Broadcasting Birth Control: Mass Media and Family Planning 9780813561530

Citation preview

Broadcasting Birth Control

Critical Issues in Health and Medicine Edited by Rima D. Apple, University of Wisconsin–­M adison, and Janet Golden, Rutgers University, Camden Growing criticism of the U.S. health care system is coming from consumers, politicians, the media, activists, and healthcare professionals. Critical Issues in Health and Medicine is a collection of books that explores these contemporary dilemmas from a variety of perspectives, among them political, legal, historical, sociological, and comparative, and with attention to crucial dimensions such as race, gender, ethnicity, sexuality, and culture.

For a list of titles in the series, see the last page of the book.

Broadcasting Birth Control Mass Media and Family Planning Manon Parry

Rutgers University Press New Brunswick, New Jersey, and London

Library of Congress Cataloging-­i n-­P ublication Data

Parry, Manon. Broadcasting birth control : mass media and family planning / Manon Parry. p. ;  cm.—­(Critical issues in health and medicine) Includes bibliographical references and index. ISBN 978–­0-­8135–­6152–­3 (hardcover : alk. paper)—­ISBN 978–­0-­8135–­6151–­6 (pbk. : alk. paper)—­ISBN 978–­0-­8135–­6153–­0 (e-­book) 1. Birth control—­Case studies. 2. Communication in family planning—­Case studies. I. Title. II. Series: Critical issues in health and medicine. [DNLM: 1. Contraception—­history. 2. Contraception Behavior—­history. 3. Family Planning Services—­history. 4. History, 20th Century. 5. Mass Media—­history. HQ 766] HQ766.P26 2013 363.9'6—­dc23 2012040306 A British Cataloging-­in-­Publication record for this book is available from the British Library. A portion of chapter 2, in different form, appeared as “‘Pictures with a Purpose’: The Birth Control Debate on the Big Screen,” in Journal of Women’s History 23, no. 4 (Winter 2011): 103–130. Copyright © 2011 The Johns Hopkins University Press. Copyright © 2013 by Manon Parry All rights reserved No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, or by any information storage and retrieval system, without written permission from the publisher. Please contact Rutgers University Press, 106 Somerset Street, New Brunswick, NJ 08901. The only exception to this prohibition is “fair use” as defined by U.S. copyright law. Visit our website: http://rutgerspress.rutgers.edu Manufactured in the United States of America

“Should we allow the women to continue to use injurious, health-­ruining measures to prevent conception, or, what is still worse, hurry themselves to their graves by repeated abortions—­or should the knowledge of sage and hygienic anticoncepts—­for there are such—­be spread broadcast?” —­Socialist physician William J. Robinson, Limitation of Offspring, 1904

Contents

List of Illustrations

ix

Acknowledgments

xi

Chapter 1

Introduction

Chapter 2

Battling Silence and Censorship

12

Chapter 3

The Medium Shapes the Message

45

Chapter 4

“Most of the World’s People Need Planned Parenthood”

76

Chapter 5

Soap Opera as Soap Box: Family Planning and

Chapter 6

1

the Telenovela

111

Twenty-­First-­Century Sex: The Small Screen

129

Notes

145

Index

173

vii

Illustrations



1 Depiction of Margaret Sanger’s arrest in the motion picture Birth Control, 1917 20



2 Film still showing Margaret Sanger and a doctor in the motion picture Birth Control

21



3 Baby show at a movie theater, 1919 24



4 Advertising the film No More Children, 1929 26



5 Television producer Martha Stuart, 1970 65



6 Artificial womb experiment, 1970 72



7 Hand-­drawn depiction of fetal experimentation, 1973 73



8 A mobile film unit presentation, Morocco, n.d. 78



9 Listening to educational radio in Somalia, 1963 87

10 Watching message-­laden television in an Indian village, n.d. 126 11 HIV education through theater in Brazil, n.d. 127

ix

Acknowledgments

This book would never have been possible without the generous mentorship of Sonya Michel, who guided me during the development of the original dissertation project. I hope to follow her fine example as a friend and colleague as I move into the next stage of my career. I would also like to thank Elizabeth Fee and Patti Tuohy at the National Library of Medicine in Bethesda, Maryland, for encouraging me to continue with a doctoral degree and giving me the flexibility and support needed to complete it while working full time. I have benefited greatly from the creative and energizing environment of the library’s Exhibition Program and thank everyone there for cheering me on throughout this project. Special thanks go to Beth Mullen for providing feedback on the manuscript and to Nancy Dosch, who helped me identify and view material from the library’s film collections. I am also especially grateful to Hugh Rigby and Anwar Singletary for their assistance during their time at the Johns Hopkins University’s Center for Communication Programs. Both made extraordinary efforts to locate vital materials and rescue films and documents in danger of being permanently lost. Lawrence Kincaid and Phyllis Piotrow provided me with some fascinating insights into their work in the field of family planning communication. Research for this book was funded in part by a grant from the Margaret Storrs Grierson Travel-­to-­Collections Fund and a Scholar-­in-­Residence Fellowship, both from the Sophia Smith Collection, Smith College; and a Dissertation Grant from the Schlesinger Library at Harvard University. Archivists at both institutions helped me navigate complicated unprocessed collections and pointed me to additional sources. In particular, I thank Amy Hague and Nichole Calero at Smith College and Lynda Leahy and Ellen Shea at the Schlesinger for all of their assistance. Jennie Correia at the Katharine Dexter McCormick Library of the Planned Parenthood Federation of America also provided permission for me to review closed files in the archives of Planned Parenthood at Smith College. Matthew Connelly directed me to useful materials at the headquarters of the International Planned Parenthood Federation in London, where Sarah Shaw arranged for complete access to their on-­site resources. Kim Head, Gail Gilbert, and May Miculis organized a rewarding visit to the Airlie Conference Center to allow me to rifle through storage facilities there. I also thank Marie

xi

xii Acknowledgments

Villemin Partow for her guidance in conducting photo research at the World Health Organization in Geneva, Switzerland, and, with her colleagues Reynald Erard and Donna Kynaston, for facilitating publication of illustrations from the collection there. In addition, the help of Isabelle Nonain-­Semelin and Adele Torrance at UNESCO was expert. Karen King, Mike Henry, Chuck Howell, and Thomas Connors were invaluable guides to the National Public Broadcasting Archives at the University of Maryland, and Jared Case assisted me with film research at the George Eastman House. In addition, I would like to thank Sara Stuart, Martha Stuart’s daughter, for her valuable input on an early draft essay and for sharing photographs of her mother at work. Janel Hoppes Poche at Juárez & Associates Inc. in Los Angeles and Bill Ryerson and Emily Frazier at the Population Media Center in Shelburne, Vermont, located hard-­to-­find materials on my behalf. Katherine Bliss, Ziv Eisenberg, Peter Engelman, Julie Passanante Elman, and Gabriela Soto Laveaga kindly shared drafts of their work, and Devin Orgeron offered useful feedback on a draft chapter. Johanna Schoen also allowed me to read her work in progress and offered sage advice regarding the history of anti-­abortion imagery. Leslie Reagan and two anonymous reviewers provided invaluable feedback on part of my second chapter, and Janet Golden and another anonymous reviewer gave great suggestions for improving my draft manuscript. I am grateful to my editor, Peter Mickulas, and the rest of the staff at Rutgers University Press for helping me bring this project to fruition and to Kate Babbitt for her meticulous attention and helpful guidance in the copyediting phase. I also thank David Kirby and David Weinstein for their ideas about interesting sources in media history; and Vanessa Northington Gamble, Saverio Giovacchini, Nancy Struna, and Psyche Willliams-­Forson for their comments and suggestions. Anna Bedford, Amy Corbin, Henrike Lehnguth, and Amber Nelson gave up a great deal of their time to share their enthusiasm and ideas. Members of my family in the United States and the United Kingdom have been typically kindhearted and unfailingly optimistic as I wove my way toward this point, and I especially thank James, Diane, Izzy, Pete, Alex, Harvey, Rhys, Barry, and my mum for all their support along the way. This book is dedicated to Michael, who makes all the hard work worth it, and our joyous daughter, Odetta, with all my love.

Broadcasting Birth Control

Chapter 1

Introduction

In 1967, Walt Disney Studios, in collaboration with the Population Council, released an animated movie called Family Planning. This extraordinary film, which was translated into twenty-­three languages and was distributed widely in Asia and Latin America, features Donald Duck at an artist’s easel illustrating the burdens of unlimited reproduction and the technologies of birth control while a narrator describes the benefits of limiting family size. America’s beloved cartoon duck was put to work to promote the use of contraception as part of an international movement against overpopulation that flourished in the 1960s and 1970s, but the film is part of a much longer history of the birth control movement’s use of mass media. In fact, media has played a key role in the birth control movement since the very beginning of its twentieth-­century campaign. The history of the birth control movement is traditionally told through accounts of the leaders and organizations that fought for legal access to contraception. The extensive use of mass media to build support for legalization and then publicize the idea of fertility control and the availability of contraceptive services has been largely overlooked. Scholars have only recently begun to examine the cultural work of printed media, including newspapers, magazines, and even novels, in advancing the cause.1 This book builds on this scholarship, moving beyond the printed page to examine the films and radio and television broadcasts birth control advocates developed and the communications experts they increasingly turned to for guidance over the course of the twentieth century. Taking advantage of a rich and relatively unexplored archive of media materials and archival documents describing their production and use, this

1

2

Broadcasting Birth Control

research reveals the critical role of media in the campaign to transform the private subject of birth control into one fit for public discussion. Of course, other factors contributed to the gradual shift in its favor. I do not focus on measuring the impact of specific media on laws and social prohibitions. Instead, I explore the expectations birth control advocates held for film, radio, and television and how these expectations, and the media themselves, helped shape the messages they disseminated. The story is not one of uninterrupted progress from repression to openness. In fact, information about ways to prevent or end pregnancy circulated freely in the early nineteenth century in family conversations and in consultations with midwives and healers and began to appear in print in the 1830s. By the 1850s, magazines, newspapers, and popular health manuals featured numerous advertisements for drugs and home treatments. This increasing visibility brought the topic of reproductive control under the scrutiny of purity crusaders and members of the medical profession, who sought to stamp out the proliferation of advertising and the activities of nonphysicians. The distribution of material about contraception and abortion was eventually restricted thanks to their efforts. In 1873, Anthony Comstock, founder of the New York Society for the Suppression of Vice, successfully petitioned Congress to limit the delivery by post of “obscene materials,” including descriptions of contraceptive devices and abortifacients and information on how to obtain them. The ruling was followed by similar state laws, the last of which was not overturned until 1965.2 In the decades following the Comstock Act, advocates for “voluntary motherhood” launched a campaign to legalize contraception, but the movement made few gains against the powerful anti-­obscenity lobby. In the early twentieth century, Margaret Sanger, Emma Goldman, and Mary Ware Dennett spearheaded various efforts, and Sanger quickly became the movement’s leading figure. From the very beginning of their activities, campaigners used the mass media as a way around the Comstock law.3 Historians characterize the period from 1914 to 1936 as one of declining radicalism as Sanger established her leadership. The movement shifted away from the rhetoric of female sexual liberation that had first informed its efforts in an attempt to make “birth control” respectable, replacing the term and narrowing the agenda to “family planning.” This is often described as the end of the agitation phase, when birth control advocates gave up their most controversial activities in an effort to build alliances with powerful elite groups, especially the medical profession.4 Incorporating media history into the history of the birth control movement demonstrates, however, that rather than retreating into dignified discussion with only medical experts, birth control advocates

Introduction 3

continued to use mass culture to build broad support. Decades later, as U.S. advocates began to collaborate with their international colleagues to promote family planning, they again faced the question of how to establish respectability. Although some private negotiations were crucial, family planning promoters remained convinced that by sheer virtue of their public visibility, media activities could convey the idea of widespread acceptance, if they were carefully deployed. Historians have overemphasized the extent to which the birth control movement traded controversy for propriety in their efforts to win mainstream approval. In fact, as I shall illustrate here, campaigners’ forays into the mass media provoked outrage and censorship in each new medium. As the birth control debate transcended the written word and became images on a screen or phrases broadcast over the radio, critics scrambled to define the parameters of what should be seen or heard and by whom. The introduction of each format, from film to radio and then television, sparked renewed concern over media’s ability to inform, influence, or, if left unregulated, corrupt the audience. Attempting to professionalize the movement, the Birth Control Federation of America (later the Planned Parenthood Federation of America) hired physicians to fill key roles in the organization and handed over responsibility for the distribution of contraception to the medical profession. This collaborative strategy (which, as historians have noted, compromised the original idea of woman-­led fertility control) was replicated in the media production processes of the birth control movement. Although originally media activities were undertaken by the same women who campaigned for the organization, including Sanger, these activities were gradually assigned to a rising class of professional communications experts. Previously, Sanger and her colleagues had used media with great confidence in its effects, but they had not critically evaluated its impact. Much of their early work had been undertaken without any detailed study of which media were the most persuasive, largely because of the implicit assumption that radio and print were influential and that cinema was especially so. Beginning in the 1930s, however, scholars in the emerging field of communications began to evaluate the role and influence of mass media more carefully. The first major study relating to birth control was launched in Indianapolis in 1937, in response to the shrinking size of white middle-­class families. This early survey of 1,444 “relatively fecund” Protestant white couples was intended to show how to promote larger, rather than smaller, families.5 Attempts to measure public attitudes about family limitation were not taken up in earnest until after World War II.

4

Broadcasting Birth Control

During the war years, psychologists, sociologists, and political scientists interested in persuasive communications applied their research to propaganda efforts to bolster support for the conflict at home and promote the image of the United States around the world. The emerging specialty they forged grew significantly during this period as influential European sociologists, including Theodor Adorno and Paul F. Lazarsfeld, emigrated to the United States and as leading psychologists, such as Carl I. Hovland and Harold D. Lasswell, undertook related research. When postwar concerns turned to maintaining peace, the idea that overpopulation could destabilize nations made the subject a high priority for some of these scholars as they looked for peacetime applications of their work. As a result, many of the founding members of the communications field also became influential figures in family planning promotion, including Wilbur Schramm, who founded the world’s first academic communications department at the University of Illinois in 1947.6 Several other key researchers began their work at a pioneering communications program at the University of Chicago, including Bernard Berelson, one of the first group of scholars on the faculty there, who joined the Ford Foundation in 1951 and ten years later became director of a new communications research program at the Population Council. Donald J. Bogue, also from the University of Chicago, developed the most influential communications theory of the 1960s; it was first used in agricultural development and was quickly transferred to the promotion of family planning. The field continued to grow in the 1950s. The International Communication Association was founded in 1950, and in 1951 the organization launched the Journal of Communication. In 1963, the journal published a special issue on Communication and Mental Health, the first issue devoted to a health topic. Communications scholars had studied everything from voter motivation in political campaigns to the role of mass culture in the creation of a consumer society. Those who tried to mimic the efforts of commercial advertisers in order to sell health-­related behaviors (including the use of birth control) to a wide audience, crafted a new academic specialty that came to be known as health communication. Practitioners divide the field of health communication into specific areas of research: analysis and intervention in media representations of health issues; scientific communication between researchers; communication between health care providers and between physician and patient; and health education campaigns. Of these, most research falls within the categories of interpersonal communication between patient and physician and mass communication health education campaigns.7 In the formative years of health

Introduction 5

communication between the 1960s and the 1980s, as the U.S. government funded family planning programs around the world, the subject of health education by mass media dominated the field’s research. This focus generated the wealth of media products I explore here and a canon of key theories or their development and use. The international family planning movement thus played an instrumental role in establishing and expanding health communication as the field’s methods were theorized, applied, and evaluated in the promotion of contraception around the globe. Because their background was so far removed from the feminist origins of the birth control movement, many in the communications field were more concerned with the goal of successful persuasion than with the idea of female empowerment. The influx of communications professionals thus further diluted the campaigners’ focus on women’s rights, in much the same way that collaboration with the medical profession had done in previous years. However, while Sanger’s earlier compromise radically altered the kinds of contraceptives that were available and the ease with which women could access them, the clash of agendas between feminists and communications professionals was more quickly understood and addressed.8 As I explore, the debate that later emerged in international family planning over the ethics of media persuasion and the promotion of family limitation arose precisely because of the influence of communications theorists on the strategies of the movement. Private Life and Public Health

Public health advocates, convinced of the power of mass media to influence audiences, have used film, radio, and television to deliver educational messages ever since they were introduced. This extends even to early campaigns on such intimate topics as breast and cervical cancers and venereal disease. In fact, although scholars have sometimes assumed that social taboos surrounding such subjects excluded them from public debate, historians have begun to reevaluate the extent to which such topics were suppressed. In some cases, such as efforts to prevent venereal disease during wartime, the perceived risk justified campaigns about issues that were at the margins of publicly acceptable discourse. Such campaigns also performed social functions beyond their assumed or actual health gains, such as the surveillance and control of target populations. Within the United States, for example, authorities have insisted on physical examinations of prostitutes, foreign travelers, and the poor and people of color in order to regulate sexual activity, limit immigration, and justify eugenic policies of sterilization and institutionalization.9

6

Broadcasting Birth Control

Posters about cancer risk and magazine advertisements warning against the spread of tuberculosis also reveal the race, gender, and class assumptions of their authors. Early-­twentieth-­century public health films about tuberculosis or malaria, for example, commonly blamed immigrants and the poor for the spread of disease. Fear of contamination by foreign, pathologized bodies shaped the discourse of international health after World War II in the films of the World Health Organization and the Communicable Disease Center in the United States (now the Centers for Disease Control). These narratives also made their way into popular culture, where contagion served as a metaphor for the spread of immigrants, communism, or sexual permissiveness.10 Although the materials of public health campaigns have been analyzed for the prejudices and assumptions they reveal or perpetuate, few researchers have done more than deconstruct the meanings encoded within them. Only occasionally have researchers investigated the production of such media. Yet a closer look at the intentions of media creators, the models they drew on, and the assumptions they made about their audiences can be richly rewarding and offers the opportunity to reconsider some of the most significant questions in the history of the birth control movement. First, as I will show, the mode of delivery has had a significant impact on the content of birth control media. To what extent were the movement’s shifting political strategies shaped, therefore, by media practices? As influential communications theorist Marshall McLuhan proposed in 1964, “the medium is the message,” framing media materials and the ways they are understood. Weaving an account of the opportunities and limitations of each of the forms of media with an exploration of the visual and aural techniques birth control advocates used, I aim to make a significant contribution to our understanding of the history of the birth control movement by demonstrating how its media campaigns informed rather than simply reflected its strategies and goals.11 Second, going beyond a visual or textual analysis of images and scripts sheds light on the question at the heart of much recent scholarship, namely whether the birth control movement intended to empower birth control users or impose their own values upon them. Historians have explored in detail the tension between personal liberty and state power in the provision of birth control and abortion, concluding that supporters of women’s access to contraception have not always had women’s best interests in mind. Carole McCann, for example, describes the campaign to legalize contraception as only a “partial success” because of paternalistic racial and class assumptions that undermined the movement’s feminist intentions.12 While I acknowledge that these factors constricted some women’s access to a complete range of reproductive health

Introduction 7

services, my research suggests that family planning promoters were convinced of their clients’ desire for contraceptive services and acutely aware of the ethical issues involved in their work. Moreover, among those who developed media for family planning in the postwar period, I have observed a divide that emerged between those who prioritized the empowerment of their female clients and others who were content to leave gender inequalities in place so long as contraceptive use was adopted. Because the birth control movement was dominated by white middle-­class women and powerful figures in business and politics, the concerns of poor families and people of color were undoubtedly marginalized. Among African Americans, the legacy of white control over black sexuality during slavery as well as coercive and paternalistic practices in clinics fostered great distrust of birth control programs well into the late twentieth century. By the 1960s, instead of privileging access to abortion as a key reproductive right (as did middle-­class white women), women of color were more focused on securing access to prenatal and antenatal care and challenging family planning policies intended to prevent poor women from having children. Yet black women also struggled against the pronatalist stance of black nationalist leaders in their efforts to gain access to family planning and control their own fertility. For this reason, family planning promoters could count on well-­known African American supporters to endorse birth control in the media.13 Studies of the international population control movement after World War II, when U.S. family planning programs expanded overseas, are similarly critical of the interactions between those who promoted the use of contraception and their target communities, focusing on the purported paternalistic, imperialist, or racist motivations of the “population controllers” who focused primarily on the birth rates of people of color. At best, scholars have concluded, white feminists misunderstood the needs of their clients and collaborated with repressive forces in the movement. As their work has shown, across the international field not all types of contraception were offered to all women, and some were coerced or misled into ending pregnancies, testing new contraceptive technologies with significant side effects, or undergoing sterilization.14 Yet it is important to remember that while some family planning promoters may have been motivated by prejudice, fear of an overpopulated world, or their own self-­interest, many others joined the campaign to free women, in the words of Margaret Sanger, from “sexual slavery.” There is little doubt that women the world over—­and men—­have sought opportunities to control their own fertility. Their attitudes toward family planning programs have differed in various communities and should be understood in their specific contexts. They

8

Broadcasting Birth Control

may also change over time and in particular circumstances. Acknowledging this, historians have begun to consider in more detail the complex relationship between family planning providers and users. As Johanna Schoen concludes in her study of poor women’s access to contraception in the segregated South, “despite the existence of real power differentials between policy makers, public welfare workers, philanthropists, physicians, and the recipients of birth control, no one ever possessed total control, and all participants shaped every outcome in the process of negotiating women’s access to birth control, sterilization, and abortion.”15 Schoen argues that family planning users were not unaware of the race and class prejudices underlying many programs but took advantage of services for their own ends nonetheless. Moreover, while certain reproductive choices may be considered drastic and extreme by some, they have offered affordable, reliable, and discreet protection for others. Laura Briggs’s careful study of Catholic Puerto Rico, for example, where family planning programs had been undertaken since the 1920s, illustrates that a campaign by mainland feminists to end sterilization in the 1970s limited poor women’s access to one of the cheapest contraceptive options available, one that could have been undertaken without the need for a husband’s compliance or permission.16 The history of birth control, then, is more complex than simple acquiescence or resistance to the goals of family planning promoters. Accordingly, I argue, the media campaigns I explore here are not in themselves exploitative, nor are they value free. While I cannot know the motivations of all of the people involved in the production of these materials, I can reveal some of the discussions behind the scenes that shaped their form and use. At an international conference on health education using television and radio in 1980, John Cain of Britain’s BBC raised the question central to those involved in the production and dissemination of birth control media, namely whether the role of health communication was to inform people “with a view to encouraging them to make up their own minds or [whether it was] in the business of persuading and pressuring people to change their way of life.”17 His query resonates throughout this study. Uncovering the Archive

The media pioneers I focus on have left a valuable but uneven archive of sources for research. For the first half of the twentieth century, the personal papers of Margaret Sanger and some of her colleagues and the records of Planned Parenthood and its predecessor organizations offer a wealth of material that includes correspondence and meeting notes. Film, radio, and television scripts

Introduction 9

document media strategies and the thinking behind them. Unfortunately, many of the earliest films are lost, although some important examples have been preserved at the Library of Congress. Advertisements, reviews, and the comments of critics can help fill in missing plot details of some films and the look and feel of others. These early movies are richly contextualized by a wide range of examples of Progressive Era films about social issues. While the story of media production can be pieced together from such sources, it is much harder to determine the scope of dissemination. Records of film showings at individual movie houses or the broadcast schedules of particular radio stations are hard to find, and where they are available offer only an incomplete glimpse into one community’s cultural options. Moreover, they tell us little about an audience’s interest in or reactions to particular productions. For this reason, I have not addressed the reception of birth control media in this study. Occasionally, I have included individual responses to a particular example where it might aid our understanding of the tone or context of a production. However, by going beyond an analysis of the content of family planning media to examine the discussions that occurred behind the scenes, I can reveal the intentions, assumptions, and strategic decisions that shaped the finished product. For the middle of the century, the approaches laid out in radio and television scripts and film proposals and surviving examples of a wide range of films, videos, and other campaign materials can be related to a growing body of communications literature that informed their production. Journal articles and the internal correspondence of Planned Parenthood and the International Planned Parenthood Federation also provide a sense of the distribution of this media. From the 1960s, when the international family planning movement took off and media production expanded dramatically, through to the end of my study in the early years of the twenty-­first century, these sources provide a more complete picture of the life cycle of a particular production—­including the discussions and activities of information and education committees, the changing theoretical approaches of family planning communications theorists and practitioners, and, in some cases, even evaluations of the distribution and impact of media campaigns. Instead of taking such reports at their word, I use these sources to illustrate the aims of the media producers and their sense of the influence of their work. Conclusion

Advocates for access to contraception used the tools of mass media to challenge the silencing of the subject and to transform it from a private concern to

10

Broadcasting Birth Control

a public issue. Broadcasting family planning publicized the topic and helped convey that it was acceptable. Yet the compromises made by family planning promoters in their struggle to air these messages have had profound implications for reproductive health in the United States. Margaret Sanger and her colleagues toned down their feminist rhetoric of sexual liberation in their attempts to build mainstream support. Although they continued to get their message out in a variety of media, censorship and broadcasting conventions further diluted the kinds of representations they could promote on movie screens, over the radio, and on the nation’s television sets. As they negotiated for access to public platforms for promoting their cause, advocates minimized the connections between contraception and sexual freedom. In this way, the medium helped shape the messages of the movement: campaigners for legalized birth control (and, later, family planning) gradually deemphasized sex. As feminist historians have charged, family planning promoters gave up the reconfiguration of gender roles that the sexual liberation Sanger proposed had promised. By ceding the territory of sex, the movement missed the opportunity to put women fully in charge of their reproductive lives. Historians have traced the global legacy of that compromise in the history of sterilization abuses, unequal access to contraception, and the narrow agenda of international population control. The emergence of the AIDS epidemic further illustrated the terrible consequences of this shift. In the United States, the government’s reluctance to address not just homosexuality but also heterosexuality, even as the death toll and infection rate rose exponentially within both populations, existed in spite of (and in fact in response to) an increasingly sexualized mass culture. I argue that it also reflects the historical trajectory of the campaign to promote family planning. While some scholars remain preoccupied with the question of the motivation of the international family planning movement in the past, many of the gains of previous decades are currently being undermined by the restriction of reproductive rights at home and around the world. Anti-­imperialist critiques of the excesses of the population control era and support for the idea of cultural relativism have dovetailed with the conservative agenda in the United States to greatly impede women’s access to contraception globally. In 1984, the Reagan administration curtailed the distribution of family planning information by refusing USAID funds for any organization that provided abortion services or gave clients information about abortion. The requirement limited access to other reproductive health services as organizations struggled to separate such activities from their other work or prove that they could do so. The policy became known in the aid community as the global gag rule for its restrictions

Introduction 11

on free speech and public debate related to family planning. In the years since, succeeding U.S. administrations have illustrated their political leanings by endorsing or circumventing this restriction, reshaping reproductive health by funding or defunding services and setting a standard other nations have followed. The policy was overturned by Bill Clinton in 1993, reinstated by George W. Bush in 2001, and overturned again by Barack Obama in 2009. In an increasingly polarized political climate, it is difficult to imagine a time when communications professionals, women’s health advocates, politicians on the left and the right, and members of the entertainment industry worked together to market family planning to the masses. This account reveals the long history of the battle to broadcast birth control and some of the unexpected alliances formed along the way.

