Day after day the attendants at the British Museum piled books and pamphlets on the table before my seat. As I pored over the vital statistics of Europe it seemed to me that chiefly in the Netherlands was there a force operating towards constructive race building. The Dutch had long since adopted a common-sense attitude on the subject, looking upon having a baby as an economic luxury—something like a piano or an automobile that had to be taken care of afterwards.

The Drysdales often mentioned the great work done by Dr. Aletta Jacobs of Amsterdam and Dr. Johannes Rutgers of the Hague. The story of Dr. Jacobs’ conquest of nearly insuperable obstacles to a medical career was particularly appealing. Born in 1854 in the Province of Groningen, she was the eighth child of a physician who, on eight hundred dollars a year, had to support his wife and eleven children. Even before adolescence she had asked defiantly, “What’s the use of brains if you’re born a girl?” She was determined to become a doctor like her father, though no woman had ever been admitted to Groningen University. Her spirit was so indomitable that when at seventeen she had passed the examinations and demanded entrance, she had been permitted to listen for a year, and then allowed to register as a permanent student.

In 1878 Dr. Jacobs had finished her studies in medicine at Amsterdam University and gone to London, where she had attended the Besant and Bradlaugh trial, met the Fabians, met the Malthusians, become an ardent suffragist. This first woman physician in the Netherlands had returned to Amsterdam and there had braved the disapproval of her father’s friends by practicing her profession and by opening a free clinic for poor women and children, where she gave contraceptive advice and information, the first time this had ever been done in the world.

Within a few years and within a radius of five miles the proportion of stillbirths and abortions as well as venereal disease had started to decline, children were filling the schools, people were leaving their canal boats to go into agriculture.

The Netherlands being such a small country, where one person’s business was everybody’s business, such changes could not escape notice. Just about this time Dr. Charles R. Drysdale, then President of the English League, had been invited to address an International Medical Congress held in Amsterdam. The results of Dr. Jacobs’ clinic were so apparent that immediately thereafter the Dutch Neo-Malthusian League had been formed and thirty-four physicians had joined it. When other centers were established, purely for consultation, the word clinic was applied to them also. In 1883 Dr. Mensinga, a gynecologist of Flensburg, Germany, had published a description of a contraceptive device called a diaphragm pessary, which he and Dr. Jacobs had perfected. Dr. and Madame Hoitsema Rutgers had taken charge of the League in 1899 with such success that the work had spread through that well-ordered kingdom. In recognition of its extensive and valuable accomplishment, Queen Wilhelmina had presented it with a medal of honor and a charter, and counted it one of the great public utilities.

In my statistical investigations I paid special attention to the birth and mortality rates of the Netherlands to see how they had been affected over this period of thirty-five years. They showed the lowest maternal mortality, whereas the United States was at the top of the list; three times more mothers’ lives were being saved in the little dike country than in my native land. Furthermore, the infant death rate of Rotterdam, Amsterdam, and the Hague, the three cities in which the League was most active, were the lowest of all those in the world.

During the same period the death rate had been cut in half, but, surprisingly, I found that the birth rate had been reduced only a third. In other words, the death rate had fallen faster than the birth rate, which meant that the population of the Netherlands was increasing more rapidly than that of any other country in Europe.

I had much difficulty in reconciling these figures with my preconceived idea that birth control would automatically bring about a decrease in population. Since it was increasing, then perhaps birth control was not, after all, the answer to the economic international problem. If this were true all my calculations were going to be upset.

Impatient to go to the Netherlands and dig out the real facts, not only from Dutch records but from personal observation, I decided quietly—most of my decisions in those days were quiet ones—to cross the Channel. This implied possible unwelcome encounters with inquisitive officials, floating bombs, submarines, and every type of inconvenience and delay, but my eagerness made me discount the hindrances.

I applied, to the Dutch Consul for a visa to Bertha Watson’s passport.

“Eighty cents, please,” and no questions asked.

So that I should not have to return to London before going on to Paris I presented myself at the French Consulate also. I waited two hours. “Two dollars, please,” and still no queries.

I attached myself to the end of the long line waiting at Victoria Station to have passports inspected, and was soon safely on the train for Folkestone. We were late when we reached the Channel. Again we lined up for inspection. Many Belgian women with four or five children were going back to their people; the sleepy little ones and the tired women settled on the platform to rest until some had gone through. Two detectives glanced casually at my passport, and then allowed me to enter the official chamber. Inspections had been growing steadily more strict; this was the ultimate test. There sat in a row three officers in mufti, well-fed and brusque with authority. I handed my passport to the first, who looked me up and down as though I were a treacherous enemy, then pushed it over to the next. This man too viewed me with suspicion and mistrust, and pulled out a notebook, scanning the names to see whether mine were on the proscribed list. The last of the three, who was to make the final decision—crisp, trim, and hard as nails in voice and manner—demanded, “What are you going to the Continent for, Madam? Another joy ride? You Americans must think that’s all this War amounts to. Can you produce any good reason for letting you through?”

