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Marie Stopes: history erases ugly facts to create a mythical feminist hero

Tue, 2019-05-07 13:10

For some, the name Marie Stopes speaks of one of the biggest abortion providers in the world. For others, it speaks of a person, a feminist icon and pioneer for birth control and family planning.

Both are true, but few people know about Marie Stopes the woman, the author, palaeobotanist, family planning pioneer, and eugenicist. It is Marie Stopes the woman that I focus on here because she is key to understanding the Marie Stopes organisation of today.

Marie Stopes is widely lauded today as a feminist hero and women’s rights campaigner.

The BBC history page dedicated to Marie Stopes describes her as a: ‘campaigner for women’s rights and a pioneer in the field of family planning’ and says nothing negative about her. A biography on the Manchester University website describes her as:  ‘…truly an extraordinary woman. Despite the hardships she had faced from her opponents, she continued to pursue the causes she believed in, and remains to this day as a much loved and respected figure. In honour of her name the charity Marie Stopes International [was] established in the 1970s.’  Readers of The Guardian voted Stopes as Woman of the Millennium in 1999. In 2008 she was chosen by an all-female, all-feminist committee to be one of six women pioneers in the Royal Mail’s Women of Distinction collection.

 The organisation named after her, Marie Stopes International (MSI) is clearly proud of their link to her, with their website making clear that their present work is built on her legacy:

The way we provide contraception and safe abortion services has been shaped, to a large extent, by our history. And by the lives of two pioneers of the family planning movement, Dr Marie Stopes and Dr Tim Black. Both built reputations for their client-centred approach and their willingness to push boundaries – qualities that are central to how we work today.

However, both the MSI website, the BBC historical figures page dedicated to Stopes, and many other biographies leave a great deal of interesting information out. In particular, her openly racist and eugenic beliefs and practices have been largely overlooked and ignored or, at best, framed as an embarrassing footnote to her achievements. 

Here are some less well-known facts about Marie Stopes and her beliefs:

  1. From 1918 to the early 1930s she published several books on marriage and birth control. One of these was Radiant Motherhood (1920) and in a chapter headed ‘A new and irradiated race’ Stopes reveals her underlying (and repulsive) agenda behind her push for widespread birth control: ‘it is the urgent duty of the community to make parenthood impossible for those whose mental and physical conditions are such that there is a certainty that their offspring must be physically and mentally tainted…’ She wants their sterilisation made immediate and made compulsory otherwise there will be an: ‘…ever increasing stock of degenerate, feeble-minded and unbalanced who will devastate social customs…like the parasite upon a healthy tree.’
  2. She did not just write, but actively lobbied the Prime Minister and Parliament to pass Acts to enforce compulsory sterilisation in order to: ‘…ensure the sterility of the hopelessly rotten and racially diseasedby the elimination of wasteful lives.’
  3. Stopes also urged the National Birth Rate Commission to support the compulsory sterilisation of parents who were diseased, prone to drunkenness or of ‘bad character’.  To use a selection of her words, the: ‘hopelessly bad cases, bad through inherent disease, or drunkenness or character’, ’wastrels, the diseased…the miserable [and] the criminal’, ’degenerate, feeble minded and unbalanced’, ’parasites’, and the ‘insane’. In Wise Parenthood she explains: ‘Our race is weakened by an appallingly high percentage of unfit weaklings and diseased individuals.’
  4. Marie Stopes’ first family planning clinic was in North London in 1921 and was run by an organisation she founded: The Society for Constructive Birth Control and Racial Progress. It was no coincidence that her birth control clinics were clustered in deprived areas, to focus on reducing the birth rate of the poor lower classes and prevent the birth of those whom she considered to be ‘the inferior, the depraved, and the feeble-minded’.
  5. Her views were not a passing fad. In 1934 she publicly stated that all half-castes should be sterilised at birth. In 1956, two years before she died, Marie Stopes asserted that one-third of British men should be forcibly sterilised, ‘starting with the ugly and unfit’.
  6. Stopes cut her own son out of her will simply because he married a girl who wore glasses. Instead, the bulk of her estate went to the Eugenics Society.
  7. Stopes was a Nazi supporter. In 1935, she attended a Nazi Congress for Population Science in Berlin. Four years later she sent Hitlera gushing personal letter along with a volume of her love poems: ‘Dear Herr Hitler, love is the greatest thing in the world: so will you accept from me these that you may allow the young people of your nation to have them?‘ A poem of hers from 1942, at the height of the Jewish Holocaust, has this to say:  ‘Catholics and Prussians, The Jews and the Russians, All are a curse, Or something worse…’ The irony of people today praising Stopes is captured by Anthony Ozimic of SPUC: ‘Praising Marie Stopes as a woman of distinction should be as unacceptable as praising Adolf Hitler as a great leader. Both promoted compulsory sterilisation and the elimination of society’s most vulnerable members to achieve what they called racial progress.
  8. The BBC website states that the Catholic Church was Stope’s fiercest critic. They fail to clarify it was actually the Catholic Church that most opposed her appalling eugenic beliefs. In the 1920s, a legal victory against the rising eugenic tide was won by Dr Sutherland, with the support of the Catholic church, over Marie Stopes. Sutherland actually opposed eugenics long before he became a Catholic. Yet Stopes is lauded today as a feminist hero, while the story of the eugenics libel trial, and the Catholic role in trying to stop eugenics, has been either overlooked or dismissed as simplistic Catholic opposition to contraception.
  9. Moreover, Dr Sutherland and others were actively trying to prevent and cure tuberculosis, (the disease of poverty) while at the same time influential eugenicists decried their efforts as a waste of time. Eugenicists considered tuberculosis was a ‘friend of the race’ because it was a natural check on the ‘unfit’ and poor, killing them before they could reproduce.
    How ironic that Stopes, who describes poor children as ‘puny-faced, gaunt, blotchy, ill-balanced, feeble, ungainly, withered’ is the one now feted as a feminist heroine, and Sutherland who tried to treat and heal them is forgotten.
  10. The deliberate excision of Stopes’ eugenic legacy has made her a secular saint. The abortion industry in particular, and liberalism in general, have effectively erased Stopes’ racism and hatred of the poor (such inconvenient historical facts) from their collective memory. Yet the truth is, Marie Stopes was not motivated by a kind of early feminism but rather ‘by the urge to reduce the numbers of the ‘burgeoning lumpenproletariat.’