Chapter 2

Battling Silence and Censorship

As a propagandist, I see immense advantages in being gagged. It silences me, but it makes millions of others talk about me, and the cause in which I live. —­Margaret Sanger, Ford Hall Forum speech, April 16, 19291

Publicity lay at the heart of Margaret Sanger’s approach during the early days of the campaign to legalize birth control. She considered “agitation through violation of the law” the vital first step in a long-­term strategy.2 Despite the Comstock Law of 1873, which banned the dissemination of contraceptive information, manufacturers had continued to advertise methods to prevent and end pregnancy under the euphemism “female hygiene,” but because the illegal trade was unregulated, customers ran the risk of purchasing ineffective or even dangerous products. Although Sanger was publicly dismissive of these black-­market peddlers, privately she supported their work.3 The movement’s first challenge was to get the subject out into the open, and any kind of media coverage helped achieve this. Even censorship provided an opportunity to expose the restriction of birth control information; she drew attention to this in 1929 by appearing in Boston with a white gag over her mouth and handing her speech to historian Arthur Schlesinger to read. Sanger’s campaign began in print in 1914, when she deliberately challenged the Comstock law by publishing a pamphlet called Family Limitation. After

12



Battling Silence and Censorship 13

flinging down the gauntlet, she left for Europe to avoid prosecution, returning to the United States after the death of Anthony Comstock. On October 6, 1916, with her sister Ethel Byrne and her colleague Fania Mindell, she opened the first birth control clinic in the United States, in Brooklyn, New York. Nine days later the clinic was raided by police and the three founders were arrested—­an outcome that Sanger had not only anticipated but deliberately provoked. Birth control advocates became increasingly adept at manipulating the nation’s media to keep their frequent clashes with the legal system in the newspapers. Emma Goldman, a leading member of Industrial Workers of the World (IWW) and a birth control advocate, urged Sanger not to plead guilty in order to prevent her trial from being quickly concluded and thus losing the chance to attract publicity. IWW activists had used a similar strategy on numerous occasions. Goldman wrote to Sanger in December 1917 that because of the newspaper coverage of the high-­profile case, “the birth control question has taken hold of the public as never before.”4 The three women who had been arrested at the clinic were convicted, and Sanger served thirty days in jail. The media frenzy that had surrounded their arrest continued during their incarceration. Newspapers gave particular coverage to a hunger strike undertaken by Fania Mindell. Sanger’s newsletter, The Birth Control Review, also reported on these events and regularly published letters from women seeking information about contraceptive methods. Many of the women who wrote in noted that they had read about Sanger’s work in the press, confirming the important role of the mass media in publicizing and building support for the movement. “Pictures with a Purpose”

The Comstock statute applied only to the dissemination of “lewd materials” through the mail and across state lines; film, which developed later, was beyond its purview. Motion pictures could also reach a far larger and less literate audience than mailed books or pamphlets on the subject of family limitation. Calls by progressive reformers for the “repeal of reticence” so they could take on social problems such as prostitution and venereal disease resulted in a growing public discourse on sexual issues that paved the way for birth control films. In 1905, New York physician Prince Morrow launched the social hygiene movement; his goal was to tackle syphilis and gonorrhea. The campaign intensified after the discovery of a successful treatment for syphilitic disease in 1909, and in 1913 audiences heard the word syphilis in theaters for the first time in the New York production of Eugene Brieux’s play Damaged Goods.5 This new openness was summed up in an article in the monthly periodical Current Opinion, which declared the current time “sex o’clock” in America.6

14

Broadcasting Birth Control

Issue-­focused filmmakers responded with motion pictures on a broad range of formerly taboo subjects. Physicians and health organizations including the American Cancer Society and the National Tuberculosis Association turned to the new medium to promote health. The 1914 film version of the play Damaged Goods launched a subgenre of sex hygiene films to address sexually transmitted disease. Looking to exploit the reach of the motion picture to present their views and the reform arguments of the day, others explored labor disputes, drug trafficking, and women’s suffrage as well as more controversial topics, including eugenics and vivisection.7 Filmmakers specializing in message films vied for audiences with others who were simply cashing in on the trend of controversial topics with films about “white slavery” that offered sensationalized stories about the abduction of young women for prostitution. This booming industry for sensational filmmaking and concern about the influence of motion pictures quickly stirred calls for censorship from anti-­ obscenity reformers. From 1908 to 1934, film industry leaders imposed their own guidelines as a way to stave off state or federal regulation. In 1909, filmmakers launched the National Board of Review of Motion Pictures, which became the unofficial clearinghouse for new films over the next few decades.8 This strategy of internal regulation was initially successful, and filmmakers continued making movies on marginal topics, although motion pictures gradually came under increasing scrutiny as state and national censorship boards were established. The first pictures to address the idea of controlling reproduction focused on abortion. Despite the successful effort, led by the medical profession, to criminalize abortion in the late nineteenth century, pregnant women and their partners in the early twentieth century still generally viewed the renewal of menstruation (as early abortion was referred to) as acceptable. They found plenty of physicians and other practitioners who were willing to perform the procedure.9 Films, however, commonly represented the illegal practice as the whim of financially secure young women who chose frivolous desires over motherhood, dramatizing President Theodore Roosevelt’s critique of self-­indulgent Anglo-­Saxon women who risked “race suicide” by avoiding their duty to reproduce. Roosevelt attacked birth control on the grounds that the “viciousness, coldness, shallow-­heartedness” of selfish childless women would lead white Protestant Americans to be overrun by inferior peoples. He based his argument on the declining birthrate among native-­born Americans and increasing immigration, especially of Eastern Europeans, drawing on eugenic theory that blamed crime and delinquency on reproduction by the “unfit,” meaning poor and disabled people and criminals.10 This discourse was not an exclusively



Battling Silence and Censorship 15

white preoccupation. W.E.B. Du Bois, one of the first black public figures to support birth control, advocated the judicious use of contraception by the “Talented Tenth” of African Americans as a mechanism for racial progress. Other black intellectuals, however, including Marcus Garvey, fiercely disagreed and opposed the limitation of fertility on religious and nationalist grounds.11 Filmmakers were able to circumvent the usual strictures against the dramatization of controversial issues by framing their films as “pictures with a purpose”—­entertaining melodramas with a moral lesson or social message.12 By making clear distinctions between villains and victims and providing plot resolutions that rewarded moral decisions and punished sins, pictures with a purpose satisfied the censors and honored the melodramatic format of narrative storytelling that dominated cinema by this time. Mother, I Need You (1918), for example, tells the story of a young woman who was drugged and taken advantage of. After her abortion, her doctor is indicted, but he is pardoned when the truth about the young woman’s victimization comes out.13 Film historian Eric Schaefer has identified five major character types that appeared in early sex hygiene films: the innocent, the corrupter, the charlatan, the crusader, and the parent.14 In Mother, I Need You, the victim, Eva, and her seducer clearly fit the first two categories, while the physician who performs the illegal abortion is the charlatan and the district attorney is the crusader who works to expose his actions. The selfish woman Roosevelt singled out for criticism appears so frequently in films featuring abortion that I am adding her to Schaefer’s list of types: the refuser, as I am calling her, denies her natural mothering instincts but is later redeemed when she realizes her folly. Without any formal criteria for determining the educational value of a film, censors and reviewers made their own evaluations. In the case of Mother, I Need You, a writer in Moving Picture World concluded that the warning carried by the storyline legitimized the risqué narrative: “Despite its rather repellent plot, [the film] has a certain message of value and interest.”15 Reviewers frequently took the opportunity to clarify their moral stance against abortion by commending actors and actresses who took on “unsympathetic” roles in these tawdry tales. Far from putting off female viewers, these proscriptive narratives held great appeal. Audiences who flocked to the theater were especially likely to show a special interest in “women’s issues.” Movie theaters were part of an emerging culture of public activity that alongside department stores, amusement parks, and the international exposition had a special appeal for women unaccustomed to such freedoms. In addition to inviting women into darkened spaces occupied by men, the cinema brought sexuality further into the public

16

Broadcasting Birth Control

domain with portrayals of fallen women and prostitutes. Although these films were laden with moral lessons intended to circumscribe women’s sexual activity, they also provided an unprecedented display of female sexual agency.16 Promoting Birth Control on the Big Screen

Films about abortion drew on familiar moral codes and represented sexually active women in a negative light. The advent of films favoring birth control, however, introduced audiences to more positive portrayals of women who advocated female perspectives on the issue. The New York Dramatic Mirror declared on February 10, 1917, that birth control had the Midwest “in its grip” and listed four films (of at least ten in circulation) that were showing in theaters in the region. Birth control advocates seized the chance to insert their perspective into the growing debate about controlling reproduction. Lois Weber, one of the most well-­respected directors in Hollywood at the time, was free to make a range of socially oriented films. Her early productions tackled temperance and capital punishment. Where Are My Children? (1916) was the first of two of her films that promoted birth control.17 The square-­up, an argument that appeared at the beginning of a film to justify its content, suggests that the subject is one of “serious public interest,” making the case that cinema should enjoy the same right as other mass media to explore current issues. The text declared: “Newspapers, magazines, and books have treated different phases of this question. Can a subject thus dealt with on the printed page be denied careful dramatization on the motion picture screen? The Universal Film Mfg. Company believes not.”18 Despite this assertion, the question of whether motion pictures were an appropriate venue for the topics discussed in the nation’s newspapers was far from settled. In the Supreme Court case of Mutual Film Corp. v. Ohio (1915), the lawyer for Mutual Film argued that movies should be protected from censorship under the provisions of free speech because they constituted filmed versions of the issues that were written about in newspapers and magazines. Although this reasoning was frequently repeated over the coming years, the Court rejected it, arguing that there are “some things which should not have pictorial representation in public places.” The justices denied film the protection of free speech on the grounds that filmmaking was primarily an entertainment business, not an educational enterprise, despite the number of filmmakers who were producing films with a social or health message.19 The decision granted states and municipalities the power to censor films and ushered in a patchwork of censorship boards with a variety of standards across the country. Universal was so concerned about possible censorship they apparently delayed the release of Where Are My Children?, although they may also have



Battling Silence and Censorship 17

played up the situation as an opportunity for publicity. The Washington Post acknowledged that the film dealt with delicate subject matter but concluded that it was “far from offensive.”20 In fact, there were few attempts to prevent the movie from being shown. One factor in its favor was that the storyline did not advocate birth control in general; it promoted it for large families who had no means to support more children and to prevent the birth of “defective” offspring. The plot involves two storylines. Mrs. Walton, a classic example of the refuser figure, has had several abortions to avoid giving up her busy social life for motherhood. Her husband, district attorney Richard Walton, is an advocate of eugenics and birth control who desperately wants children. In the first part of the narrative, Richard has to prosecute a physician for giving information on contraception to poor patients despite his own support for the practice. In the second narrative, he brings a case against an abortionist, Dr. Malfit, and discovers that his own wife has visited the doctor repeatedly. Richard returns home and accuses her of murder. By the time Mrs. Walton realizes the error of her ways, it is too late for her to fulfill the ideal of womanhood as a mother. She has become sterile, a narrative solution that punishes her for aborting her previous pregnancies. The film ends with a moving scene of regret as the couple sits by the fire and imagines the children they never had. Weber mollified censors by attacking abortion while promoting birth control. Some reviewers were confused by this tactic or considered it a misstep, even though denouncing abortion was in keeping with the strategies of the birth control movement. Referring to Richard Walton’s accusation that his wife was a murderer, a reviewer who was sympathetic to the cause wrote, “If Mrs. Walton was guilty of a crime, then her husband lent his influence in the making of many other criminals. In appealing for sympathy the authors lost sight of the most important significance of their theme,” namely, the impact of the Comstock Law on people with good intentions. Yet, as another reviewer acknowledged, wealthy women already had access to birth control information from their physicians. “The whole purpose of a campaign of the kind being waged by Mrs. Sanger and Emma Goldman,” the author noted, “is to place the same means within the reach of the less fortunate.”21 The double narrative also opened the way for promoters to highlight different aspects of the issue for their target audiences. An advertisement in the New York Times on September 27, 1916, described the film as “humanity’s most powerful weapon against the premeditated destruction of the unborn,” while other write-­ups emphasized the race suicide argument or the pro–­birth control storyline. In fact, varying standards of censorship meant that very different versions of the film were played in various locations around the country.

18

Broadcasting Birth Control

As Weber commented, “In my native state of Pennsylvania the entire first part of the play was excised by the censors. The scenes in the slums, and all the incidents going to prove that under certain circumstances birth control was justifiable, were entirely cut out, and any believer in birth control who happened to see the play in that state would not give me any credit for stating their cause at all.”22 The Supreme Feature Film Service, which held rights to the film in some states, unsuccessfully challenged the Pennsylvania censors on the grounds that the topic was “a subject upon which hundreds of volumes have been written, [and upon which] eminent men like Theodore Roosevelt and many others have vented opinions.”23 Of course Roosevelt had decried birth control, not promoted it. Despite the controversy (or perhaps because of it), Where Are My Children? was a huge success. The Atlanta Constitution of November 5, 1916, described it as “one of the most remarkable preachments yet filmed.”24 For the most part, the educational message reassured censors, while the entertainment value appealed to audiences. The movie was also positively reviewed by film critics, thanks to the expert blending of these two elements. Margaret Sanger and her colleagues were apparently less enthusiastic. In an interview in The Overland Monthly, Weber noted that the American Birth Control League would have preferred an emphasis on the first part of the story without the second storyline about abortion.25 Because the film gave more time to the narrative about Mrs. Walton’s behavior, some, including Sanger and her colleagues, saw the picture as another argument against race suicide and, by implication, against birth control. Abortion storylines had already proven their popularity, and perhaps Weber hoped that this strategy would maximize the reach of her message. At the same time, of course, it would increase profits, although she argued that commercial success did not motivate her decision to include both narratives. Acknowledging that the film “would not entirely satisfy an ardent propagandist,” Weber argued that birth control advocates would prefer a picture that only those who were already interested in the topic would ever go and see. Nonetheless, a reviewer in Moving Picture World criticized Weber for not using the more “straightforward” approach to birth control proselytizing that Sanger and Emma Goldman favored.26 These two influential figures in the movement had yet to use film for their cause, although Sanger took up the medium a year later. “An Honest Birth Control Film at Last!”

Up to this point, filmmakers had framed their propaganda in melodramatic narratives, drawing on the key arguments for and against birth control circulating in public discourse. Referencing the idea of race suicide among the rich,



Battling Silence and Censorship 19

films opposing family limitation depicted selfish women who drove their husbands away by refusing motherhood. Films favoring birth control, including The Laws of Population and Where Are My Children?, focused on the needs of the poorer classes and on the eugenic value of preventing the “unfit” from having children. These films contributed to the growing dialogue on the topic. But before Sanger joined in, the link between these movies and the birth control movement had not been explicitly drawn. The next step was to connect audiences with the activists who led the campaign. Before her incarceration in 1914, Margaret Sanger had already begun working on a film, no doubt emboldened by the growing number on the topic.27 Birth Control Review insisted that there was room for another depiction of the issues because several movies, including Weber’s pro–­birth control production Where Are My Children?, misused the theme of birth control as a vehicle for the story of abortion.28 However, Sanger’s film, Birth Control, which was finally released in 1917, was not as readily embraced by exhibitors as previous films about reproduction had been.29 The Review contrasted the enthusiasm of theater owners to show these “profitable films which cater to the powers that be by deceiving the public as to the real meaning of birth control” with their timidity regarding the one “genuine” birth control film on the market. Sanger’s notoriety ensured that her film would attract special scrutiny from censors, and no doubt this contributed to exhibitors’ reluctance to show the movie alongside others on the topic of controlling reproduction. The film also departed from previous productions by drawing explicitly on real events. Sanger emphasized the reality of the birth control crisis by dividing the narrative into two parts: an interview in which she described why she joined the movement juxtaposed with scenes that depicted the deprivation of large, poor families followed by a dramatization of her fight to change the law. She also exploited her notoriety to promote the movie in publicity materials. She vowed in an accompanying “certificate of genuineness” that this was the only film on the topic that she would appear in and linking it to the work of the movement by stating that part of the profits would go toward the birth control cause. As the star of Birth Control, Sanger used the medium’s visual power to project an image of herself as the embodiment of the movement. Audiences in this era tended to regard film representations of actual situations as more reliable and authentic than newspaper accounts, and Sanger took full advantage of this to counter her characterization in the press as an extremist. Moving away from her socialist and working-­class roots, she presented a contrasting image to her radical counterpart, immigrant Jewish activist Emma Goldman. Sanger’s Anglo-­American ethnicity and middle-­class appearance marked her

20

Broadcasting Birth Control

as more reasonable, and her demure demeanor and slight frame were distinctly different from the images of Goldman circulating at the time. As one reviewer commented in Variety, Sanger appeared as a “placid, clear-­eyed, rather young and certainly attractive propagandist that swayed crowds at her meetings and defied the police both before and after her incarceration.”30 One advertisement for the film featured a still that played on this image to illustrate the severity of the law against birth control (fig. 1). The scene shows a diminutive Sanger being handcuffed, surrounded by policemen and a top-­hatted public official. The juxtaposition of the uniformed guards and their fragile female captive concisely conveys the sense that Sanger’s punishment was far too severe. As the central woman pictured, she represents the brave challenger to the powerful men who would enslave women in a cycle of perpetual childbearing. Birth Control opens with superimposed images that contrast a poor mother who is struggling to cope with family life with a wealthier woman who has the money to find out how to limit her family size. In an interview interspersed

Figure 1  Still from the motion picture Birth Control (1917) depicting Margaret Sanger’s

arrest. Source: “An Honest Birth Control Film at Last!” Birth Control Review 1, no. 3 (1917): 11.



Battling Silence and Censorship 21

with scenes from the slums, Sanger describes an incident from her nursing career, which, she claims, converted her to the birth control cause, when she and a physician attended the home of a woman who was suffering from complications after an abortion (fig. 2). As they left, the patient apparently begged the doctor for the information that would allow her to prevent future pregnancies, but he would not divulge it. Appalled at his callous response, Sanger became an advocate for birth control.31 At the time, most physicians wanted nothing to do with the birth control movement and railed against women who demanded greater control over their fertility as part of their campaign for education and work opportunities alongside men. Doctors counseled one another to consider “the difference between the dragged-­out woman on the verge of consumption . . . and the society belle who mistakenly thinks she does not want babies when every fiber of her being is crying out for this means of bringing her back to healthy thought” when patients asked for advice on preventing conception.32 Physicians agreed with other critics that wealthy women should be at home fulfilling their duties as wives and mothers, not contributing to the decline of the race. They also saw

Figure 2  Still from Birth Control (1917) showing Margaret Sanger and a doctor visiting

a woman to treat her for complications following an abortion. Source: Sophia Smith Collection, Smith College.

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Broadcasting Birth Control

birth control as an underhanded way to avoid the penalties of immoral sexual activity such as venereal disease or pregnancy outside marriage. Sanger’s conversion narrative takes aim at the medical profession, while the scenes portraying weak and disabled children and their overwhelmed mothers draw on eugenic arguments. Furthermore, the storyline suggests that upper-­class families withhold knowledge of the methods of controlling fertility in order to maintain the poor “as the servant and laboring classes.” This narrative strategy antagonized the commissioner of licenses for the city of New York, George H. Bell, who served as a film censor, on the grounds it would “promote class hatred.” When he threatened to revoke the license of theaters that showed the movie, the public debut was cancelled. Instead, Birth Control was shown to a private audience of about 200 supporters. On June 6, Sanger received a temporary injunction that allowed the debut screening. The decision was based, in part, on the film’s lack of instruction about actual birth control methods. The producers, Message Photoplay Company, tried to secure a permanent injunction from the appellate division, the state’s highest court, but the justices reversed the decision and instead sided with Commissioner Bell. The court argued that the film was liable to engender a desire to obtain illegal contraceptive information. This was, of course, one of its goals; publicity materials explicitly described the film’s intention “to create public sentiment in favor of the repeal of the [Comstock] statute.”33 The Limits of Propaganda

Sanger’s struggle to overcome the law was depicted on the big screen in a second Lois Weber production titled The Hand That Rocks the Cradle (1917).34 It is likely that the success of her first film on the topic and her support for birth control, prompted Weber to start developing another production even before Sanger’s film was released. Although work on the film began before the furor surrounding Birth Control erupted, the storyline similarly courted controversy by echoing Sanger’s conversion narrative. Weber plays a physician’s wife who decides to distribute contraceptive information when her husband refuses to break the law to do so. The wife ends up in court. The square-­up contains a note from Weber saying that she purposely avoided showing slums or the heights of affluence and instead represented her intended audience, “the general public.” Despite this comment, perhaps made in response to objections that Birth Control promoted class warfare, The Hand That Rocks the Cradle still compared the hardships of poor large families with the more comfortable lives of smaller, richer ones.



Battling Silence and Censorship 23

Reviewers found little reason for censorship, and one writer noted that in fact, all the publicity surrounding Sanger’s film only added to the attention Weber’s film received. Even so, Commissioner Bell banned The Hand That Rocks the Cradle in New York on the grounds that it inflamed the controversy over Margaret Sanger’s arrest. Clearly he had caught on to the strategy Weber and Sanger were using to keep their subject in the news. As the National Board of Review acknowledged, the film “opens up for the discussion the problem [of] whether or not a change is needed in the existing law regulating the dissemination of birth control.”35 Weber’s film also suffered from bad reviews, perhaps because she sacrificed the dramatic sophistication for which she was famous in order to proselytize. Unlike her previous production, which successfully blended drama with propaganda, the entertainment value of The Hand That Rocks the Cradle was apparently undermined by its labored focus on the arguments for birth control. One reviewer described it as “a preachment, not a play,” arguing that propaganda films should not be shown in places intended primarily “for amusement and recreation.”36 The standard for film entertainment was increasing at the time. Studios were releasing increasingly complex and visually rich productions such as The Birth of a Nation (1915), and despite some support for topics such as birth control, critics expected pictures with a purpose to be as captivating as any others. Sanger’s film had broken the convention of framing birth control films in fictional storylines by drawing on her own campaign and arrest, essentially introducing what would later be seen as documentary elements. When Weber followed suit, she abandoned some of her aesthetic principles to make an overtly propagandistic picture. As the comments above suggest, reviewers were beginning to question such blatantly didactic uses of the cinema. Audiences, however, seemed to be less critical. In a showing in New York, for example, viewers applauded an intertitle that read: “If the lawmakers had to bear children they would change the laws.”37 Birth control films made an impact, and box office success was soon followed by a legal breakthrough. In 1918, just one year after motion pictures on the topic had “gripped the nation,” the New York Court of Appeals expanded the exemption that allowed physicians to prescribe contraception in order to cure and prevent disease. This paved the way for physician-­run birth control clinics, and in 1923 Sanger launched the Clinical Research Bureau (which in 1928 was renamed the Birth Control Clinical Research Bureau), which dispensed contraception and collected data on its use. From this point on, publicity helped launch clinics around the country.38 Sanger and Weber had

24

Broadcasting Birth Control

raised questions about the restrictions against contraception by dramatizing the legal battle for birth control. Heavy-­handed censorship then afforded them the opportunity to extend the fight, generating more press coverage during the struggle to have both movies shown. The effort to change the laws against the movies was thus part of the larger campaign to change the laws against all birth control information. Over the next few years, the movement’s successes and audience fatigue fueled a backlash. The House without Children (1919), based on a play first produced at the height of pro–­birth control films in 1917, was an obvious attack on the campaign. A character, significantly named Margaret, argues for birth control while her husband longs for a son. The wife eventually gives up her aversion to motherhood and the couple goes on to have two children. Reinforcing the film’s pronatalist message, a theater in Washington, D.C., promoted a “better babies” event during the run of the movie (fig. 3). Similar contests were held across the country in the early decades of the twentieth century to showcase healthy and happy children born to parents who were “fit to marry” and

Figure 3  Baby show apparently sponsored by a movie theater showing the anti–birth control film The House without Children in Washington, D.C., in 1919. Source: LC-USZ62–53551, Prints & Photographs Division, Library of Congress.



Battling Silence and Censorship 25

reproduce.39 The smartly dressed crowd of white mothers and children gathered in front of the theater underscores the film’s focus on the responsibility of middle-­class women to have large families. By the 1920s, controversy over educational cinema, including sex hygiene films, was also on the rise. Before the end of the Great War, the Public Health Service (PHS) films Fit to Fight (1918), Fit to Win (1919), and The End of the Road (1918) had avoided censure due to the wartime imperative of protecting the health of soldiers. Under this justification, these films were tolerated because they promoted sexual abstinence rather than the use of prophylaxis and drew on traditional codes of conduct to frame their message in morally appropriate terms. After the war, however, sexual hygiene films enjoyed no such cover and generated controversy when they were used to educate civilians. With the possibility that they would now be seen by mixed audiences of men and women and that exhibitors could exploit the sexual focus to attract audiences, critics charged that viewers would be corrupted.40 As overtly educational films on controversial topics increasingly aroused the ire of censors, the interests of producers and reformers in using commercial cinema began to wane. Birth control films fell victim to this trend. The decline in birth control films went hand in hand with growing conservatism about women’s roles. As wartime work opportunities receded, women were encouraged to return to more conventional lives as wives and mothers. Historian of medicine Alexandra Lord has described how the Public Health Service attempted to “restore traditional values through the use of traditional images” in the venereal disease film The End of the Road, which focused on women’s role in society. A similar practice appeared in postwar films on the subject of birth control. This backlash occurred in the midst of the roaring twenties, when divorce rates were on the rise and the flapper typified the modern, sexually independent young woman. Message films again portrayed selfish women who tried to avoid having children and presented narratives that valorized mothering as a woman’s most fulfilling activity, as the titles Motherhood: Life’s Greatest Miracle (1925) and Miracle of Life (1926) succinctly convey.41 A Second Chance at the Cinema

The market for films promoting birth control rallied later in the decade and was vastly expanded by the introduction of synchronized sound around 1927. Weekly paid admissions, 50 million in 1926, rose to 90 million by 1930 as ever-­ larger audiences flocked to theaters.42 Before rigorous censorship was enforced by the Production Code Administration in the 1930s, two films took advantage of the gap between existing censorship practices and the new technology to

26

Broadcasting Birth Control

promote birth control. No More Children (1929) was based on a real case in which a Cleveland judge denied a divorce to a couple with four children and instructed them to practice birth control (fig. 4). Materials that promoted the film noted the introduction of “drastic” sterilization laws in Iowa to prevent people with mental and physical disabilities from having children. Advertisements

Figure 4  Advertising accompanying the showing of the film No More Children at the

Uptown Theatre in Washington, D.C., ca. 1929. Source: LC-USZ62–118854, Prints & Photographs Division, Library of Congress.



Battling Silence and Censorship 27

depicting a stork with a ball and chain asked provocatively, “Should the stork be shackled?” Although the publicity materials appear to condemn birth control, the film presented two stories in its favor. The prologue begins at the office of Dr. L. Lee Krauss, a real doctor described as president of the Bureau of Moral and Hygienic Education who was also an author and lecturer on “Dope, White Slavery and Sex Topics.”43 The company behind the film had also released The Road to Ruin the year before, the tawdry story of a young woman who is corrupted by her association with older men into games of strip poker and prostitution.44 Dr. Krauss’s association with these crowd-­pleasing subjects mark him as an unusual, perhaps marginal, member of the medical profession, yet Margaret Sanger was happy to encourage him. While she may have courted the approval of respectable physicians in public, in private she endorsed challenges to their stance against birth control. As she wrote to Krauss in 1932, “A moving picture is certainly a splendid medium for the work. . . . If you can help us get that abominable law changed through your educational campaign, it will be a blessing to humanity.”45 Dr. Krauss plays himself, giving advice to a young newlywed who complains that because of the neglect of her physician and her mother she is going to have a baby. Georgia doesn’t want to go through with the pregnancy, but Dr. Krauss argues that an abortion would be against nature, all law, and ethics. He goes on to say she has a duty, and she responds, “What right have you to speak of duty; your duty is plain and you shirk it. Both mother and you are old-­fashioned; laws are being altered by church and state to meet the changed conditions; Don’t put your head in the sand like an ostrich. . . . They are new ideas, but they are not unnatural. Just where, Doctor, do you men, you lords of creation, tell us we must bear children? Why should women do all the sacrificing?”46 As she tries to leave, Dr. Krauss tells her to sit down and tells her the story of another young woman. This story becomes the main narrative of the film. A wife who is barred in court from having any more children but is unable to find information about birth control commits suicide after becoming pregnant again. The tragedy, like Georgia’s dilemma, is presented as the result of the prohibitions against contraceptive information even for married women. The film places the blame with the legal system in two ways: the prohibitions of the Comstock Law that leave the woman ignorant of birth control and the judge’s hypocrisy in banning the couple from having more children without giving them the means to prevent it. Georgia takes the medical profession to task in her attack on Dr. Krauss and criticizes old-­fashioned thinking when she blames him and her mother for keeping her in the dark.

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Broadcasting Birth Control

This renewed call for the “repeal of reticence” continued in Her Unborn Child (1930).47 Helen Connover, a character who funds birth control clinics, tries to arrange an abortion for her nephew’s girlfriend. In a scene that provides an opportunity for the film to present arguments for and against birth control, the elderly physician Helen meets with refuses her request. “Better a few unwanted children,” says Dr. Remington, “than to interfere with the laws of God and nature.” Connover chastises the doctor for being “so stupidly conventional” and for bringing religion into the debate. “No woman should be forced to become a mother against her will,” she declares. In a final attempt to win him round to her way of thinking, she appeals to his status as a physician, asking him to face the issue “scientifically.” In the version I viewed, which may have been edited by state censors, Helen Connover does not appear in any later scenes, leaving only negative references to her by other characters. The film thus shies away from fully endorsing the opinions she represents, although this may not reflect the original intentions of the filmmaker. Still, the ambivalence the narrative displays, by presenting strong arguments in favor of birth control but resolving the story in a more traditional way, epitomizes efforts since the early years of silent film to introduce audiences to the conflicting arguments of the birth control debate within the conventions of morally appropriate storylines. In the late 1920s, increasingly stringent regulations against these film topics were proposed as censors fought for more effective regulation. Throughout the decade, new regulatory mechanisms were established within the motion picture industry, but since they were voluntary, they were largely ineffectual.48 The addition of sound increased the stakes significantly, allowing characters to express more complex viewpoints than intertitles had allowed for. The use of innuendo and double entendre also broadened opportunities to include oblique references to controversial topics. Spoken dialogue was much harder to censor than intertitles, as any edits would be much more noticeable and disruptive to the narrative. Although the decade began with the bold examples of No More Children and Her Unborn Child, the introduction of the Hays Office movie code in 1930 and the launch of the Catholic Legion of Decency in 1933 (renamed the National Legion of Decency in 1934) secured the pledge of millions of Catholics to boycott movies it deemed immoral. The Hays code, written by Father Daniel Lord, S.J., was most rigorously enforced by a lay Catholic, Joseph Breen. Films on the subject of birth control were unlikely to win over these censors. The new production code declared sex hygiene, venereal diseases, surgical operations, scenes of actual childbirth (in fact or in silhouette), and other



Battling Silence and Censorship 29

“sex perversions” to be improper subjects for motion pictures. After 1934, any film that was to be shown in a major American theater required a seal of approval from the Production Code Administration. The new code, which Catholics and the Legion of Decency had campaigned for, made another birth control film unlikely. In May 1934, Sanger received a letter from a contact who had asked two major motion picture companies about the possibility of such a project. He reported that despite favorable responses, both were concerned that “Catholic antagonism” would prohibit the production, and “on account of that one question, the Hayes [sic] organization might frown upon the proposition entirely.”49 The new code pushed birth control propaganda out of mainstream Hollywood cinema. However, the subject resurfaced in an illicit new genre created by the ban—­exploitation films, or “sex pictures.” As Depression-­era audiences turned to the more affordable entertainment of the radio, filmmakers on the margins of commercial production tried to lure customers back with this type of low-­budget feature, which included mostly unknown actors and was made purely for entertainment value. While major studios steered clear of sex-­related subjects, including venereal disease and abortion, exploitation filmmakers monopolized them as the narrative justification for stories that featured nudity and sexual licentiousness. Although this meant they were denied the Production Code’s seal and thus were banned from the most lucrative movie houses run by major studios, the forbidden status of these films assured them audiences in smaller venues. Their producers gave up any pretense of educational value and focused on the dramatic mileage of the topic of sex. The title of one such film, Race Suicide (1937), had become code for any sex-­related drama, not a reference to the birth control debate. It appealed not because of the social lessons the film could teach but because of the lurid reality of the story.50 The opening credits, which scrolled over the pages of a newspaper, declared the film a “Real Life Drama” that was based on news reports about an organized gang of illegal abortionists who had been brought to justice. Abortion served as a prurient plot device, and the clinic provided the forum for nudity in scenes of women undressing. Early in 1935, Sanger was invited to appear in a motion picture on birth control but was warned off the project by a colleague, who knew that the production company, Kinematrade, specialized in sex pictures.51 By the mid-­ 1930s, no reputable filmmaker was broaching the topic of birth control. The regulations of this period thus brought to a halt a lively campaign of motion picture propaganda intended to make Americans “birth control conscious.”52

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Broadcasting Birth Control

The Shift to the Radio

As the struggle to clean up the movies raged on, birth control advocates moved away from the medium of film and expanded other public relations efforts instead. Margaret Sanger resigned from the American Birth Control League (ABCL) after her efforts to provoke the media led to conflicts with the organization’s acting president, Eleanor Jones. The ABCL spent the 1930s fighting to prove that with Sanger gone, birth control was “out of the hands of its propagandist pioneers,” although the organization continued to court the press.53 Sanger remained in charge of the Clinical Research Bureau, and in 1929 she launched the National Committee on Federal Legislation for Birth Control, Inc., a new organization aimed at overturning the law against contraception. From 1929 to 1937, the committee arranged more than 1,789 lectures by 100 different speakers, and from 1931 to 1937, it mailed more than 68,000 letters a year.54 Sanger had jumped into cinema at a time when the market for birth control films was flourishing and before rigid censorship closed off the field, and she showed the same initiative when film was no longer an option. She followed the audience as poorer Americans turned away from the movies and began listening to the radio. Radio broadcasting began in the early 1920s, when listeners met on their neighbors’ porches and at the general store to tune in. As more families acquired their own sets in the car and at home, people heard broadcasts in their everyday travels to and from work and around town. In the 1930s, women (and some men) listened to soap operas as they undertook household chores during the day, and at night, children and parents gathered round the radio together. The new medium raised questions similar to those that accompanied the development of the motion picture: what effect, negative or positive, did radio have on listeners, and should its main purpose be to educate or entertain? These questions took on a particular hue because radio offered a less mediated experience than the movie theater. Whereas men and women could be separated in theater audiences and children could be refused admittance to films that were suitable only for adults, radio was already inside the house. Any member of the family could listen at home, where men and women, boys and girls, often tuned in together. Radio also offered listeners a personal connection to a real-­time experience that thousands could enjoy at the same time. The effect was a curious combination of the public and the private, what historian Jason Loviglio calls an “intimate public.”55 Listeners shared a social space with others who tuned in to join an audience that was both local and national from the comfort of their own homes. This intimacy was used to powerful effect by President Franklin D. Roosevelt in



Battling Silence and Censorship 31

the 1930s, when his fireside chats helped reassure the nation that the country’s economy could be built back up after the devastation of the Great Depression. At the same time, this characteristic posed unique challenges. The question was how to exploit the commercial potential of the medium without following the scandalous path some parts of the movie industry had taken. Following the model devised by motion picture producers, broadcasters tried to avoid governmental regulation by establishing their own guide to conduct. They did, however, call for federal help in their efforts to cut down on competition. In the early years of radio, pioneer companies such as Westinghouse, Radio Corporation of America (RCA, a subsidiary of General Electric), and American Marconi competed for airtime with thousands of amateur enthusiasts taking up wireless transmission across the country.56 These companies scrambled to buy up patents on the rapidly evolving technology of broadcasting and formed alliances with one another to consolidate their power. Industry leaders called for federal intervention to regulate the hundreds of stations broadcasting across one another and interrupting each other’s transmissions. In 1927 the government responded by launching the Federal Radio Commission (FRC). The idea that the FRC might favor larger companies at the expense of smaller stations created opposition among reformers who were determined to harness the educational power of radio. They had also learned from the motion picture industry and wanted to prevent the same triumph of entertainment over education in broadcasting. Gradually they lost out to the few companies that dominated the industry by the 1930s. As large companies embraced advertising and sponsorship in order to profit from the new medium, they created a commercial monopoly that pushed educationally oriented broadcasters to the margins of the industry.57 Banning Birth Control from the Airwaves

At the beginning of radio, most stations broadcast phonograph recordings, weather reports for ships, and occasional news items. Gradually, as they tapped the potential of the technology to bring live events to people far away, some stations began introducing sports commentary and musical performances. Transmissions of presidential speeches offered a compelling example of the potential of radio to promote a cause, but broadcasters were cautious about antagonizing listeners or the government by promoting political views. In the years before radio advertising was considered, opinion-­based broadcasts were studiously avoided. Live transmissions raised the risk that guest performers might be less careful, however, so broadcasters created ways to deal with such incidents.