Fortunately I was prepared for such a contingency. I took out of my purse a letter from Bernarr MacFadden asking me to answer certain questions in the form of articles for Physical Culture such as the relation between the unfit and population growth. I offered this document while those in line behind me waited restively. He read it meticulously, taking longer than necessary as it seemed to me in my nervousness. At last he folded it neatly and said, “A good work, this. Too bad someone hasn’t done it before.”

Then he put his last official stamp on my various papers and I passed through for the gangplank.

No complications presented themselves at the Hague, and early on a January morning in 1915 I registered at an inexpensive hotel. It was comforting to hear a radiator sizzling once more. I joined the other guests who were cheerfully breakfasting together en famille at a single table, and, since I spoke neither Dutch nor German, silently munched my black bread and cheese, downed the excellent coffee, and watched interestedly. Though stolid in appearance like all the Dutch, they were friendly.

I did not try to telephone Dr. Rutgers. Instead, though it was not yet nine o’clock, I hailed a taxi and held out to the driver a slip of paper on which I had written the street and number. In response to my ring at the door to which I was delivered, a tiny square window in the upper part opened mysteriously and a face—wizened, aged, and inquisitive—was framed in the aperture. It remained while I explained my mission. Apparently trust was inspired because, my story finished, the door swung wide and the face, materialized into Dr. Rutgers, ushered me into the library, where I waited until he came back in his street clothing. Then we went out to a second breakfast in a near-by cafÉ.

The doctor turned out to be a kindly little man, whose wife was now an invalid. It was hard for him to talk English. Most of the Dutch had four languages, but only those who had lived in England spoke English well. The difficulties, however, lessened as we nibbled brioches and sipped coffee after coffee until noon. Warming to my narrative of the battle in the United States, he shook his head when he thought of what I might have to face in the future, and expressed more concern over my predicament and more heartfelt sympathy with my having had to leave the children behind than anybody I had yet met. He was the first person to whom I had been able to overflow about my personal sadness.

On his part Dr. Rutgers described his hardships in keeping the clinics open and, through the League, preventing adverse legislation. Neo-Malthusianism had never been popular anywhere, no matter what the proof in the lessening of human misery and suffering. Dr. Rutgers had borne alone the brunt of all the criticism directed at his society.

The Rutgers method for establishing new clinics had resulted in a sound system for dealing with the birth rate. The men and women who acted as his councilors understood that a rising birth rate, no matter where in the country, would soon be followed by a high infant mortality rate. Accordingly, they reported this quickly to the society, which sent a midwife or practical nurse, trained in the technique standardized by Dr. Rutgers, into the congested sector to set up a demonstration clinic. She usually took an apartment with two extra rooms, one for waiting, the other a modestly equipped office like that of any country midwife.

Her duty was to go into the home where a child had died, inquire into the cause, and give friendly advice regarding the mother’s own health. She also encouraged her not to have another baby until the condition of ignorance, poverty, or disease, whichever it might be, had either been bettered or eliminated. Whenever four had been born into such a family this advice was made more emphatic.

As soon as Dr. Rutgers had explained his policy to me I had that most important answer to the puzzling and bothersome problem of the increasing population in the Netherlands brought about by birth control. It was proper spacing. The numbers in a family or the numbers in a nation might be increased just as long as the arrival of children was not too rapid to permit those already born to be assured of livelihood and to become assimilated in the community.

Dr. Rutgers suggested I come to his clinic the next day and learn his technique. He was at the moment training two midwives preparatory to starting a new center in the outskirts of the Hague. Under his tutelage I began to realize the necessity for individual instruction to patients if the method of contraception prescribed was to fulfill its function. I wondered at the ease with which this could be done. Very soon even I myself, unable to talk to these women in their own tongue, instructed seventy-five.

I used to bombard the little man with questions concerning each case. I took issue with him over his autocratic system of dictating without explanation. Merely saying, “This is what you do. Do this always,” had to my mind no educational value.

“Don’t you think it would be a good idea to tell your patients what you’re aiming at and why?” I asked.

“No, can’t take time. They must do what they’re told.”

His was the doctor’s point of view with which I was familiar, but with which I could not agree.

It also seemed to me a mistake to regard the women merely as units in a sociological scheme for bettering the human race. On the file cards were inscribed only names and addresses; no case histories. I wanted to know so much more about them. How many children had they already had? How many had they lost? What were their husbands’ wages? What was the spacing in each family, and what were the effects? How successful had been the method of contraception?