Stopes and other eugenicists endorsed legalised birth control because the working class was too ‘drunken and ignorant’ to be trusted to keep its own numbers down.

This all helps to explain why today, Marie Stopes International, arguably the biggest abortion and birth control provider in the world, focuses on providing cheap abortions in developing countries directly to the poorest women in the world.

Recall, as I quoted above, the MSI website: ‘The way we provide contraception and safe abortion services has been shaped, to a large extent, by our history. And by the lives of two pioneers of the family planning movement, Dr Marie Stopes and Dr Tim Black.’

I agree with them: Marie Stopes’ eugenic and racist goals in family planning shape MSI even today:

The truth is, liberal abortion legislation and ‘safe abortion’ provision in developing countries has no effect on maternal mortality rates ie. women’s health (note, an attempt to discredit these findings had to be retracted!).  Liberalising abortion laws increases numbers of abortions but what genuinely improves maternal mortality rates and health and thus truly helps women (and their unborn children) is education, nutrition, clean water, sanitation and maternal health care for women.

It seems that a neo-colonial and eugenic agenda carries on, with a different cloak and mantle and exported to a different part of the world, but with the same underlying agenda that Marie Stopes had.  History repeats itself, but in such cunning disguise that we never detect the resemblance until the damage is done.’

 

Categories: Discussion

Prenatal Screening and Down Syndrome – million-dollar ethics

Wed, 2019-05-01 17:01

The Nuffield Council on Bioethics, an independent think tank on bioethics, launched their report on the ethical issues of NIPT(non-invasive prenatal testing) in 2017.  NIPT, a new more accurate way of screening for Down syndrome, is part of the genetic testing market, predicted to grow to a value of $22 billion by 2024.

NIPT raises many ethical difficulties, covered by Nuffield. However, the Down syndrome (DS) community did not agree with all of its conclusions. Sally Phillips, actor, comedian and mother of a young man with Down syndrome, made this clear in her response when she questioned the difference Nuffield had drawn between screening for sex and screening for Down syndrome. “For you we still fall the wrong side of the line… leaving DS in the significant medical conditions box you are saying that discrimination against their lives does not have the right to be protected against.”

However, the report did, at least, outline some of the issues to be resolved in order to have a more ethical roll-out of NIPT. Two years on, how far have we got?

NIPT is a groundbreaking technology that uses a sample of the mother’s blood, containing maternal and placental cells, to estimate the chance that the baby will have a genetic variation. It is already in wide use in the private sector, where companies in the UK are offering parents the chance to find out if their unborn baby has a higher chance of everything from Down syndrome to deafness.

