Up against it: the clergy's struggle with the Catholic hierarchy over legal contraception.

The struggle to make contraception socially acceptable--and subsequently legal--in the US lasted from before 1930 through the late 1950s. During this time there were literally hundreds of skirmishes between the opponents of birth control and Planned Parenthood and its supporters. The role of the clergy was central to much that happened in those years. During the 1930s, 1940s and 1950s, the clergy brought the "sanction of the sacred" to birth control, reiterating time and time again that responsible use of contraception was not only moral, but also had a spiritual dimension.

During the 1930s and the war years women's reproductive behavior was relatively unscrutinized. Depression and war meant that society had bigger fish to fry. In that climate of societal indifference, contraception slowly became more available. Some southern states were even distributing birth control devices in public clinics. Illegal abortion was practiced openly by some physicians in large cities, and therapeutic abortions were not uncommon in hospitals, at least for middle-class and wealthy women. But in the post-war years all that changed. For whatever reasons--anxiety about what to do with twelve million returning veterans, (almost all men) or a reaction to the freedom (financial and otherwise) women had acquired through working in war plants and serving in the military--society began to push women back into traditional roles. Suddenly all the sources of "authority"--doctors, clergy, magazine editors, even government officials--began to hit the same note: a woman's place was in the home; a woman's destiny was motherhood. This powerful pull toward social and sexual conservatism meant that women's ability to prevent unwanted births was now under serious scrutiny.

However, before the 1950s were over, an alliance between clergy, Planned Parenthood, and physicians would tear down one of the major barriers to women's reproductive freedom--the discriminatory policies of New York hospitals, though not without a struggle. The following accounts of the "Poughkeepsie Seven" and Dr. Louis Hellman's battle with Catholic-supported New York City public hospitals are just two of many.

DEFENDING DOCTORS: THE "POUGHKEEPSIE SEVEN"

On the morning of Friday, February 1, 1952, the front page of the New York Times carried the headline, "Catholic Hospital Tells Doctors To Quit Staff Or Birth Control Unit." Six days earlier, St. Francis Hospital, a 200-bed Catholic facility in Poughkeepsie, New York, had given an ultimatum to seven doctors on its medical staff--either break all corrections with Dutchess County League of the Planned Parenthood Association, or resign from the hospital's staff. They were given nothing in writing, and were told--incredibly--they had only 72 hours to decide. None of the doctors were Catholic. Four were Protestants, three were Jewish. Most of the doctors had been with the hospital for years. Their work with Planned Parenthood was no secret. In fact one of the doctors, Dr. Florence Gottdiener, was the assistant medical director of the local Planned Parenthood clinic. Why this sudden action? Why only three days to decide?

At first no explanation was forthcoming from the administration of St. Francis Hospital. And efforts to reach the New York Catholic Archdiocese, which had jurisdiction over the hospital, were unsuccessful.

As banner headlines in the local paper proclaimed, "St. Francis Hospital Warns Staff Against Planned Parenthood Affiliate," (1) the local Planned Parenthood League formed a special steering committee to deal with the crisis. Clergy were involved from the outset and their actions would be critical in the resolution of the crisis. Citing economic reasons, two physicians bowed to the hospital's directive and resigned from Planned Parenthood. But four others refused to resign. One other made it clear that as soon as his scheduled patients had their babies at St. Francis, he would resign from the staff of St. Francis and rejoin Planned Parenthood.

The ministerial committee of Planned Parenthood--nine ministers and one rabbi, all from Poughkeepsie--issued a strong statement condemning the hospital's action and supporting Planned Parenthood: "The attempt to police the thoughts and personal actions of individuals in our American democracy is un-American and contrary to our cherished principles.... The planned family is necessary for the well being of this and every other community throughout the world." (2)

In response, the dean of Catholic clergy in the area, Monsignor Michael E O'Shea, explained his defense of the hospital's action. Claiming that the hospital had been "lenient" toward these seven physicians, he said, "logically and in justice they should be called upon to resign from the hospital staff." (3) He was immediately rebutted by one of the doctors, Dr. John E Rogers, who said that in 22 years of practice in Poughkeepsie he never heard a word about a hospital policy concerning connections with Planned Parenthood, "It would appear that at sometime during this period of time, the hospital administration would have given us a lecture on the subject." (4)

In the face of this criticism, responses coming from the Roman Catholic community were tinged with more than a little denial. Monsignor O'Shea could not accept the statement of the Planned Parenthood clergy. Though it was obviously untrue he persisted in saying that "This is a point on which Catholic, Protestant, and Jew should be agreed since it is the Bible which expressly forbids birth control." When it was clear that there was no such agreement, he declared, "It is scandalous that there should be in Dutchess County a ministerial committee backing up the assertions of the League for Planned Parenthood." (5)

But the clergy were only beginning to express their opposition.