If this information had then been recorded, the birth control movement could later have cited chapter and verse in its own support.

After my morning’s work with Dr. Rutgers I usually repaired to the Central Bureau of Statistics with my three-in-one translator, interpreter, and guide. My findings were that in all cities and districts where clinics had been established the figures showed improvement—labor conditions were better and children were going to schools, which had raised their educational standards. Professional prostitutes were few, and even these were German, French, Belgian, or English, because Dutch women were encouraged to marry early. It made a difference. From the eugenic standpoint there had been a rapid increase in the stature of the Dutch conscript as shown by army records. The data proved conclusively that a controlled birth rate was as beneficial as I had imagined it might be, growing out of the first clinic initiated by the enterprise of Dr. Aletta Jacobs.

I was, of course, looking forward to meeting Dr. Jacobs, and sent her a note asking for the privilege of an interview. A reply came, curt and blunt; she would not see me. She was not concerned with my studies or with me, because it was a doctor’s subject and one in which laymen should not interfere. Already I had come to the same conclusion in principle, but was dismayed at this first rebuff I had encountered. I was also hurt as much as I could be hurt during that period when I seemed to be one mass of aches, physically and mentally. Not until much later did I learn that to be a nurse was no recommendation in Europe, where she was more like an upper servant, a household drudge who took care of the sick instead of the kitchen.

For two months I wandered about the Netherlands, visiting clinics and independent nurses in the Hague, Rotterdam, and Amsterdam. In spite of the League propaganda against commercialization I found many shops in which a woman, if she so desired, could purchase contraceptive supplies as casually as you might buy a toothbrush. Unfortunately in some of them she could be examined and fitted by saleswomen who had but little training in technique and scant knowledge of anatomy. Although the Dutch League had several thousand members—each one active, writing to papers, talking to friends, attending meetings—and although fifty-four clinics were in operation, many well-informed people did not know anything about them. More surprising still, the medical profession as a whole appeared to be utterly ignorant of the directed birth control work that was going on. It did not, therefore, seem extraordinary that no inkling of all this—either clinics or contraceptive methods—had ever reached the United States, and practically no attempt to copy it been made in England.

Even in this neutral country signs of war were everywhere. Along the way were soldiers in uniform, armed and keeping guard, and at the stations Red Cross wagons were in readiness. Feeling among the Dutch was greatly mixed: Queen Wilhelmina’s husband was a German; the army and the aristocracy were for the Triple Alliance; the poorer classes were more influenced by the sufferings of the thousands and thousands of Belgians who had flocked to Dutch firesides for food and shelter.

Nowhere else was I so impressed with the tragedies of war. Often about four o’clock I had kaffee klatch at the home of some Dutch lady who sat, very proper, while the maid served coffee, the best in Europe, from the big, white, porcelain pot. I suspected most of the morning had been spent in supervising preparations for the delicious food.

At one of these afternoons I was introduced to five German delegates who had come to attend the Women’s Peace Conference. They found it difficult to forgive the stories of German atrocities which England had allowed to circulate. I ventured to inquire how they could disprove them, especially in view of the report of the Bryce Commission. “Was not war cruel and savage, and might not these things have happened?”

“Yes, yes,” one said, “but hundreds of our German boys are brought back to us, dead and alive, whose noses and ears have been cut off, put in packages, and taken to headquarters for reward. However, we would not dream of accusing the French or the English soldiers of such barbarisms. We know that because their code forbids them to do these things themselves they have called in the Moors and the Gurkhas and the savages from Africa.”

Unable to comprehend how those towards whom they felt such friendliness could return this sentiment with hatred, the women said to me in bewilderment, “Tell us really why people who do not know us hate us as they do.” The dignity of their sorrow, the heavy burden of grief under which they labored, the very calmness and fairness with which they bore it, had a quieting effect.

The Netherlands was the place to regain a certain sense of balance, especially if you had passed through England, where feeling was so embittered. I overheard in Amsterdam a most illuminating conversation between two Englishmen and a German. After going over the pros and cons, they shook hands all around, agreeing that six months after the War was settled German and English trade would be hand in glove, trials and grievances forgotten.

To go directly to France from the Netherlands was next to impossible; nor did I find it easy to travel roundabout by way of England, owing to the recently instituted German submarine blockade. Then at last I heard that a freighter was to be sent to London to test it. Day after day I went to the docks for news, and employed the interval with pleasant social contacts.

