Hera Cook, The Long Sexual Revolution: English Women, Sex, and Contraception 1800-1975 (Oxford: Oxford University Press, 2004.) Pages xiv + 412, Hdbk £35.00

This book is an elegantly argued and important work and a major contribution to the history of demography and birth control, women’s history, and the history of the body and of sexuality. Hera Cook synthesises an impressive range of scholarship over diverse disciplinary fields, drawing on epidemiology, anthropology, demography, social history, and the histories of gender and sexuality. These are impeccably woven together to make a compelling argument about the always contingent nature of sexual desire in women, and the perennial importance of the impact of reproduction and economic factors in the equation.

She eschews the practice prevalent in the history of sexuality of citing evidence relating to a particular, often idiosyncratic, individual, or specific group, as an uncomplicated representation of more general attitudes and practices. However, she does not overlook the importance of statistically quite limited phenomena, such as increasing premarital sexual experimentation in the 1950s, as precursors of what would become much wider social upheaval. There is an admirable attention to the need to locate attitudes and behaviour chronologically, by social class, and in many cases by specific regional location. She is also rightly critical of attempts to claim that women have always had means of controlling their own fertility, at least in ways that were both reliable and safe.

The book begins with an analysis of the physical burden placed upon women by reproduction, and examines the effect of the extremely high levels of fertility around 1800 in motivating women to control births. This is contextualised within the developing debate on contraception, and the continuing low (at least, successful) use of methods of birth control. Cook places this firmly within contemporary sexual ideology and praxis to indicate some of the problems that there might have been in getting from desire to exercise some control over reproduction to doing something actually effective about this. Controlling conception, whether by abstinence partial or absolute, or using the various other methods available, required modification of sexual response and gender expectations.

The picture that emerges of English marital sexuality during the nineteenth and the early part of the twentieth century is grim and depressing, but certainly in accordance with much of the evidence that can be gleaned on the topic, for example the thousands of letters from Marie Stopes’s grateful readership. Ignorance of the basic mechanics of sexual intercourse and even of reproduction was rife. The two genders had little in common and lived in largely homo- rather than hetero-social worlds (with some local variations). Reticence on the whole subject was the common standard.

There are some very minor points that one might niggle at. When talking about the impact of late marriage (the classic North Western Europe marriage pattern) on fertility (p. 16), Cook does not mention the age-related decline in female fertility which must also have played a part, given the eschewal of marriage during the years of (usually) highest fecundability and its deferral to a point when the woman’s fertility must have begun to recede. I would also be inclined to be less absolute in claiming that ‘the separation of birth control and sexuality’ in advice literature ‘continued to shape the public discourse on birth control well into the 1960s’ (p. 61). Contraception and ecstatic marital sex were inseparably intertwined in the message of Marie Stopes, for many years the best-selling guru of twentieth-century sex advice, while other more radical voices, such as those of Stella Browne and Margaret Cole, pointed out that the capacity to avoid extra-marital pregnancy had wide-ranging implications for sexual mores, though their impact was probably much more limited. Syphilis (p. 80) does not have a overall low rate of mortality: not only were massive under-reporting and euphemising of causes of death from syphilis or syphilis-related diseases common, but what it does have is a very slow progression from initial infection to death, providing lots of opportunity for an apparently healthy person to infect others. But these are all issues of emphasis, not errors.

Cook, overall, makes a compelling case for there having been a transformation in sexual mores, building on existing trends (such as rising rates of coitus, female sexual experimentation), with the introduction of the Pill in the 1960s, giving women for the first time in history the chance to enjoy ‘casual, low-risk sexual activity’. While conceding that the outcomes were complex, we can agree with her that it was a significant element among the ‘substantial improvements… in the lives of English women over the past two centuries’.

LESLEY HALL, Wellcome Library for the History and Understanding of Medicine, London