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Authors: Ellen Chesler

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The Pope may have been reticent to dignify the subject by addressing it directly. Earlier, the Vatican had cautioned its priests not to inquire openly into the private practices of their confessees, even when illicit behavior was suspected. Church fathers unwilling to challenge long-standing patriarchal principles also advised that absolution be granted women who confessed sexual submission to husbands engaging in Onanistic practice. But gradually this modest, laissez-faire attitude was abandoned at the urging of officials in Belgium, France, and Germany, who were increasingly alarmed about precipitous population declines and the growing challenge to their authority from secular doctrines. In the 1890s, even as the Vatican embraced a more liberal social activism, it was formally instructing priests to confront penitents with a rigorous inquiry into their sexual lives.

Concern about Catholic fertility in America, moreover, had distinct political overtones. Still an embattled minority in 1850, with only a million and a half constituents and one bishop, the “Church of Rome,” as it was derisively known, confronted outspoken suspicion and prejudice here and had no choice but to shy away from organization and controversy. Only as a consequence of internal population growth and vast ethnic migrations from Central and Eastern Europe would the Catholic population in this country reach 12 million by 1900 and more than 33 million by 1950, making it the largest single denomination nationwide, and one capable of asserting moral authority and political influence.
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A freethinker like Michael Higgins would then have most certainly known about contraception, but Anne Higgins remained a pious Catholic whose religious faith helped sustain her tenuous hold on life and provided an important social bond—as the woman who ministered at her sickbed and the parish priests who helped feed her children so well illustrate. Through the many years of Michael's apostasy, she kept her devotion to her church, never flagrantly disobeying his wishes by baptizing the children or attending mass, but instead, saying her prayers in private. Her fecundity, however, offered one indisputable, public testimony to her moral rectitude, and in the gilded Higgins family Bible, she dutifully recorded the birth of each child in a bold and confident script, beneath the papal injunction, “Lo children are an heritage of the Lord.” When she died, these private devotions were recognized by the parish priest who administered the sacraments and buried her inside the consecrated grounds of St. Joseph's Church cemetery in Corning, where years later Michael was laid to rest nearby in a grave unmarked and unblessed.
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It is also apparent that Anne's childbearing redeemed her aspirations for this world, as well as for the next. By the industry of her older children, the larger opportunities of her young ones were secured. An identical pattern of mobility had, in fact, existed in her own family. Her youngest brothers, William and Richard Purcell, left jobs as potters in New Jersey in the 1880s, went to law school, and then headed west to the Dakota territories, where they made their fortunes as lawyers and wheat ranchers. In 1887, William Purcell was appointed United States attorney for the region by Pres. Grover Cleveland. In 1906, he was elected to the legislature of the new state of North Dakota as a Democrat, and in 1911, was designated by a new governor to fill a vacancy in the United States Senate. Though he was not reelected and served for only three years, he was able to help out Michael Higgins, then an aging widower living in a veteran's retirement home in Bath, New York. Margaret and her sister Nan documented the well-worn saga of their father's capture of rebel soldier and mule, and their uncle filed a private pension bill on his behalf, securing him an increase in the meager income he collected as a disabled Civil War Veteran. Margaret never mentioned this lineage in her autobiographies. She may have hesitated to acknowledge an uncle who was a proud and practicing Catholic. Even more important, perhaps, she might not have dared give credence to the notion that all those Higgins children had provided her poor mother with what little fulfillment she found in life. It was the deprivation of that life, and of her own childhood, that governed her mature thoughts and feelings.
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In Margaret's memory, her mother was forever cooking, cleaning, or sewing, in a futile attempt to bring order to her chaotic household. But constrained by poverty and poor health, she did little more than exacerbate her children's sense of material and emotional deprivation. A Corning neighbor once recalled the chagrin of a Higgins brother made to wear girls' clothes while his mother mended his only pair of pants. By contrast, a serene photograph survives from what were obviously better times, when the four sisters assembled in elegant dresses, each fashioned by hand with loving and meticulous attention to the details of the pleated bodices and mutton sleeves.