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Broadcasting Birth Control

At Westinghouse, for example, the studio engineer at their Newark, New Jersey, station had an emergency switch that would change the transmission to phonograph music if needed. Nevertheless, this station was the first to refer to contraception on the air. In 1921, actress Olga Petrova was invited to perform, creating some anxiety among staff because she was known for speeches on the topic of birth control. Petrova reassured Westinghouse executives that she just wanted to read some of her own versions of nursery rhymes. However, when the broadcast began, she recited “There was an old woman who lived in a shoe, she had so many children because she didn’t know what to do.” The engineer didn’t have time to switch to the phonograph, and the offending phrase went out live. Executives panicked about the possibility of a government clampdown on the station and called an emergency meeting. They decided never to invite Petrova back on the air and to scrutinize every planned program more closely. Borderline broadcasts, such as appearances by performers who might tell risqué jokes, were cancelled outright.58 There was no government backlash, but the slip haunted broadcasters for the rest of the decade. The minimal formal restrictions that were in place created confusion over exactly what was allowed. Section 29 of the 1927 Federal Radio Act specifically stated that censorship was not part of the mandate of the Federal Radio Commission. Yet section 11 stipulated that the commission could deny broadcast licenses to stations that did not serve “the public interest, convenience, and necessity.”59 The act also banned obscene, indecent, or profane language, which might be interpreted to include any discussion of birth control, although this issue was not explicitly mentioned in the text. Most radio stations were unwilling to test these vague boundaries, even though they apparently had greater freedom than motion picture producers had enjoyed. In March 1929, in the absence of clear guidelines, the industry adopted its own restrictions. The National Association of Broadcasters, which had been launched in 1923 to fight music publishers’ demands for copyright fees for music played over the radio, established the first code of ethics. This brief document, which formed the basis of several new codes adopted over the next few decades, listed two clauses that could apply to birth control. The first recognized that the audience included people of all ages and all types of political, social, and religious beliefs and forbade broadcasters from airing “any matter which would commonly be regarded as offensive.” The second code, clearly drawing on the guidelines of the Comstock Act, stipulated that “matter which is barred from the mails as fraudulent, deceptive, or obscene shall not be broadcast.”60 The restriction closed a loophole, although as a self-­imposed industry ideal it did not carry the same legal weight as the Comstock legislation.



Battling Silence and Censorship 33

The code of ethics was clear enough, however, that few broadcasters were willing to address the subject when birth control advocates first approached them. In November 1929, the American Birth Control League got into a battle with the leading network, RCA’s National Broadcasting Company (NBC), when the station refused to air coverage of the league’s three-­day conference. The American Civil Liberties Union (ACLU), which had been founded in 1920, took up their case with the Federal Radio Commission, which deferred to NBC’s Advisory Council. The ACLU presented an argument that was regularly used to defend birth control films: that because the subject was frequently discussed in the nation’s press, refusing coverage on the radio constituted censorship regarding an important issue. The Advisory Council countered that radio and newspapers could not be treated in the same way. The difference, argued the Advisory Council, was that radio could be overheard by any member of the household, not just the person who had originally tuned in. Council member Owen D. Young, the CEO of RCA, declared that birth control “was the kind of subject which was not yet ripe for introduction through the radio to the homes of America, available for any member of the family, of any age or condition, to turn on.”61 In his view, programming needed to be appropriate for all ages and levels of maturity. The other members of the council agreed. Attacking the birth control movement’s mass media strategy, they also argued that the stations would be engaging in propaganda if they agreed to air programs on the subject before it was widely accepted. Sanger and her colleagues wanted to use radio in order to build support for birth control, but NBC would not cover the topic while it was still controversial (in the opinion of NBC executives). The decision of the Federal Radio Commission set a precedent that most other broadcasters followed. Of the 115 radio stations that the American Birth Control League contacted in 1930, only twenty-­seven replied. Eight were supportive, but just two said they would air a program for the organization. The league began broadcasting on one station in Buffalo the same year and by 1931 had secured a weekly program on another station: WEVD, a station operated by the American Socialist Party and named in honor of organizer Eugene V. Debs. Programs entitled “Birth Control, a Matter of Public Policy,” “Mrs. Average Citizen Asks Some Questions,” and “Birth Control—­A Woman’s Right and a Human Right” featured panels of doctors, ministers, and social workers who discussed the issue.62 This unique opportunity was possible because of WEVD’s mission to provide an educational forum on workers’ issues. Birth control advocates had to rely upon stations like WEVD to get their message out because the larger ones were reluctant to air anything on the topic.

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Broadcasting Birth Control

Education versus Commercialism

Stations with an educational mission were a vocal but vulnerable minority in the radio community. Led by reformers who opposed the expansion of commercial radio and the consolidation of the market that had begun in the 1920s, they drew on some of the same resources critics of the commercial used in the campaign against the excesses of the movie industry. The Payne Fund, which published the most influential studies about the impact of cinema in the late 1920s and early 1930s, began studying radio in 1927.63 Armstrong Perry, a former freelance journalist, became the fund’s radio counsel and served in the National Committee on Education by Radio, a lobbying group. The Payne Fund helped establish a series of annual conferences to explore the theme of Education on the Air. The conferences attracted reformers who were critical of the monopoly large companies held within the radio industry and argued that educational broadcasting was bound to lose out to entertainment in the competition for airtime and audiences and thus needed special protection to survive. Commercial broadcasters had indeed tried to force smaller stations off the air or at least onto less powerful bandwidths using the argument that the crowded airwaves created interference during broadcasts. In 1928, the Federal Radio Commission held hearings to decide the fate of 162 stations it was planning to shut down after receiving complaints from the larger companies. The first of the threatened stations to testify, WEVD, gave a compelling summary of its mission and the forces against it at the time. “If WEVD is taken off the air and in fact if it is not treated on a parity with others who are richer and more influential with the government,” argued a representative for the station, “the people of the nation can truly recognize that radio which might be such a splendid force for the honest clash of ideas,—­creating a free market for thought,—­is nothing but a tool to be used by the powerful against any form of disagreement, or any species of protest.”64 The station survived the crisis and in later years extended its educational mission, broadcasting a series of programs in its University of the Air that featured such well-­known guests as John Dewey and Albert Einstein. Ironically, it was their high position in the monopoly system that made the most powerful broadcasters nervous about controversial topics. Eager to avoid further regulation that might affect their control of radio, industry leaders were careful to present themselves as neutral purveyors of quality programming, not a mouthpiece for propaganda groups. This was the only way to defend the idea that private ownership and network domination constituted a valid system for managing the nation’s airwaves.65 They also stood to lose money. As stations sought higher profits through advertising, they became increasingly



Battling Silence and Censorship 35

nervous about offending sponsors or antagonizing powerful lobbyists. Catholic groups were especially influential, and this made contraception a particularly unpopular topic. A 1934 summary noted that “any advocacy, or even mention of birth control, or especially of the role of the Catholic Church in opposing birth control” was kept off the air.66 This timid approach also applied to other topics related to sexuality such as venereal disease. Public health leaders had emphasized abstinence rather than prophylaxis in earlier motion picture campaigns against syphilis because of opposition from the Church and their moral interpretation of the disease, and they retained this approach for radio. But having been driven out of film when educational topics were banned from the cinema, syphilis was just as controversial over the airwaves as it had been in the movies. In 1934, the Columbia Broadcasting System (CBS) told Health Commissioner Thomas Parran of New York State, a Catholic, that he could not mention the words syphilis or gonorrhea during a scheduled radio address on the subject. The show was the fourth part of a nineteen-­episode series on health issues, and other episodes had aired without any difficulty. Instead of Parran’s speech, the network broadcast fifteen minutes of orchestral music. Leading public health figures denounced radio censorship in response, and the incident became a national scandal. In a similar incident not long before, John Rice, health commissioner of New York City, was cut off the air by NBC during a luncheon speech when he began talking about syphilis. After the Parran controversy, Rice wrote to CBS, NBC, and fifteen newspapers to protest. M. H. Aylesworth, president of NBC, replied that the station had to be careful because of the criticism they received from parents who did not think their children should be exposed to such subjects. He argued that remarks made in a lecture hall or published in print might not be appropriate for broadcast because listeners thought of the radio as an invited guest in their homes.67 The lone broadcaster brave enough to buck convention seems to have been WEVD, who stepped in to put Parran on the radio. As they testified to reformers at the Education on the Air conference the following year, “We were the only station in the country that extended its facilities to a prominent health authority, who was recently barred from delivering his speech on a network. He delivered the canceled speech over WEVD in the exact manner he wanted to.”68 Eighteen months after the CBS decision, Parran, who was by then the nation’s surgeon general, launched a national campaign to tackle syphilis and the secrecy surrounding the disease. As he wrote in an article in Reader’s Digest, “we might virtually stamp out this disease were we not hampered by the widespread belief that nice people don’t talk about syphilis.”69 Yet like the

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Broadcasting Birth Control

campaigners against venereal disease who preceded him, Parran was careful not to step into the birth control debate by promoting the use of condoms. In 1934, the government replaced the Federal Radio Commission with the Federal Communications Commission (FCC). The Communications Act that established the FCC had little effect on the power of the bigger companies that dominated the industry, but it did include requirements that commercial radio stations air educational or public service programs for free. This marked a major shift from the early days of radio, when stations could refuse to air any program on any grounds. Although this law created a window for noncommercial broadcasting on national networks, the gain was very limited because stations were still beholden to their influential sponsors.70 The American Birth Control League responded quickly to the FCC mandate with a series of radio addresses. The first nationwide broadcast was transmitted on the formerly reluctant NBC network on 12 February 1935. It featured Congressman Walter N. Pierce talking about “Birth Control Legislation.” The following day a news commentator on WOR radio in Newark, New Jersey, announced an ABCL petition and launched the country’s first radio poll on the question of birth control. Sanger was thrilled to note that hundreds of letters were sent to the station. Approximately 95 percent were in favor of birth control, proving that in the five years since the ABCL first approached NBC, advocates had indeed been able to secure public support.71 Birth control advocates drew on the political rhetoric of the New Deal to frame their argument on the radio. Building on the phenomenon of President Roosevelt’s fireside chats, Sanger and her colleagues compared their campaign to the government’s role in regulating agricultural production and managing the economic and social welfare of the country. On WWJ radio in Detroit, Michigan, in 1939, Dr. Clarence Cook Little, managing director of the American Society for the Control of Cancer, participated in an interview for the ABCL on “The Relation of Birth Control to Democracy.”72 The interviewer noted that “nearly everybody has heard about, and is interested in, such subjects as crop control, flood control, disease and crime control, but birth control—­that is, controlling the number of children in the family—­is less talked and written about.” Cook explained the reasons for the discrepancy, arguing that because the consequences of unrestrained reproduction were not felt immediately, they were not taken seriously. He also chastised the “mistaken attitude” that “absence of control means freedom.” At the time, critics of the government’s incursion into working and home life were making just such an argument. New Deal rhetoric also influenced a major shift in the terminology of the birth control movement. In 1935, Sanger used the phrase “family planning” in



Battling Silence and Censorship 37

a radio address she delivered on CBS. She noted that listeners had heard a great deal about national security through national planning and said that now was the time to consider family security through family planning.73 Historians have described Sanger’s shift in terminology to “family planning” and “planned parenthood” as a move away from the feminist goals of female self-­determination implied by the original phrase “birth control.” Yet the radio scripts make it clear that several years before ABCL was renamed the Planned Parenthood Federation of America in 1942, birth control advocates invoked the idea of planning to draw an explicit link between their cause and the transformation of U.S. life under the New Deal. In the context of financial instability following the Great Depression, birth control advocates also reiterated their economic arguments about the benefits of limiting family size in relation to the father’s earnings. Storytelling Replaces the Lecture Format

Birth control broadcasting expanded as radio matured. As programming became more sophisticated, birth control advocates were forced to change their approach. In the early years of radio, the novelty of tuning in to hear a voice from miles away—­across the “ether,” as it was called—­was in itself enough to attract listeners. Broadcasters desperate for material paid little attention to the format in which it was delivered during the first fifteen years. The pioneer birth control programs, for example, followed the simple format of a lecture or a question-­and-­answer session. But on October 30, 1938, the potential of dramatized narratives to engage and influence audiences was powerfully demonstrated when War of the Worlds was broadcast on CBS. The radio play, based on a novel by H. G. Wells, described an alien invasion of the United States using the format of news bulletins to document the crisis as it unfolded. Panic spread across the country as listeners jammed emergency phone lines and fled their homes. Although the mass hysteria the broadcast generated led to calls for radio censorship, public opinion improved in a matter of days. In fact, the audience for the next week’s radio drama almost doubled.74 The following year, when the American Birth Control League (now renamed the Birth Control Federation of America, or BCFA) considered a radio campaign, it took note of the changed expectations of radio broadcasters and audiences. The creation of the BCFA marked the end of the split between Sanger and the American Birth Control League; both the ABCL and the Clinical Research Bureau, which Sanger had retained control of, were absorbed by the new organization. As the BCFA launched this new chapter of their work, staff began researching the idea of a radio disk, a prerecorded program that could be distributed to radio stations countrywide.

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Broadcasting Birth Control

Staff member Martha Mumford proposed three possibilities for program formats: a series of short talks given by nationally recognized figures in the birth control movement, a quiz or question-­and-­answer session led by Margaret Sanger, or a skit portraying the “evils” of unplanned parenthood that would demonstrate how birth control could prevent them. As stations were more likely to broadcast a dramatic program than a “purely educational or propaganda offering” by this time, the BCFA decided to develop a skit.75 The scriptwriter and supervisor of production was Benjamin Potts of N. W. Ayer Advertising, who had helped to create media campaigns for the National Tuberculosis Association. After three years of working on TB propaganda, Potts had developed a method that balanced factual information with the appeal of the story. Because the most influential people in the field were usually the least likely to hold the audience’s attention, he had devised a way of “‘humanizing’ the dignitary or expert and making his or her words the climax of a dramatic build-­up.” The program would begin with a story of the hardship faced by a family who don’t have enough money. The guest speaker would then deliver a message about birth control, tying the points back to the elements in the story. The culmination of the piece was the happy resolution—­the explanation that birth control could alleviate the problem. Potts developed “Almost Daylight,” a script about a woman who abandons her youngest child at a children’s home but is caught leaving by a policeman. In the dialogue between them, the initially unsympathetic officer realizes that the mother cannot afford to raise all the children she has and that she is not to blame. Their exchange counters common misconceptions much as a question-­ and-­answer format would have done but in a dramatized fashion that was more likely to engender compassion among listeners. As Potts explained, “The effect of this approach to the problem transforms a lecture into a human interest story, and gives dramatic impact with a strong emotional appeal to a message that would otherwise miss all but the social-­minded and the intellectual.”76 As they attempted to keep up with the changing style of radio, birth control advocates increasingly turned to such personalized narratives to increase the impact of their broadcasts. Opposition on the Radio

Not every issue could be handled this way, however. Father Charles E. Coughlin, a right-­wing radio preacher with a reputation for fiery attacks on his enemies, used some of his weekly sermons to denounce the growing movement in support of birth control, “a subject which should never be mentioned in decent society but which this very day has been made a by-­word in the mouths



Battling Silence and Censorship 39

of inquiring children.”77 Coughlin denounced the economic arguments birth control advocates made and railed against race suicide. Although he explicitly blamed the newspapers for publicizing their cause, it is significant that he used radio, as did his opponents in the birth control movement, as the primary means to appeal to thousands of potential supporters. Most U.S. households contained a radio by the early 1930s (although poor families in the South and African American families were less likely to own one until the 1940s), and Coughlin recognized the expanding reach of the technology. As he said in response to boos from birth control advocates at a House Judiciary Committee hearing where Sanger testified in 1934, “I’ll take care of them over the radio.”78 Sanger used her celebrity to counter such attacks, broadcasting regularly to quash rumors and misinformation. Her opponents, for example, continued to deliberately confuse birth control with abortion, just as they had done in the era of birth control films. In a 1935 radio address, Sanger restated the difference in clear terms. “There has been a lot of loose talk about birth control ‘operations,’” she said, adding that “there is no such thing as a birth control operation. Remember this: birth control means to prevent, not to destroy.”79 Five years later, with the charge still circulating, some birth control broadcasts began by stating that birth control did not mean abortion or sterilization.80 Opponents could not turn back the rising tide of support for birth control. In 1934, writer Dorothy Dunbar Bromley declared that this contentious issue had “become respectable,” thanks in part to the extensive publicity activities of Sanger and her supporters.81 By 1936, when Fortune magazine reported that 63 percent of Americans believed “in the teaching and practice of birth control,” social commentators were denouncing what they called a birth control plague and blaming propagandists for its creation.82 The same year the provisions of the federal Comstock Act were overturned, when the Supreme Court, in a case instigated by Sanger, U.S. v. One Pack of Japanese Pessaries, ruled that birth control could no longer be declared obscene. In 1937, responding to the changing climate of opinion, the American Medical Association finally endorsed birth control. This opened the way for several new lines of argument in birth control media. Advocates could now highlight the support of members of the medical profession, and they invited them on to the radio to explain the health benefits of child spacing. They also differentiated between the safe methods available from qualified physicians and nurses at clinics and the ineffective and dangerous gadgets advertised under the euphemism of “feminine hygiene.” Doctors could propose birth control programs alongside other public health initiatives that already received

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Broadcasting Birth Control

broad support, such as campaigns against tuberculosis and diphtheria and efforts to maintain a pure water and food supply. By January 1940, a Gallup poll found that 77 percent of Americans supported the idea of the provision of birth control in government-­supported clinics. The improving image of the movement meant that its members could ramp up publicity efforts and go beyond simply justifying contraception. The same year, the BCFA began using the radio to support fund-­raising campaigns.83 However, though birth control advocates had created scripts that local broadcasters could adapt to include speakers from the community and specific information about the location and opening hours of area clinics, they were not successful in their efforts to persuade some small stations to air their programs. In April 1941, radio industry insiders told birth control advocates that they needed to break into the major networks before they would be able to persuade more regional broadcasters to take up their programs. “Helping a Nation at War”

When the United States joined World War II at the end of the year, radio broadcasting was quickly put to service for the war effort, opening the way for propaganda in a manner that had been previously unthinkable. In fact, critics of President Roosevelt’s New Deal, especially newspaper owners, had vigorously criticized his use of mass media to change public opinion. The war swept aside such objections and shored up the image of radio as a purveyor of truth. Broadcasts from London during the blitz and from the frontlines of battle turned the medium into the most trusted of all mass media, above motion pictures and newspapers.84 In 1942, for the first time, the Birth Control Federation of America, renamed the Planned Parenthood Federation of America, persuaded national networks to broadcast coverage of its annual meeting during prime air time.85 The next task was to reassure station managers and listeners that birth control would not jeopardize the war effort. In the context of the ongoing need for new citizens for the workforce and to defend the country, arguments in defense of birth control needed to be particularly persuasive. Radio scripts addressed the concern that family planning would lead to a rapid decline in births by stressing that most “normal” people wanted to have babies, they just wanted to plan when to have them, and by noting that the American birthrate was in fact flourishing. Planned Parenthood also contrasted family planning with fascist pronatalism. As a script for a Richmond, Virginia, station put it in 1942, “While Hitler enslaves German women and tries to drive them to further breeding with the whip, we have been thinking of our American mothers as precious human



Battling Silence and Censorship 41

beings, of our babies as the citizens of the free world of tomorrow.” This theme echoed the message that the Office of War Information, the government’s propaganda department, was disseminating in its extensive use of radio broadcasts. Programs such as “Women versus Hitlerism,” “The German Mother,” and “The Nazi Estate of Matrimony” described German women and those of occupied countries as being forced to bear children, even outside marriage, to stock Hitler’s armies.86 In 1943, Planned Parenthood produced a radio broadcast about the burden of pregnancy for wartime couples. The script was drafted by Mildred Gilman of Planned Parenthood’s Public Information Department and was finalized by E. Stephen Carlin, a scriptwriter in the Continuity Division of NBC. To enhance its national appeal, the cast included several actors described as NBC stars. “Freedom from Fear,” which was broadcast on WRNL in Richmond, Virginia, on October 1, 1943, told the story of a nurse at a factory who investigated low morale and declining productivity among the female workforce. She learned that many of the women dreaded visits from their husbands on leave from the army because they might lose their jobs if they became pregnant. The nurse resolved the situation by persuading the factory’s management to provide birth control information, job guarantees, and health services for pregnant women.87 The show was marketed to women. It was intended for broadcast in the morning or early afternoon when soap operas, a recently launched genre of daytime drama, usually aired. These programs, originally developed by advertisers to help sell household products, played an important role promoting women’s new responsibilities during the war. With men drafted into military service, hundreds of thousands of women were needed to staff the manufacturing plants that produced armaments and everyday necessities. The radio serials focused on the intimate lives of a small group and could be easily adapted to include women characters who valiantly went to work and women who were punished by misfortune if they proved too lazy or self-­indulgent to join the effort. The writers reinforced the gender expectations of their time and mimicked the proscriptive function of the “fallen woman” genre of motion pictures. The soap opera format provided ample opportunity to depict sexual mores and the consequences of transgressing them. By broadcasting in their usual schedule, birth control advocates exploited this context to reinforce their message. Yet “Freedom from Fear” offered a means of escape from some of the consequences that these dramas described, such as pregnancy outside marriage. The storyline also tapped into a particular construction of female sexuality that helped mobilize American support for the war. As historian Robert Westbrook has demonstrated in his adroit discussion of the function of the pin-­up girl, the

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Broadcasting Birth Control

government worked closely with Hollywood filmmakers during World War II to present women as “icons of male obligation.”88 Posed images were circulated in magazines and plastered on airplanes, and young women sent their sweethearts self-­portraits in the same style. The soldiers were fighting for these women, who would also be their reward when they returned home victorious. In this construction, working wives had to make themselves sexually available when their husbands were home on leave. Planned Parenthood could help them uphold this patriotic duty without the burden of becoming pregnant. Although the narrative of “Freedom from Fear” specified that married couples should use birth control, in reality the clinics made it possible for single men and women and those engaging in sexual activity outside marriage to have a great degree of sexual independence. The characters the drama depicted were already married, but at least one of the surviving radio scripts from this time noted that Planned Parenthood would “welcome girls about to be married.”89 It seems that single women could also use the federation’s services if they presented themselves as brides-­to-­be. In answer to critics of birth control who opposed the movement on these grounds, scripts declared that it was unfair to withhold information from married people in order to prevent the actions of a “doubtful group” who “wish to evade the moral law.”90 Despite the possibility that birth control could get into the wrong hands, responses to the broadcast were largely positive, and station managers applauded the “tasteful” approach to the subject. The contemporary relevance of the narrative no doubt played a part, as did changing attitudes to nonreproductive sexuality typified in, and partly constituted by, the rise of the pin-­up girl and other erotic imagery in advertising and popular culture.91 This shift presaged growing support for the goals of Planned Parenthood, and the organization lost no time in expanding their advertising campaign to local stations that had previously proven resistant to their messaging. Favorable reactions to repeat broadcasts of “Freedom from Fear” in Mississippi, Delaware, New York, and Maryland won the approval of other stations for future shows.92 This encouraging response led Planned Parenthood to develop numerous other broadcasts. In addition to prerecorded programs, the New York headquarters prepared template scripts that regional affiliates could use, such as “Should War Brides Have Babies?,” a scripted conversation between a minister, an educator, and a psychiatric social worker. Organizations were to select figures from their own community to fill the roles. To help local branches negotiate with station managers, Planned Parenthood provided guidelines for planning their approach to local broadcasters. They advised them to take influential members of the community such as clergymen or business



Battling Silence and Censorship 43

leaders to the radio station when submitting media for audition in order to highlight support for the broadcast. They also noted that the Office of War Information had informed them it did not need to approve the broadcast and that the U.S. Public Health Service recommended child spacing services in its “Outline of an Industrial Health Program.”93 League representatives were encouraged to cite the results of a recent poll in Fortune magazine when local radio stations anticipated opposition from Catholic groups. The poll found that 84.9 percent of women who were asked (including 69 percent of the Catholic women who were surveyed) agreed that birth control information should be available to married women. Not entirely confident that they could escape censure, however, the national headquarters also advised against any advance publicity. They suggested instead that local friends of the organization be encouraged to tune in and to send a letter of support after broadcasts. Levels of local broadcasting were highly variable across the country. Because of the short lifespan of some radio stations and the fragmentary nature of their surviving records, it is not clear how many regional stations ultimately aired Planned Parenthood materials. By 1944, though, it appears that many more were willing to do so than had been just a few years before. In stark contrast to the early years of radio, family planning was broadcast widely by that year and, in some areas, on a regular basis.94 Conclusion

In the first half of the twentieth century, birth control was transformed from an illegal trade discussed only in private to a publicly promoted practice. Between the mid-­1910s and the mid-­1930s, the issue made tremendous headway in the cinema. Where they were well received, films may have helped normalize the topic. Where they provoked censorship, they also ignited discussion. Yet the medium was useful only when film could bestow credibility through its status as mainstream, educational entertainment. After the Hays Code was enforced in 1934, it became impossible to use entertainment film for educational projects about sexual matters. Because the Catholic Church was so influential in the drafting and application of the code, birth control became a particularly problematic subject for motion pictures. Before such regulations were introduced in the radio industry, birth control advocates moved their campaign from the screen to the airwaves. In a reversal of what happened in cinema, they gained more opportunities to broadcast as regulation of the new medium increased. This was due, in part, to the efforts of reformers, who were determined to keep educational material on the air. By the

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Broadcasting Birth Control

end of World War II, family planning was a household term that was regularly transmitted to the nation’s homes and workplaces on the radio. The end of the war and the development of widespread television broadcasting brought new media opportunities and challenges. Without the wartime imperative, family planning promoters needed to recast the benefits of contraception and smaller families. They benefited from the help of a new group of communications specialists who were turning from military propaganda to the concerns of a new era and the looming threat of global overpopulation.

