Editor's note: This is the second story in a three-part series about the American eugenics movement after World War II. The series focuses on the wealthy benefactors and various promoters of eugenics, including ministers, bankers, journalists and politicians (part 1); the advertising and public relations machine behind the movement (part 2, below); and the racial aspects of eugenics (part 3).
Sen. John L. Sanford was a Democrat, a Catholic—and fed up. "When you have a woman who has seven or eight illegitimate children and she keeps on having them at the expense of the taxpayers it's time to do something about it," Sanford, a Maryland lawmaker, told the Washington Star in early 1960.
His legislation called for the sterilization of any woman with more than two illegitimate children. She could also be subject to a three-year prison term, a $1,000 fine, a declaration that she was "morally unfit for the care, custody and control of any of her existing children," a permanent ban from receiving welfare payments and having the state remove existing children from her care.
Sanford's bill passed the Maryland Senate 23-3, but it never became law. It was one of many similar efforts that appeared throughout the country in the same era. In 1956 a Virginia legislator suggested that any woman with more than one illegitimate child should prove why she shouldn't be sterilized. North Carolina debated compulsory sterilization laws in 1957 and 1959. Mississippi legislators began proposing sterilization of unwed mothers in 1958, and politicians or public officials in Illinois, Wisconsin, California, Iowa and Georgia also discussed similar laws. Across the nation, eugenic sterilization was shifting from targeting poor whites, immigrants and the "feebleminded" in institutions to overwhelmingly targeting minorities.
The question is why.
In a cruel twist, the very social programs that were designed to fight poverty did what the eugenics movement had never been able to accomplish: generate accurate lists of hundreds of thousands of poor people around the country.
In many cases, that brought the people into a system that considered sterilization one way to fight poverty. Or, as some politicians quickly realized, a way to limit the cost of fighting poverty. State and local governments paid for operations, and by the late 1960s the federal government stepped in. Julius Paul, a researcher at the Walter Reed Army Medical Center, was perhaps the first to note that a surge in public demand for compulsory sterilization had returned for the first time since the early 1930s.
But the racial shift would never have happened without a change in how society viewed sterilization—which is now called having the tubes tied or a vasectomy. In the 1940s most doctors refused to perform the operation even for patients who clearly wanted it. That's where Dr. Clarence Gamble and the eugenics group Birthright played a key role. They worked on making sterilization more acceptable to the general population. Through advertising and TV and radio appearances, Birthright and Gamble tried to polish the hard edges of their message: There were far too many people unfit to be parents.
Birthright began as a tiny fringe group in New Jersey, but in the late 1940s it moved to space in the New York Academy of Medicine, a highly respected institution. The next year its members further cemented its positive reputation by furnishing information on sterilization to the Population Division at the United Nations, and Gamble had an article on sterilization published in the Journal of the American Medical Association.
In 1950 Birthright changed its name to the friendlier-sounding Human Betterment Association. Gamble hired a New York City advertising firm to help with the makeover, and soon talented graphic artists were sketching, copy was being polished and downtown printers were shipping hundreds of thousands of copies of sterilization "literature" all over the nation.
The 42nd Street firm J.M. Mathes also helped place articles in newspapers and magazines, according to records of the campaign. "Dear Dr. Gamble: Enclosed is a tear sheet from the New York Post of Sunday, November 7, in which I think you will be considerably interested! Success at last! Local magazine circles seem to be quite impressed as this appears to be the first time that sterilization has been considered favorably by the popular press," an account representative wrote.
Gamble, astute about stroking the media, wrote back asking if it would "be helpful to have letters of commendation sent the Editor? We might get the sterilization enthusiasts to send some."
Gamble's New York contact noted the images of candidates for sterilization weren't of sufficient quality. "In spite of the retouching, however, the feebleminded one left much to be desired. We very much need some good, well lighted professional pictures for such purposes. It isn't possible to do an effective job with 'snaps' the social workers take for case records."
Although the creepy brochure titled "You Wouldn't Expect" was designed in New York, it was imprinted with different return addresses to make it look like a local production from Iowa, North Carolina or other states.
Another draft for a poster to promote sterilization read:
America Needs More Little Girls Like This
Who are happy healthy and intelligent
And Fewer Little Girls Like This
Who are doomed from birth to empty meaningless lives
Paul Popenoe, a Human Betterment Association director and prominent backer of eugenics, turned to TV in the 1950s, says Edward Larson, a Pulitzer Prize-winning historian and the author of Sex, Race and Science: Eugenics in the Deep South. "You get people like Popenoe, re-creating himself and becoming the guest on Art Linkletter's House Party, trying to advise people on how to raise their children. But if you really look at those old tapes it really was eugenical thinking. But he was able to package it for television."
The Human Betterment Association insisted its push for sterilization had no overt racial bias, the mention of which is absent from thousands of pages of its records and correspondence. But the association was naive about how potent a force racism would become. Knowingly or not, it helped enable a vastly expanded network of people who might impose sterilization on the unwilling. Frustrated by delays and limitations in working with state eugenics boards, the group built a network of hundreds, or perhaps thousands, of doctors and social workers who would perform the operation. Many of those operations—but not all—simply represented the growing numbers of Americans who wanted a safe, permanent form of birth control.
Birth control was controversial in the mid-20th century. The debate wasn't over abortion, but whether even married couples had the right to use any form of birth control at all. A 1942 editorial from the Lowell Sun in Massachusetts showed a common view. "Birth control is in itself a negation; it is in essence negative. It accomplishes nothing; no good comes of it; it is wholly unproductive. It is against the law of God; it is contrary to the laws of nature. The mere thought of its practice is repugnant, utterly repugnant, to the rational human mind ... And where is there the husband or wife who claims such omnipotence that he or she would unnaturally challenge the will of the Almighty to create a child?"
According to that logic, even the use of foams, condoms or the rhythm method was immoral, and women who had six or eight children were supposed to keep having more. Such views enraged Gamble, and in fact, on that issue history has come down on his side.
This debate over voluntary sterilization was a key point for the Human Betterment Association. Alongside support for eugenics that most now find repugnant, the group was in the vanguard of fighting for the now basic right of access to birth control.
But the support for voluntary sterilization helped to gloss over abuses. Its carefully crafted press releases and public statements mistakenly imply that virtually everyone sterilized under state laws agreed to the operation. However, numerous protest letters in Georgia suggest otherwise. One Atlanta woman wrote to the superintendent of Milledgeville State Hospital, baffled about her sister's order for sterilization. "She has always cared for or associated very little with men, and in the two odd years she was married never became pregnant so I am at a loss to understand the reason for the operation." The superintendent wrote back that he would "be delighted" to explain the purpose of the operation if the sister visited the institution. Despite the sister's continued objections, the 38-year-old woman was sterilized the following year.
And though there were public reports about the activities of state eugenics programs, extreme details were kept secret. In North Carolina a previously unpublished 1953 memo suggests building "a file on children ten years of age and under whose IQ's fall below 50. I would further suggest that follow-up letters be written when the child becomes twelve years of age. We will have this information available for whatever use we may wish to make of it." North Carolina also compiled lists of "the names of feebleminded Negroes in your county, over 12 years of age, for whom a petition has not yet been filed with the Eugenics Board."