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From the fragments we have, we can only presume the quality of young Margaret's emotional life. Yet it hardly seems too much to say that the woman whose earliest memory was of a mother who might die—the woman who held on to the knotted braid of her youth—was telling us something important about the bond that is the essential foundation of personality. Though on most occasions Margaret would identify her iconoclastic father as her most significant influence, children depend on the approval and affection of both parents. And the child who early on senses her mother at risk, and never experiences this first attachment as secure and uncompromised, may be especially burdened. Margaret remembered herself as a toddler beset by fears of wandering away and getting lost, of sleeping in the dark, of descending unlit cellar stairs, all commonly understood anxieties of separation, intensified, no doubt, in her own experience by her mother's actual, precarious situation. Her autobiographies also recall that this pattern of insecurity carried forward into later childhood when she felt compelled to test herself in dangerous and forbidden situations, such as crossing a harrowing railroad bridge, where a single misstep would have sent her plunging into a ravine below. They admit, as well, to her intense jealousy of Ethel, her younger sister, who as the winsome baby girl of the family became their mother's favorite. Margaret claimed that in triumphing over such childish phobias and rivalries, she had secured and prepared herself for the risk and adventure of her adult experience, but it is just as likely that her continued preoccupation with this behavior was evidence of its sustained irresolution. Never secure in the embrace of her own mother, she seems never to have known herself with a reflected contentment. And this emotional residue of childhood most certainly compelled her toward public exposure and her historic role as a social reformer.
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Anne Higgins died of consumption on March 31, 1899, at the age of fifty, worn-out and emaciated, her only solace, perhaps, that it was Good Friday, one of the holiest days of the year. Mary and Nan had not been able to come up with enough money to support Margaret through the third year of Claverack required for a diploma, and, instead of finishing school, she had somehow (perhaps, with the help of her mother's family) located a position in an elementary school in New Jersey, where she spent an exhausting half-year trying to teach English to foreign-born first graders. However trying this experience, teaching was a coveted avenue of upward mobility, and she could only have come home reluctantly in midcourse to nurse her dying mother through the final stages of her illness. She was herself just nineteen years old.
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The ever-obliging Mary recorded in her diary that she had just finished baking an angel-food cake for the parish bazaar when a boy came hurrying up the hill with the news. She ran home to find her father sitting dazed and despondent by the corpse. He removed Anne's gold wedding band and gave it to her, a gift of which she thought herself unworthy. The assistant pastor of St. Mary's Church administered last rites and years later claimed that Margaret had stood at the foot of her mother's bed and looked on coldly, refusing to kneel and join in the prayers, but he seems to have confused her with Ethel or Nan, for Margaret had been invited to spend the Easter weekend with a boarding school friend from Buffalo and returned hastily only when she received a telegram of the news. The dependable Mrs. Abbott, for whom Mary still worked, got out black dresses, hats and trimmings, veils and gloves, so there would be proper mourning attire. And Mary herself took care of the casket and all other arrangements, a responsibility that left her with a terrible headache, the only sign of emotion she let slip into her record of the day's events.
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Margaret's autobiographies treat the event with a suspicious economy, a single, if resonant, sentence recalling the mournful howl of her family's beloved dog, Toss, as he stood guard over the body. The event was years away, of course, yet the absence of the barest mention of grief is in stark contrast to the intensity of many of her other memories and of the one reaction she did acknowledge in this instance. She was enraged by the necessary reallocation of household drudgery after Anne was gone. With the older girls off working, the care of a bereft father and three young boys still at home fell to her and to Ethel. They had to wash and scrub and mend the trousers.

Margaret may have resented and belittled her father's mourning, because it seemed so hypocritical. She had lived away from home for almost three years and was eager for independence when her mother died, though still very uncertain of what to do with her life. In this fragile moment of emotional and physical separation from her own youth, she was probably not disposed to feel her sorrow deeply, or dwell on her loss. She seems instead to have experienced her mother's death as an unwelcome inconvenience and imposition, behavior that is commonly observed among adolescents who lose a parent while still absorbed in the challenge of resolving identity conflicts of their own.