Chapter 3

The Medium Shapes the Message

At the end of World War II, Planned Parenthood had to redefine its role. Communications experts, who had benefited from the wartime need for propaganda, required a new focus in the postwar period. Experts on public opinion who had specialized in promoting the image of American activities now hoped to find a purpose for mass persuasion in peacetime. In a return to the concerns of an earlier era, demographers, economists, and politicians began to express anxiety about the rate of reproduction among the poor, this time not just at home but around the world. Overpopulation threatened to spark new wars just as peace had been secured. For a field in search of a focus, the issue was ideal. It resurrected the specter of unchecked population growth that had dominated the birth control debate in the early twentieth century and elevated it to a matter of global importance. As one prominent communications expert suggested to a colleague in 1945, “Our big task now is to communicate to large masses some of the ideas that may save us from race suicide.”1 Family planning advocates were able to capitalize on the growing interest in the overpopulation issue to expand their media activities. As specialists who were looking for postwar applications of their research devised new strategies of persuasion, they developed the first theories of mass communication specific to family planning. Planned Parenthood applied these ideas in various projects, eventually founding a specialized department of Information and Education to shape the organization’s media efforts. The partnership between family planning advocates and the burgeoning academic discipline of communication proved mutually beneficial as messaging strategies were theorized and tested in the service of the population crisis. Planned Parenthood gained new expertise

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while communications researchers found renewed purpose (and funding) for their work. Politicians and the press took up the issue of fertility control as part of an intensive focus on overpopulation at the same time that other sexually related topics were beginning to appear more regularly in public discourse. Indeed, the representation of sex in U.S. culture expanded exponentially in this period as commercial media diversified and attitudes toward sexuality became more liberal. The new attitudes were apparent in the introduction of Playboy magazine in 1953, and accelerated by the Kinsey reports on sexuality of 1948 and 1953, and the Food and Drug Administration’s approval of the contraceptive pill in 1960. In the mid-­1960s, polls revealed broad public support for family planning for population control.2 As a result, family planning promoters found new opportunities to broadcast their message. Planned Parenthood began to target television, the most popular medium of the era. Although at first they encountered the same kinds of barriers as they had in film and radio, they eventually found TV more accommodating. The industry was struggling to assert its relevance in the face of criticisms over programming that was bland and of poor quality. Following the lead of the women’s movement and other supporters of abortion reform, Planned Parenthood began to broaden its purview to include campaigning for legal abortion for the first time. As the sexual revolution unfolded in the 1960s, family planning advocates expected increasing tolerance for the topic among broadcasters and audiences. However, the growing public discourse on sexuality gradually began to impede family planning advocacy because it also galvanized groups opposed to sex education, women’s liberation, public funding for family planning, the sexual revolution, and abortion. Both supporters and opponents used media to win over public opinion on the abortion issue. This battle increased in intensity after the procedure was legalized nationwide by Roe v. Wade in 1973. As the backlash grew, family planning promoters frequently found themselves on the losing end of aggressive publicity stunts. Patients and clinic staff also suffered threats and harassment. These events and growing conservatism about the treatment of sexuality in educational media convinced Planned Parenthood to tone down its rhetoric and deemphasize sex. The organization thus completed the process initiated when the movement began to align with the medical profession earlier in the century and parted ways with feminism. This capitulation had enormous consequences for the promotion of family planning and access to contraception and abortion services in ensuing years. The shift also prompted some family planning promoters to strike out on their own, either to pursue less conservative media projects or to advance an explicitly feminist agenda.3



The Medium Shapes the Message 47

Diffusing the Population Bomb

During the 1950s, a significant shift in public attitudes and government policy on family planning took place that was fueled by two issues: growing anxiety about the dangerous consequences of overpopulation and the Cold War struggle against the Soviet Union for global influence. Analysts in the United States predicted a “population bomb” that would lead to food shortages, starvation, and rioting. Communist leaders could then exploit this instability to extend Soviet power into vulnerable nations. In an effort to prevent this, demographers, economists, politicians, and environmentalists converged with family planning advocates around the concept of worldwide population control.4 Environmentalists first popularized the subject of overpopulation in 1948 with the publication of two books written by conservationists, The Road to Survival by ornithologist William Vogt and Our Plundered Planet by Fairfield Osborn, the head of the New York Zoological Society. Both authors wrote that if the world’s population continued to grow unchecked, catastrophic damage would be done to the earth’s resources and food shortages would cause widespread warfare. Scientific data gathered by demographers, who forecast unsustainable population growth, and economists, who linked economic development to smaller family size, brought scholarly credibility to the topic. By the mid-­1950s there were five academic journals on population issues in the United States as well as two international publications to which U.S. scholars frequently contributed.5 In the context of this increasing fervor, a number of powerful figures were inspired to devote themselves to the cause, and their involvement rapidly catapulted the issue to the top of the government’s agenda. In 1952, philanthropist John D. Rockefeller III founded the Population Council, which began promoting the worldwide use of contraception to limit family size. Hugh Moore, who had made his fortune in the Dixie Cup Corporation, also aggressively marketed the issue with the help of influential advertising guru Bruce Barton. His 1954 pamphlet, The Population Bomb, had been distributed to over 1.5 million Americans by the mid-­1960s; in 1968, sociologist Paul Ehrlich wrote a book with the same title. Moore also launched full-­page advertisements in the New York Times, the Wall Street Journal, and Time magazine, a media strategy that was considered “highly unorthodox” by researchers concerned about the overpopulation issue; these researchers advocated scholarly publishing as the way to convey the evidence of the problem.6 Moore replied that nobody had listened to the dire warnings of demographers before he took the issue to the masses through the media, adding: “You’ve been raised in academic halls. I’ve been

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raised in the marketplace. I’m used to presenting facts dramatically.”7 Despite its detractors, his approach proved successful and demonstrated the value of mass media strategies. Before the 1950s, support for the idea of providing family planning education in other countries was below 50 percent. Within a few years of Moore’s campaigning, the numbers began to rise, to 55 percent in 1959, 66 percent in 1963, and 79 percent in 1965.8 Like Sanger’s attempts to provoke controversy, the high-­profile advertisements generated attacks by the Catholic Church, which brought a far wider audience to the topic than had been previously reached by family planning communication efforts. Impressed by this impact, Planned Parenthood would later utilize the press for a national advertising campaign. The topic of overpopulation was broadcast on the newest medium of mass communication, television, beginning in December 1951, when journalist Edward R. Murrow, renowned for his war reporting from London during the blitz, described global population pressures in the first program of Year of Crisis, his annual roundup of the news, which aired on CBS. The issue made headlines throughout the decade, and by 1959, when CBS Reports broadcast an hour-­long documentary on India’s population problem, 9 million viewers tuned in. When the program was rebroadcast early in 1960 with an extra half-­ hour of footage on the issue of population and economic development, it was watched by a record-­breaking 9.5 million people.9 Gen. William H. Draper Jr., former undersecretary of war, brought the subject of overpopulation under government review, proposing federal funding for family planning programs around the world. President Eisenhower rejected the recommendations of the Draper report (which was formally authored by the President’s Committee to Study the United States Military Assistance Program), although they laid the groundwork for later federal involvement.10 Also in 1960, the Catholic bishops of the United States stepped into the fray and denounced public assistance for the promotion of family planning at home or abroad. But as the New York Times reported on December 1, 1959, far from quelling the debate, their statement helped move the issue “from the areas of private morals and theology into the realm of public discussion of political action,” in effect servicing the efforts of the family planning movement by spotlighting religious opposition.11 The controversy that resulted produced a massive increase in media coverage, including a cover story in Life magazine and essays in Catholic publications questioning the Church’s position. By the end of the decade, the number of articles on the topic of birth control indexed in the Readers’ Guide to Periodical Literature had doubled, rising from 82 in the 1940s to 177 in the 1950s, including titles such as “Stop the Explosion?,”



The Medium Shapes the Message 49

“What Should We Do About the World Population Problem?,” “Population Explosion,” and “New Light on India’s Worry.” Overpopulation—­and therefore family planning—had become central issues of the era. In theory, communications specialists who joined the population control effort could draw on the strategies of mass persuasion that had been tested and perfected during the war. Emboldened by the success of consumer advertising and various wartime communications projects, they entered the postwar period with a generous assessment of the power of mass media to influence opinion. They endorsed a strong effects model that depicted audiences as passive receptors who uncritically accepted the ideas directed to them. After the war, as they undertook more systematic study and evaluation of communications campaigns, some researchers became less confident. The limited effects model, which postulated that audiences read their own interpretations into media messages and differed widely in their understanding and acceptance of intended meanings, soon displaced the strong effects model as the leading explanation of media influence.12 Scholars gradually gave up on the idea that the majority of an audience could be swayed by broadcasting and looked instead for opinion leaders, or “influentials,” who could adopt a new idea quickly and then promote the message to a wider group. This strategy, known as the diffusion model of influence, was first described by rural sociologists studying the implementation of hybrid corn farming in the Midwest in the 1940s. This theory dominated communications research for the next two decades, a period when over 400 publications on diffusion were printed. The model held that innovative audience members who were aware of activities and ideas circulating outside their immediate network of contacts would adopt a new idea early and then persuade their friends and neighbors.13 Such research informed increasingly sophisticated media efforts by Planned Parenthood. In 1953, it provided member organizations with a plan for using radio and for expanding into television. The briefing explained that the “so-­called ‘mass audience’ reached by some of the commercial shows” was not their only target and that affiliate groups should also aim to reach the “supporter” audience, “the opinion-­molders in your community” who tune in for panel shows and forums where special guests discussed news items. This represented a shift from the organization’s earlier use of the media to target large working-­class communities through popular cinema and extended the more diverse approach it had used with radio in the 1930s and 1940s, which had included expert panelists and lectures as well as soap-­opera formats. Planned Parenthood distributed program scripts, announcements, and

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human interest stories and encouraged affiliates to add their own materials to enhance local appeal.14 The wartime enthusiasm for scientific research, which had contributed to the discovery of the atomic bomb and the development of the field of communications, had also generated a growing professional class of experts who studied every aspect of human behavior. The postwar baby boom meant that the family became the center of U.S. life, and Planned Parenthood incorporated research by scientists and sociologists on such issues as infertility, child psychology, and juvenile delinquency into its postwar work. National radio campaign spots of thirty to sixty seconds focused on “marriage education” to help young couples build happy homes, fertility treatment, and “responsible parenthood,” which could give families the opportunity to plan when to have a first child and how long to wait before having another—­in consultation with medical experts, of course. Broadcasts emphasized “birth by choice, instead of by chance” as a shorthand way to refer to the full scope of services Planned Parenthood offered. These included infertility treatment as well as family planning, and radio scripts focused on the physical and psychological benefits of family planning for mothers and children, and stressed the role of family planning in preventing broken homes. These programs also emphasized the importance of happy, healthy families for strong and stable countries, thus extending the concept to national and international security.15 The 1953 campaign included fifteen-­ minute scripted conversations between the radio announcer, a Planned Parenthood officer, and a representative of a particular profession selected from the local community in the region where the show was broadcast. The script titled “Parents Are Human Too” included a psychiatrist or social worker who talked about the impact of unwanted children. In the case the experts consider in this script, a child grows up emotionally insecure as a result of finding out that his mother had wanted to give him up for adoption. The parents are also presented as victims who try to cope with an expanding family on a fixed salary and feel guilty about their negative attitude toward the new child. The psychiatrist speculates that the situation could even result in the husband deserting his wife. Throughout, the script highlights psychological factors such as the warning that a woman who undergoes an illegal abortion may suffer tremendous guilt and “neurotic problems.” Like the anti-­abortion preachments of the silent film era, the narrative threatened sterility for women who terminate a pregnancy. By including this argument, Planned Parenthood affirmed their commitment to planning for children, not permanently preventing them. While the inclusion of the psychological reasoning illustrates the high status of scientific thinking at this time, the



The Medium Shapes the Message 51

survival of the moralizing argument against abortion indicates the stigma that still surrounded pregnancy termination in the postwar years, and the unwillingness of Planned Parenthood to challenge it. Although the organization would later gain the confidence to support abortion (and indeed provide it), they have not maintained a strong and sustained public defense of the procedure since it was legalized, an issue I return to in the conclusion of this book. Adding a new dimension to the older economic arguments for limiting family size, the script titled “Planned Parenthood Is Your Business” features a local businessman whose viewpoint is shaped by child development theories as well as “practical economic considerations.” He explains that it is important for parents to space births so that they can give each child the needed care and affection, and not just as a way to ensure that the family has enough money. He notes that of the many charities he supports, most are just patching up problems that could have been prevented by family planning. Taking up the question of U.S. consumer capitalism, the businessman argues that while the country’s way of life depends on growing markets, producing too many children does not necessarily mean more consumers and may actually decrease a worker’s buying power. Families with too many children become an economic liability because they rely on taxpayers to support the children they cannot afford to raise. Connecting dependence at home to the global context, the speaker compares such families to overpopulated nations that will burden the United States. In addition to the usual appeals about the benefits of birth control, radio broadcasts for domestic audiences often included this new emphasis on the importance of family planning around the world, drawing on the explosive metaphor of the population bomb: “It is obvious we cannot afford to have the world breed itself into starvation. Food—­or the lack of it—­is a weapon. The men behind the iron curtain use this weapon to turn hungry, frustrated people against the free world. They are using population pressures as another force against us. These two weapons—­too many people and not enough food—­can explode in all our faces, unless we adjust the scales and make them balance properly!”16 Despite the urgency of such appeals, the family planning movement’s traditional opponent, the Catholic Church, remained resolutely opposed to contraception. Family planning advocates quickly turned such opposition into opportunities to maximize their exposure. Just as it had done in the early postwar period, Planned Parenthood encouraged affiliates who worked in communities with organized resistance to bring influential business leaders to meet station managers and invite broadcasters to annual meetings and other events. In the event of a challenge, station managers who had become involved in the

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movement’s activities would be more likely to stand up to critics and continue broadcasting. Local Planned Parenthood groups were instructed to ask their communities to support radio and television stations by sending messages of congratulation after every broadcast. If necessary, they could even call on the federation for assistance during a crisis, as experience had taught that “a little national leverage often helps solve tough local situations.”17 National attention proved helpful in Poughkeepsie, New York, in January 1952, when seven physicians were told to resign from the Duchess County League of Planned Parenthood or lose their jobs at Saint Francis Hospital. While three physicians temporarily withdrew from the league, the others steadfastly refused. Ten days into the saga, the story had made national headlines. Planned Parenthood drew on their longtime supporter, radio station WEVD, which hosted a debate about whether birth control and religion were compatible. (The station had aired a similar program after Pope Pius XII addressed midwives in 1951.) The intensive coverage of the controversy and the support of this broadcaster helped keep the issue in front of audiences and stir outrage among members of the public, who decried the influence of Catholics on the medical care of others.18 Moving into the Mainstream

While an occasional controversy could prove useful, Planned Parenthood set its sights on mainstream approval in the decades after World War II. With several decades of radio broadcasting under its belt, the federation turned to the new medium of television in the 1950s. The first regular television broadcasts in the United States began in 1941, governed by the Communications Code of 1934, which had established the Federal Communications Commission. Although the code included requirements that broadcasters air educational or public service programs for free as part of their schedules, the provision had not been rigorously enforced in the radio industry. In television, the public service responsibilities of broadcasters were quickly trounced by the demands of advertisers, who refused to sponsor any programs featuring messages that might attract negative attention from religious or conservative groups. Compared to radio, the cost of television broadcasting was extraordinarily high. TV required more personnel, more preparation time to build and dress the set, and more rehearsals (especially of camera movements). Because of the expense, advertising was an accepted part of television broadcasting from the very beginning. This had significant negative consequences for family planning promotion. Unlike radio, where the issue of commercialism versus education had been hotly debated, in the television industry, any discussion of the medium’s social



The Medium Shapes the Message 53

uses was “muted and timid” because of the extraordinary costs of programming.19 Television broadcasters were constrained by the demands of advertisers who refused to sponsor programs featuring messages that might attract negative attention from religious or conservative groups. For the first two decades at least, the TV industry felt little pressure to balance entertainment broadcasting with educational programs on social issues. Mindful of their responsibility to sponsors, broadcasters were especially hesitant to allow birth control programming and had no incentive to do so. Advertising the medium as a “window on the world,” manufacturers and broadcasters promoted television as a means to overcome the isolation of family life in suburbia. Publicity materials represented TV as a democratic tool that could connect family members, especially suburban housewives, to the public sphere. Yet women who were stuck at home all day with children or household chores did not necessarily want their only interaction with the outside world to come via the television. Such a private, homebound viewing experience offered a distinct contrast to the social activity of movie-­going that had captivated an earlier generation of women. Historian Lynn Spigel cites a Better Homes and Gardens cartoon from 1951 that summarized the issue cogently: while the male breadwinner dreams of a cozy night in front of the television when he gets home from work, his wife longs to leave the house she has spent the day cleaning for a night out at the movies.20 Yet television was in many ways particularly suited to family planning campaigns, not just because of its captive female audience. As commentators noted, “TV is an intensely personal experience, second only to a face-­to-­face situation. . . . It gives an individual in his home the very complete illusion of being spoken to directly.” The technology mimicked the intimacy of radio and added the emotional power of visual communication. Of course television was subject to the same standards applied to radio in terms of its suitability for all the family. As a 1954 guide to broadcasting health messages explained, “TV is a home medium. . . . Material must be in good taste, fit for any member of the home to view.”21 Many organizations competed for the limited airtime available for public service broadcasting. The American Medical Association, for example, which had previously distributed motion pictures and radio shows, began using television soon after its introduction in the late 1940s to provide training broadcasts for physicians and updates on new medical techniques. Early in the 1950s, NBC aired the first network series of medical programs for the public, Here’s to Your Health.22 Health organizations had also begun to professionalize their media efforts. They drew on the experiences of journalists and professional writers, hiring media specialists to craft their public communications

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messaging. A survey of members of health and welfare organizations who did publicity work found that most cited radio or television experience as more important training than previous work in the areas of health and welfare. These groups were beginning to develop sophisticated strategies and lining up interesting guests, raising the standard of educational broadcasting in general.23 Mastering the medium became especially important because television became the leading media source for U.S. households; 90 percent owned a set by 1961.24 But the visual component of television posed particular problems. Communication specialists believed what was seen had more appeal than what was heard, but there were clear limits to the kinds of visuals that could be displayed. Federal Communications Commission regulations, which were crafted for radio, prohibited verbal communication about certain issues but could not contain visual realities. During the second series of I Love Lucy in 1952–­1953, for example, when actress Lucille Ball’s pregnancy was integrated into the show, the word “pregnant” was not used, although the episodes followed the family’s preparations for parenthood. That word was still banned from the air.25 In fact, very little was broadcast on the topic of family planning that could not have been conveyed over radio. In the early years of television, programming strictly followed the formats that were already perfected on the airwaves, such as expert testimonials, interviews, or panel discussions. The new medium had the power to “highlight sincerity” but also carried the risk of exposing the insincere or phony. While Planned Parenthood had found some radio formats adaptable, the federation soon realized that guests on television programs had to work confidently without scripts and needed to be able to talk easily and naturally to be taken seriously. Yet this was not always possible for the experts they often relied on to promote their cause. “To ask medical authorities to take time from their busy practices to memorize a script is often an imposition,” noted a Planned Parenthood staff member. “Moreover, these men are not actors. In their effort to work from memory they often become so tense that they do not appear well. On the other hand, reading from script is not their forte.” Medical experts were considered to be so authoritative at this time that advertisers regularly employed a man in a white coat to promote everything from over-­the-­counter health products to cigarettes. In an effort to control the practice, the American Medical Association advised the National Association of Radio and Television Broadcasters about the content of a clause for its 1952 Television Code. It stated that medical professionals had to speak only from personal experience and that a dramatized portrayal had to be clearly identified as such. Ironically, in the age of the expert, actual medical



The Medium Shapes the Message 55

professionals appearing for Planned Parenthood undermined their own authority with their stilted and awkward appearance. Apparently Planned Parenthood was not yet considering professional actors as an alternative. Instead, the organization suggested that the visual interest of a broadcast could be enhanced by supplementary materials such as photographs, graphs, maps, tables, or diagrams on a blackboard, which needed to be “roughly the same shape as the television screen” for camera close-­ups. Such visual tricks were fairly rudimentary, and supported a lecture or discussion format but did not advance the narrative on their own.26 Occasionally more artful representations were attempted, such as a “successful visual effect” promoted in 1953, when “the Seattle Committee had the announcer introduce the Committee’s TV program from down on a rug. He was surrounded by a biracial group of four children, ranging from six months to three years of age. The station was delighted with the effect, because of its visual appeal—­and it told ‘our story.’”27 The demographic mix of the group of children was no accident. The division between black commentators over the value of birth control to their communities had only intensified since the days when W.E.B. Du Bois debated the topic with other black intellectuals. By the mid-­twentieth century, the paternalism of the predominantly white family planning movement had contributed to continued opposition to the concept among black Americans. For example, the Birth Control Federation of America reconfigured the Negro Project of 1939–­1943, an initiative Margaret Sanger had proposed to promote contraceptive use among African Americans in urban and rural areas. Against Sanger’s advice, the BCFA installed white physicians to administer services, and rejected her proposals to cultivate the support of black communities and use the expertise of black leaders (although it did employ some black nurses, who were more successful than their white male colleagues in recruiting repeat visitors). In the end, the program was developed without any significant input from African American family planning advocates and failed to make any long-­term gains for the women in the target communities or in the debate over birth control and race. This was one of the most controversial projects of the federation. The missteps of the Negro Project are still drawn on today to claim that Planned Parenthood (and Sanger in particular) intended to severely restrict black reproduction, even though archival evidence and recent historical scholarship discredits this interpretation.28 The controversy continued in the era of the population bomb and led to charges that Planned Parenthood was engaged in a conspiracy against the black race. The broadcast described above fully exploited the visual power of television to sidestep this controversy by showing children of different races without

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directly addressing the issue. The overall effect emphasized diverse happy families rather than the prevention of births for any specific group. “A Giant Leap in Public Approval”

As Planned Parenthood’s general popularity increased, the organization became more confident about directly addressing controversial issues, including race, on the nation’s television screens. New opportunities opened up in the late 1950s, when a series of scandals embarrassed television executives and posed the threat of regulatory reform. After the quiz show debacle of 1958, in which it was revealed that contestants on numerous shows, including The $64,000 Question and its imitators, had been coached on the correct answers, the National Association of Broadcasters launched a $600,000 public relations campaign to improve the image of the industry. To ease the outcry, the group reaffirmed the commitment of broadcasters to cultural and public service programs. Criticism of bland programming and an anticipated plateau of advertising revenue also contributed to the association’s conciliatory attitude.29 In 1958 and 1959, the Federal Communications Commission held public hearings about the misconduct. Witnesses testified to the failure of television broadcasters to produce public service programming for fear of offending their sponsors. In his testimony, Charles Siepmann, a proponent of educational broadcasting, decried “the narrowing, to a near vanishing point, of areas of controversy.” As a result of the scandals, the chair of the FCC resigned. In 1961, his replacement, Newton F. Minow, declared television a “vast wasteland” in his first major speech. He bemoaned the cautiousness and timidity of a medium in thrall to its commercial sponsors. Far from breaking new ground and risking censorship by pushing the boundaries of acceptability (as the motion picture and, to a lesser extent, radio had done), television was not even keeping up with changing public expectations about the medium’s potential to inform. Criticism intensified in the 1960s, as civil rights groups, feminists, and other activists of the new social movements challenged the lack of coverage of their activities and denounced negative representations of women and minorities in programming and the absence of a diverse workforce in television production.30 The new desire of broadcasters to prove themselves responsible and relevant created opportunities for health-­related programming. Thus, in the 1970s, after-­school specials on drug and alcohol use proliferated, part of an emerging genre of what historian Julie Passanante Elman calls “medicalized edutainment.”31 Broadcasting health-­related issues was not entirely new. For the first time, however, this programming was initiated by broadcasters themselves



The Medium Shapes the Message 57

(rather than health or advocacy organizations) and was crafted with attention to communication theories devised explicitly for health-­related material. Most significantly for family planning promoters, broadcasters proposed moving away from single sponsors of specific programs in favor of a magazine format in which advertisers bought commercial spots between programs. The strategy was cheaper and did not tie an advertiser so closely to the content of the program, and less risky for companies to purchase broadcasting time. The old sponsorship system had ensured that sexual topics were more strictly censored on television than in film, radio, or theatre, whereas the new approach might prove more accommodating to groups whose messages often made advertisers nervous.32 Another force that propelled more candid discussion of sexual subjects on television was the era’s sexual revolution. Standards of propriety relaxed, and “sex was put on display” across U.S. culture. The increasing representation of sexuality in media led to a “sex sells” approach to consumer advertising. Sexologist Alfred Kinsey’s Sexuality and the Human Male (1948) and Sexuality in the Human Female (1953) had highlighted the fact that a wide gulf existed between conservative values about sexual behavior and the actual practices of a majority of Americans. The popularity of the first contraceptive pill, Enovid, which the Food and Drug Administration approved in 1960, illustrated the new attitudes and behaviors. It quickly became the leading contraceptive among American women.33 Political impetus also helped increase access to family planning resources, in part due to the fear that poor and minority women were reproducing too rapidly. Conservative politicians blamed black single mothers for financial dependency and political unrest in the country’s urban ghettoes. In fact, for many opponents of birth control, these fears overcame long-­standing concerns that contraception licensed immoral sexual behavior. Illinois senator Morgan Findlay, for example, opposed subsidized contraception for poor unwed women in 1963 but changed sides two years later, stating that it was the lesser of two evils. Before 1960, only seven states (all in the South) regularly included family planning as a part of public health services, but in the next five years another twenty-­five states and the District of Columbia added such programs.34 In 1965, the final vestiges of Comstockery were swept away by the Supreme Court’s decision in Griswold v. Connecticut, which overturned the last remaining state law banning physicians from prescribing contraception. The same year, the National Academy of Sciences issued a report on the growth of population in the United States that called for “the inclusion of population studies and the principles of responsible parenthood in the curricula

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of colleges, universities, and secondary schools, and continued discussion in magazines, the daily press, and on radio and television.”35 This proved to be a critical turning point for the federation. Planned Parenthood began to supply nearly 200 hundred of their affiliate organizations with TV and radio spots in addition to their usual print materials, which included posters and newspaper advertising. Martha Stuart, a former journalist whom Planned Parenthood had hired as a communications consultant and who staffed the federation’s booth at the 1965 World’s Fair in New York City, reported “a giant leap in public approval” compared to the previous year. Many attendees said that they had already heard about the organization’s work through television, and Stuart credited the mass media with improving people’s ability to react “without embarrassment” to the exhibition at the fair.36 The shift in opinion was evident even among groups that were traditionally the most resistant to Planned Parenthood’s message. Seventy-­five percent of Catholics polled by Gallup supported the dissemination of birth control information to anyone who wanted it, up from 53 percent just two years earlier. As a result of the increasingly favorable atmosphere, for the first time, Planned Parenthood staff handed out pamphlets at the fair that described specific methods of birth control.37 Gradually, broadcasters began to air programming related to the cultural shift, even without the specific request of Planned Parenthood. Capitalizing on her position in the nation’s leading birth control advocacy group, Martha Stuart made sure to write and congratulate them on behalf of the organization. Whenever stations contacted her to propose their own programs, she provided the names of possible speakers and offered to recommend particular shows to the organization’s entire mailing list.38 The receptive climate, combined with the call for more adventurous programming, meant that media outlets were increasingly interested in exploiting the most controversial aspects of the campaign for family planning as a way to attract viewers. Broadcasters looking for a new angle on contemporary issues developed the same strategy that Sanger had once used to gain press attention. In the context of the struggle for civil rights, the issue of family planning and race remained provocative. Martin Luther King Jr. supported the work of Planned Parenthood and in 1966 received the federation’s Margaret Sanger Award in Human Rights.39 Although Malcolm X denounced the term “birth control” because of its implications of control over black fertility, he also supported access to contraception.40 In contrast, the Black Panthers and nationalist movements such as the Nation of Islam saw family planning as part of a white genocidal plot and advocated procreation to increase their ranks. Although women in these movements tended to side with the male leadership, other



The Medium Shapes the Message 59

black female activists emphasized the importance of women’s right to choose for themselves. Congresswoman Shirley Chisholm, whom Planned Parenthood later honored for her support of its work, spoke out about black women’s experiences of botched abortions and argued that racial progress was better served by smaller families with the means to educate their children than by parents who could barely afford to feed and clothe their large families.41 The split led to widely divergent attitudes toward contraception and its uneven availability in black communities. For example, while a family planning clinic in Cleveland, Ohio, was burned down by arsonists in the civil rights riots of 1968, a church and a family planning center were left untouched during eight days of violence in a poor Detroit neighborhood during which most of the rest of the block was looted and destroyed.42 Planned Parenthood was happy to help broadcasters exploit the potential of the topic of family planning to attract viewers. As Stuart wrote in response to a request from NBC in 1966, “Dr. Jerome K. Holland, President of Hampton Institute, Hampton, Virginia, long time board member of Planned Parenthood . . . could address himself to the [“]birth control or not question[”] which would lend some controversy. He also happens to be Negro and could speak on the topic of the minority groups and their use of birth control (which happens, as a matter of fact, to be a rather hotly discussed matter sometimes because there are some minority group leaders who feel that birth control is some sort of White plot to eliminate them).” Including a respected black professional also served to counter the organization’s image as a white-­oriented group with a secret agenda against black Americans, a characterization that flourished even during the presidency of Faye Wattleton (1978–­1992), the first African American and the second woman (after Sanger) to lead Planned Parenthood, and that survives to this day.43 To fight bad publicity, Stuart exploited the new enthusiasm of broadcasters for edgy programming. In June 1967, when an article in Ladies’ Home Journal presented the oral contraceptive pill in a negative light, she wrote to NBC and CBS to suggest speakers who could “contribute more facts to this controversy.”44 The end result was a heated panel debate in which physicians took the author of the article to task for her selective use of data and inflammatory remarks. Planned Parenthood launched a new era of birth control media in the late 1960s, after President Lyndon Johnson highlighted the importance of access to family planning as a crucial component of his War on Poverty in 1966.45 The following year the government began funding programs to provide affordable contraception.46 By this time, more than 80 percent of Americans who were

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polled supported the idea that birth control information should be available to anyone who wanted it.47 These breakthroughs brought an end to the public relations phase of breaking down barriers to family planning and paved the way for advancing more specific program goals, including increased government involvement and education about population and family planning in schools. Planned Parenthood also ventured into new areas of broadcasting, such as Spanish-­language programming. The federation formalized its media efforts in an expanded Information and Education Department and launched two major initiatives to inaugurate the next phase: national advertising campaigns and the use of fiction programming to deliver family planning messages.48 Family Planning Advertising

Extensive national broadcasting became a possibility for the first time in 1968, when the Advertising Council, a private nonprofit organization formed in 1942 to develop public service advertisements, added Planned Parenthood to its TV-­ Radio Bulletin for the first time. Broadcasters made selections from this list of organizations to fulfill their public service requirements. The addition of Planned Parenthood had an immediate impact; all of the networks and 300 local stations aired the organization’s broadcasts that year. The wide use of two advertisements, an animated cartoon and an endorsement of Planned Parenthood’s work by Dwight D. Eisenhower, as well as the absence of any backlash encouraged Planned Parenthood to develop a major national television campaign. The result was two advertisements aimed at recruiting new patients to clinics. The broadcasts, both of which were made in twenty-­and sixty-­second versions at a total cost of $20,000, were strategically designed and carefully tested. According to local branches of Planned Parenthood that tracked the campaign, both advertisements led to a significant increase in requests for appointments and information. This occurred despite a widely publicized papal encyclical in July of that year that affirmed the Church’s proscription of contraception. After various overtures from the Catholic Church, family planning advocates had expected Pope Paul VI to provide some room for personal decision-­making, but instead, in his Humanae Vitae he took a hard line on the issue. The first advertisement featured testimonials by real patients that described their experiences at Planned Parenthood clinics. Forty of the forty-­two women who were invited to participate had accepted immediately, and all expressed great enthusiasm for the organization’s work. Unfortunately, the Advertising Council judged that some of the material Planned Parenthood thought most appealing unsuitable for broadcast. This included “the darling young thing who spontaneously blurted out how joyously she now goes to bed with her



The Medium Shapes the Message 61

husband, in contrast to the time when she worried about getting pregnant again.” Such exuberant descriptions of a happy sex life were off limits, and Planned Parenthood instead selected clips where women emphasized the professionalism of clinic staff and the safety of the contraceptive techniques they distributed. The second advertisement dramatized the daily activities of the clinic, showing a female switchboard operator providing information to a caller as the facilities and the various stages of a patient visit were visualized on the screen. This approach was more “strictly informational” than the testimonial spot, although in the end it proved more effective. Media advisors all preferred it, explaining that overuse of the testimonial by advertisers had made the public “wise and jaded” about that strategy: “They know you just hired an actress to say her hands were soft with Ivory, her tummy serene with Alka-­Seltzer and her birth control safe and effective. They don’t believe it for a minute, even if they like your message.”49 As audiences became more media literate, Planned Parenthood had to work harder to distinguish its productions from consumer advertising and to construct persuasive approaches. Beginning in 1969, in conjunction with the Advertising Council, Planned Parenthood’s Information and Education Department developed a three-­year campaign for network radio and television, regional broadcasters, and major newspapers and magazines. The project’s central goal was to establish the small family as “the most desirable and fashionable family for the future,” thus going beyond ads that informed audiences about services. This new campaign sought to influence attitudes more proactively. Some Planned Parenthood staff members saw this strategy as unethical and felt that it violated the organization’s commitment to the principle of voluntary family planning. Reactions were extreme. As one physician wrote after hearing the proposals, “Hitler would have been proud. . . . I cannot work with or for an organization which chooses to deal in propaganda, the purpose of which is to subtly coerce people to accept a given point of view.”50 While propaganda had played an essential role in America’s war effort and was widely used by the Office of War Information, evidence of its sophisticated use by the Germans created fear of and revulsion toward the tactic in the postwar years. Propaganda that promoted birth control was particularly likely to cause controversy because of the ongoing horror regarding the murder of Jews in the Holocaust. Although eugenics had been endorsed by respectable professionals earlier in the twentieth century, recognition of its genocidal applications under Nazism destroyed its credibility after World War II. To some staff, the proposed Planned Parenthood campaign seemed to threaten the organization’s credibility by veering too closely to the idea of social engineering.