On February 3, the leading ministers of Poughkeepsie all preached on the ouster of the doctors. Typical of their approach were the remarks of Dr. Philip Allen Swartz, minister of the First Congregational Church and a former secretary of the Federal Council of Churches in America. In a radio address sponsored by the Council of Churches, he expressed his gratitude for the hospital's service to the city--but nevertheless criticized the actions of the administration. "The hospital's methods savor of medieval absolutisms rather than of an enlightened scientific and dramatic society. This arbitrary directive without even a hearing before their professional colleagues is a restriction of the personal liberties of men held in high public regard. We should honor these seven men irrespective of their decisions." (6)

National press coverage followed. The New York World Telegram and Sun came to town and asked hospital superintendent Sister M. Anne Roberta, "Did you receive a specific complaint against these seven doctors?" She flatly refused to answer. She was also asked if the hospital would extend the birth control order to cover patients. She replied, "That is absurd. We don't ask patients about their personal beliefs. What they believe in is their own business." (7)

More charges were leveled at St. Francis Hospital. Dr. William Meyer, medical director for the local Planned Parenthood League, noted that the hospital had not insisted that these doctors cease using contraception in their private practices, only in their work with Planned Parenthood. "Are we to conclude from this that the church means to condone contraception for those who can afford to obtain its benefits in a physician's office while withholding the same benefits from married women in the lower economic brackets who come to Planned Parenthood for help?" (8)

Then there was the issue of selective enforcement. One of the threatened doctors, Florence Gottdiener, medical director at Planned Parenthood's Poughkeepsie clinic, noted that nine other doctors were on the staff of St. Francis and also on the staff at Planned Parenthood. But nothing had been done to them. The state was asked to investigate whether the hospital's ultimatum violated New York's non-discrimination laws.

Even Time magazine covered the story, noting that the hospital was still not forthcoming with answers to the questions everyone asked--why had things gone on for so long without action, and why the 72-hour notice? But the big question that everyone was asking was who gave the order to initiate this action. One local newspaper, the Compass, said that two of the people involved believed the order came from "someone higher up. (9) This could only mean the Archdiocese of New York, known to be one of the most conservative dioceses in the country. Though we have no hard evidence to prove this allegation, it seems quite plausible. It is highly unlikely that the decision came from St. Francis. In fact the trustees of the hospital had never even heard of the decision until it was announced.

All attempts to reach New York Cardinal Francis Spellman were turned away.

In the absence of any statement from the archdiocese, public opinion grew increasingly unfavorable. When a Catholic hospital threatens to discharge physicians who disagree with it about contraception, it comes across more as an abuse of power rather than as moral leadership. The action by St. Francis Hospital also awakened the fears of many non-Catholics that the church might ride roughshod over them whenever it was in a position to do so. The Poughkeepsie situation demonstrated this perfectly. This was a small city. In such a place, though there will always be controversies, people in general want to get along. People become especially anxious when theological opinions seem to be affecting their healthcare systems. Many non-Catholics used St. Francis Hospital. They probably had few worries about it, but now they were facing a situation where their doctor might no longer be able to treat them in that hospital. And that would not be because of the doctor's skills, but because he or she belonged to Planned Parenthood.

But a prospective patient probably couldn't care less whether the doctor belonged to Planned Parenthood, the Elks, or the Socialist party, so long as he or she was the best doctor available.

Given all these factors, it was not surprising that the controversy ended the way it did. As the year went on, four of the physicians, led by Dr. Albert A. Rosenberg, who continued to serve as chair of Planned Parenthood's medical committee, steadfastly refused to resign either from the staff of St. Francis or from Planned Parenthood. Nothing was done to them. The hospital took no action.