Rather than have a cocktail before lunch or dinner the Dutch assembled at their favorite restaurants for apÉritifs. The glass, with winged rim spreading out about half an inch from the top, was filled to overflowing with Bols. You were not supposed to touch it at first; instead you leaned over and sort of scooped a little with your mouth before picking it up and enjoying it. The French apÉritifs were pleasant and mild, but Holland gin was so strong and raw that I marveled at the way they could take it with a smile. I was definitely unequal to the art.

One evening I was invited to play billiards with a Dutchman, an Englishman, and a German. I accepted as naturally as for a game of whist. Afterwards the Dutchman said that, though no respectable Dutch wife could have played billiards in that room without later being approached or insulted, an American woman could do anything and still not lose caste. She minded her own affairs, paid her own bills, and even if she were seen on the streets late at night without an escort everyone knew she must be on legitimate business.

Then the Englishman spoke to the same effect. He said you found the American woman in all sorts of out-of-the-way and often questionable places, but you needed only to look into her candid face to find an answer to what she was doing there. European women owed her a great deal for her pioneering on the Continent. In England it was a common sight to see the most estimable women smoking cigarettes in all fashionable restaurants and hotels just as in America.

“Just as in America!” I gasped, remembering my astonishment at having seen women smoke publicly in London. “I’m sure there must be some mistake. Ladies are not supposed to smoke in America. As an example to Europe they’re a failure, because they haven’t even won that liberty for themselves.”

This was a surprise to them all. But the Dutchman rallied to the defense, shifting the subject. “Nevertheless, she is the best-dressed woman in the world.”

“What about the Parisian?” I exclaimed.

“I except none. I have been over half the globe. I have paid particular attention to foreigners, their customs, their education, their tastes, and I have been convinced that today the Parisian woman has had to yield to the American in respect to clothes and fashion. Paris designs are intended for the United States, not for France or England. The Frenchwoman may be trim and neat and jaunty, but it takes a woman of wealth in France to be in the fashion, while in New York, every shopgirl wears cheap editions of the latest styles.”

The German was deep in thought during these speeches, resting his chin in his hand. Aroused by the striking of the clock he suddenly interpolated, “Why, you can always tell an American couple in Europe. The woman is too bossy, she leads the way, she does all the talking and ordering, while the man trails on behind her and silently pays the bills.”

“Well, you must have seen him when he was on his good behavior,” I suggested, “for at home he is not so silent about paying the bills.”

Unabashed, the German continued, “My brother who has long lived in America says the woman there is the head of the house, that she manages all; her word is law. Is this true?”

He seemed greatly disturbed, and I was about to reply, but the Briton rose to speak. “Of course she is, because she’s far superior. Why, American men have nothing in common with the women. They are coarse, blunt, crude, while the women are finely sensitive, exquisite, and courteous. The man has nothing to give his wife but money; he comes home at night and talks business, introduces into his home only friends who will help him out financially, and when his wife discusses music, art, or literature, he falls asleep and snores. That’s why she brings her fortune into Europe for a husband. She finds her equal in the Frenchman, the Italian, the Spaniard, but particularly in the Englishman. For every Englishman is a gentleman, and every American woman is a lady!”

The German added a final convulsive note to the settlement of the woman problem by adding, “Is it true the American husband not only washes the dishes but pushes the perambulator?”

“Why, yes, he often does that.”

“That is terr-r-r-rrible,” he answered, the r’s rolling out, and his hands clasped tight to his temples.

And at that we all departed for our rest. But a few days later one or another of the quartet was demonstrated right. News came that my boat was about to leave at once, and I sought out the Captain. At the first intimation of my errand, he waved his hands and said, “No! No! No women!”

I kept on talking until I made him admit he was interested in America, in diet, and in population. When I found he was a reader of Physical Culture I produced my open sesame letter and again it was more potent than a passport. I stood reasoning with him on the pier, until finally he said, “There’s a rule to take no women. But you Americans are not like others. I think I can put you in.” I was allowed to embark.

During the voyage we were most careful, anchoring at dusk, and when it was light keeping sharp watch for floating mines which might have broken loose from their moorings. It took us two nights and a day to make a crossing that ordinarily occupied only nine or ten hours.

I had plenty of time to sort out my impressions and conclusions regarding the birth control movement. They had been revolutionized. I could no longer look upon it as a struggle for free speech, because I now realized that it involved much more than talks, books, or pamphlets. These were not enough.

Personal instruction had been proved to be the best method, and I concluded clinics were the proper places from which to disseminate information but also, admirable as they were in the Netherlands, they ought not to be placed in the hands of unskilled midwives, social workers, or even nurses. These could, of course, instruct after a fashion, but only doctors had the requisite knowledge of anatomy and physiology and training in gynecology to examine properly and prescribe accurately.

I had a new goal, but how difficult and how distant its attainment was to be I never dreamed.