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Because the messages proposed an ideal family size, they were likely to offend people with large families and condemn them to public scorn. One critic drew on images of victimization and racial discrimination and tied the issue to the contentious question of race politics and birth control in the United States, asking pointedly, “Into whose window will we throw rocks, on what lawn dump garbage or burn crosses?”51 Many in the broader community of population specialists were also concerned that the threat of overpopulation had been exaggerated, especially within the United States, where the birth rate was approaching the level of replacement rather than growth. In 1972, when this balance was achieved and the news was widely publicized, the population bomb argument fell apart, at least at home. The birth control movement was left without an explanation for the merits of freely available contraceptive services. On the positive side, evidence was mounting that media persuasion might have greater potential than the postwar pessimism had suggested. The doubts of the 1950s and the idea of limited effects began to shift as data from a series of new media efforts once again suggested modest gains in influence. The most convincing examples came from the relatively new field of health communication, in campaigns to prevent smoking, decrease behaviors associated with the risk of heart attacks, and encourage seatbelt use. Recovering from their postwar crisis of confidence, researchers began to gather evidence that media messages that were straightforward and were repeated regularly were effective in delivering public health information. By the early 1970s, communications experts were expressing cautious optimism that “mass media campaigns can be moderately successful under certain conditions,” an idea long endorsed by commercial advertisers, of course.52 More Americans were receiving messages (both accurate and inaccurate) about drugs, alcohol, sex, and dangerous behavior from entertainment television than from any other source, and television was becoming a critical tool in the battle for influence. The precise elements of an effective strategy, however, were still debated. Some communications experts recommended the use of humor, for example, while others insisted on a more solemn—­or even a fear-­inducing—approach. Although celebrity spokespeople garnered audience attention (a fact Planned Parenthood exploited early on in their use of actor Charlton Heston in a television advertisement), “ordinary” people whom the target audience could more easily identify with often had more credibility with viewers.53 Whatever the technique used, broadcasts had to rise to the standard of surrounding programming and compensate for the cynicism of an increasingly sophisticated audience.



The Medium Shapes the Message 63

Planned Parenthood senior staff member Fred Jaffe, who had more than twenty years of experience in communications and media, worried that the new campaign signaled a step backward to a less sophisticated era. Jaffe criticized the Advertising Council media harshly, saying, “I am most appalled by the amateurishness of the ads. Almost every one of them is a direct preachment. . . . The genius of American advertising (if it has any) is precisely that it avoids preaching and gets its message across by suggestion, implication or persuasion, allowing the audience essentially to make its own decisions about the wisest course of action for them. Even the anti-­smoking ads do not contain a direct injunction to the viewer to stop smoking.” In his opinion, persuasion was not off limits if it was done carefully and subtly. But direct appeals were too blatant and too “preachy.”54 As critics had complained earlier in the century, “preachments” ruined entertainment if didacticism overtook the dramatic narrative. Despite the negative responses, the campaign went ahead under the leadership of Robin Elliot, director of the Information and Education Department, and the Richard K. Manoff advertising agency. While the specific approaches used in the draft proposals were recrafted, the general strategy remained intact. Notably, the campaign stayed away from the alarmism of the population bomb and did not target any one group, poor or wealthy, white or black. Instead, it emphasized that the desire to plan a family was universal. The campaign focused on three groups: opinion makers, couples, and young people. Rather than proposing a particular family size as the ideal or suggesting the best age to have a child, most media products emphasized the importance of planning, including messages such as “an unexpected child can really rock the cradle,” and “get to know the two of you before you become the three of you.” The messages focused on the financial toll of unplanned pregnancy and its impact on lifestyles, career choices, and relationships. One television advertisement showed a young man navigating a giant board game, moving money from categories for education, doctor’s bills, and a family vacation to provide for unexpected babies.55 As with the testimonial advertisement a year earlier, messages with sexual connotations were dropped at the request of the Advertising Council, which rejected the proposed caption, “one thing about the ‘population problem,’ you don’t have to get out of bed to fight it.”56 The more conservative strategy helped Planned Parenthood win over the networks, and once the campaign was up and running, it generated little opposition. The increased use of the mass media by family planning promoters thus reinforced the limits of educational media on the topics of sex and reproduction. When Planned Parenthood launched its first nationwide advertising campaign in 1972, “the messages were

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so bland they probably could have passed Anthony Comstock,” said J. Mayone Stycos, founder and director of the International Population Program at Cornell University.57 Planned Parenthood was forced to make compromises that were incongruent with the growing sexualization of other media. Broadcasters seemed happy to flout convention when it came to commercial programming, but they were timid about doing so in an educational or public service context. The issue came down to two factors: the greater revenue generated by commercial shows (which could be resold if they proved popular with audiences) and the problems associated with explicitly promoting a particular agenda in public service announcements. While conservative groups did criticize sex in entertainment and advertising, they leveled their most aggressive campaigns against family planning promotion. Putting Abortion on the Air

Criticism and censorship did not shut down the national advertising campaign, but these challenges clearly framed the kind of messaging and the types of broadcasts that family planning advocates could undertake. Planned Parenthood was increasingly out of step with the goals and activities of the women’s movement, and as a result, some family planning promoters sought new avenues for experimentation. Martha Stuart, the organization’s communications consultant, left to found a company based on more explicitly feminist goals, including a direct campaign to destigmatize abortion. Her medium of choice was television. As she explained, “Television has been used primarily to transmit information. It has been perceived only as a cognitive medium. But television’s greatest potential, we believe, is in reaching people at the deeper, ‘affective’ level. Conventional cognitive television can modify what people know and think. ‘Affective’ television can modify what people feel and do.”58 After leaving Planned Parenthood, Stuart took up family planning as part of a television series she developed called Are You Listening? In addition to programs about reproductive health issues, the series covered topics such as prisoners, black mothers on welfare, and the police (fig. 5). Cutting through the political rhetoric and media hype that surrounded contentious topics, each show presented an opportunity for viewers to hear from people who had been scapegoated or stereotyped—­those known only as “objects of the angry national debate.” As she explained in the introduction to each episode, “I want you to get to know them as people.” Abortion had been discussed only occasionally on television in the preceding years as individual states, beginning with Colorado in 1967, began to reform abortion law. Over the next two years, as eight more states legalized the practice, the issue began to feature more regularly on



The Medium Shapes the Message 65

the small screen, although predominantly on factual programs rather than on those for entertainment. Four documentaries aired between 1965 and 1972. The first program on the topic, a fifteen-­minute drama titled “Abortion: A Look into the Illegal Abortion Racket,” appeared on the syndicated program Confidential File. The first network broadcast on the issue, “Abortion and the Law,” was written by a progressive journalist and filmmaker David Lowe and was narrated by Walter Cronkite, for CBS Reports.59 Compelling examples of the need for reform had also made news headlines, such as the case of Sherri Finkbine, a married mother of four who was forced to travel to Sweden to terminate her fifth pregnancy after discovering that the thalidomide she had taken was liable to have caused significant damage to her fetus. As press coverage of the debate heated up, dramatic shows also picked up the topic. In the 1960s, CBS aired an episode of The Defenders called “The Benefactor” in which a physician is arrested for performing abortions. All of the show’s sponsors canceled their advertisements, and affiliate stations in Boston, Providence, Rochester, and elsewhere refused to air the episode.60 Despite

Figure 5  Martha Stuart in a television studio in 1970, preparing to record an episode

about mothers on welfare for her series Are You Listening? Source: Sara Stuart, Communication for Change.

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the penalties, writers continued to capitalize on audience interest by inserting the issue into established programming. The campaign to reform abortion law was thus helped along by media projects that were undertaken without the direct involvement of the family planning movement. The orientation of early abortion-­related broadcasting toward the news media established how U.S. television framed the debate and who would be invited to speak about it. This had marginalized women’s experiences and the viewpoints of feminists. Stuart set out to transform this context, arguing that in order “to speak humanely and helpfully” about pregnancy termination, “a shift in the terms of public discussion” was required.61 In 1972 she produced Women Who Have Had an Abortion, one of three shows she developed on the subject. The episodes did not focus on the political leaders or medical experts who commonly framed the news coverage and had appeared in Planned Parenthood’s broadcasting. Instead, they brought together people with personal experience of the issue, to contribute to an informal discussion led by Martha Stuart. This was an important shift in approach that reflected trends in the feminist movement, particularly the model of “speaking out” by which women in consciousness-­raising groups came to understand the structural nature of their oppression by sharing their experiences with one another.62 As historian Leslie Reagan has remarked, speak-­outs were an important political tactic because they “took abortion out of the realm of private secrets and made it an issue that women could talk about in public.”63 Stuart broadcast these conversations between participants, expanding the audience for such disclosures significantly. She selected women who illustrated the diversity of the abortion experience, and their willingness to come forward cut through the stigma and secrecy that surrounded the subject. More than a simple testimonial, the discussion format allowed participants to question and challenge one another and to express ambivalence about abortion or change their opinions during the episode. Other family planning advocates outside Planned Parenthood (who therefore had greater freedom to experiment) also began to look for ways to integrate women’s voices in different genres. In an effort to move away from the didactic format of advertising or public service announcements, they turned to entertainment programming. The opportunities were slim in dramatic genres. In 1971, at least two dramas with an apparently anti-­abortion stance aired, along with just one show that supported abortion rights. A Brand New Life and the first episode of Marcus Welby, M.D. presented anti-­abortion viewpoints, while The Bold Ones supported a woman’s right to choose.64



The Medium Shapes the Message 67

Part of the challenge was the reluctance among broadcasters to deal with sexual issues, even when competing for audiences. CBS staff who reviewed materials for broadcast (a procedure that was introduced after the quiz scandals of the 1950s) reported that scriptwriters “avoid sex, but go the violent route because of greater social tolerance.”65 This phenomenon was apparent across the networks. Family planning promoters working in a variety of organizations set out to change this by actively seeking out writers who would tackle the issue in entertainment programming. David Poindexter, a media specialist in the Methodist Church who served on the Broadcasting and Film Commission of the National Council of Churches, had advised CBS news in the 1960s about the presentation of religious issues as an official liaison. In 1970, he became director of a new Population Communication Center within the Methodist Church that was supported by the Population Institute, a secular organization based in Washington, D.C. Poindexter organized a meeting in 1971 that was attended by John D. Rockefeller III (chair of the Commission on Population Growth and the American Future), Senator Robert Packwood (R-­Oregon), George H. W. Bush, chair of the Republican National Committee, and top executives from all three television networks. The goal of the meeting was to convince broadcasters to air programs related to family planning. The successful meeting was followed by several conferences with television writers and producers in New York and Los Angeles and the launch of a prize fund that allocated $10,000 for the best treatment of family planning topics in an hour-­long primetime program and $5,000 each for the best half-­hour program and series episode during the 1972–­1973 season.66 In response, in 1972 writer and producer Norman Lear developed two episodes of the CBS sitcom Maude in which the title character decides to terminate her pregnancy and persuades her husband to have a vasectomy. The Los Angeles chapter of Planned Parenthood served as technical consultants on the script. The series was a spin-­off from Lear’s breakthrough hit All in the Family, which had launched one year earlier and had become the first successful situation comedy to regularly tackle controversial topics. By the end of its first season, it had reached number one in the ratings. The show’s popularity paved the way for others to take on difficult issues, and by 1972 twenty new series were tackling subjects that had been previously off limits, such as lesbianism, venereal disease, and embryo transplantation. Thanks to the work of David Poin­ dexter and his allies, Maude was one of four programs that addressed aspects of family planning in the fall of 1972.67 Lear had an unusual level of autonomy that may have helped him successfully air programs on the theme of abortion. The popularity of his shows and

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his volatile behavior in disagreements with executives made it unprofitable for the network to challenge him, and his technique of videotaping episodes before a live audience on a weekly production schedule instead of filming weeks in advance made it difficult for his bosses to track exactly what he was up to in the studio. Even so, writers were required to submit scripts for review, and Lear was not able to get around this requirement on such a hot topic. In the end, after the plans of CBS reviewers to postpone the episodes failed, they instead insisted that Lear introduce a character who went ahead with an unplanned pregnancy. Under the FCC’s Fairness Doctrine, which was introduced in 1949 but was not formally adopted into regulations until 1967, broadcasters who aired programs that tackled controversial issues had to give equal time to competing points of view. To preempt criticism, this strategy of incorporating both sides of competing views became the key formula in the new, bolder broadcasting that was initiated by All in the Family. Lear complied with the requirement, but Planned Parenthood’s Information and Education Department anticipated opposition to the Maude episodes and circulated an action memo that proposed that individual members write to local network affiliates, to the head of standards and practices at CBS, and the FCC to endorse the first part of the two-­part episode and prevent protesters from interfering with the broadcast of the second episode. Population Institute and Planned Parenthood staff also campaigned against network affiliates who refused to broadcast Maude in their communities. After the first half of the episode aired, 373 callers rang CBS to express their anger, and over the next few days Lear and the network received hundreds of letters (eventually numbering 24,000), including one package of photographs of aborted fetuses. At issue for most letter writers, both supporters and opponents, was whether a comedy was the right forum for such a serious issue. An article in the Jesuit publication America declared that if the topic had been treated in a serious drama or in a panel discussion of experts, it would have provoked “only marginal objection.”68 The problem was the comedy format of the show.69 Catholic organizations mounted an aggressive counter-­campaign, arguing that true balance could be achieved only by developing two more episodes in which Maude decided to have a baby or by allowing an anti-­abortion program to air in the time slot for the series. When CBS refused, these organizations complained to the FCC on the grounds that the Fairness Doctrine had been violated. The network argued that Maude was “solely intended for entertainment and not for the discussion of viewpoints on controversial issues of public importance,” implying that the abortion plotline was merely a dramatic element, not an educational one.70



The Medium Shapes the Message 69

Certainly entertainment programming could include little of the details of the issue or convey the range of differing opinions, as Martha Stuart’s series had done. However, the potential of commercial television remained a tantalizing one for family planning promoters, even despite (or perhaps because of) the controversy that including such issues on popular shows generated. In an effort to illustrate their thanks for broadcasters’ attempts to address the issue in spite of Catholic opposition, Norman Fleishman, director of the Los Angeles chapter of Planned Parenthood, organized a party in support of Lear. It generated such enthusiasm that he decided to hold such events regularly. By 1977, the Population Institute, which had set up a West Coast office in 1970 (which Fleishman later headed), had awarded $100,000 to broadcasters who aired programming that addressed aspects of family planning and international population.71 On January 22, 1973, the Supreme Court legalized abortion across the country in its Roe v. Wade decision. Initially, the new climate had a positive impact on family planning broadcasting. In June, the FCC ruled against anti-­ abortionists’ complaints about Maude. The decision affirmed that the Fairness Doctrine did apply to entertainment programming, just as it had to factual broadcasting, but it asserted that balance need not be exhibited within the same program so long as it was evident in the broadcaster’s schedule as a whole. This meant that the two-­part episode of Maude could be rebroadcast in the summer rerun of the series, creating a total of 140 million viewers, 80 million of whom watched both the original broadcast and the repeat.72 But the breakthrough was short lived. The national legalization of abortion also galvanized the anti-­abortion movement. Over the next few years, as the backlash intensified, addressing the topic of family planning, especially abortion, became a riskier proposition for broadcasters. Planned Parenthood Enters the Abortion Wars

In the early 1970s, after disassociating birth control from abortion for decades, Planned Parenthood landed right in the middle of the increasing controversy over pregnancy termination. The Children’s Television Workshop (CTW), the production company behind the successful series Sesame Street, began to explore the potential for using their model of educational television to promote healthy behaviors, including contraceptive use, among adult audiences in a variety show format. As part of the development of the series, CTW surveyed over 200 doctors and health officials to identify topics for a series of programs.73 In March 1973, CTW staff held various task force meetings, including sessions on family planning, with invited figures from Planned Parenthood.

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These participants supported the idea of featuring family planning on the show, providing that the approach reflected the shift in focus of their messaging efforts since the collapse of the overpopulation argument in the U.S. context. They had replaced this outdated issue with an emphasis on the personal benefits of planned families, as in the Advertising Council campaign. While this satisfied both board members of the council and network managers, media writers and producers complained that the new narratives lacked the urgency and emotional force of the population bomb argument. Jacqueline Babbin, a New York City–­based producer, found the approach “boring,” and, along with CTW staff, pushed for a more dramatic storyline. When Ella McDonald, the director of a family planning program in New York City, commented that a pregnant eight-­year-­old had attended her clinic, the group agreed this was just the kind of situation that could work. Because of the very young age of the pregnant child, the example was less easy to dismiss than teenage pregnancy, which for some critics served as an important warning to young people to refrain from premarital sex and did not justify the need for abortion.74 Before any serious work was done to develop the idea, anti-­abortion campaigners began publicizing the shocking story that PBS television was planning to air an episode of Sesame Street in which a child would have an abortion. The confusion stemmed from a Planned Parenthood newsletter in which president Alan Guttmacher mentioned the discussions he was involved in with the Children’s Television Workshop. Deliberately inflaming the controversy, religious leaders began circulating the misinformation among their congregants and calling for action. Ringleaders of the response used a range of strategies. One San Francisco resident reported that the Catholic school her two daughters attended had written to parents “demanding” that they send letters of complaint or lose their children’s place in the following year’s classes. “We have to have our children bring the letters to school, sealed and addressed and stamped, but they want to check off everyone’s name to make sure we did exactly as we were told, or rather [were] blackmailed to do.”75 This author sent her letter but used it to expose the school’s activities and express her support for Planned Parenthood. Many others who were mobilized for the campaign against CTW were more compliant, and thousands of angry letters flooded in to the organization. Letter writers drew on the rhetoric and images that were circulated in anti-­ abortion propaganda, which included graphic images of aborted fetuses and misrepresentations of experiments involving them. In 1971, Cincinnati physician Dr. Jack Wilke and his wife, Barbara, both of whom had campaigned against contraception and pornography as part of a broader movement against sex education, introduced these graphic images into public discourse for the



The Medium Shapes the Message 71

first time in their Handbook on Abortion. Feminist scholars have linked the use of such images to an escalation in the tactics of anti-­abortionists and the displacement of women’s rights by the rights of the fetus. The National Abortion Federation documented 115 violent incidents at 46 clinics from 1977 to 1982. By the end of 1985, 92 percent of abortion clinics reported incidents of harassment that ranged from picketing to vandalism. As political scientist Rosalind Petchesky has asserted, “A picture of a dead fetus is worth a thousand words,” none of which attest to the plight of the prospective mother. Scholars have explored the introduction of endoscopy and ultrasound around this time and the impact of the unprecedented visualizations of fetal development they made possible.76 In 1965, Life magazine published a cover image by Lars Nilsson of a living fetus in the womb. Inside were a series of fetal images at different gestational stages, ostensibly taken by the same process—­ although one sentence within a page of text acknowledged that the embryos shown had in fact been “surgically removed.” The status of these dead specimens was further elided by the presentation of images of later stages alongside dates printed in large type. The dates did not refer to the main images of a more developed fetus but to smaller inset images, from earlier stages. The overall effect wrongly suggested that the fetus took on a recognizably human form early in pregnancy, therefore implying that it was viable outside the womb long before it could actually survive. Nilsson published many of the same images in his 1966 book A Child Is Born: The Drama of Life before Birth, which was reprinted in 1977 and again in 1990.77 Abortion opponents exchanged graphic pictures with each other and sent them to groups they protested against, including CBS during the Maude controversy. As historian Johanna Schoen has shown, such images helped recruit opponents. She quotes a demonstrator who referred to a depiction in the Wilkes’s Handbook (fig. 6) that allegedly showed a physician in England torturing a live “aborted baby.” The image depicts a fetus in an artificial womb that was designed to keep premature babies alive. Although this research relied on the use of aborted as well as premature fetuses, anti-­abortion activists presented the process as a willful neglect of human life, not an attempt to preserve it. As a participant at a rally against abortion told another attendee, “It’s legal . . . to do experimentations on a live baby that’s been taken out by abortion . . . like put electrodes on it. They’ve operated on babies, taken organs out when they’re alive and they say: ‘Well, look we don’t have to anesthetize them, they’re not human.’”78 Schoen demonstrates that resorting to graphic imagery accompanied a particularly aggressive phase of the anti-­abortion movement that culminated in

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Figure 6  This photograph of an artificial womb experiment that was conducted in 1970

was reproduced in anti-abortion literature. Source: Cambridge Newspapers Ltd.

the bombing of clinics in the 1980s and murder of abortion providers starting in the 1990s. Interestingly, she argues that anti-­abortion activists took a different visual approach in the 1990s, when they used line drawings of medical procedures and a photograph of a young girl whose arm had been severed in an attempted D&E (dilation and evacuation) abortion. She suggests that these more palatable images played a part in the success of the campaign against so-­called partial birth abortion because they could be more widely circulated and referred to in court and congressional testimony. Before that shift in visual strategies, however, graphic images were circulated in pamphlets and magazines, on billboards, and on posters on picket lines outside abortion clinics. A pencil drawing of the Wilkes image of supposed experimentation on a fetus also appeared in at least one of the letters to CTW (fig. 7).79 In response to the controversy, CTW staff met with anti-­abortion groups and the topic of family planning was quietly dropped from the series. Although the producers stated that the change was not the result of the outcry, anti-­ abortionists claimed the decision as a victory. The clash had a chilling effect on family planning broadcasting, and emboldened the opposition. The anti-­ abortion movement proceeded to develop increasingly disturbing media materials, such as the 1984 film The Silent Scream, produced and narrated by



The Medium Shapes the Message 73

Figure 7  Hand-drawn depiction of fetal experimentation on a letter sent to the Children’s Television Workshop, October 8, 1973. Source: Box 49, Folder 28, Viewer Mail—California—Kids 1973, Archives of the Children’s Television Workshop, National Public Broadcasting Archives, University of Maryland Libraries.

former abortion provider Dr. Bernard Nathanson. In this distorted depiction of an abortion viewed via ultrasound, Nathanson provides an emotionally laden voiceover that accompanies blurry images on the screen, graphically describing a fetus that is supposedly trying in vain to escape the abortionist’s actions. The film has become known as “the anti-­abortion movement’s single most successful piece of propaganda and one of its most effective recruiting tools.”80 It inspired a second film in 1987, Eclipse of Reason, which protested second-­ trimester abortions.81 Yet instead of developing visually compelling counterpoints to anti-­ abortion propaganda, the family planning movement took a different, more measured route, continually emphasizing the happiness available to educated individuals who could exercise their own choices. The narrative of The Silent Scream was laden with misrepresentations and inaccuracies, which Planned Parenthood attempted to expose and correct in their published response to the film, a pamphlet entitled The Facts Speak Louder: Planned Parenthood’s Critique of “The Silent Scream” (1985). While the written format of this publication no doubt allowed for a careful and detailed repudiation of the representations in the Nathanson film, it was undeniably less “affective.” A filmed version, produced by the offices of Planned Parenthood in Seattle and King

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County, was no more effective. In fact, Lee Minto, director of the Washington branches of Planned Parenthood, stressed that “we did not wish it to be highly emotional. We tried to make it a reasoned response.” As a result, she noted, “What we’ve got is a bunch of talking heads. It’s not even terribly interesting.”82 Contrary to Planned Parenthood’s assertion, the facts could not speak louder than the “thousand words” of graphic media images, many of which still circulate in anti-­abortion publicity. Conclusion

The decision to counter such a powerful visual piece as The Silent Scream with plain text and no images reflected wider trends in family planning promotion that had lasting consequences. It is hard to imagine how Planned Parenthood could have responded on an equally emotionally affecting level without reproducing images of pitiable poor families as Sanger had so controversially done in her 1917 film Birth Control, for example, or dead women, as appeared in so many narratives about the perils of illegal abortion. But members of Planned Parenthood clashed fiercely about about how to use the media to promote birth control. Family planning advocates who denounced the use of persuasive media techniques were either unaware of the organization’s long history of such work or did not associate previous efforts with their goals. While they were unable to stop the trend, these dissenters were able to insist that the messaging be modified. Internal divisions over the right way to use media persuasion—­whether to inform or persuade—­as well as the failure of the population-­bomb argument, which had proven to have been wildly overplayed by the early 1970s, no doubt informed Planned Parenthood’s increasingly cautious approach. In addition to these pressures, the concerns of the Advertising Council and the requirements of the networks forced the Information and Education Department to compromise its approach to media messaging. Appeals to emotion, graphic imagery, references to sexuality, and humor were all sacrificed, despite their value for persuasive communication. The constraints lasted well beyond the most fervent years of anti-­abortion activism. In 2001, the president of the Population Reference Bureau, a clearinghouse for international family planning information and resources, acknowledged that the “debasement of photography” in anti-­abortionists’ use of images was one of the main reasons researchers working on family planning continued to shy away from visual materials.83 In the meantime, the visual strategies of the anti-­abortion movement, which were largely uncontested in the mainstream media although feminist scholars critiqued them in detail, crept into the health care industry in literature written for parents who had suffered a miscarriage.



The Medium Shapes the Message 75

An image of an adult thumb and finger holding the feet of a fetus (also from the Wilkes’s publication) focused on a recognizable body part. The caption said “Tiny human feet at ten weeks, in the Uterus, perfectly formed.” But the image failed to include the rest of the fetus’s body, which of course was far less developed at ten weeks. Footprints based on this image appeared on hospital literature for women who had miscarried and were worn as a pin on the lapels of health care staff.84 While it was intended to convey empathy and possibly comfort grieving parents, the image, perhaps unknowingly, also implied an anti-­abortion message. The practice is likely to have silenced patients who wanted to discuss the possibility of terminating a pregnancy. Meanwhile, Planned Parenthood eradicated sexuality from its media messages. Family planning promoters had always been subject to broadcasting conventions that determined what they could advertise and how, and it is clear that in the era of the sexual revolution, the organization took a particularly timid approach. By the time the U.S. government got involved in international campaigns in the 1960s, the subject of the next chapter, the same process was well under way in the activities of the International Planned Parenthood Federation and its colleagues in the global population control movement.