She immediately enrolled herself in a school of nursing. Yet for years thereafter her mother remained a distinct if unresolved presence. In 1920, two decades after Anne died and in the same year that American women finally won the right to vote, Margaret published her first book, a manifesto that demands the democratic dissemination of birth control as a fundamental right of women. The book proposes that political and economic enfranchisement will not alone guarantee an end to discrimination—that medicine and science must also be harnessed to secure women an equal right to experience the full range of human possibility. It bears a simple but powerful dedication to the memory of a mother “who gave birth to eleven living children.”
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CHAPTER TWO
Love and Work

E
ager to leave Corning, Margaret arranged through Claverack connections to be placed as a probationer in the nurse's training program at the White Plains Hospital downstate in Westchester County. Michael Higgins's behavior deteriorated markedly in his wife's absence. He suddenly became an “irritable, aggravating tyrant,” by his daughter's recollection, interfering with her ambitions and social life, on which he placed rigid curfews. The family scattered, the four oldest having already established themselves in jobs. Mary's employer moved to Buffalo, and Nan followed her there as a commercial secretary, later moving to New York City. Joseph and Thomas remained in the glass factory. The fifth in line, John, left home in 1895 never to be heard from again, and was subsequently presumed dead in a drowning accident. The younger ones got caught up in their father's fury. Ethel eloped with a high school sweetheart in an ill-fated marriage that produced two children before it broke up. Richard only twelve years old in 1901, had a run-in with the local police and was booked for willful injury to local property. With an older brother, Lawrence, he eventually left home, wandered around and with Nan's help found his way to Lehigh University and then into the navy during World War I. Robert, the baby brother who became a football star, was also sent away to school by his older sisters.
1

Margaret settled on training as a nurse, an occupation considered far more menial and unworthy than teaching. Before the formalization of nursing education in the late nineteenth century, the line between nursing and domestic service was not clearly delineated, and old stereotypes were hard to overcome. Overworked and underpaid, nurses traditionally ministered to the most elementary needs of their patients, emptying bedpans, changing soiled linens, cleaning and even cooking, their status elevated beyond servant only by what little patina derived from their association with emerging medical professionalism. What Margaret really wanted was to become a doctor, a highly considered profession for educated girls of the Victorian middle class, because medical ministrations seemed a natural extension of inherently female sympathies, but the aspiration was far beyond her own economic reach. Nursing was in this sense a disappointment. The hours were too long and the work too arduous, but by her own acknowledgment, the experience left her with a discipline and an endurance she depended upon for the rest of her life.

Two trends would converge by the turn of the century to revolutionize the delivery of health care in this country and dramatically alter its professional and social status. First, scientific advances in bacteriology allowed physicians to understand the etiology of disease, a critical step in the development of modern diagnostic and therapeutic procedures. Second, a specialization of medical practice logically followed these advances. Doctors, once concerned with the patient's overall well-being, were transformed into specialists in the cure of isolated illness, and hospitals, until then institutions of last resort serving mainly the poor, became more sterile and disciplined bureaucracies providing training for physicians and nurses and treatment for all social classes.
2

This transformation undermined the traditional holistic approaches that had first attracted Margaret to medicine as a career option. The ratio of women doctors actually began to decline by the early decades of this century, as medical schools and hospitals began to practice sex discrimination under the guise of professional standardization. Yet these developments, in turn, had precisely the opposite effect on nursing, where the number of professionals began to increase dramatically, from some 15,000 in 1880 to 120,000 in 1900. Formal schools of nursing and professional associations were organized on the model developed by Florence Nightingale in England, and leaders in the field made insistent arguments claiming nursing as women's work on the same grounds that women doctors had done before them. Since no secondary degree was then prerequisite, nursing also became more accessible than medical school to women in circumstances like Margaret's.
3

Preparation for nursing differed widely in length and intensity, from elite, hospital-based programs to short-term correspondence courses. New York State took the lead in formulating legislation to register nurses and to regulate their training through standardized three-year courses, while also continuing to permit those without this formal preparation to work as “practical” nurses.

