whose need was greatest. I told them that I believed I had found a means to help them, but before I could fully recommend it, they would have to agree to regular examinations during the first months of its use. Some of these women eventually agreed to the experiment, and the results were such that, some months later, I was able to announce that I could provide a safe and effective contraceptive.

      Although I deemed it unnecessary to advertise my wares, I felt duty-bound to announce that I was now able to prescribe contraception for those women wishing to avoid pregnancy on social, moral, or medical grounds.

      Not for one moment did I delude myself that I would be supported by many of my fellow doctors. I knew that they were deeply conventional and also that they were ignorant of society and social issues. Hence, I expected very little cooperation. On the other hand, I had never imagined that I would create such a furor. But in fact I incurred the wrath of the entire medical establishment. Even those who privately agreed with me carefully kept it to themselves for fear that they would receive the same treatment. These were difficult times for me, and I sorely missed the one man in whom I had always been able to confide. Sadly, my father was gone, and the few friends I trusted simply lacked the medical and sociological knowledge to be able to understand the importance of my work for humanity. I discussed this so often with them that they finally suggested, with the best of intentions, that I should publicly admit I had made a mistake and state that I would no longer provide this treatment. Fortunately I had never doubted my actions; otherwise I might indeed have followed their advice. But I was too deeply influenced by what I had seen and by my belief that this work would benefit humanity.

      As the only woman doctor in Holland, I often found it difficult and painful to row against the tide of lies and slander spread by my male counterparts. However, the absolute conviction that I was doing the right thing, and the awareness that this whole situation concerned not only individual suffering but also the interests of society at large, gave me the strength to stand by my point of view. But, even so, I was sometimes assailed by doubts. I would wander aimlessly around the Vondelpark, oblivious to my surroundings and wrestling with the dreadful thought that maybe, despite everything, I had made a mistake. Could the availability of contraception ultimately lead to a world without children? Would it cause adultery? And, if the birth rate fell, would the country's economic position be threatened? I was obsessed by these questions and wanted to find answers, though I was a layman as far as economics was concerned. But I kept thinking that the longing to have a child is so strong in most normal women that only for the most serious reasons would they choose to avoid motherhood. Of course, I thought, contraception would certainly lower the number of unwanted pregnancies and hence should be welcomed for many social, sociological, and individual reasons. If there were fewer unwanted babies, the race would advance, which in turn would lead to greater social well-being and human happiness. Studying this subject in great depth finally convinced me that I had taken the right course of action. I already felt what Nietszche later so eloquently wrote: not propagating the race, but raising the level of humanity, must be the aim of existence.

      These experiences thoroughly undermined my trust in other people. I knew in advance that those narrow minded in outlook and suspicious of all innovation were bound to disagree with my way of thinking. I also reasoned that my opponents would include both those whose religious beliefs were directly contradicted by my opinions and those who were quite simply ignorant of social problems. But this did not bother me. In fact, through what I said and wrote, I even hoped to convert a few of them. But not for a single moment did I expect the level of hostility and obstructiveness I encountered from my fellow doctors (and particularly from the obstetricians and gynecologists whose livelihood I apparently threatened). Had they cast doubt on the contraceptive's reliability, they would have at least been forced to confront its social implications. I, in turn, could have defended my views, and an honest discussion would have ensued based on differences of opinion and experience. The issue of contraception was also later occasionally broached by the Geneeskundig Tijdschrift (Medical Journal). And whenever this happened I joined in the debate, with the result that I eventually emerged victorious. However at first my opponents were quite willing to resort to spreading stories that were entirely untrue. They accused me of promoting abortion and of leading an immoral life. How I wished I could refute these lies in public! But I never got the chance. These tales were never related to me directly. On the very few occasions that I managed to unearth the original source, the culprit was invariably either an obstetrician or a gynecologist. I would always confront him and demand an explanation for his behavior, but usually he would shrug it all off with some remark about contraception being the same as abortion. Of course, such reasoning was totally illogical because, as everyone knows, while the former is legal, the latter is a criminal act. For the rest, the people who opposed me in this manner were generally careful not to air their questionable opinions in public.

      The more my practice expanded, the more I was viewed as a formidable competitor, which meant that ever-increasing numbers of my colleagues were siding with my opponents. Unable to defend myself, I simply continued to live my life and tried to perform my work openly and as honestly as possible.