Chapter 4

“Most of the World’s People Need Planned Parenthood”

In the early years of the postwar period, U.S. family planning promoters dramatically expanded their activities beyond the borders of their nation.1 Under the threat of a global “population explosion,” their interests began to coalesce with the foreign policy concerns of the U.S. government. As a result, organizations were permitted to promote their cause through federal channels. The government not only opened its airwaves to the issue but also got into the business itself by providing funding explicitly for the development of family planning media. The government’s motivation, the overpopulation issue, heavily influenced their message, which focused on the economic benefits of fewer children for countries and for individual families. Although governments and family planning advocates in some European countries had already successfully launched programs to promote the use of contraception, campaigners in nations around the world had struggled for decades to get the issue on their governments’ agendas. The mid-­century global food crisis proved a turning point that convinced formerly reluctant leaders in impoverished nations in Asia, Latin America, and Africa that unchecked population growth threatened national and global stability. Like-­minded groups worked together to organize conferences and committees to cultivate support for family planning, culminating in the launch of the International Planned Parenthood Federation in 1952. The U.S. government initially relied heavily on the family planning movement for its media activities. In 1952 the State Department began broadcasting Planned Parenthood worldwide over Voice of America, its own radio network. The programs publicized the problem of overpopulation, often using the same

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materials first heard on domestic radio, as in 1953 when a speech given by Sanger in Sweden was aired on the CBS series This I Believe and then rebroadcast on Voice of America.2 American family planning promoters were soon offered unprecedented levels of funding for their international work. In November 1961, President John F. Kennedy established the U.S. Agency for International Development (USAID) to administer nonmilitary foreign assistance, and within a few years family planning had been added to the list of programs the organization could support. Between 1965 and 1968, USAID’s contributions to this issue increased substantially, from $2.1 million to $34.7 million. By 1973, USAID’s budget for family planning had risen to $125 million. The United States also played a major role in the formation of the United Nations Fund for Population Activities (UNFPA), which was established in 1969 to promote family planning in low-­income countries.3 By then, the U.S. government was the main source of funding for family planning programs worldwide.4 This meant that organizations such as Planned Parenthood and the Population Council could depend on public funding to support some aspects of their work. Once again, mass media was central to the effort to disseminate the family planning message. The vast amounts of money devoted to international projects paid for a proliferation of media on the topic. Communications specialists working with USAID, the International Planned Parenthood Federation (IPPF), and groups such as the Population Council began with the diffusion-­ of-­innovations model, the most influential communications strategy of this period. Indeed, even into the twenty-­first century, communications specialists cited international family planning messaging as “one of the best examples of the validity of the theory of ‘diffusion of innovations.’”5 The approach, which relies on innovators in a target community to support and adopt family planning early on and then encourage others to do the same, had been used with great success in the United States. After 1960, communications researchers in low-­income countries used the strategy to introduce a wide range of practices, from the new agricultural technologies and techniques of the Green Revolution to public health campaigns to prevent malaria and improve nutrition. By 1964, they were adapting these methods to the dissemination of information about family planning.6 By the mid-­1960s, effective low-­cost contraceptive technologies had been developed, including the IUD and the pill. Cheap media tools such as posters, cartoon booklets, and radio broadcasts were used, and field workers recruited from target communities in Asia, Africa, and Latin America would travel into rural areas to deliver information and family planning supplies and inform

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villagers about the breakthrough contraceptives that were available. Increased funding made possible the extensive use of film, which was considered the leading technology of postwar international communications. Projectors and makeshift screens brought family planning messages to even the most remote communities, and mobile film units were used in Bangladesh, Indonesia, India, Jamaica, Malaysia, Pakistan, Thailand, and across Latin America (fig. 8).7 Beyond the capacity to rapidly reach large groups of people, mass media had a symbolic function. As J. Mayone Stycos noted in 1977, “In many countries, tabus against publicity about contraceptives are more potent than laws against the sale or distribution of contraceptives themselves.”8 Overcoming the prohibition against publicly displaying prophylactics and discussing contraception was the first step in legitimizing birth control as a practice. This had been a key strategy of the early days of the movement in the United States, and although communications experts did not explicitly cite these origins as their inspiration, they could draw on decades of examples. In countries that launched national family planning campaigns, advocates hoped to go beyond simply legitimizing the subject; they wanted to remove any stigma and normalize the use of contraceptives. Bernard Berelson of the

Figure 8  A mobile film unit presentation to a rural community in Morocco, n.d. Original caption: “Entertainment and information attract a rapt audience in a Moroccan community.” Source: WHO/ UNESCO/G. Bohm.



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Population Council confidently proclaimed that “the very massiveness of the mass media can promote this image of social acceptability.” He believed that in addition to demystifying the subject, publicizing family planning created the impression that it was widely accepted and something that everybody was doing.9 At first, then, international family planning campaigns were characterized by great faith in the power of media. However, as I described in the previous chapter, in the United States, the early optimism of family planning promoters was gradually replaced with awareness of the limitations of the impact of media in the mid-­twentieth century. Those lessons were even more apparent internationally as promoters tried to transfer communications strategies developed in the United States to other contexts. Berelson recognized that the subject was a difficult one to talk about in many cultures. Local people might resist being told an ideal family size by someone from another country or their own government. Still, he believed that the lack of media competition in target nations in the developing world and the originality of the message would prove highly persuasive. As he saw it, “Anything you say is attractive just by virtue of the fact that it is novel.”10 The first campaigns appeared to prove him right, creating high levels of awareness of the availability of birth control. Beginning in the 1950s, surveys in India and other developing countries showed that attitudes toward birth control were overwhelmingly positive. But family planning promoters gradually realized that spreading the word that contraception was available was not enough. For long-­term impact, they needed to move beyond providing information and begin experimenting with techniques that would persuade people to use birth control. During the next two decades, beginning in the late 1960s, these efforts came under attack from both left-­and right-­wing groups. In addition to clashes in the countries family planning promoters targeted, they faced criticism at home. Both feminist and conservative groups challenged the goals and practices of international population control. The same critique of the ethical issues involved in media persuasion (as opposed to providing information) that had arisen in the United States became central to efforts to overhaul family planning communications in the 1970s and 1980s. Health communications experts involved in family planning promotion reconceptualized their activities and began to move away from movies toward a more grassroots model based on indigenous media, such as puppet shows, dramatic performances, and songs. They also began to emphasize female empowerment and community participation and to provide a diversity of media messages that better reflected the changing rationale and rhetoric of international family planning.

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From Population Control to Female Empowerment

The motivations for international family planning campaigning, like those propelling the domestic movement in the United States in the same period, diverged along two major strands: feminist and demographic. Although proponents of these two positions may have had similar goals, their approaches differed. Because feminists were likely to prioritize women’s access to contraception rather than the general goal of increased contraceptive use, they were more attuned to the roles poverty, gender hierarchies, and lack of education played in limiting reproductive use. “Population controllers,” however, tended to see contraception as a simple solution to such economic and social problems. They were less invested in the broader agenda of social change that the international women’s movement advocated. Their impetus stemmed from concern about overpopulation and Cold War fears that communist nations could secure the allegiance of poor countries. In the 1950s, American demographers connected overpopulation to poverty and argued that the economic development of vulnerable countries was stifled by high rates of population growth. One of the most influential studies focused on India and suggested that low-­cost family planning programs to lower fertility would yield significant increases in per capita wealth.11 Smaller families would leave more disposable income and decrease a state’s burden for services such as schooling, housing, and health care. From the outset, then, philanthropic and federal investment in promoting international family planning was framed in economic terms. This emphasis overlapped with some of the rhetoric of the birth control movement in the United States and its allies in other countries, but it excluded feminist rationales for helping men and women plan their families. The population control agenda had a significant impact on the ways family planning programs were introduced around the world. Even the development of contraceptive technologies was directly affected by the neglect of a woman-­ centered approach. Funding for research was awarded to those working to develop long-­lasting techniques such as the Depo-­Provera injection rather than to those who might have been interested in exploring low-­technology options with fewer side effects.12 Of course the development of the pill, which Margaret Sanger pushed for and her friend Katherine McCormick financed, medicalized birth control and reflected Sanger’s emphasis on allying with the medical profession. The technology requires a prescription and can only be administered under the care of a health professional. The preference for high-­technology solutions was also widespread among family planning providers, most of whom assumed that women in target countries couldn’t be relied upon to use



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contraceptives consistently. Long-­ lasting injections and IUDs required less patient compliance than other methods, such as the pill, condoms, or foam. Target groups were frequently offered only a limited range of contraceptive options (if they were given any choice at all). The model that was widely used focused on increasing the numbers of contraceptive users instead of on expanding the range of reproductive health services available. In his scathing critique of the activities of international population control advocates, historian Matthew Connelly downplays the idea of varying motivations within the community of family planning promoters, and emphasizes their supposedly mercenary, rather than humanitarian, goals.13 Yet the evidence does not support an interpretation that condemns them completely. Over several decades, feminist groups and others concerned with the ethical dimensions of population control steered the movement away from a narrow economic agenda and toward a rights-­based approach. Many did so while working with or in organizations involved in international family planning, such as Martha Stuart and members of the IPPF. The transition from population control to reproductive rights was formalized at successive meetings of governments and non-­governmental groups organized by the United Nations to establish a global consensus on how to approach family planning. At the first World Population Conference, which was held in Bucharest in 1974, developing nations argued that international population assistance was a racist and imperialist project that was promoted by wealthy nations whose goal was to limit the need to provide foreign aid. By the second meeting in Mexico, ten years later, many of these critics had come to view rapid population growth as a pressing issue that affected maternal and infant mortality and compounded the health and social problems created by urbanization. Although some remained critical of the world economic order, they began to focus on family planning as an urgent and achievable priority. The reframing of the family planning agenda that resulted is evident in the increasingly feminist rhetoric used at these international meetings, beginning with the emphasis on a couple’s right to choose the number and timing of their children at the Teheran Conference on Human Rights in 1968. At the Bucharest conference in 1974, the phrase “couples and individuals” was adopted instead, and this language was used again at the meeting in Mexico in 1984.14 It is ironic that by that time, the Reagan administration was scaling back funding for international family planning due to the Republican policies of Ronald Reagan and increasing conservative pressure. In response to the rise of second-­wave feminism and the influence of Third World feminists, the United Nations declared 1975 International Women’s Year and 1976–­1985 the United Nations Decade for Women. In 1977, it established

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International Women’s Day.15 The transformation of attitudes and approach these events signaled became evident in the changing media strategies of family planning promoters. In the early years, when the dominant language of international population control advocacy explicitly emphasized the financial responsibilities of parenting (often to the exclusion of any other issue), media products rarely strayed from this rhetoric. The economic argument shaped family planning media throughout the 1960s, until the International Planned Parenthood Federation and others began to argue for an approach that would instead honor the newly articulated goals of female empowerment and community participation. Launching International Family Planning: India Leads the Way

India had become something of a poster nation for the idea of the ticking population bomb ever since 1968, when Paul Ehrlich described his experiences in Delhi as the catalyst for his commitment to population control. As we crawled through the city, we entered a crowded slum area. The temperature was well over 100, and the air was a haze of dust and smoke. The streets seemed alive with people. People eating, people washing, people sleeping. People visiting, arguing and screaming. People thrusting their hands through the taxi window, begging. People defecating and urinating. People clinging to buses. People herding animals. People, people, people, people. As we moved slowly through the mob, hand horn squawking, the dust, noise, heat, and cooking fires gave the scene a hellish aspect. Would we ever get to our hotel? All three of us were, frankly, frightened. . . . Since that night I’ve known the feel of overpopulation.16

In fact, by 1968, India had a long history of efforts to establish family planning. One of the world’s first government-­operated birth control clinics was founded in the state of Mysore in 1930, and five years later family planning became an official national policy. However, contraception was inaccessible to the majority of poor women for years. The Indian birth control movement faced hostile opposition from Catholics and Gandhians and workers in the movement risked political reprisals for merely promoting the idea. Instead, in the 1920s and 1930s they invited foreign advocates, including Margaret Sanger, to visit the country and speak out strongly in favor of contraception. A key argument of the opposition in India was the notion that Indian women would become westernized and reject their traditional roles if they had access to contraception. Because of this feeling, a fellow speaker advised Sanger in 1924 “not to stress



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the woman freedom viewpoint until you have a foothold,” and visitors were careful to frame their remarks in the context of maternal and child health.17 Sanger had brought some media materials with her to teach the basic techniques of contraception to health professionals, but she and her Indian colleagues steered clear of any mass media campaigning, although her visit did generate newspaper publicity.18 They eschewed the media until the idea of birth control was well accepted by the country’s elites, rather than using it to build widespread support as they had done in the United States.19 In the years following Indian independence in 1947, the country’s leaders sought to establish national family planning services as a way to speed economic growth and development, but health officials who were hostile to birth control hired few physicians for women’s health programs and failed to implement an extensive program, despite the availability of government funding. In the 1950s, confident in the government’s support, family planning promoters began taking a more active role to galvanize support. The IPPF felt that advocates could campaign both behind the scenes and more publicly in developing nations: “The IPPF can play its most important and unique role by persuading the intelligentsia of the need for governmental concern, and by creating a climate of public opinion which will convince the politicians that governmental action meets a popular demand.”20 To document public enthusiasm and the feasibility of family planning campaigns in various countries, advocates developed surveys to measure knowledge, attitude, and practice (abbreviated to KAP). Family planning promoters launched their first large-­scale study of attitudes outside the United States in 1951. They anticipated a receptive climate given the long history of birth control advocacy within India, and they found the results encouraging. Potential users expressed support for family planning and requested information and resources. From 1965 to 1977 at least 500 such studies were done; over 240 were undertaken in India alone.21 KAP research served multiple goals. First, a survey of public opinion could formally record how many people were supportive of or were personally interested in contraception. This data could back up the movement’s long-­held claims that people around the world wanted to control their fertility. Although many survey participants undoubtedly did have the positive views they expressed, it is also likely that some may have felt obliged to give their interviewer a favorable answer; research has shown that interviewees who anticipate that a particular answer or outcome is preferred are liable to aim to please their questioner. Such answers “relieved the apprehensions of family planning programmers” by confirming a preexisting desire for family planning, but they

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may have hidden the ambivalence of some interviewees or glossed over their difficulties in reconciling individual views with the values of a spouse, a family, or a community.22 Another benefit of the survey approach was that it provided a “relatively uncontroversial” way to initiate family planning activity when opposition prevented more direct activity such as the provision of clinic services.23 Results of KAP research could be distributed to policy makers to allay their fears that the general public might prove hostile to the subject. Presumably, a secondary benefit was also the opportunity to inform participants of the existence of various reliable forms of contraception. By introducing interviewees to the groups working to establish such services, the survey process could help recruit people to the practice as well as the cause of family planning. All of this could be accomplished discreetly on a local level through interactions between researchers and their target population without drawing the kind of attention a massive media campaign might generate. In 1952, a year after the initial KAP survey, India became the first of the developing nations to launch a nationwide population control program. After decades of efforts by Indian advocates and the support of international colleagues, the widely publicized and hotly debated overpopulation argument had finally convinced many elite opponents that unchecked population growth was harmful to India’s future. Yet public health officers spent just half of the funds the government allocated. By the end of 1956, they had established 147 new clinics, only twenty-­one of which were in rural areas, where the majority of the population resided.24 It was not until the 1961 population census demonstrated that the clinic system was not attracting enough participants to slow the rate of growth that the government began to use the media systematically to publicize services and promote the benefits of smaller families. By then many other nations had launched their own programs. A common early tactic was the use of a logo that could be displayed on buses and trains, in shop windows and government buildings, on billboards and posters on the street, in community buildings and health care facilities, blanketing public space with family planning messaging without the expense of a major media campaign. While many countries, including Kenya, Pakistan, Singapore, Jamaica, and Korea, tried to convey meaning with their logos by depicting a normative family size of two adults and two children, communications specialists advocated a less didactic approach. Wilbur Schramm, a pioneer of the field in the United States, praised India for choosing an inverted red triangle, a symbol with no prior meaning that had no image or text that could be misinterpreted and that could be easily reproduced by non-­artists. The image quickly



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became synonymous with family planning; it could be found wherever services were available or family planning promoters were discussing the topic. At first, traditional means were used to disseminate the message. For example, the red triangle appeared alongside campaign slogans on cloths that were draped over elephants that traveled with promoters from village to village.25 However, such techniques could hardly saturate the culture with the message that family planning was safe, effective, and available. The most affordable communication tools, such as word of mouth and leafleting, were not adequate ways to quickly reach the large rural groups family planning promoters had in their sights. Pamphlets, like press coverage, were of little use among populations with low rates of literacy. These challenges prompted the government and family planning promoters to add more expensive media to their campaigns. India’s national effort was relaunched in the late 1960s. Three billion rupees (equivalent to $400 million US at the time) were allocated for the five-­ year period from 1969 to 1974. Of that, $19 million was set aside for mass communication. By 1971, some 600 family planning programs were broadcast on the radio every month and a newsreel was produced every week. Eight to ten films were released each year for the next few years., Approximately 5,000 film showings and 5,000 public meetings were organized, and about 20,000 song and drama troupes gave performances on the subject of family planning.26 During the postwar period, family planning activities increased in many countries. They were introduced in two phases. The first became known among family planning promoters as the clinic era because of an emphasis on the provision of services that was modeled on Planned Parenthood’s clinic-­based approach in the United States. Kenya, for example, the first sub-­Saharan country to join the IPPF (in 1965), established free services and within eight years was recruiting 2,500 new contraceptive users a month. In the first four years of Iran’s program, 1,200 clinics were launched, most of which offered free services. This medically oriented strategy depended on a robust network of health care services and the willingness of locals to meet with medical staff to gain access to contraception. The strategy in this period was to use strictly informational communication, based on the assumption that publicity about the availability of services would be enough to encourage people to take advantage of them. Local circumstances sometimes made it difficult to transfer the clinic system, however. There was a shortage of medical personnel and health facilities (especially in rural areas) in many countries, existing clinics often emphasized dealing with more immediate child and maternal health problems, and men controlled the fertility decisions of women in many cultures.27 In Kenya, for example, mass publicity was postponed so that health care providers could be trained to serve the anticipated demand.

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Mass media became much more significant in the second phase, which family planning promoters in the 1960s described as the field era. In this phase, extensive use of mass media was coupled with face-­to-­face outreach to bring the message to community members and provide opportunities for questions and discussion. Massive networks of paraprofessionals were trained to serve their local communities, as in Taiwan and Korea, where thousands of field workers visited villages even in the most remote locations. Family planning media was used to recruit both workers and the target audience of potential contraceptive users. Publicity promoted the idea of family planning, and field workers explained the techniques and talked to users at their homes and workplaces. Providers also set up services in convenient locations (an example is the vasectomy clinics established in railway stations in Bombay in the mid-­1960s) and targeted couples at opportune times, such as following the birth of a child.28 Family planning promoters didn’t expect media alone to persuade people to use contraceptives, but they considered it a crucial element of the two-­stage approach that combined advertising and interpersonal communication. Mass media strategies drew on existing broadcasting infrastructure and introduced new ways to reach disparate audiences. Television broadcasting, which overcame the problem of illiteracy, was impractical in poor countries because of the lack of mass communication networks. Radio was more widely available (fig. 9); by the end of the 1960s, it was estimated that there were 110 million sets in the developing world.29 The medium quickly became the cornerstone of family planning communications. During one week in 1967, Pakistan radio broadcast a talk by a doctor, a discussion, an interview program, a symposium, a “feature,” specially produced songs, an interview with village workers, an interview with a couple using birth control, another discussion, and a ballad called “Punthi Path,” all on the topic of family planning.30 The “KAP-­G ap”

Despite the initial success of the two-­phase approach in recruiting couples to family planning programs, by the end of the 1960s participation rates were in decline around the world and the number of users had begun to plateau. In addition, discontinuance rates were high. Informing people of the availability of birth control and motivating them to use it consistently were proving to be two very different things. Those who studied the phenomenon blamed a variety of factors, including social pressures for girls to marry and bear children young. Another factor was the failures of family planning technologies, which included real and imagined side effects and bad experiences with particular methods. Yet even where



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Figure 9  Members of the Baziri tribe listen to the radio, Somalia, 1963. Original caption: “In the village of Noleye members of the Baziri tribe are trying to give up the nomadic life and settle as farmers. Our photo shows the settled nomads listening to the radio.” Source: WHO/Eric Schwab.

support for family planning was high, researchers found low rates of use and high probabilities of discontinuance.31 This widely acknowledged phenomenon was described as the “paradox” of research findings: “widespread desire for small families, while . . . the actual volume of clinic visits does not reflect that desire.”32 KAP studies were not adequate to explain the gap between positive attitudes toward contraception and low usage; they provided only the data for measuring the rate of decline.33 Some of the leading figures in family planning communications began to express their doubts about the usefulness of existing media methods and the strategies of program leaders in this period. Critics singled out administrators who enthusiastically undertook their own artistic endeavors but refused to incorporate scientific communication principles. While the finished products might look good, they proved uninspiring to target audiences. This might be discovered during a pretesting phase, if only people bothered to undertake one. Furthermore, as Frank Wilder, the Ford Foundation’s consultant to India on mass media for family planning, bemoaned, administrators often sacrificed persuasive film scripts to instead describe in clinical detail a particular contraceptive method. While physicians might be pleased with the results, such scripts would be lost on lay audiences, who might even be discouraged by

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“overdosing” on clinical description.34 Such mistakes stemmed from a failure to clearly define the target audience, an issue that cropped up frequently because of the desire of family planning promoters to repurpose expensive materials for different groups. Critics also began to question the wisdom of transferring an agricultural model—­the theory of the diffusion of innovations—­to the field of family planning and the overreliance on health education strategies drawn from medicine instead of from market research or advertising.35 Family planning, they argued, could not be promoted like other technological innovations or public health initiatives. While improved farming methods or malaria prevention activities could prove their benefits relatively quickly, the gains of smaller family size might not be obvious for a number of years. Adopting new practices to fend off hunger and disease was also likely to be more obviously appealing than adopting family planning, which meant going against tradition, social values, or the personal inclinations of one or both partners. Yet because of the huge successes of consumer advertising, communications experts remained reluctant to give up on the potential of the media. The key, some argued, was to devise a strategy that was specific to family planning. Because KAP studies included little information about the cause of the problem, some began to study media more closely, reworking KAP studies as KAMP studies (the M stood for media) in order to evaluate more precisely a target audience’s exposure and response to family planning messaging.36 Communications theorists looked to U.S. advertisers to learn from their remarkable successes in building and sustaining consumer culture. Social marketing, one of the more influential communications theories that was proposed as a result, was based on an advertising model and shifted away from delivering information and toward instilling motivation. In other words, social marketers attempted to sell positive social change just like soap.37 Techniques that had been developed to convince the U.S. public to buy would have to be modified for other audiences, of course. In the United States, “television alone could sell a new product to millions who never used it before, in the space of mere weeks,” but in countries marked by high illiteracy and supposed “adherence to tradition and primitive communications,” the usual avenues were unavailable, unworkable, or inappropriate.38 Solving the technical limitations was only half the battle. The failure of information campaigns to promote long-­term contraceptive use suggested that another strategy was needed. Toward the end of the 1960s, family planning promoters began a new approach that concentrated on using the mass media to motivate audiences to use family planning instead of simply informing them of its benefits.39



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The communications specialists working in this field began to place greater emphasis on the dramatic, emotional, or motivational value of media. The exemplar of the new approach was an animated cartoon called Family Planning that was produced by the Population Council and Walt Disney Studios in 1967. The venture was the most expensive family planning film of the time by far (it cost $300,000 to produce), but the investment paid off. The IPFF later described Family Planning as “the most effective of all the Motivational films” of its time.40 This was not the first time Disney had produced a message film. In 1940, President Roosevelt established the Office for Coordination of Commercial and Cultural Relations between the American Republics to promote his Good Neighbor initiative. This was renamed the Office of the Coordinator of Inter-­American Affairs (OCIAA) in 1941. The OCIAA used the press, radio, and film to “carry a message of democracy and friendship below the Rio Grande.”41 Walt Disney was one of the first Hollywood producers to participate; his studio developed “direct propaganda films couched in the simplicity of animation,”42 many of which featured the studio’s beloved characters, including Donald Duck. Historians Lisa Cartwright and Brian Goldfarb have focused on fifteen Disney films from the 1940s that address health topics, arguing that like other narratives of global exchange from this period, they reveal a fear of contagion from interaction with foreign cultures. Cartwright and Goldfarb also suggest that the use of animation, a technique directed at children in the United States, reflected paternalistic attitudes toward Latin Americans that were based on assumptions about their more “primitive” lifestyles.43 Such attitudes were prevalent among many involved in this program of cultural exchange. But animation had also been used in the United States in a wide array of health films for adult audiences, adding a humorous and entertaining element to such serious subjects as venereal disease. Family Planning features Donald Duck at an artist’s easel, painting images of families from around the world and various birth control devices while a narrator describes the benefits of limiting family size. Early in the cartoon, images of peoples of different cultures are merged into one everyman as the narrator explains that the story is relevant to all of us in the world’s “family of man.” As film historian Robert Eberwein notes in his brief discussion of the film, the result is a curious hybrid of cultural symbols, creating perhaps one unrecognizable man rather than a universally identifiable everyman. Although Eberwein condemns how the film “offers its presumably white audience evidence about the value of birth control while confirming stereotypical fears about the Other,” it appears that this costly production was actually intended for a large and

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diverse international audience.44 In fact, the “family of man” approach was a deliberate strategy to transcend a specific location, race, or ethnicity. As an IPPF summary of the benefits of cartoons explained, “due to their schematic way of depicting people, places, dwellings, etc., these films are not tied to a fixed and recognizable locale and can thus very effectively cross national boundaries.”45 Family Planning was translated into twenty-­three languages and was distributed widely in Asia and Latin America. Despite the IPPF’s favorable analysis of the film, the storyline drew on a tired plot that (even in the IPPF’s own view) had dominated family planning media for too long. The formulaic comparison, which pitted a large family against a smaller one in a competition for health and a good standard of living, had been evident in family planning media from the opening decades of the twentieth century. In the simplistic juxtaposition presented in Family Planning, the larger family experienced a series of expensive crises while the smaller family was able to gradually build wealth, acquire consumer goods (including a radio, the fastest-­spreading communications technology of the time), education for the children, and enough land to support offspring and sustain their families. Simply put, the message of the film was that “families that do not plan their families are poor and unhealthy; families that do plan, own things, are healthy and have a ‘winner’s’ attitude towards life.”46 Family planning promoters recognized the limitations of such exaggerated filmic representations relatively early, and by 1969, just two years after the Disney film, communications specialists were reporting that this “threatening approach” had failed.47 Exaggeration could be interpreted as unrealistic and unbelievable, and viewers tended to reject fear-­based appeals. They were also likely to focus on the family most like themselves (the poor one) and see little in the experience of the wealthier group that was relevant to their lives. In an Indian poster campaign, for example, observers identified with an “unhappy family” with many undernourished and badly clothed children rather than with the well-­clothed and well-­fed “happy family” with few children. Target audiences may also have failed to buy into the consumerist model of upward mobility the film promoted. The economic argument came under further attack from critics in developing countries, who questioned the simplistic message that fertility control could solve social inequality. In the 1970s, this critique radically reshaped family planning media.48 Turning Point: “No-­o ne ever planned their family with a poster”

In 1973, delegates to the twenty-­first annual conference of the IPPF reviewed the preliminary results of the first global study, Survey of World Needs in Family



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Planning,49 which estimated that 500 million women risked an unwanted pregnancy each year and that two-­thirds did so because of inadequate knowledge of contraception.50 Both the information campaigns of the early 1960s and the motivational efforts later in the decade had clearly failed to help families put into practice the techniques of fertility control. If no one ever planned their families with a poster (as influential members of the family planning community now thought), why would a radio broadcast or a film prove any more effective? The massive expansion of media efforts had not translated into long-­term change in family planning practices. Family planning promoters were also beginning to express doubts about the direction communications theory was taking; they questioned the premise of strategies “designed to convince, persuade or ‘engineer consent.’”51 The phrase “engineer consent” comes from a 1947 essay by public relations pioneer Edward Bernays, who had worked on the Dixie Cup promotion that made Hugh Moore’s fortune. Bernays had experience with health topics from the fluoridation campaign of the Public Health Service in the early 1950s and campaigns for the National Multiple Sclerosis Society from 1954 to 1961, but he was also known for more notorious efforts that included promoting smoking for women in the 1920s and the overthrow of the elected president of Guatemala in 1954. Moore had drawn on everything he had learned from Bernays in his efforts to publicize the population explosion in the 1950s, but by 1973 members of the family planning community had begun to reject such tactics. The debate was moving beyond the question of whether or not media persuasion actually succeeded in changing attitudes and behavior to a reappraisal of whether it was ethical to attempt to do so. For some, this came down to a clear distinction between both genres and messages. Donald Bogue, of the influential Chicago school of communications research, made a strict delineation: Information is defined as communication of facts. It is a representation of truth as it is understood. We may act out these truths in dramatic form to help people see reality as it really exists. This leads to the documentary film or radio program or the documentary pamphlet. Reports of actual or imaginary but typical personal experiences may be a part of information programs. . . . Propaganda is defined as emotional appeals and the exaggeration, distortion, or suppression of facts. Propaganda goes beyond facts. It tries to persuade through playing on the emotions instead of appealing to the intellect.52

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Motivational films incorporated elements of both categories—­facts, personal experiences, and emotional appeals. For family planning promoters, the question was whether communications specialists who were working to create media for family planning organizations took persuasion too far by exploiting the feelings that could be generated with the creative use of the media. At the same time, a confluence of other factors threatened the credibility of the family planning movement and helped usher in a new era. First, the end of the overpopulation crisis in the United States and the backlash there led by conservative groups against family planning began to undermine support and funding for international efforts. In addition, feminists criticized the movement’s motives for promoting family planning overseas and some strategies that, they argued, led to the coercion of vulnerable men and women. Family planning advocates who were wary of the excesses of population control efforts condemned the authoritarian, undemocratic, hierarchical structure of family planning programs and media campaigns and a sole focus on reproduction when families faced significant other challenges to their health and well-­being. These critics shunned old habits such as appealing to male decision-­makers instead of attempting to improve the status of women, relying on the short-­ term goal of recruiting new users instead of sustaining long-­term practices, and focusing narrowly on family planning as a medical issue without giving enough attention to broader social issues such as employment for women, social security for old age, and tax reforms that would encourage smaller family size and benefit families. The field’s focus on the economic benefits of smaller families, exemplified in the large family/small family narrative common in family planning media, did not address the “revolution in sexual mores” that was required in many cultures if family planning was to become an accessible choice for the world’s women.53 The international meetings organized by the United Nations set the tone for a new approach. In 1974, at the World Population Conference in Bucharest, participants agreed that family planning should be seen as part of the process of social change and development and that access to education on the issue was a fundamental human right. The consensus established at the World Conference of the International Women’s Year in Mexico in 1975 reaffirmed the notion that family planning education and services are not only good for women’s health but are also integral to improving the lives of women, including their opportunities and status.54 Internal documents from the IPPF illustrate how significantly these ideas reshaped the media strategies of family planning promoters. One report, for example, cited the work of influential Brazilian theorist Paulo Freire, who



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proposed that education be radically reframed as an exercise in “conscientization” in order to empower peasant classes with an understanding of their own oppression, thus giving them the means to act in their own interests.55 One IPPF document concluded that “the realization that an individual can control his or her fertility and, in this respect at least, is not in the hands of destiny,” could be seen as part of such a process.56 The IPPF formed a Working Party on Education and Training to evaluate existing strategies in light of the questions that were raised at the Bucharest meeting. The committee again pointed to the need for communication strategies that were specific to family planning communication and critiqued the IPFF’s reliance on “borrowed models” from other fields, particularly health communication. “Contraception has been seen as a ‘habit’ which can be acquired much as preventative measures to combat dysentery or malaria,” the committee stated.57 Such an approach completely ignored the structural barriers that limited the freedom of men and (especially) women to choose how and when to control their fertility. The IPPF focused on transforming family planning into a popular movement with grassroots participation as part of a wider effort to improve people’s economic circumstances and access to education. The new philosophy neatly dovetailed with a changing emphasis in the field of communications from a narrow focus on a specific and sometimes idealized message to a more open-­ ended strategy that could acknowledge competing views and a more realistic appraisal of benefits and limitations. This change was based on growing evidence of the poor impact of several of the standard approaches to mass communication, including fear-­based appeals, exaggerated claims of negative or positive effects, and one-­sided narratives that played down real problems such as the side effects of contraception and the social stigma associated with using it in some cultures. Experience had shown that mass media communication was effective for dispelling rumors, but only if the source was untainted by any perceived agenda. The federation had also learned that in areas where counterpropaganda against family planning was expected, presenting both the positive and the negative sides of an issue was more effective than simply sticking to a promotional message.58 In response to these discoveries, the IPPF proposed an information service that would give journalists up-­to-­date information instead of trying to convert them to a particular point of view. The federation chose this method instead of countering misinformation with a particular messaging strategy in the hope that this would prevent “the dissemination of unfavorable comment, often arising out of ignorance, which spilled over from one country to another.”59

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In 1976, the organization formalized a shift to a more community-­oriented approach to public education. The new policy had three main components: intensifying efforts to reach rural people, integrating family planning with other development programs (and moving away from a medical service model), and creating a more popular movement through wider community participation in the design and delivery of family planning. Mass media campaigns could still play a role, but the time had come for the IPPF to reframe its contribution. In the rest of this chapter I explore some of the new media that resulted.60 The Transformation of the Family Planning Film

The change in approach is evident in the shifting strategies of one of the most prolific family planning filmmakers of the period. In 1972, Phyllis Tilson Piotrow, a former assistant to Gen. William Draper (the figure behind the Draper report) and a leading figure in the population control movement, launched the Population Information Program (PIP), which drew financial support from and operated under the auspices of USAID.61 The same year, Dr. Murdoch Head, a Virginia physician and entrepreneur, established the Airlie Foundation to work closely with PIP through its profit-­making film company, Ravens Hollow, to produce family planning films for worldwide distribution. From 1971 to 1978, USAID awarded $16.6 million to the Airlie Foundation and the PIP. The Airlie Foundation made more than 100 films on population and health issues during this time.62 The foundation developed three types of productions: instructional or technical films for medical personnel, informational films about the biology of reproduction and types of contraceptive technologies for the public and for family planning field workers, and general films highlighting population issues and family planning projects around the world, which constituted the largest group and are my focus. These were set in a wide variety of international locations and were available with different language soundtracks. In the past, the IPPF had complained that U.S. film producers were unwilling to spend money to customize films for regions that were only a small part of the total global market. As it reported, “A Family Planning film made for an American audience is considered ready for release in the WHR [Western Hemisphere Region] as soon as its sound track is dubbed into Spanish.”63 Yet adapting materials for new international audiences involved more than replacing soundtracks. Family planning promoters working on international projects also realized that materials developed for one region could not necessarily be effectively used elsewhere.



