BIRTH CONTROL ADVICE [To the Editor of THE SPECTATOR.
SIR,—I am afraid that your correspondent, Mr. T. Magnus Wechsler is far too optimistic in thinking that not a single Local Authority can be cited which does not provide for con- traceptive instruction where further pregnancy would be detrimental to health. It would, I fear, be possible to prOvide him with a fairly long list by name. The. National Birth Control Association endeavours to keep an up-to-date list of authorities taking action of one kind or another for giving such instruction. Out of 1,200 Local Authorities only. 48 have up till now either established a clinic at a hospital or otherwise, or arranged a special session of their M.--and C.W. work for birth control advice, or (as Mr. Wechsler states) arranged to send patients to a private Birth Control Centre
paying fees. The latter method has at present been adopted by only 15 Authorities. In addition, some 14 Authorities are known up to date to be considering schemes, some of which are on the eve of being put into operation.
The remainder however is very large. It is true that in a good many cases (the records of the Association show 26, but this is probably inadequate) Medical Officers of Health have been authorized to give advice where in their opinion it is needed, and in the limited number of localities where a voluntarily supported centre exists often, though not always, advise patients (at the latter's own expense and that of the charity) to seek help there. In the great majority of cases, however, no such centre exists, and neither the MAUI. himself nor his assistants are trained in the necessary technique and are therefore unable to teach their patients. A great need is the inclusion of this training in the curriculum of medical students and of post-graduate courses. To our know- ledge there are districts (and probably the actual numbers are considerable) where the authorized advice is of the most inadequate description. When all this at best is allowed for, however, there still remain hundreds of districts where no contraceptive advice is available from such sources at all and many where local Councils have definitely and within recent months turned down a proposal to provide it to women whose health requires it.
It may be. hoped that the latest Circular from the Ministry of Health calling attention to the findings of the Departmental Committee on Maternal Mortality and Morbidity, and the need of avoiding pregnancy by women suffering from many types of diseases will encourage Local Authorities to use such powers as they possess. As Mr. Wechsler points out, they are severely handicapped by the limitations stated in Memo- randum 153. The new Circular, however, does definitely enlarge these powers when action is taken on certain lines.— (Acting Secretary).
National Birth Control Association, 26 Eccleston Street, S.11' .1 .
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