And then, quite anti-climactically, one year later the "crisis" was over: In January 1953, St. Francis renewed the contracts of all of the doctors. Dr. Rogers, one of the three who temporarily left Planned Parenthood, indicated that the local community of physicians was contemplating "mass withdrawals ... if the hospital had failed to renew the privileges for anyone." (10)

The New York State Planned Parenthood Federation issued a gracious statement praising the hospital. "It is indeed a happy conclusion to an unfortunate situation. It also is a conclusion that reflects the reasonable attitude of the management at St. Francis Hospital, giving freedom of action for the highest standards of medical practice.

Our federation offers its congratulations to the seven physicians and its gratitude to them for their consistent stand while honoring St. Francis Hospital for its part in closing the books on the Poughkeepsie incident." (11)

Consistently the hospital had no comment. Sister Ann Roberta would not confirm that the reappointments had been made. She said only that there would be no statement from the hospital. What began with an ultimatum ended with silence.

THE 1958 BATTLE OVER THE NEW YORK CITY PUBLIC HOSPITALS

In 1958, the New York City municipal hospital system had a total of 20,959 beds and a budget of $135,000,000. In that year 210,000 patients were admitted as inpatients. Their outpatient clinics had 2,614,000 clinic visits. An astonishing number of New Yorkers, particularly the poor, used these hospitals and their services. But through an almost secret policy, birth control was kept out of everybody's hands. If a woman asked for contraception she was told, "We don't give out such information."

When Dr. Alan Guttmacher moved to New York from Baltimore in 1953, he was asked about his plans by the board of the hospital system and said that he wanted to start a contraceptive clinic. One board member, a layman, said, "Dr. Guttmacher, I don't think you should do that--you have no idea of the amount of Catholic financial support this institution has." He replied, "I thought it would be ridiculous for us to give in to this, instead of doing what was normally considered good medicine." (12)

When Joe Kahn, a reporter for the New York Post, began a series on the subject of birth control in the spring of 1957, he went up against a wall of silence and stonewalling. As he queried the major officials of the city's health system, each evaded the topic either by pleading lack of expertise or just plain pleading not to be put on the spot. The highest official, Mayor Wagner, flatly denied any "gentlemen's agreement" not to provide contraception.

"There is no ban on birth control information in city departments. I have never issued such an order and to my knowledge, there is no city law against it. Department heads may do whatever they believe is right to further the health and general welfare of the people." (13) But his subordinates were not going to accept the mayor's invitation. They knew that birth control was a taboo subject in New York City. The reason was obvious. The Roman Catholic church was unalterably opposed to birth control, and 46% of the voters in the city were Roman Catholic.

In addition, the city had witnessed a demonstration of the power of Catholic social agencies. In 1953, the city Welfare and Health Council, an assemblage of hundreds of social agencies, finally admitted Planned Parenthood to its membership. In protest, 54 Catholic agencies resigned, withdrawing their financial support. After two and a half years, the Welfare and Health Council admitted defeat and reorganized in such a way as to bar Planned Parenthood from policy-making and take away its vote.

For its part, the Roman Catholic leaders of the city denied that it had forced the city to agree to any policy. The Rev. Timothy J. Flynn, information director for Cardinal Spellman, said, "The Archdiocese of New York has no agreement with the city administration, and we are not aware of any ban on birth control information in city agencies. If such clinics were established by the city or state, naturally we would be displeased." (14) There is no reason to doubt this statement, though it is a bit disingenuous. The fact is they didn't need an agreement.

In fact this "gentlemen's agreement" to ban contraception seemed to need little enforcement. People seemed intimidated and were quite afraid to challenge it. Joe Kahn noted this when he said, "I was inspired in a bitter sort of way, by many people who took me aside and said they were for me, but not publicly. Some of these, at first--and rather incredibly--were people in Planned Parenthood." (15) So, on the eve of the battle, the city hospital policy against birth control was firmly established and--apparently--unchangeable.

