Susanne M Klausen, Race, maternity, and the politics of birth control in South Africa, 1910–39, Basingstoke, Palgrave Macmillan, 2004, pp. xix, 221, £45.00 (hardback 1-4039-3452-5).

Abstract

In South Africa “population control” is commonly associated with the racist policies pursued by the Nationalist Party during the apartheid years between the 1960s and 1980s. Such ideas, however, pre-date the apartheid regime. As Klausen points out in her engaging and scholarly book, ideas of population control and the provision of contraception in South Africa can be traced back to the efforts of middle-class social reformers in the 1930s, supported by the Department of Public Health, to combat the fertility of poor whites. Much of the work of these reformers was driven by fears about the decline of the young nation, the degeneration of the white race and concerns about the stability of the family in the light of rising maternal mortality. As Klausen shows, South African birth control activists in the 1930s were divided between two different ideological camps. The first group, primarily made up of male professionals, was inspired by eugenicist ideals. Their aim was to curb the fertility of the supposedly biologically inferior poor whites and feebleminded. In the aftershock of the Great Depression, poor whites became a key social concern and focus for fears about the future of white society. The eugenicists believed that controlling the birth of “unfit” whites would not only strengthen the white race, but also reduce the middle-class taxes subsidizing the survival of poor whites. In contrast, the second group of birth control activists, mostly maternal feminists, sought to improve maternal and infant health and welfare among South African women of all races. Inspired and supported by Marie Stopes back in England, these campaigners thought contraception would help mothers space their families and thereby stabilize the family and strengthen the nation state. Using records from birth control clinics in Johannesburg and Cape Town, Klausen skilfully shows how the different ideologies affected the types of contraceptive services provided. Established by eugenicist-inspired birth control activists, the Johannesburg clinic hosted contraceptive services for white women only. The clinic itself limited the choice of contraception to the diaphragm and hired only male doctors. The clinic in Cape Town, however, set up by maternal feminists, deployed female doctors and offered a wide range of contraceptive technologies to women of all races. Attendance rates at the two clinics reflected the differences in the types of services provided. While the Johannesburg clinic struggled to entice women to its doors, the one in Cape Town was highly popular. Klausen's research of the two clinics powerfully illustrates not only the different ways ideology shaped provision in the two cities, but also how such services were influenced by patients. Women's lack of attendance at the Johannesburg clinic prompted a major shift in its organization. By the late 1930s the clinic was employing women doctors and being run by lay female members. Moreover women of all races were being encouraged to use its services. As Klausen points out, such changes demonstrated “that the relationship between users and providers was not one of control from above by providers” and that “the service providers needed users more than users needed the birth-control clinics” (p. 104). While focusing on South Africa, Klausen's study meticulously shows how the ideas and practices of the different birth control campaigners drew upon and influenced those being developed in other countries such as Britain. For anyone interested in the history of birth control, Klausen's book provides a fascinating insight into the complex dynamics between ideology and the provision of services, as well as the influence of international and local politics on the networks that shaped access to contraception.