Some US companies are offering prenatal genetic testing to sequence the whole genome of babies, whilst others have suggested that we will be able to use genetic testing (not specifically NIPT) to identify the chance of the embryo having a low IQ. Further, a patent has been issued for using genetic testing to analyse unborn babies for the chance that they may have autism.

Back in the UK, the National Screening Committee announced their approval of the use of NIPT in the NHS screening pathway in October 2016, on a Saturday, in the Guardian, without waiting for Nuffield’s final report. However, although roll-out of free NIPT tests in the NHS was planned for October 2018, it is not yet officially part of the screening pathway. The hold-up was legal rather than ethical and that may soon be resolved. However, so far most of the ethical issues raised by the Nuffield report have not been addressed. I cover four main ones below:

  • There continues to be no national care pathway for women wishing to continue their pregnancy following a high chance or positive result from testing (20, Nuffield Report). Neither NICE nor the Royal College of Obstetricians and Gynaecologists (RCOG) have prioritised this in the last two years. What little guidance there is remains buried in RCOG guidelines entitled Termination of Pregnancy for Fetal Abnormality published in 2010. Nuffield strongly suggested that the name of this guidance should be changed immediately to reflect the inclusion of continuation of pregnancy guidance and that that section should be substantially expanded, or separate guidelines should be produced.
  • Misinformation continues to abound around what NIPT is and what it can do (6.8, Nuffield report). NIPT is a more accurate screening test, but it is not a replacement for a diagnostic test such as amniocentesis or CVS. Further, tests are evaluated by different measures, the difference between these appears to continue to elude manufacturers, clinics, midwives, consultants and the media. Sensitivity measures what percentage, of all tested fetuses that have the variant, the test will find. Positive predictive value of a result is how likely your high chance result is to have correctly identified the baby as having Down syndrome. NIPT will pick up 99% of babies in some populations, although the bias of available studies has been questioned by the Warwick systematic reviewers. However, if you are a pregnant woman, interested in how likely your high chance result from NIPT is to be correct, then the positive predictive values range widely, starting about 46%, depending on your age and combined screening test results. There is a useful calculator here.
  • Nuffield also recommended that private companies be regulated, and their advertising controlled by the Committee for Advertising Practice (6.39, Nuffield report). There are now CQC inspections, but it isn’t making much difference to the misleading information being given in the advertisements.
  • Genetic counsellors remain few and far between, and despite Nuffield highlighting this as a need, (6.30, 6.36, Nuffield Report) little has been done. Some courses to train already stretched midwives have been offered, but this has hardly plugged the gap. ARC( Antenatal Results and Choices) are offered as a solution. However, they haven’t collaborated with Down syndrome charities, as was suggested, And, although, the Nuffield report found them to be non-directive, the following facts call the usefulness of their helpline into question:
    • they were formally known as SAFTA, (Support After Termination for Abnormality);
    • they have received donations from manufacturers of NIPT totalling £11,500 from 2014-2017;
    • their booklets strongly orientate towards the difficulties of continuing your pregnancy and they offer no support groups for women continuing their pregnancy.

What is needed is an NHS helpline staffed by trained genetic counsellors to help patients process all the prenatal genetic information that is now available. This has been called for by the Down Syndrome Association. The need was also clearly demonstrated, by a case in the press recently, where a woman was given a high chance result from a private clinic for Turner syndrome, with all the associated worry and suggestions of invasive testing only to realise, after much research, that her result was approximately only 40% likely to be correct.

Some things have been done. For example, heads of screening in each NHS Trust have received training and Public Health England have revamped their Screening for You and Your Baby booklets and produced template letters for issuing test results. However, these are still not being used everywhere, with one woman recently receiving a letter saying “We are pleased to inform you that the blood test….. shows you are at low risk for Down’s syndrome’. What would they say to her friend whose child does have Down syndrome – commiserations?!

In this landscape it is very hard to see how women can make truly informed choices. And anyway, genetics do not tell you who your baby will grow up to be. They could be a famous actress like Sarah Gordy, or a Special Olympics swimmer like Shauna Hogan. They may marry the love of their life, like Maryanne and Tommy Pilling, have more complex needs that mean they need full time care, or like the majority, be somewhere in between. Everyone, including those with Down syndrome, are, thankfully, far more than their genetics.

Where does this leave us?

The NHS used to be for healthcare, but it is now far wider ranging than that. The technology is moving apace, and the UK is aiming to be at the forefront of the genetic revolution. We need to decide what place we will allow ethics to play in the face of this multi-million-dollar industry. And if we will allow ourselves to listen to the quieter minority voices of those whose communities are already being impacted.

 

Categories: Discussion