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Airlie tackled this issue by providing films for specific regions, such as Latin America, using unspecified locations from the area and common themes. Expert reviewers complained, however, that the Spanish translation was sometimes badly done and that the soundtrack revealed U.S. accents, undermining the persuasiveness of the film for Latin American audiences. Films developed for other regions also posed translation problems. Even audiences who shared the same language had difficulty understanding films made in other places, such as Caribbean-­made films that other English-­speaking audiences found hard to comprehend. Similarly, audiences who learned English from British teachers struggled to interpret U.S. accents.64 Airlie’s first USAID-­funded film project was to develop films for the elite of Latin America during a period when Catholic opposition to contraception silenced public debate on the subject and restricted the open distribution of services. Some of the first examples strike a tone of urgency that is reminiscent of the media productions in the early years of the overpopulation fear in the United States. Countdown to Collision (1973), for example, which was produced in English and Spanish, includes scenes of catastrophic devastation, pollution, and overcrowding in order to emphasize the burden of an unrestricted growth rate on the world’s limited resources. As developing nations began to see overpopulation as a serious internal issue instead of rejecting it as a preoccupation of industrialized nations, the tone of the films changed. The appeals remained urgent, but they became more optimistic than the classic fear approach that was first presented to U.S. audiences in the 1950s and 1960s.65 Nonetheless, in a 1976 evaluation of Airlie’s work, Latin American physicians from the family planning community took issue with the films and the implication that slower population growth was a panacea for all social and economic ills. Their comments mirror the complaints of leaders of developing nations that the Bucharest meeting of 1974 placed too much emphasis on population control. Despite their interest in family planning, these critics argued that social change was necessary if poverty was to be properly addressed.66 Some also felt that the films provided a tourist-­friendly view rather than the hard realities of life for the rural poor. While U.S. filmmakers may have used this representational strategy as a way to avoid overly dramatic images of desperate need, it fell short for those who were campaigning for broader social change and wanted to highlight the harsh realities of poverty and inequality. The team at Airlie responded to the changing tide in their field and the objections of experts in target regions by presenting a less hysterical evaluation of the impact of overpopulation and broadening their depictions of its causes and consequences and the options for improving the situation. Mexico in the

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Year 2000 (1979), for example, features upbeat music and a focus on the children who will learn from the viewing generation’s example, even as it traces population growth from 14 million people at the start of the century to 65 million by 1979 and predicts an overwhelming 132 million by its end. In fact, after decades of population growth, the country’s rate had already begun to decline, from 3.5 percent in 1965 to 3.3 in 1970. The shift accelerated over the next decade, to 2.6 percent, as family planning promoters continued to broadcast their message.67 Mexico in the Year 2000 highlights the encroachment of cities onto farmland, the rise of pollution, and the decline of rural jobs due to mechanized agriculture and stresses that the new social order will require new skills. Footage of slum life is briefly included, along with many images of people doing backbreaking labor to earn a living. The narrator states that many of the new jobs in the changing economy would require fewer workers with a higher level of education than traditional farm work called for. Overall, the tone is positive, emphasizing employment in the emerging oil and gas industries, the great breakthroughs in child survival and health care that contributed to the population growth, the availability of government-­supported family planning, and the idea that the right balance can be achieved. By 1976, according to a USAID evaluation, motivation was less “relevant” than it had been when the Airlie Foundation began its work in Latin America in 1971, presumably as a result of the increasing interest in population control in developing nations. Although the film campaign was likely a minor factor in a shift from population control to reproductive rights in the context of unemployment, urban overcrowding, and increasing poverty, a report for USAID did suggest that “perhaps Airlie films can be credited for some small part of this trend.”68 As a result of this transformation of family planning philosophy, later films addressed the other issues that were emerging in the international field, especially the role of women. Tú (You, 1976) tells the story of a young couple, Pedro and Elena, and their decision to wait to have children and to only have two.69 A voiceover narrates the story of their life together. Excerpts of their Spanish conversation can be overheard as the film dramatizes their relationship and their disagreement over when to marry. Pedro, a medical student, would like to wed early and move in with his parents. Elena, who is training to be a teacher, dreams of a house of their own and persuades him to wait. As the narrator notes, she “speaks for a newly articulate world of brides-­to-­be”—­women who do not want to rush into marriage and motherhood. In the decisive scene that changes Pedro’s mind, Elena shows him what she has been learning in her economics class. The economic argument is still



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central in this example of family planning promotion, but here it is laid out in a newly transparent way. The narrator asserts that in disagreements over the idea of limiting family size, this approach “almost always triumphs,” implying that individuals can use the same technique in their own negotiations with partners, family, and friends. The image of the female character calculating the cost of one child and explaining the price of a large family to her male companion marks a major break from depictions of women in previous family planning media. Elena is far removed from the images of harried and disheveled wives struggling at home with large families while their husbands try to make a living. Furthermore, while Pedro says he wants three boys and one girl, Elena asks why not one boy, and one girl, two boys, or even two girls? At the end of the film, after she has won him around to her way of thinking, we see the couple walking toward the camera happily with their son and daughter. In Dos Caminos (Two Roads, 1979), two young women from a rural town somewhere in Central America move to the city to pursue an education.70 The film begins as Yolanda returns to her hometown alone and thinks back over their experiences. She and a male narrator tell the story as the scenes and dialogue play out beneath the voiceovers. Yolanda studies hard to become a nurse, but her friend Consuelo becomes wrapped up in the excitement of city living, neglects her studies, and falls for the charms of a young man. After becoming pregnant, she undergoes an illegal abortion. Yolanda discovers her sick in bed at home and takes her to the hospital, but Consuelo dies. Yolanda returns to her town to try to prevent such tragedies. She takes a job at the local clinic to provide women with information on family planning. Consuelo’s downfall is blamed on her lack of experience and education. The narrator also singles out the romantic ideals peddled by cinema and television (as opposed to the purposeful dramas created by family planning promoters, presumably) and notes that young girls are made vulnerable by a lack of information and the ability of men to simply walk away from unplanned pregnancy outside marriage. The narrative is sympathetic to the young woman’s plight and creates a moving story while also cleverly taking advantage of chances for more straightforward messaging. Scenes of Yolanda at college, for example, provide the opportunity for her to recall what she has learned about female fertility. She tries to warn Consuelo that after the onset of menstruation girls can become pregnant at any time. In a scene where Conseulo tells her of her problem, Yolanda argues that the pregnancy is also the responsibility of her boyfriend and that she must tell him so the two of them can deal with it together. In the scene that follows, Consuelo’s boyfriend first asks if she’s sure the baby is his, then rejects the idea of marriage and says he knows a woman who will take

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care of the problem. Then he walks away and leaves her to face the situation by herself, “as young girls have been left alone in such circumstances all over the world, all through time,” the narrator intones. The film thus critiques male irresponsibility at the same time that it presents it as inevitable. The Airlie Foundation’s earlier attempts to show empowered women had been poorly received by the USAID reviewers. The filmmakers sometimes included local influential figures to appease their objections to family planning, but research had shown that doing so quickly dated a film. Films featuring specific women in leadership roles were criticized for depicting exceptional individuals rather than the experiences of the majority of Latin American women. This approach was also problematic because it had the potential to alienate viewers who disagreed with the politics of a particular individual shown. Some of the women the Airlie films profiled were seen as merely symbols rather than as effective leaders. As one reviewer commented, the female senators shown in Cita en Santo Domingo (Rendezvous in Santo Domingo, ca. 1973) “are a joke . . . they have no power.” Stories of more universal experiences, like those described above, were potentially timeless, less vulnerable to the dynamics of local political cycles, and more realistic for viewers who criticized the uneven changes in women’s roles and status. While depictions of female politicians pushed the idea of changing gender roles too far for some viewers, women playing nurses or teachers could still illustrate modern values and education within the confines of these traditionally female occupations.71 The Failures of Film

The vast amount of money spent on film in this period raised the question of whether this investment was in fact paying off. Airlie films ran from thirty seconds to thirty minutes and cost around $1,800 to $2,058 per minute of finished film, compared to the average cost of films made for government agencies of $1,236. The high cost was attributable to the expense of filming in overseas locations and the widely acknowledged superior technical quality of Airlie’s finished products. Most ran at around twenty minutes and could be bought for $70, $130 less than films of the same length produced by Planned Parenthood. Still, at a cost of almost $30,000 to produce, the films needed to be distributed extensively to justify the expense, even if there was no expectation of recouping costs.72 Distribution of the Airlie catalog was problematic, however. Some films were frequently requested, while others languished on the shelves. This had less to do with the relevance or quality of the film than with the word-­of-­mouth promotion of certain productions once groups started using them. Because they were made without a specific distribution plan for target countries, some



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never gained the publicity needed to promote them. Established media channels, such as broadcast television, were apparently reluctant to show the films on the grounds that they were unsuitable, but it is also likely that because no effort was made to court television producers, such collaboration could not be established. Attempts to create a centralized film distribution service, such as a combined effort by the IPPF, UNESCO, and UNFPA from 1972 to 1975, were short lived.73 Distribution across broad regions was ineffective because films were likely to have a different reception from country to country; a production might be considered relevant in one place but not in another. Films also provided numerous opportunities for audiences to misinterpret intended messages. As a report by the Johns Hopkins University communications program that inherited the Airlie collaboration put it, “the medium itself may distract from the message,” a phenomenon that was not fully appreciated in the enthusiasm for using the technology in the 1960s and 1970s.74 The IPPF concluded, for example, that “many people cannot perceive symbolic representations of an object,” such as a picture of an item that is larger in size than the original artifact. Some of these difficulties had been evident with the basic technology of the poster or flip chart, as in one example where only four out of twenty-­five traditional birth attendants in a nutrition class in India could identify common vegetables from color illustrations. The communications specialist who observed this phenomenon did not consider the possibility that the birth attendants may have been unfamiliar with the specific foods depicted, nor did she note if they were characteristic of the region or were well drawn. Negative results were frequently taken at face value and health communications experts assumed that their target audiences had minimal visual literacy instead of critically assessing the barriers to communication that had been overlooked.75 Film was thought to compound some of the problems seen with other media. Even in Latin America, with its long history of cultural exchange with the United States, U.S. conventions of visual display and narrative apparently created problems. One example comes from a Walt Disney film on malaria that included several close-­ups of a mosquito. Farmers in a rural community laughingly reported after watching the film, “Now we understand why you Americans are so worried about malaria; you have such big mosquitoes in your country.”76 While it is not clear if the viewers were mocking their visitors, health communications experts took such comments very seriously. If the assessments made by family planning promoters were accurate, the implications for family planning imagery were potentially disastrous. A close-­up of an IUD, for instance, could easily give a misleading and terrifying impression of

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the size of the device and its effects. Partial representations of body parts and unnatural colors might also confuse viewers.77 Because IPFF staff members believed that target audiences had only minimal media literacy, the federation complained that many films were “too sophisticated” and included “too many ‘nice things’ to see and hear [that] distract the audience from the family planning message.”78 Using the local language did not render images that had been produced elsewhere meaningful for audiences who were new to film, especially if the format was unfamiliar in that region, as documentary filmmaking was outside the West in the 1970s.79 Flashbacks might be difficult to comprehend if audiences hadn’t seen them before. Complicated plots lost the viewer, no matter how closely they concentrated on the storyline. Viewers tended to focus on the visuals and ignore a voiceover altogether if the two competed for their attention. Yet simplistic films were unsuitable in countries with indigenous film production and among educated audiences. An early animated film used in Brazil, for example, was very popular with village viewers who watched it repeatedly (although apparently they did not understand its family planning message), but health workers felt that the simplistic approach insulted their intelligence. In urban areas where viewers had access to high-­quality entertainment film, such as India, family planning media had to match the same level of production values and dramatic sophistication.80 Communications specialists began to realize that separate films were needed for distinct audiences within each country, not just for the different regions of the world. Attempting to reach everyone with the same production could mean no one was won over. Of course it is difficult to tease out the facts of the situation, as so many variables shaped an audience’s reactions. Viewers might be bored with a particular media presentation. Perhaps they were well aware of their teachers’ low opinions of their capacity to understand and chose to reinforce or make fun of such perceptions. Whatever the audience issues at the beginning of media campaigns, it is likely that viewers would adapt to the new media after repeated exposure. For this study it is enough to note that family planning promoters became increasingly pessimistic about the ability of their audience to comprehend messages in “foreign” formats. Audience research in other areas of media communication had long suggested that viewers tended to pay the most attention to messages that corresponded with their beliefs and to reject those which didn’t. While a film might help reinforce an existing attitude or provide further information or justification for it, could motivational media messaging really transform incompatible views or behavior?81



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Many other problems had to be faced. The need to expand into rural communities necessitated greater cost effectiveness. In addition to the usual difficulties of clearing customs, the cost of transportation was increasing. It was difficult to maintain the broadcasting equipment and train field workers in the use of the technology. Most significantly, the films could not stand alone—­ viewers usually required a discussion of the ideas and images they had seen to help them relate the message to their own needs and experiences.82 The IPPF reported that many program staff selected films that were inappropriate for a particular audience without any awareness of how to present them or follow up after a showing. All of these difficulties fed into growing dissatisfaction with film among family planning promoters and the communications experts they collaborated with. As the challenges began to outweigh the benefits of this expensive strategy, they began to explore other media options. Moving into Folk Media

Some communications specialists turned to the traditional arts that had entertained communities over hundreds of years. This “folk media” included songs, dance, plays, storytelling, proverbs, and puppet shows and offered important advantages over the high-­technology media formats that had been most popular in the 1960s beyond a lower cost. As filmmakers Anthony and Elizabeth Isaacs reported at a UNESCO/IPPF meeting on the subject of folk media in 1972, “By using the various folk arts, we are immediately working on established channels of communication within the particular society concerned and speaking to people in a language which is familiar to them.” Performances could be adapted to feature local elements or references and to respond to the reactions of the audience. The methods were also inexpensive and easily portable. These traditional formats were popular among rural villagers, the main target audience and the one that was seen as the most resistant to family planning messaging. Puppets, clown characters, or masked or mystical storytellers could also communicate difficult ideas about sex and contraception that were usually not spoken of in public forums.83 Communications experts felt that folk media was more of an emotional and moral medium than an intellectual one. While this deterred some from using it to deliver complex health information, others saw great potential in less didactic approaches. Some, however, questioned the idea of commandeering indigenous cultural forms in this way and warned of the risk of “cultural genocide” if communities realized that their traditional media had been corrupted, although it is likely that over their centuries of use these forms had been adapted for a wide variety of educational and even political purposes. The key was to work

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with local artists to develop a performance that satisfied both the performer’s creative standards and the goals of the family planning promoter. Most of the attendees at the UNESCO meeting where the approach was first laid out came from the traditional societies where folk media was deemed most useful. They added localized input and expertise to the experiment.84 This new strategy did have some limitations, however. Modernizing communities were liable to consider some traditional arts old-­fashioned or backward and reject their messages. Materials had to be made locally, not only because unfamiliar dress and language could prove distracting but also because they could convey attitudes that contradicted local circumstances. A 1981 overview of films still in use mentioned specifically that some depictions of women, for example, “might disturb some audiences.”85 The complex cultural significance of particular masks, ceremonies, or storylines could be lost on family planning promoters, who might inadvertently use these forms in an inappropriate way or select a style of delivery that was antithetical to the intended message. One of the showcase projects was a Nigerian film called My Brother’s Children (1970) that was produced by husband-­and-­wife team Anthony and Elizabeth Isaacs for the Family Planning Council of Nigeria and was sponsored by the IPPF. My Brother’s Children was a film of a play. Thus, it harnessed the benefits of a live performance and used a traditional format that was supposedly more inherently appealing to audiences while eradicating the possibility that fluctuations in dialogue and action from one showing to another might alter or dilute the intended message. Having enjoyed a high level of control over their previous media productions, family planning promoters were clearly reluctant to loosen their grip, even as they turned over the creative elements to folk artists.86 In Nigeria, where there were more than 200 distinctive ethnic groups and various languages and religions, a production made for one community was unlikely to appeal to another group. Instead of attempting to produce something for the country as a whole, the Isaacs settled on the Yoruba-­speaking peoples, who numbered 14 million in the early 1970s. The film was based on scrupulous research on Yoruba culture and featured well-­known actors speaking the language. The filmmakers settled on a traditional form of communication, the folk drama, which consisted of sketches and a song and dance. The format, which was usually a domestic comedy or, less often, a historical story, was already associated with messaging and covered themes that related to the subject of family planning such as the proper treatment of wives and conflicts between old and new ways.



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The film’s storyline dealt with the burden on a young man living in town, Mr. Adeleke, who returns to visit his village under pressure to support his younger brother’s large family. Large families, especially those with many sons, were traditionally revered in Yoruba culture and gave both women and men status in the community. Family planning was also opposed because of a belief in reincarnation, the idea that children were a gift from God, and a previous mortality rate of 40 percent for children under five. However, as mortality rates improved, families living in cities found schools and living conditions crowded and struggled with high food prices and unemployment. In urbanizing areas at least, values were beginning to shift to allow for the idea of limiting family size. The story is set in a small town in what is considered the heartland of the Yoruba people. The site had been previously used for a very famous child health project. This linked the plot to the improved mortality rates of infants; by 1970, most Nigerian children grew to adulthood. The narrative illustrated the organization of family life in Nigeria. Eldest sons were responsible for the families of their brothers (especially after the death of the siblings’ father). This narrative structure also meant that the message did not single out the viewing individual. Rather than suggesting “you have too many children,” noted the producers, the film instead said “your brother has too many children.” The narrative also acknowledged the importance that was placed on childrearing traditionally by having Mr. Adeleke return to his village for the important naming ceremony to celebrate the arrival of his brother’s new child. The newborn is called Motunrayo, meaning “I am joyful again,” further underlining the happy associations with a growing family in Nigerian culture.87 This celebration of childbearing, which seems at odds with a message of family limitation, in fact had a long history in family planning media. From the earliest years of the birth control movement, smaller, happier, and healthier (or “fitter”) families were promoted, and at the height of the overpopulation argument, Planned Parenthood was careful to stress that the organization was not against anyone having children but was instead proposing that everyone be given the means to plan when to have their families. Various scenes in the film provide the opportunity to explain the possibilities of family planning and address the decision-­making process in Yoruba culture. When Mr. Adeleke is asked if he will take in some of his brother’s children, he reveals that he can barely afford to keep his own smaller family and educate his children, a goal of aspirational urban Nigerians. Mrs. Adeleke goes to market with her sister-­in-­law, and when she hears that the latter had to quickly return to work after the birth of her last child because of financial hardship, she describes the work of the Family Planning Council of Nigeria.

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The scene relates to various aspects of gender relations in Nigeria that played into the acceptance of family planning: the fact that a large number of Yoruba women participated in long-­distance trade (as evidenced by the market), which exposed them to new ideas; that women need economic independence to help support their families; and that men and women share decision-­making in towns but are less likely to in villages. No sets were used; African audiences preferred to see films set in real places. Because folk performances are generally unscripted, the Isaacs did not use some of the techniques of modern film production, such as multiple takes from various angles that required the uniform repetition of the same lines of dialogue. Instead, the film is edited from a series of longer master takes for each scene, containing the dialogue in one shot. Although the production had none of the quick cutting effects commonly used in contemporary film, the “stagey” effect produced by the master-­take approach actually suited the content because audiences expected the theatrical style of a play. As was traditional with folk drama, the performers used gestures to accompany the dialogue, a useful strategy given that audience members tended to talk freely during performances. The finished product was shown on Nigerian television and in various communities, and it was discussed on numerous radio shows in West Africa and on BBC World Radio. Two universities added the production to their archives of classic Yoruba-­language materials. Kola Ogunmola, the performer who helped develop the play and starred in the film, was reportedly delighted to show it whenever he was on tour; IPPF had provided a projector for him. Viewers apparently enjoyed seeing their community depicted in color (which was rare because there were few commercial films at this time and television plays were shown in black and white) and commonly returned for repeat viewings. Many commented that they recognized the reality of the problem depicted. The film was also popular among audiences beyond the original target group, including university students (who would become community elites), health and development workers, and government staff, who were impressed by the “integrity” of the film and considered it “a genuinely African product.”88 Although many Nigerian viewers were enthusiastic, family planning promoters were less impressed and doubted that the film was effective in delivering the desired message. William O. Sweeney, a communications specialist at the Ford Foundation, felt that the attention to Yoruba culture overshadowed the actual message of the story. Nigerian sociologists evaluating the film had a more nuanced assessment. Though they were generally supportive of the attention to cultural detail, they did note that in at least one instance, when a character advises his daughter to plan her family when she gets married, the film



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departs from Yoruba realism and reveals “too conscious an effort” to get the message across.89 In their view, this heavy-­handed preaching undermined the guise of entertainment. Despite the concerns of family planning promoters that visual materials were difficult to understand for audiences who were new to film, the Nigerian evaluators found that the visual cues in My Brother’s Children, such as the apparent affluence of Mr. and Mrs. Adeleke conveyed by their dress and healthy appearance, were more readily recalled by viewers than the discussions in the dialogue. The authors of the evaluation concluded that “the brain as it were closes itself to the messages directed at the ear but the eye continues to see, incapable of resisting the fascination of moving images projected on the screen.” Leaving aside the question of whether visual messaging was more powerful than verbal messaging or less open to resistance, it certainly compensated for some of the practical difficulties that prevented audiences from fully engaging with the spoken narrative. As the report made clear, viewers tended to talk to one another during the showing and to come and go throughout as they would during other village entertainment. There was also competing noise from attending children as well as the distraction of the technology of film (particularly the projector) to contend with.90 Visual cues were important in reinforcing or restating the aural messaging in such contexts. While this evaluation (which is the most comprehensive account I have found) provides some useful insights into the use of family planning media, it is also deeply flawed. For example, the test audience was not the intended target. The film was made for people living in towns, and it was unlikely to win over the rural viewers who watched it because the storyline focused on the burdens of a town dweller who was reluctant to support his brother in the countryside. The researchers compared attitudes toward family planning in one rural community before and after residents were shown the film with those of a control community who did not see it. At the start of the study, over half of both groups already expressed a favorable attitude toward family planning, which the authors attributed to the previous decade of programs and publicity campaigns around the country.91 Those who were unaware of any effective methods for preventing conception were less likely to support the idea of it, while those who knew of techniques were more supportive. Because the film was more motivational than informational (because it dealt with the reasons for using contraception rather than any detailed discussion of techniques), those who lacked technical knowledge were likely to remain ignorant and therefore unsupportive. Family planning promoters had shied away from extensive technical descriptions in films for general audiences because they believed that they were too clinical for general

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viewers and were more suitable for health care providers. They were also mindful of cultural prohibitions against discussing the processes of reproduction in mixed audiences. The finding that knowledge of contraception was in itself motivational suggests that some of the vast amounts of funding spent on persuasive media might have been more usefully directed toward educational strategies that conveyed basic practical information. The study concluded that while most viewers enjoyed the film, most barely recalled its message and it had no discernable impact on opinion. As the authors who studied the film’s reception summarized, “The film show was an experience—­shortlived, ephemeral, folded in the darkness of the evening and gone forever.”92 The day after viewers saw the film, the pressures of work and survival in a rural economy took over. Doubtless the disconnection between the intended audience and the one that was evaluated explains some of this. Consigning viewers to a passive role of spectatorship may also have contributed to the problem. In the final section of this chapter, I turn to a more participatory form of communication that was proposed for the promotion of family planning. Feminism and New Media Strategies

Media specialist Martha Stuart was inspired to expand her work overseas by the 1974 International Population Conference in Bucharest.93 Village women were not included at the conference, although they were often the topic of discussion. Instead, the men who dominated the leadership in the global family planning movement and some women spoke for them. Stuart decided to take her model of participatory communication to women in rural communities around the world, setting off for Egypt with portable video technology that had only just become available. She developed a large collection of work on family planning issues in India, Colombia, Jamaica, Egypt, Mexico, and Indonesia. As the destinations multiplied, the range of issues she tackled also expanded. In later projects she interviewed men in Colombia who were planning to have a vasectomy, Palestinian refugees, and, on her last filmmaking trip, Native Alaskans struggling to preserve their traditional way of life. Although the programs were originally intended for use in the country in which they were produced, they were also picked up for broadcast in Canada, Australia, and the United States (where the satellite feed was offered to more than 3,000 public broadcasters and there were eighty-­one commercial broadcasts of Stuart’s films in 1982 alone). The following year, PBS showed forty-­six of Stuart’s programs, the entire collection that was available at that time.94 Unlike film production, video technology could be taken from village to village, allowing people to more easily participate in recordings produced for



“Most of the World’s People Need Planned Parenthood” 107

their own communities. By the late 1970s, family planning promoters were critiquing the urban bias of media materials and calling for localized materials that focused on smaller, rural communities. Tailoring film or television to discrete groups was too expensive to justify such limited use, but video could much more cheaply accomplish this specificity. An added benefit was that video production and distribution could be undertaken outside the hierarchical systems of film or broadcasting, which tended to exclude ordinary people or grassroots programming.95 Stuart’s approach was a direct response to criticism of the top-­down communications of previous years and departed markedly from previous strategies in the birth control and family planning movement. As a way of increasing legitimacy, radio and film producers of birth control programming in the first half of the twentieth century had often included an expert, usually a physician, to advance the narrative and deliver the story’s message. This strategy reflected the high status of the physician in U.S. society for most of the twentieth century. Historians have noted the gradual disappearance of the doctor from advertisements for drugs and therapies as new medical technologies and pharmaceuticals displaced the traditional skills of the physician after World War II. The growing feminist critique of the medical profession and the development of a women’s health movement in the 1960s further undermined the status of the physician, particularly in the arenas of sex and reproduction.96 Stuart’s technique was very much in keeping with this new mindset. Initially, she was concerned that the people she approached about family planning might not want to share their real opinions on camera with a stranger from the United States, but she soon learned that the process was actually less challenging abroad than it had been at home. For example, she reported that in Colombia, it was “easy to establish the fact that I didn’t have a hidden agenda and that I was really interested in what they thought and felt and that there was nothing I needed to hear them say nor was I going to judge them.”97 During her videotaping sessions, Stuart asked open-­ended questions to start a discussion. As the goal was to air opinions rather than to come to any kind of agreement, she solicited different perspectives on the same issue and let disagreements stand. The format was unusually informal, and this antagonized some viewers, who compared it unfavorably to more traditional formats. As one reviewer of a program called “Indochina Refugees” complained: The program has no beginning and no end. Individuals begin speaking in response to directions or questions asked before videotaping begins, and the majority either speak English with great difficulty or require

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translators. Where several speak at the same time, a good deal of babble is introduced, and considerable patience and perseverance is required to understand the narration. Camera work is often deficient, focusing overlong on individuals who are not speaking. In addition there are no visual aids to help identify geographical locations, nor is there printed material to help in making the fullest use of the audio presentation. Finally, there is no summation and no conclusion drawn.