Not surprisingly, later in the spring, the church weighed in. Monsignor Thomas J. Flynn, information director of the Diocese told the New York Times that, "any unnatural or artificial method of birth prevention is an immoral practice." To make sure the intentions of the diocese were clear he added," We would consider it immoral if the city embarked on a birth control program." (16)

DENIAL OF SERVICES: THE CRISIS BEGINS

In July, Dr. Louis Hellman sought to fit a contraceptive device for a Protestant woman who was in hospital with a severe case of diabetes. Claiming that another pregnancy would endanger her life, he was prepared to proceed with the fitting, using devices supplied by a pharmaceutical house, not by the city. The Kings County hospital medical board had given him authority to proceed in such circumstances. After hearing of Dr. Hellman's intentions, Dr. Harvey Gollance, supervisor of Kings County Hospital, ordered him not to proceed--but would not put the order in writing. Dr. Hellman was shocked. "Such an action would be highly improper on the part of the hospital director. One just doesn't do this sort of thing to a responsible physician." Following a call from Dr. Morris Jacobs, Commissioner of Hospitals, indicating that this was an order, Dr. Hellman said that he would comply. Appearing as it did on the front page of the city section of the Times, the story caused a mini-firestorm. A Protestant woman, being taken care of by a Jewish physician, had been refused a critically important medical service at a public hospital. And she had been refused because a city hospital was deferring to Roman Catholic opinion on this issue.

There was outrage for a number of reasons. Her physician stated that without contraception, the woman might now have to be sterilized in order to safeguard her health. Secondly the incident had made it clear that the calculated ambiguity of Commissioner Jacobs simply masked a hard--and secretive--policy. But people were also up in arms at the clear evidence of one religion being favored over another in the public square. Dr. Alan Guttmacher, director of obstetrics and gynecology at Mount Sinai Hospital and chair of the medical committee of Planned Parenthood Federation of America spoke to the medical issue: "I am shocked and disgusted. This points up the fact that Dr. Jacobs' platitudinous statement to the New York Academy of Medicine that he does not interfere with medical treatment elected by any chief of service at a city hospital is not only doubletalk but a total fabrication." (17)

Mayor Wagner was dragged into the controversy. He danced carefully around the issue by saying that he would enquire about the facts of the case from Dr. Jacobs. Dr. Jacobs continued to stonewall the press. At this point the New York Board of Rabbis, a collection of 600 Reform, Conservative, and Orthodox rabbis of Greater New York, issued a strong statement against the hospital policy: "we deplore the notion that patients in tax-supported hospitals who do not wish to adhere to the views of religious groups to whom the Department of Hospitals seems to be deferring, should be compelled to do so even if their very lives may be endangered.... Under our Constitutional principles of religious liberty government agencies may not directly or indirectly impose upon others the religious beliefs or practices of any one faith, nor as in this case may they influence the policies of tax-supported hospitals as if they were sectarian institutions." (18)

Press reaction was immediate and highly critical of the hospital's policy. Noting that the issue could have desperate urgency for the poor, the New York Post said, "It can be a matter of life and death for a lot of people who are unable to obtain the services and help of highly-paid private specialists." (19) For the New York World Telegram, legality was the issue, "We cannot see how Dr. Jacobs and the Board of Hospitals ... can justifiably reach any conclusion except that what is lawful throughout New York State must also be lawful in municipal hospitals." (20)

Editorially, the New York Times acknowledged Catholic objections to contraception, but went on to say "there are other Americans who do not share these views, and in the case of such patients we believe it would be wrong to confuse religious belief with medical practice." (21) The Protestant Council asked the 162 chaplains serving in city hospitals to "examine the situation" and report to the council. In particular the chaplains were asked if they knew of any direct or indirect interference with physicians. Then the Council appointed a committee of five Protestant clergy and a layman and demanded an immediate meeting with Dr. Jacobs. But Dr. Jacobs refused to meet with them.

Counter-pressures began to come from the Roman Catholic community. The Pasteur Guild, an organization of Roman Catholic employees in the Department of Hospitals wrote to Dr. Jacobs describing birth control as "morally objectionable, subversive of nature, and as insidious as the `snake of Eden'." Roman Catholic nurses pointed out that they might be forced to assist in fitting birth control devices, something they believed that they--in good conscience--could not do. The National Council of Catholic Women and the National Council of Catholic Men sent congratulatory telegrams to Dr. Jacobs. The Catholic Physicians Guild expressed its "determined opposition to such an immoral program." (22) But the main statement came from the diocese itself.