At White Plains, Margaret entered into an accredited two-year program that combined textbook instruction with experience on the wards and in homes nearby. Completion of this course would have qualified her for the additional, specialized year of training soon to be required for certification as a registered nurse. The conditions of nursing in what was still a rural setting were essentially primitive and harsh. The original twelve-bed hospital was housed in a converted and inefficient three-story mansion and left her with vivid memories of climbing dark and drafty stairwells, where every step echoed with strange sounds that conjured up her worst childhood phobias. There was no central heating or plumbing. A new wing in 1900 added modernized facilities, but with no resident physicians on staff, responsibility for maintaining the ill fell solely to the probationary nurses. By Margaret's recollection, the nurses were often prey to the nighttime entreaties and assaults of drugged and delirious patients, a daunting assignment under any circumstances, and a particularly harsh burden, perhaps, to a young woman wary of a hard-drinking and temperamental father.
4

Margaret went about her duties, presided at births and deaths, assisted in surgery, and earned enough respect to be appointed head nurse of the women's ward. In a letter to Mary, she described one case where she served on “special” duty during the surgical removal of a cancerous growth in a patient's intestine. “I am nearly dead,” she admitted. There were also many more routine assignments, and when she became a celebrity years later, she would still receive letters from women who remembered her fondly as their own nurse-midwife.

Through all this, however, her own health deteriorated, and after experiencing loss of weight, low-fever, and constant fatigue, she underwent the first of a number of surgical procedures for what was diagnosed as tuberculosis in the adrenal glands, a highly communicable form of the disease which she may have contracted from her mother. Conditions at White Plains depleted her resistance to infection, and this first breakdown established an associative pattern of stress, overwork, and illness that would repeat itself throughout her life. Small pockets of tubercular infection remained in her neck, and the operation left her with a draining sinus that opened and closed repeatedly over the next twenty years, causing sporadic incidences of acute illness and interim fever and weakness.
5

Despite this situation she was photographed in the candy-striped uniform of the training nurse, looking frail but cheerful. She lived in a local boarding house with her dear friend, Amelia, and other new classmates who provided sororal support, exchanging gifts of books, photographs, and bedroom slippers at Christmas and other holidays. Her sister Mary, and Nan, who had moved to New York City and found work as a private secretary, sent small amounts of expense money and welcome gifts, which she vowed to repay in other ways, as she put it, “when I get rich.” There were also occasional outings with suitors, including a weekend visit in June of 1902 from the handsome and devoted Corey Albertson of Claverack, whom she described elusively in a letter to Mary as “the same old boy.” The two young people apparently had a secret agreement to marry, but Margaret wanted her nursing degree first, and she may have been troubled as well by her perception of the deep social chasm that existed between them outside the egalitarian setting of the boarding school. Albertson was from a middle-class family, and she apparently never brought him to Corning or introduced him to her family.
6

Margaret was completing her training and planning on entering the third-year degree program, when she traveled to New York City over the summer for a special clinical course at the Manhattan Eye and Ear Infirmary. She had missed a month of school because of her operation, and the summer session provided an opportunity to make up the lost credits. She welcomed the chance to serve in a modern, scientific facility and to enjoy a more leisurely schedule. The few letters that survive from this experience communicate a rare self-esteem born, perhaps, of this first opportunity to experience herself as a competent and accomplished professional. Her newfound independence may also explain her extremely erratic response to a romance that suddenly altered the course of the plans she had charted.

There are several conflicting stories about how she met William Sanger. One suggests that he dropped by a hospital dance in White Plains one evening to deliver a set of architectural drawings to a doctor who was his client, another, that he came in to the hospital in Manhattan to have a fragment of construction glass removed from his eye. Whatever the exact circumstances, he pursued her from the moment they met with a torrent of emotional and romantic gestures including daily letters and phone calls, books and flowers, a gold watch and chain and the promise of a diamond ring. Her longtime suitor, Corey Albertson, dropped inexplicably from the picture, and she quickly agreed to marry Bill instead, as soon as she finished the nursing degree, which remained, unequivocally, her primary goal.