      It was an age steeped in hypocrisy! I am particularly thinking of those clergymen who would denounce contraception from the pulpit and then pack their wives off to my office. I also remember women who were only too pleased to use the means I prescribed for them yet never lost a chance to condemn me at every tea party and sewing circle. and, while publicly denouncing my work, some doctors would still expect me to instruct them in the practical application of birth control! Fortunately these irritating experiences were more than made up for by the gratitude of a great many women and the warmth and friendship of a number of people in high places." pp. 48-50

      Appalled by the degrading medical exams that prostitutes were forced to undergo and physician were expected to provide, outraged that women were degraded so that men's carnal lust could be satisfied without fear of disease, enraged at the sexual double standard where women paid the price for men's carnal desires, Jacobs fought legalized prostitution. As was the norm throughout much of Europe and the British Empire, legalized prostitution was the scourge of women. (See A Singular Iniquity: The Campaigns of Josephine Butler, Glen Petrie, Viking Press: New York, 1971) Working-class women could be denounced as a prostitute by almost any man, a jilted boyfriend, a spurned lover, a rejected suitor, an angry acquaintance. Without trial or even a right to know who accused her, a woman would be given a "medical exam" If she was a virgin before the exam, often the doctor broke her hymen and presented her with a certificate certifying that she was free of disease, ruining her reputation and virtually pushing her into prostitution. If she refused the exam, she was committed to prison until she relented, ruining her reputation and forcing her into prostitution. If she was an unmarried woman and not a virgin, she was branded a prostitute, and, if disease free, given a certificate enabling her to ply her trade. Once denounced, a woman could not win. Organized prostitution, known as "white slavery", was a thriving racket, luring unsuspecting girls into prostitution with the promise of a legitimate job or kidnapping girl children off the streets. Upper class men were protected from their own vice by requiring that these women be certified to be free of disease. As soon as the girl became diseased, she was turned loose, disposed of, to fend for herself. Unemployable, the girls starved, turned to crime and went to prison, or continued to ply their trade to lower class men who were not so fastidious about their companions. Jacobs campaigned strenuously to change the law: if men wanted to continue their vices, they should not be protected from the consequences of their actions.

      But the campaign on which Jacobs worked longest and hardest was the woman suffrage campaign. Indeed, as a reaction to her campaign, when the Dutch constitution was "reformed" in 1887, the word 'male' was inserted to mean that only males could be Dutch citizens and males could vote, outraging the women of the Netherlands and giving the Dutch woman suffrage movement a much needed spur. Jacobs took over the leadership of the Association for Woman Suffrage in 1903 and remained its president until votes for women became a legal reality.

      In her widowhood, Jacobs and Carrie Chapman Catt went on a world tour through Africa, the Middle East, and South Asia preaching woman's suffrage, organizing woman's rights organizations, and fostering feminism activism wherever they went.

      During World War I, she began her last campaign fighting for world peace and freedom, eventually forming the Women's International League for Peace and Freedom (WILPF), which is considered the most important women's peace organization in the twentieth century: Jane Addams, its first president, received a Noble Peace Prize in 1931.

      In the words of Harriet Pass Freidenreich, "A pioneering physician and feminist, Aletta Jacobs had a twentieth-century vision, even though she lived most of her life during the Victorian era. As the first woman to attend university and receive a medical degree in the Netherlands, who then managed to combine a career with a companionate marriage and political activism, she can serve as a role model for modern professional women, although her example was difficult for other women of her own generation to emulate. Jacobs established what is often considered the first birth control clinic in the world. She also spearheaded campaigns for the deregulation of prostitution, the improvement of working conditions for women, and the introduction of woman suffrage in Holland. She was a prominent leader in both Dutch and international suffrage organizations and in the women's peace movement during World War I." (p. 179)

Reference

      Jacobs, Aletta, Memoirs: My Life as an International leader in Health, Suffrage, and Peace, edited by Harriet Feinberg, and translated by Annie Wright, Historical Afterword by Harriet Pass Freidenreich, Literary Afterword by Harriet Feinberg, Feminist Press, 1996

      The Gerritsen Collection of Women's History, 1543-1945, is often considered to be the "greatest single source for the study of international women's history and the feminist movement."

      Return to Women's History Month 2001 Table of Contents

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