"The conjugal act ... is not and can never be merely an expression of physical and biological laws. Its purpose is more ennobling--the fulfillment of the primary end of marriage in the procreation of children.... Artificial birth control frustrates that purpose ... and subverts the sacredness of marriage.... No indication or need can change an action that is intrinsically immoral into an action that is moral and lawful." (23)

In response, more and more Protestant denominational groups declared their opposition to the hospital policy. The New York Conference of the Augustana Lutheran Church inveighed that, "No private religious group has a right to impose its belief on those who are not adherents of that particular group." (24) The Rev. Dr. Hampton Adams, pastor of the Park Avenue Christian Church proclaimed that, "we do not agree that opposition to birth control is the only Christian position." The Rev. Dr. Carson Wasson, pastor of the huge Rye Presbyterian Church and board president of the Port Chester Planned Parenthood Center, stated, "It is not legitimate for that [Roman Catholic] church to make such pronouncements in areas where other Christians disagree and expect the whole population to be bound." (25)

The United Lutheran Church in America and the Baptist Ministers' Conference came out against the hospital's policy, as did the New York Association of the Congregational Church, the group ministry of the East Harlem Protestant Parish, and the Orthodox Rabbinical Alliance of America. But the most prophetic of all was the Presbytery of New York whey-reflecting a high degree of political sophistication--sent a letter to Dr. Jacobs stating, that his "arbitrary" support for one minority view and his "contemptuous treatment of others" would not long "be tolerated by a wise city administration or by an informed electorate." (26)

This drumbeat of charge and counter-charge went on for the rest of the summer. While the mayor and Dr. Jacobs might have hoped that it would blow over, they began to realize that these political efforts reflected powerful feelings in both the Protestant and Jewish communities.

By late August the ice was cracking. Dr. Jacobs tried to propose a compromise whereby non-Catholic city hospital patients could be referred to private agencies such as Planned Parenthood. But the members of the Interdenominational Alliance to whom he made the proposal rejected it.

Then an influential national Catholic journal broke ranks and raised questions about the policy of the New York and Brooklyn Roman Catholic dioceses. One of the editors of Commonweal, James Finn, noted that there had once been widespread religious opposition to birth control, but that clearly times had changed. He therefore questioned the wisdom of Roman Catholic insistence on legal directives that did not have the sympathy of most Americans. He saw a danger in a strategy that relied too much on legal coercion. It seemed to him that it produced a distorted view of the church. Moral persuasion would seem to be a wiser course. (27) Nor was Commonweal alone in this estimate of the situation. Writing in the Catholic Messenger, Monsignor J. D. Conway also pointed out the futility of the hospital policy. Monsignor Conway felt that the church had already lost the struggle. (28)

In September, Planned Parenthood and the clergy each made their final effort. The Medical Advisory Committee of Planned Parenthood and the Bronx reminded the public of an ethical injunction of the American Medical Association which warned that medical care must never be based on "exclusive dogma or a sectarian system."

At the same time the Protestant Council made a formal request that the policy be changed. And they did so in the strongest moral terms.

"Whereas it is the predominant Protestant position that there is no moral reason for not using medically approved contraception ... therefore birth control or planned parenthood practiced in Christian conscience fulfills rather than violates the will of God. (29)

Now it would be up to the hospital board. This was a group of five physicians and five lay people, plus Dr. Jacobs. There were two Roman Catholic members but another member was the vice-president of the Planned Parenthood Foundation.

VICTORY: THE POLICY CHANGES

Although there had been some signs of change, it nonetheless came as something of a surprise when the board changed its policy by an 8 to 2 vote. The new policy instructed physicians to offer "medical advice, preventive measures and devices for female patients under their care whose life and health in the opinion of the medical staff may be jeopardized by pregnancy and who wish to avail themselves of such health services."

Furthermore their statement acknowledged that, "it is generally recognized by the medical profession that contraceptive measures are proper medical procedure." (30)

Astonishingly, Dr. Jacobs continued to insist that this statement did not constitute a change of policy. Insisting that it was merely a "clarification and elaboration" of his original letter to the Academy of Medicine, he simply said--with admirable understatement--"There has been considerable airing of the subject since July and considerable events (sic) which resulted in this present recommendation." (31) Mayor Wagner made no public comment.

But it was the joint statement of the Archdiocese of New York and the Diocese of Brooklyn that offered the most insights into what this victory meant. At first glance it seemed to be no different from the traditional Roman Catholic opposition to contraception. In its condemnation of the new hospital policy it stressed the old natural law argument that the primary purpose of sexual intercourse was procreation.