In 1902, a woman in Margaret's situation could not have expected to combine a profession with a husband and family, and the prospect of marriage probably evoked deep feelings of vulnerability within her. She was, after all, her mother's daughter.
7

 

Margaret Higgins and William Sanger married on August 18, 1902, having known each other for less than six months. The decision was impulsive, the ceremony impromptu, and it took weeks for the bride to recover her emotional balance. Earlier she had written plaintively to Mary: “When I think of all the hard work—the bitter tears I shed night after night for the old training—the lonesome nights I passed waiting for some old tramp to die—then when it is finished, without a laurel to get married—then I want to stop it all. I would love one year of private nursing—and get some money—and then if anyone wants me all right—but Wm Lad does not care about waiting longer than six months—he is working like mad—he adores father already—both socialists—oh heavens—the conversations they will hold!” She also worried that without her own earnings to pay for a wedding, none of her Claverack friends could attend, because her family was too poor to mount a proper spread. She thought about eloping, as Ethel had done, but dismissed the idea and proposed to her sister that “a good way to save expense would be to have him [William] on the verge of death, and I can nurse him & insist on a deathbed marriage.” In a more serious vein, she then suggested a small wedding at home: “Have we a house or a barn—it was somewhat of a barn when I last saw it,” she concluded, this time probably only half in jest.
8

The dilemma resolved itself when Bill showed up with marriage license in hand at the hospital in Manhattan on a sultry summer afternoon and demanded her immediate assent. As she later described the scene to Mary and Nan, the two drove around in a carriage for several hours debating the matter and finally found the house of a local minister, a Rev. Dr. Norris, where a witness was waiting, along with a young boy to hold the horse. The formalities took place in haste, so she could return for the 4:30 nursing shift. She was wearing an old blue dress and looked horrid.

When the deed was done, she found herself overcome by doubt and confusion. Refusing at first to even see her new husband, she vowed in the letters to her sisters that she could not live with “such a beast of a man” and would not give up her training. “He was selfish,” she added, “afraid the precious article would be lost to him.” Since nursing students were prohibited from marrying, she at first determined to keep the event secret and remain in the hospital residence in lieu of setting up housekeeping until the following year. She begged forgiveness from the sisters who had forsworn marriage for themselves and done so much to help her, yet sheepishly explained that while she was sorry to have eloped without their knowledge, she could not have “a better husband—he is my ideal in many ways.”
9

Bill took the view that however serious the matter of marrying before her training was complete, and without the authority of her family, it was a question of “then or never.” Well aware of Margaret's professional aspirations, he had promised Mary enthusiastically in July that “I shall do my utmost to make her sojourn at WP [White Plains] less difficult. Then she will ride triumphant in Corning with her dress suit and cane in one hand and diploma in the other…. She is sunshine, true joy and happiness.” Yet, at the same time, he feared that she would be wooed away by her Claverack suitor or by one of the doctors with whom she worked. As to the degree question, he professed after the fact, “I didn't realize it would loom in such prodigious proportions…. I have persuaded Margaret to change her mind and she will send in her resignation in the next few days.”
10

In Bill's view, Margaret's choice was to have a husband take care of her or waste the best years of her life as a nurse standing on her feet all night. He promised to establish himself on a solid financial footing as quickly as possible, so she could give up the strenuous life. His marital idyll was a “a real home” with his “Margaret dearest” as “Presiding Queen,” and “love the necessary household utensil,” or so he put it in one of his many impassioned letters, his ardor and his good intentions not always matched by the felicity of his prose. His expectations of marriage were entirely conventional. He hoped to provide economic security and professional status in exchange for physical and spiritual intimacy with a woman. However strong Margaret's reservations—her sense of obligation to her sisters for their support, and her recognition of an independent impulse—she yielded to this prospect of security and companionship and, no doubt, to the drama of an impetuous, impassioned romance.
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