During these years in New York more and more my calls began to come from the Lower East Side, as though I were being magnetically drawn there by some force outside my control. I hated the wretchedness and hopelessness of the poor, and never experienced that satisfaction in working among them that so many noble women have found. My concern for my patients was now quite different from my earlier hospital attitude. I could see that much was wrong with them that did not appear in the physiological or medical diagnosis. A woman in childbirth was not merely a woman in childbirth. My expanded outlook included a view other background, her potentialities as a human being, the kind of children she was bearing, and what was going to happen to them.

As soon as the neighbors learned that a nurse was in the building they came in a friendly way to visit, often carrying fruit, jellies, or fish made after a cherished recipe. It was infinitely pathetic to me that they, so poor themselves, should bring me food. Later they drifted in again with the excuse of getting the plate, and sat down for a nice talk; there was no hurry. Always back of the little gift was the question, "I am pregnant (or my daughter, or my sister is). Tell me something to keep from having another baby. We cannot afford another yet."

I tried to explain the only two methods I had ever heard of among the middle classes, both of which were invariably brushed aside as unacceptable.. They were of no certain avail to the wife because they placed the burden of responsibility solely upon the husband - a burden which he seldom assumed. What she was seeking was self-protection she could herself use, and there was none.

Pregnancy was a chronic condition among the women of this class. Suggestions as to what to do for a girl who was "in trouble" or a married woman who was "caught" passed from mouth to mouth - herb teas, turpentine, steaming, rolling downstairs, inserting slippery elm, knitting needles, shoe-hooks.

Then one stifling mid-July day of 1912 I was summoned to a Grand Street tenement. My patient was a small, slight Russian Jewess, about twenty-eight years old, of the special cast of feature to which suffering lends a madonna-like expression. The cramped three-room apartment was in a sorry state of turmoil. Jake Sachs, a truck driver scarcely older than his wife, had come home to find the three children crying and her unconscious from the effects of a self-induced abortion. He had called the nearest doctor, who in turn had sent for me. Jake's earnings were trifling, and most of them had gone to keep the none-too-strong children clean and properly fed. But his wife's ingenuity had helped them to save a little, and this he was glad to spend on a nurse rather than have her go to a hospital.

The doctor and I settled ourselves to the task of fighting the septicemia. Never had I worked so fast, never so concentratedly.

Jake was more kind and thoughtful than many of the husbands I had encountered. He loved his children, and had always helped his wife wash and dress them. He had brought water up and carried garbage down before he left in the morning, and did as much as he could for me while he anxiously watched her progress.

After a fortnight Mrs. Sachs' recovery was in sight. As I was preparing to leave the fragile patient to take up her difficult life once more, she finally voiced her fears, "Another baby will finish me, I suppose?"

"It's too early to talk about that," I temporized.

But when the doctor came to make his last call, I drew him aside. "Mrs. Sachs is terribly worried about having another baby."

"She well may be," replied the doctor, and then he stood before her and said, "Any more such capers, young woman, and there'll be no need to send for me."

"I know, doctor," she replied timidly, "but," and she hesitated as though it took all her courage to say it, "what can I do to prevent it?"

The doctor was a kindly man, and he had worked hard to save her, but such incidents had become so familiar to him that he-had long since lost whatever delicacy he might once have had. He laughed good-naturedly. "You want to have your cake and eat it too, do you? Well, it can't be done."

Then picking up his hat and bag to depart he said, "Tell Jake to sleep on the roof."

I glanced quickly to Mrs. Sachs. Even through my sudden tears I could see stamped on her face an expression of absolute despair. We simply looked at each other, saying no word until the door had closed behind the doctor. Then she lifted her thin, blue-veined hands and clasped them beseechingly. "He can't understand. He's only a man. But you do, don't you? Please tell me the secret, and I'll never breathe it to a soul. Please!"

What was I to do? I could not speak the conventionally comforting phrases which would be of no comfort. Instead, I made her as physically easy as I could and promised to come back in a few days to talk with her again.

Night after night the wistful image of Mrs. Sachs appeared before me. I made all sorts of excuses to myself for not going back. I was busy on other cases; I really did not know what to say to her or how to convince her of my own ignorance; I was helpless to avert such monstrous atrocities. Time rolled by and I did nothing.

The telephone rang one evening three months later, and Jake Sachs' agitated voice begged me to come at once; his wife was sick again and from the same cause. For a wild moment I thought of sending someone else, but actually, of course, I hurried into my uniform, caught up my bag, and started out. All the way I longed for a subway wreck, an explosion, anything to keep me from having to enter that home again. But nothing happened, even to delay me. I turned into the dingy doorway and climbed the familiar stairs once more. The children were there, young little things.

Mrs. Sachs was in a coma and died within ten minutes. I folded,her still hands across her breast, remembering how they had pleaded with me, begging so humbly for the knowledge which was her right. I drew a sheet over her pallid face. Jake was sobbing, running his hands through his hair and pulling it out like an insane person. Over and over again he wailed, "My God! My God! My God!"

I left him pacing desperately back and forth, and for hours I myself walked and walked and walked through the hushed streets. When I finally arrived home and let myself quietly in, all the household was sleeping. I looked out my window and down upon the dimly lighted city. Its pains and griefs crowded in upon me, a moving picture rolled before my eyes with photographic clearness: women writhing in travail to bring forth little babies; the babies themselves naked and hungry, wrapped in newspaper to keep them from the cold; six-year-old children with pinched, pale, wrinkled faces, old in concentrated wretchedness, pushed into gray and fetid cellars, crouching on stone floors, their small scrawny hands scuttling through rags, making lamp shades, artificial flowers; white coffins, black coffins, coffins, coffins interminably passing in never-ending succession. The scenes piled one upon another on another. I could bear it no longer.

As I stood there the darkness faded. The sun came up and threw its reflection over the house tops. It was the dawn of a new day in my life also. The doubt and questioning, the experimenting and trying, were now to be put behind me. I knew I could not go back merely to keeping people alive.

I went to bed, knowing that no matter what it might cost, I was finished with palliatives and superficial cures; I was resolved to seek out the root of evil, to do something to change the destiny of mothers whose miseries were vast as the sky.

Whether other feminists would agree with me that the economic is the fundamental aspect of feminism, I don't know. But on this we are surely agreed, that Birth Control is an elementary essential in all aspects of feminism. Whether we are the special followers of Alice Paul, or Ruth Law, or Ellen Key, or Olive Schreiner, we must all be followers of Margaret Sanger. Feminists are not nuns. That should be established. We want to love and to be loved, and most of us want children, one or two at least. But we want our love to be joyous and free - not clouded with ignorance and fear. And we want our children to be deliberately, eagerly called into being, when we are at our best, not crowded upon us in times of poverty and weakness. We want this precious sex knowledge not just for ourselves, the conscious feminists; we want it for all the millions of unconscious feminists that swarm the earth, - we want it for all women.