Presumably, any device that frustrated that purpose was wrong. It also attacked the morality of the clergy who had opposed it: "It was particularly surprising to read statements of some non-Catholic religious leaders who based morality on individual decision or the power of a majority vote." Stating flatly that the new policy "introduces an immoral practice in our hospitals that perverts the nature and dignity of man.... By seeking the alleviation of physical ills by the destruction of a natural and moral law, it indicates a weakness in a glorious medical profession." (32)

It concluded by stating that Catholic physicians and nurses must never cooperate with contraceptive procedures at the hospital. But another dimension of the letter had considerable historical interest. The church took pains to explain that it was not unmindful of the problems of marriage, of the need for the expression of love between husband and wife, of the dangers that childbirth could pose to the mother. Here the tone was defensive, indicating that at some level the church realized that it had lost the battle for public opinion.

Criticism like that from the Commonweal article had made it clear that even the American Catholic world was no longer that supportive of coercive anti-contraceptive public policies. After all, this was 1958. A new pope, Pope John XXIII, was in office. The Vatican Council was coming, as was a completely new form of birth control-the pill. And the scientist most associated with its development, Dr. John Rock, was a Catholic. The times were clearly changing.

Ironically the most striking portion of the statement was the assurance that abstinence was not the only acceptable practice when a couple wished to avoid children. Couples could also practice the rhythm method that allowed intercourse during "periods of natural sterility." That the church felt compelled to offer its own method of contraception was the clearest evidence that the birth control movement had changed even them. Margaret Sanger had recognized the profound human need for birth control and in the end, despite the years of bitter opposition to her, the church had to follow her lead and find a method of birth control it could sanction.

In this 1958 controversy, the church lost its monopoly. Two other religious traditions represented by the Protestant and Jewish clergy presented a different religious morality, one in which contraception was highly moral. This gave political "cover" to bureaucrats like Dr. Jacobs and politicians like Mayor Wagner. They could risk offending the Catholic church because the conflicting moral claims of other religious bodies had entered the public debate in a strong and assertive way.

NOTES

(1) Poughkeepsie New Yorker. January 30, 1952.

(2) Poughkeepsie New Yorker. January 31, 1952.

(3) Ibid.

(4) Ibid.

(5) New York Herald Tribune, February 1, 1952.

(6) New York Times, February 4, 1952.

(7) New York World Telegram and Sun, February 1, 1952.

(8) New York Herald Tribune, February 1, 1952.

(9) Compass, February 3, 1952.

(10) New York Times, January 22,1953.

(11) Poughkeepsie New Yorker, January 21, 1953.

(12) Best, Winfield, "The Anatomy of a Victory: A Panel Discussion on a Public Controversy," internal document of Planned Parenthood Federation of America, New York, New York, 1959, pp. 2-3.

(13) Kahn, Joe "Birth Control: New York's Untold Story," New York Post, Spring, 1957.

(14) Ibid.

(15) Anatomy of a Victory, p.12.

(16) New York Times, May 22, 1958.

(17) Ibid.

(18) Planned Parenthood News, Fall, 1958.

(19) Ibid.

(20) Ibid.

(21) New York Times, July 18, 1958.

(22) New York Times, July 24, 1958.

(23) Ibid.

(24) New York Times, July 25,1958.

(25) New York Times, July 28,1958.

(26) New York Times, August 4, 1958.

(27) Commonweal, September 112,1958, p586.

(28) Planned Parenthood News, Fall, 1958, p.3.

(29) New York Times, September 10, 1958.

(30) Planned Parenthood News, Fall, 1958, p.1.

(31) New York Times, September 18, 1958.

(32) Ibid.

Rev. Tom Davis was Assoc. Prof. of Religion and Chaplain at Skidmore College in Saratoga Spring, NY, from 1966 to 1996. His graduate work was done at Union Theological Seminary and Duke University (PhD). Currently he chairs the Clergy Advisory Board of Planned Parenthood Federation of America and is a member of the Religion and Culture Task Force of the National Campaign to Prevent Teen Pregnancy and of the national board of the Religious Coalition for Reproductive Choice.

These extracts are from a forthcoming book on the Clergy Advisory Board of Planned Parenthood Federation of America by Tom Davis.