Janet Farrell Brodie, Contraception and Abortion in 19th-Century America. Ithaca, N.Y.: Cornell University Press, 1994. Pp. xviii+373. US$37.35 HB.

Reproductive control in the nineteenth century was a rich site for the intersection of discourses and interests, and its history throws open windows into worlds previously obscured from the historian's gaze. Janet Farrell Brodie reveals fascinating vistas of nineteenth-century American publishing, marketing, lyceum lectures, freethought, folk medicine and popular knowledge. The picture she paints has a distinctively American tone to it, between hustling small capitalist entrepreneurs and the frontier spirit of contraceptives home-concocted from kitchen staples or local botanicals. In fact, a subtext seems to be the establishment of reproductive control as, historically speaking, an 'All-American' enterprise, with the recuperation of a different model of 'family values'. Brodie argues that, prior to the Comstock Act's effective taboo on public mention of contraception from the 1870s well into the twentieth century, the culture of the USA created diverse possibilities for discussing reproductive control, as well as providing means for its practice: in fact practice was probably far more common than discussion.

Her wonderfully thorough study of the variety of means of reproductive control does not merely delineate the array of contemporary ideas about the nature of the 'safe period', or the various mechanical and chemical preventives and abortifacient substances available. With a nuanced sensitivity to the differing agendas of husbands and wives and to power relations within the family, Brodie argues convincingly for the ways in which couples might have conceptualised the employment of the various methods of restricting their families. She additionally gives exhaustive consideration to how effective methods might have been, and concludes that expedients which the perfectionist late twentieth-century spurns as barely better than nothing (prolonged breast-feeding, douching) might at least achieve the nineteenth-century married couple's more limited aim of delaying the next pregnancy. So meticulous is this account of the efficacy of available methods that, supposing one of those cataclysms beloved of science fiction writers returned the USA to a pre-industrial society, it would be almost possible to use this work as a contraceptive handbook.

Almost: sometimes Brodie seems a little uncritical of the recommendations she discusses. A number of the substances advised for douching sound leg-crossingly unpleasant, if not dangerous, while some abortifacients could be lethal (as, of course, could instrumental intervention to terminate pregnancy). She also seems to give less emphasis than she could have done to the fact that even before Comstock foreclosed informed debate, many of the devices in circulation were completely ineffectual either to prevent conception or procure miscarriage.

She presents the campaign to obliterate the trade in reproductive control as very largely orchestrated by Comstock and his supporters. It could have been rewarding to contextualise this campaign in wider discourses around the need to control perils to the national well-being, during a period when the health dangers of unbridled laissez-faire capitalism were becoming apparent. New interventionist agendas concerning the physical and moral health of the nation extended well beyond the doctors' campaign to improve their professional status, which Brodie does discuss.

Questions also arise as to the precise relationship between the methods she describes and the decline in the birth rate. A range of approved female hygienic practices involving douching and pessaries, Brodie points out, could have influenced, not necessarily intentionally, the likelihood of impregnation. How far, we may wonder, did the whole cumbersome paraphernalia of contraception--calculations of a misapprehended safe period, the douching before and after, deployment of barrier devices--have the effect of simply reducing the number of occasions of sexual intercourse below the optimal level for conception?

The proliferation of information about something, and what is actually happening, are two very different things: Brodie is aware of this, but could perhaps have developed the implications further. A possibly productive analogy is the present obsession with slimming. Diets are likely to succeed if, however they achieve it, they get people eating less. The plethora of books on the topic ranges from those aligned with current approved scientific ideas about nutrition to those very distant from them. A slimming industry flourishes, while on the one hand, obesity is actually increasing, and on the other, so are eating disorders.

This is, however, asking for improvements to a book already very good and very rich. It rescues from obscurity all manner of forgotten individuals and movements and is clearly the product of deep research and considerable knowledge (which makes it all the more surprising that Brodie does not seem to know--p. 227--that potassium bromide was prescribed as a sexual sedative). It raises stimulating questions about popular health movements, the communication of knowledge, the spread of print culture, the rise of consumer society and the role of advertising, about public disapproval of practices pursued in private, as well as making an important contribution to the already distinguished field of the history of birth control.

Lesley Hall

Contemporary Medical Archives Centre

Wellcome Institute for the History of Medicine

London, England.