Others were more appreciative of “the value of using ‘real people’ . . . in dealing with current social issues,” even if the presentation was not as sophisticated as other film productions used in family planning promotion.98 As noted by the IPPF (one of her funders), Stuart’s novel contribution was “to give a voice to the people of the region whose opinions we have ignored so far.”99 The boxes of original footage and edited transcripts and tapes in Stuart’s archive suggest that these programs were not completely unmediated. Correspondence relating to the IPPF-­funded program recorded in Bogota, Colombia, in 1971, for example, hints at some of the political issues behind the scenes that framed the final version shown on television screens. A representative of the local family planning organization Profamilia noted that several women in the program mentioned the positive role of the United States and expressed their gratitude. She advised, however, that this relationship “shouldn’t be mentioned as you know it is one of the arms they have against Family planning, that the U.S. want to abolish the under-­developed countries.” She also cautioned Stuart about the dangers of including the group’s negative comments on the stance of the Church and the lack of government help.100 Although informal reports of audience support for her work were sometimes included in funding applications and program proposals, Stuart did not do any systematic investigations of the impact of her shows. However, her archive does provide a glimpse into the power of Stuart’s filmmaking projects to generate diverse reactions within the local community. During the Bogota project, for example, the floor director walked off the job, apparently because for either personal or professional reasons he was uncomfortable with a program about vasectomies, while the director decided to undergo the procedure himself. The public relations contact was also mobilized by the production process and decided to get fitted with an IUD.101 Stuart’s work clearly had the potential to spread information about family planning at the same time that it gathered data on local attitudes. Her films did not use didacticism. Instead, they were intended to spontaneously motivate people to become contraceptive users as a result of the conversations of participants and viewers—­a classic



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example of the diffusion-­of-­innovations model but with a new twist: the participation of the intended audience. Conclusion

Although American advocates of contraception began their international work with high hopes, exporting family planning messages in the media proved challenging. Some of the difficulties stemmed from the lack of infrastructure, such as the absence of existing media networks and difficulties transporting materials to every region they were needed. Other problems arose in translation. Strategies that had been devised for one place proved less appealing to audiences in another location. Communications scholars involved in family planning began to acknowledge some of the limitations of mass media communication. Films could become quickly outdated. By itself, media was often useless or even damaging to the campiagn to promote family planning. A storyline could not possibly address the full range of questions or concerns that might arise in each particular local context. This meant that a trained professional was needed to follow up with a discussion that could explain confusing or misconstrued elements of the story, address rumors about side effects, or direct people to local services.102 Concerns about the ability of audiences to interpret media messages also appear to have had a stifling effect on the creativity of family planning promoters, which led to a limited range of narratives and approaches in the films of the time. The IPPF complained that the film techniques being used were too conservative and differed little from those that had been used twenty-­five years before. In their opinion the problem with many family planning films was not that they quickly become dated but that “they [were] already dated” when first produced.103 Although repeated exposure did improve the familiarity of audiences with media technologies and narrative strategies, it is likely that simplistic films rapidly became unappealing as viewer sophistication increased. Moreover, the whole project of promoting family planning faced criticism from both conservative groups in the United States and feminists around the world. Interfering with the birthrate of other nations was sometimes interpreted as a sinister plot of wealthy western whites to dominate people of color in poorer countries. Family planning promoters began to reevaluate the use of media in light of these developments. Their enthusiasm for a more participatory and less hierarchical approach shaped both the content and form of family planning productions, leading to greater use of folk media and video. The idea of motivation had not been wholly abandoned, but it was now understood as

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something that should be undertaken locally with the involvement of indigenous communities.104 In response to growing right-­wing pressure in the United States to limit family planning funding, a representative of the Reagan administration at the 1984 conference organized by the United Nations Fund for Population Activities announced that USAID funds would no longer be granted to any organization that provided abortion services or gave clients information about abortion. The requirement limited access to other reproductive health services as organizations struggled to separate such activities from the rest of their work or prove that they could do so. The policy became known in the aid community as the global gag rule because of its restrictions on free speech about and public debate related to family planning. Countries that had partnered with U.S. media producers to promote family planning in the 1960s and 70s became increasingly dependent on their own resources in response to these constraints. The growing support for indigenous cultural production and the collapse of U.S. funding for international family planning set the stage for the next major media development.

Chapter 5

Soap Opera as Soap Box Family Planning and the Telenovela

Miguel Sabido: You’ve coined beautiful phrases—­the medium is the message, etc., but please tell me how we can apply them . . . Marshall McLuhan: I do not know and I do not care. I am only a theoretician of communication. Sabido: What good are your theories if you don’t know how to apply them for the good of humanity? —­Recollections of Miguel Sabido, International Communication Division Conference, Mexico City, 19741

In the years after this purported exchange with the giant of North American communications theory, theater director and television producer Miguel Sabido became famous for his prosocial (meaning positive social effects) model of persuasive media communication in entertainment television. As the previous chapters have shown, family planning promoters had long been interested in the possibility of converting their messaging from educational sources to forms of mass entertainment in order to maximize audiences and increase impact. Internationally, there had been numerous efforts in the

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postwar period to use commercial venues, from television networks in Brazil to cinemas across India, where a high volume of films were produced and distributed through the thriving domestic filmmaking network. At least two full-­length commercial entertainment family planning films that were made in this period were widely shown in movie theaters in the Philippines and Thailand. Batingaw (The Bell, 1974) was seen by over 800,000 theater-­goers and broadcast on television to an audience of approximately 1 million people. Patesumpan Untarai (Dangerous Relations, date unknown) apparently attracted large audiences to theaters where condoms were distributed. The tickets also entitled viewers to half-­price vasectomies. Overall, however, even the most entertaining productions were usually shown in venues used for education and discussion, such as village meetings. In large part this reflected the focus of family planning promotion on rural life and the lack of commercial entertainment media infrastructure in such areas. Even in India, rural populations saw family planning films only about once every three years when mobile vans traveled from region to region. The country’s 7,000 cinemas served only one per 100,000 people.2 Sabido began experimenting with the use of the telenovela (or soap opera) in the 1970s to disseminate educational messages on a variety of topics, including family planning. His approach, which became known in communications circles as the entertainment-­ education strategy, proved massively successful and was widely imitated around the world. The terms edutainment and infotainment also describe the use of entertainment to deliver educational messages, although neither implies the full spectrum of research and evaluation that goes into an entertainment-­education initiative based on the Sabido method. Both terms are also sometimes used derisively to critique educational cultural programs that are seen as “dumbing down” their intellectual content in order to appeal to target audiences. The origins of the technique can also be traced to the Australian Broadcasting Corporation radio series The Lawsons (1944), which became Blue Hills in 1949, and the British Broadcasting Corporation radio soap opera, The Archers, which began in 1951 and is still on the air today. Although neither of these were developed with the input of communications scholars, both were designed to diffuse information about agricultural innovations in farming communities.3 The strategy, which also has its roots in the long history of family planning media, from melodramas in early cinema to wartime soap operas, eventually became as influential in health communication as the diffusion-­of-­innovations model had been in the previous decades.



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The launch of Sabido’s influential telenovela is surprising because it occurred within just a few years of the Mexican government’s shift from a decades-­ old pronatalist policy that had restricted access to contraception. However, a national family planning campaign that used the telenovela format to distribute its message led to a 34 percent decline in the rate of population growth in the period 1977 to 1986. The United Nations Fund for Population Activities held its 1984 meeting in Mexico City in recognition of the country’s astonishing shift from a birth rate of 7.7 children per woman in the early 1970s to 3.6 a decade later.4 In this chapter, I describe Mexico’s rapid transition from a country where contraceptive use was largely prohibited to an exemplar of modern family planning promotion and the legacy of the Mexican approach for media communications for health. The Hidden History of Birth Control in Mexico

Mexican birth control advocates had begun discussing the subject with their American counterparts early in the twentieth century, but both the government and the Catholic Church were opposed to the idea of introducing family planning services to the country. A translated pamphlet originally written by Margaret Sanger, The Regulation of Natality or the Standard of the Home: Safe and Scientific Methods to Avoid Conception, began circulating in Mexico in 1922, part of a “propaganda campaign” by Mexican birth control advocates that had little effect.5 Public health campaigns to prevent the spread of infectious disease and modernize the nation had taken place in Mexico since at least the late nineteenth century, and there was certainly no shortage of strategies for communicating about health-­related issues (including sexual topics) with the general public. Because of low levels of literacy, a wide variety of tools had been used, including public talks, exhibitions, and films. As health promotion efforts intensified in the first half of the twentieth century, campaigners (including representatives of U.S. organizations and Mexican eugenicists) used all available media.6 Public health campaigners in Mexico, like their U.S. counterparts, understood the influential role public discussion could play in destigmatizing private subjects. The Mexican Public Health Department’s Propaganda and Education Section, for example, targeted shame and secrecy in campaigns against syphilis and prostitution with the slogan “Syphilis is not a secret disease. If you do not confess your affliction it will appear in your children.” Eugenicists and feminists also lobbied (unsuccessfully) for mandatory sex education in schools on the grounds that “sex and all it symbolized needed to be publicized and sexual

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anatomy itself . . . [had to] come under the public domain,” as historian Alexandra Minna Stern has noted.7 Stern concludes that issues related to motherhood, childhood, and sexuality that had formerly been dominated by patriarchal forces were gradually co-opted by a medicalizing and paternal state in the course of pronatalist nation-­building in the 1910s. In that decade, Mexico lost more than 5 percent of its population in the violence of the revolution, epidemics (including the influenza pandemic of 1918), and migration to the United States. The population declined from 15,160,000 to 14,355,000. In addition, poor sanitation was responsible for a child mortality rate of more than 20 percent. Combined, these factors created anxiety about population decline which reinforced earlier, nationalistic goals of population growth and led to the Population Law of 1936, to encourage large families. Legislation known as the Sanitary Code prohibited contraception without a prescription from a doctor, the manufacture of contraceptives was restricted, and advertising about contraceptives was banned.8 In 1937, Hazel Moore of Sanger’s Birth Control Clinical Research Bureau visited the few officials and private physicians in Mexico City who supported family planning. She noted that her contacts feared public resistance, especially to the idea that the government or outsiders were involved in trying to control fertility.9 At the time, childbearing was valorized as the most significant social contribution a woman could make to the development of the country.10 The glory of motherhood was central to representations of national progress and was promoted in a wide range of media, from newspaper campaigns to celebrate Mother’s Day to popular film programs subsidized by the state in order to maximize audience attendance.11 As in U.S. cinema, where melodramatic narratives punished female characters who did not conform to a narrow range of gender roles, on Mexico’s big screen the happiness of women was directly related to their success in marriage and motherhood. In the period 1940 to 1970, the country’s population of 20 million more than doubled. This coincided with significant economic growth that was so pronounced it became known as the “Mexican miracle.” The country’s leaders associated population growth with prosperity and economic growth. The combination of the celebration of childrearing as the apex of female accomplishment, the Church’s opposition to contraception, and pronatalist policies limited family planning programs for decades. The possibility of national family planning did not emerge until the late 1950s, when the economy began to falter and a declining mortality rate began to create population pressure.12 Increasing levels of poverty and high birth rates across Latin America made the region a focus of the first International Planned Parenthood Conference



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held in Bombay in 1952. Demographers estimated that Mexico’s population could grow to anywhere from 200 million to 800 million by the year 2000. These dire projections won over some physicians and members of the government, although none would admit it publicly. Instead, some private clinics began offering contraception to the small numbers of elite women who could afford such services. In 1958, U.S. physician Dr. Edris Rice-­Wray founded the Asociación Pro-­Bienestar de la Familia Mexicana (Family Well-­Being Association) in Mexico City, the first family planning clinic in the country. Antipathy toward the idea that the United States might be funding population control programs restricted Planned Parenthood from establishing facilities under its own name, although the organization was in regular contact with Rice-­Wray and local supporters.13 Private clinics in Mexico in the 1950s operated discreetly. In accordance with the Mexican law prohibiting “propaganda for contraception,” they did not publicize their activities, spreading news of their services by word of mouth rather than in press releases or media campaigns.14 The reticence surrounding the topic appears to have been so pronounced that Mexico’s integral role in the development of norethindrone, a synthetic estrogen-­related compound that was used in the development of the contraceptive pill, was largely uncelebrated for decades.15 When the International Planned Parenthood Federation described Dr. Rice-­Wray’s work in its 1959 newsletter, she wrote an angry response to the organization emphasizing the need for discretion. I thought I made it clear that we must have no publicity whatsoever and that we didn’t even want anything to come out in the news about us until we get much stronger. Perhaps it is difficult for others in other countries to understand how precarious our position is here in Mexico. The church is very strong and ruthless. They would go to any lengths to destroy us if they knew we existed.16

In fact, the government closed down Rice-­Wray’s clinic in 1961, although it reopened a year later. By 1965 she had moved her clinic and begun operating as the Centro de Investigaciones de la Fisiologia de la Mujer: Asociación Pro-­ Salud Maternal (Center for the Investigation of Female Physiology: Maternal Health Association), a name that tapped into the culture’s celebration of motherhood as a cover for family planning services. Attitudes toward birth control began to change in the region in the mid-­ 1960s, and the IPPF began organizing meetings with like-­minded colleagues and promoting press coverage about the population explosion, although supporters in the region were at first more concerned about the high rates of illegal

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abortion. Abortion was something of a taboo subject until Chile published data in a 1962 report that found that between 1938 and 1960 the number of abortions in that country had more than tripled.17 Other nations soon followed with their own studies of the scale of the problem. In 1963, the IPPF declared that one of its goals for the region was to explore the possibility “of using press publicity on family planning programs to develop informed public opinion favorable to family planning.” The federation began distributing articles; for example, it sent copies of four essays to 170 Latin American newspapers. In response to the IPPF’s efforts to generate coverage of the issue, Reader’s Digest magazine published on the topic in its Spanish and English editions. In a major breakthrough, the Catholic Encyclopedia planned to include a discussion of abortion in its new edition.18 In 1964, the IPPF held its fourth Western Hemisphere Region conference in San Juan, Puerto Rico, which was attended by representatives from twenty Latin American countries. Although few expressed concerns about population issues, government leaders, church officials, and physicians conveyed great dismay about the rates and dangers of illegal abortion. The Spanish-­language magazine Visíon, which was widely circulated in South and Central America, reported on the San Juan conference in an article entitled “More People, More Problems.” The piece linked rapid population expansion to social and economic problems such as those in Brazil, where poor adults from rural communities were overwhelming city slums as they moved to urban areas to find work. In 1965, at the first Pan American Assembly on Population, which was held in Colombia, attendees expressed a desire to launch family planning efforts, signaling a change in thinking across the nation. When the pope confounded the expectations of the family planning movement and reaffirmed the Catholic Church’s ban on artificial contraception in 1968, support for family planning only increased as religious leaders around the world struggled to reconcile the rule with the needs and behavior of their congregants.19 Despite the changing climate, family planning promoters remained cautious. Some argued vehemently against waging persuasive media campaigns across Latin America on the ground that crossing the line between information and persuasion would be “the kiss of death” to any organization in a Catholic context. In Mexico, without the imprimatur of a national campaign, little progress was made, and by the beginning of the 1970s, the country’s population had risen to almost 50 million people. Concerned about increasing unemployment and worsening economic conditions for rural Mexicans, President Luis Echeverria reversed his pronatalist policy and announced that family planning



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was a basic right: in 1972, the government launched a national family planning program financed by the United Nations Fund for Population Activities. In December of that year, eighty Mexican bishops issued a declaration implying that families had the right to make their own decisions about contraception, in defiance of the Vatican.20 The declaration advocated pastoral solutions to the practical problems that beset poor families and concluded that a parent’s important decision to have another child or not “implies the right and responsibility to decide upon the method.”21 Studies conducted by the Coordinación Nacional de Planificación Familiar (CONAPO), the national family planning council the Mexican government set up to establish free clinics, concluded that earlier efforts had failed to adequately disseminate information about contraception, no doubt because of the restrictions on publicity for family planning. Just as U.S. health campaigners had increasingly turned to media professionals to devise effective communication strategies, the government invited members of the Mexican Association of Public Relations Firms and Media to the National Publicity Council to compete for the contract to develop a campaign. One of the winning efforts, “Vámonos Haciendo Menos” (Let’s Become Fewer), targeted macho behaviors and entreated men to control violent and impulsive tendencies, to show understanding toward women, and to apply these new approaches to the role of fatherhood. Promotional materials aimed at women discouraged passivity, long a valued trait of traditional Mexican womanhood, and instead described a “true woman” as one who “intervenes, has opinions, decides, participates, contributes.”22 The campaigns emphasized that taking control of one’s fertility was an important way to accomplish this. One advertisement went so far with the notion that a woman should decide that men complained stridently, and the government responded in 1976 with an alternative message that stressed family planning as a couple’s choice. While the “Vámonos Haciendo Menos” campaign encouraged new gender roles, it still focused on stereotypes about Mexicans (macho men and passive women) and reinforced class and racial divisions. Overall, the approach reflected the assumption (which family planning promoters regularly decried as incorrect) that people have many children because of “pervasive cultural and religious norms encouraging maximum child bearing, obsessive sexual patterns, and economic ideologies for the large family.”23 As the KAP (Knowledge, Attitude, Practice) studies had suggested, even in communities where large families were the norm, people were still interested in limiting their fertility provided they could do so without the opprobrium of religious or political leaders and friends and relatives.24

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The campaign failed to address the role of systemic factors such as unemployment and instead encouraged men and women to transform gender norms with their own behavior. These points echo the criticisms of the family planning community’s lack of attention to the structural inequalities that create and maintain poverty. Yet considering these efforts in the context of other international campaigns casts the media materials in a more favorable light. In fact, the Mexican government’s attempt to address gender inequalities represented some of the most progressive thinking of the 1970s and pointed toward a new vision for family planning communications that dominated the field in the years after the end of the era of population control. Family Planning on the Small Screen

Television was launched in Mexico in 1950 by entrepreneurs who had built their fortunes in radio broadcasting and film. This small group built up a vast commercial industry without any regulation by the Mexican government. Twenty years after the introduction of television, there were 4.5 million sets in the country and more than seventy television stations. By 1970, broadcasters were competing for viewers and advertisers, and the declining quality of television productions led to a public outcry. President Echeverría called for reform, objecting to the sex and violence in imported U.S. television shows. This resulted in the division of television stations equally between the public and private sectors and the requirement that private broadcasters provide socially relevant programming. The Televisa station took control of the private channels that were created when several of the stations merged. Miguel Sabido, Televisa’s vice-­president for research, was a key participant in the reform negotiations and a leading influence in the search for a more socially useful application for television.25 Sabido proposed the idea of a prosocial telenovela. While they are similar to the soap opera format that flourished on the radio in the United States in the 1930s and 1940s, telenovelas (like the Latin American radionovelas of the same era) exhibit a number of key differences that were important factors in the success of Sabido’s work.26 The programs are made up of a finite set of half-­hour episodes that span various allotments of time from three months to one year, like a miniseries. This gives the format considerable flexibility to tackle new issues with each series. The genre includes historical narratives, supernatural and science fiction tales, and, most commonly, romantic and family relationships in everyday life. The programs constitute Mexico’s most popular television format, and several are shown every weeknight in the primetime hours of 5 to 8 p.m. and 9 to 10 p.m. While one telenovela is winding to a close, others



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will be building up from their early episodes, attracting viewers who will continue watching when the series they first tuned in for comes to an end. Mexican audiences (men and women, and sometimes children) are thus likely to follow several different shows at the same time. Sabido had studied theater at the National Autonomous University in Mexico, where his teacher encouraged him to approach directing from a theoretical perspective, drawing on the fundamentals of many genres, from comedy to tragedy. He continued this approach at Televisa, where in 1974 he founded the Instituto Mexicano de Estudios de la Comunicación (IMEC; the Mexican Institute for the Study of Communication) to investigate the educational uses of television. Sabido drew on communications research from the United States but was disappointed in the consensus there about the limited effects model of media influence. Although numerous studies posited television’s negative effects (especially the impact of violent scenes on children), those investigating the benefits of the medium generally concluded that audiences selectively absorb only messages that confirm their existing beliefs. This pessimism has long frustrated supporters of entertainment-­education. Despite ongoing concerns about popular culture’s deleterious effects on everything from women’s body images to young people’s propensity for binge drinking and violence, few have taken seriously the idea that entertainment can promote valuable social messages. Many are apparently skeptical of the positive persuasive influence of popular media, perhaps because of their low opinion of its quality or the way it is used to manufacture consumerism and social compliance.27 The issue echoes a common refrain among communications researchers that although critics appreciate the power of consumer and pharmaceutical advertising, they have little faith in other uses of media persuasion to sell social values or healthy behaviors. As two of the leading scholars of the entertainment-­education approach argue, “It is ridiculous to say that television can persuade us to drink Coca Cola, and the next minute, through a soap opera, it cannot teach us.”28 Sabido’s assessment of the possible uses of television was optimistic because he had produced a series of popular historical soap operas in the late 1960s that had generated interest in Mexican history and culture. Around the same time, a Peruvian series, Simplemente María (Simply Mary), also illustrated the influential power of the telenovela format. The storyline follows María, a poor migrant to Lima who is treated badly by her rich employers and seduced and then abandoned by a wealthy man, leaving her unemployed and raising a child alone. By learning to read and taking sewing lessons, she begins to build a new life for herself, eventually making her fortune as

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a fashion designer thanks to her skills with a Singer sewing machine. After twenty years, she and her literacy teacher admit their love for one another and the two are married. No communications scholar formally evaluated the series at the time, but they have since reconstructed the history of the program and its impact with interviews of viewers, some of whom still remembered important plot details and could sing the theme song twenty-­five years after the broadcast. The series attracted extremely high numbers of viewers and had a measurable effect on their behavior, for example increasing sales for sewing machines and the demand for literacy classes. It was also a major commercial success (it generated $20 million in profits by 1977) and has since been remade at least four times. At the close of the twentieth century, Simplemente María was still known as the most popular telenovela ever broadcast in Latin America. The show was also exported to the United States for Hispanic audiences and various languages were dubbed in for international distribution. Its impact elsewhere has also been significant. In 1994, for example, the show earned the highest audience ratings ever achieved in Russia.29 IMEC studied Simplemente María and a variety of other television formats, including news broadcasts and game shows. Sabido’s first prosocial soap opera, which established his theoretical model, incorporated many of the elements that had helped to make the Peruvian telenovela so successful. Some of these factors mirrored emerging trends in family planning communications, such as the focus on indigenous production (most other telenovelas shown in Peru were developed in Mexico or Brazil) and the use of a rapidly expanding media infrastructure (television ownership was increasing rapidly in this period). During the series, the telenovela was also remade as a radio show and two-­hour film that used the same actors as the television program. This extended the reach of the series to people with access to a radio (which at the time was estimated to include the country’s entire population) and attracted new viewers, many of whom watched in groups at stores or other locations where televisions were communally available. From its conception, Simplemente María was intended for wide distribution, so no particular references were made to Peru as the location of the story (in fact, the series was originally adapted from an Argentinean program of the same name), and careful editing was done to create scenes that could represent any major city in the region. The appeal of the program across Latin America was enhanced by the inclusion of celebrities from other countries, including Mexico, Colombia, and Puerto Rico, as well as well-­respected Peruvian actors. Sabido adopted many of these techniques in his own work.30 Sabido cited Stanford psychologist Albert Bandura, the proponent of social learning theory (the idea that people learn by observing and modeling



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the behavior of others), as a key influence on his theoretical approach. Reading Bandura, he said, helped him appreciate that people could learn from the lives of media characters. The telenovela format provided viewers with both positive and negative role models who illustrated how certain behavior led to good outcomes.31 The melodramatic storyline, “a mediation between good and bad,” allowed writers to link particular behaviors to major consequences. Sabido also sought to create characters with universal appeal, drawing on Carl Jung’s theory of universal archetypes.32 The Cinderella story of Simplemente María drew on the image of the self-­made woman who achieved success through hard work, self-­reliance, and a heroic struggle against oppressive forces. Sabido’s telenovelas included characters with similarly recognizable characteristics. The format also capitalized on the viewer’s interest in the lives of others. Sabido understood that audiences did not watch shows just to know the resolution of the story. Indeed, as most telenovelas revolve around the same few narrative ideas, viewers can quite easily predict the final outcome. However, audiences still enjoyed participating in the emotional ups and downs of the narrative, speculating and commenting on the plot as it went along. Sabido described this as a fascination with “gossip” and suggested it was a useful part of human nature rather than simply the trivial pursuit of women, as it was often characterized. Sabido believed that by provoking casual chatter among viewers about the dilemmas of the characters, the soap opera “creates a climate for social change.”33 To reconcile the idea that media messages exert the greatest effects on only a small group of viewers with his sense that telenovelas could have a broad impact, he used the theory of the two-­step flow of communication laid out by sociologists Paul F. Lazarsfeld, Hazel Gaudet, and Bernard Berelson (who later became such an important figure in family planning communication).34 In this model, viewers who have absorbed the media message will communicate that idea to others, further spreading its reach. Most significantly, this understanding fused the potential power of media with the more persuasive function of interpersonal communication, bringing together both the media and the outreach elements of the diffusion-­of-­innovations model of international family planning campaigns. The key difference here is that viewers rather than trained fieldworkers played a key role in the outreach effort. This created a model of peer education. From 1975 to 1982, Sabido developed six television soap operas for Televisa based on his entertainment-­education strategy. His first, Ven Conmigo (Come with Me), was modeled on the literacy campaigns Simplemente María had generated and was intended to encourage illiterate adults to study and to

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motivate literate adults to teach others.35 He hired Celia Alcántara, who had written the original Argentinean series that had inspired Simplemente María, to develop the script. At first, the programs attempted to teach adults to read and write, but the didactic focus of the show apparently dulled the entertainment value. The production team (which included Sabido’s sister, Irene, a teacher and television producer at Televisa) changed its approach to encourage people to enroll in a national adult education program, presenting the idea that life is a school and people of any age can learn. This storyline was deeply interwoven with the various romantic plots that were typical of the genre. The revamped series gradually increased in popularity until it had exceeded the ratings of other telenovelas broadcast by Televisa. The year the show aired, enrollments in adult literacy classes were nine times higher than they had been the previous year. Sabido’s next series, about family planning, was shown five nights a week for eight months, from August 1977 to April 1978. Because the Church and the government in Mexico had encouraged large families for decades, the series needed to do more than simply inform viewers of the availability of family planning. Just as the international family planning movement had moved from information to motivation, so Sabido attempted to inspire audiences to use contraception. The three main goals were to inform couples about family planning methods and about government clinics where they were available, to motivate people to use family planning, and to induce those who already did to encourage others to do so.36 Acompáñame (Come along with Me) addressed elements of gender inequality that could stand in the way of a woman’s access to contraception. It promoted the equal status of women and the importance of improving communication between husbands and wives. The storyline follows three sisters and the impact of their different reproductive experiences on their lives. Esperanza has many children and faces an unwanted pregnancy, while Amanda uses birth control to plan her family. Martha, already overwhelmed with caring for three young children, is relieved to discover she is not pregnant again, and she and her husband decide to begin using contraception. Mirroring the messaging of the “Let’s Become Fewer” campaigns, both Esperanza and Amanda have to become more involved in decisions about their children; Esperanza’s formerly hardworking husband becomes a drunk because of the pressures of providing for such a large family and Amanda’s husband dies of cancer.37 Because the characters of these telenovelas were so true to life, audiences identified strongly with them. After Mary’s daughter-­in-­law in Simplemente María died in childbirth, several thousand Lima residents dressed in mourning



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attire attended the taping of the funeral episode. Sales of flowers and Valium increased. Similarly, when Mary finally married her loyal teacher, the church where the wedding was filmed was crowded with audience members who would not leave to allow the crew in until they were promised that they could give their wedding gifts to the (fictional) bride and groom after the ceremony. This blending of fantasy and reality became a key element of entertainment-­ education.38 The educational goals could not be achieved solely through the dramatic content of the program, however. Sabido also devised an epilogue that was presented by a celebrity at the end of each episode to summarize that program’s content, relate it to the lives of viewers, and present an action that people could take in response to the motivation the program had inspired. Epilogues to Ven Conmigo, for example, provided the address of the ministry of education, where literacy booklets were available. Two hundred and fifty thousand newly enrolled adult learners visited the address the day after it was broadcast, causing gridlock in Mexico City that lasted until midnight. Acompáñame, which was broadcast in 1975, had an immediate impact. A study of 800 adults living in Mexico City illustrated that viewers knew more about family planning methods than nonviewers and were likely to express a positive attitude toward the use of contraception. CONAPO received an average of 500 telephone inquiries a month during the series, and many callers mentioned the telenovela as their reason for phoning. Twenty-­five hundred women responded to an idea suggested in the show and registered as voluntary workers in the national family planning program.39 Contraceptive sales increased 23 percent in one year, compared to a 7 percent increase the preceding year, and more than 560,000 women enrolled in family planning clinics. Family planning promoters in the United States were impressed. After visiting Mexico at the start of the series and again after it ended, David Poindexter, who had persuaded U.S. broadcasters to integrate family planning messages in shows such as Maude, encouraged influential contacts, including U.S. senators and the director-­general of the BBC, to write to the president of Televisa in support of another entertainment-­education soap opera. Sabido went on to produce five more television series that addressed family planning and other social issues.40 Ethical Issues

Recognizing the power of face-­to-­face communication but also the reality of the lack of enough field staff, family planning promoters had long argued for “some means which will combine the intimacy of a home visit with the possible reach of a radio broadcast.” Television could offer just such a combination, and the telenovela added the emotional impact of affective storytelling.

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By uniting educational goals with entertaining approaches, Sabido thus sought to communicate emotively as well as cognitively, echoing Martha Stuart’s ideas about the use of television to change not only what people think but also what they feel and do.41 Once again, however, the strategy raised ethical concerns, especially given the unexpectedly strong effects Simplemente María and its imitators generated. Some of the criticisms included the point that the deliberate blurring of fantasy and reality may create disappointment among viewers who cannot achieve the same results as the characters they identify with in their romantic relationships or careers. Others argued that when television producers and networks want to continue a series purely for profit, educational or social goals can be quickly abandoned. Finally, some were concerned that codifying the strategy raises the possibility of misusing its power to influence viewers for negative ends. In answer to questions about the ethics of entertainment-­education, Sabido maintained that because the values he was communicating were consistent with Mexico’s constitution and the documents of the United Nations that the country had signed (presumably the declaration of the UNFPA meetings of 1974 and 1984), his work was promoting not simply his ideas but those that were sanctioned for the country as a whole.42 He used such documents as the moral framework for his approach, then constructed a “values grid” that expressed the particular behaviors each series was supposed to encourage or discourage. For his work on family planning, Sabido asked Catholic Church leaders to help devise the grid. The resulting document served as a formal statement that had been agreed upon by the religious community, the government, and the media team to guide the development of the telenovela. This strategy seems to have helped build consensus among those who might otherwise have objected to the idea of using television broadcasting to influence personal behavior. Even so, some criticized Sabido’s work for exploiting the commercial excesses of Televisa and for giving Mexico a bad reputation by showing poverty, charges that were often leveled at those who sought to use popular media to promote family planning. There were also clear limitations to the approach that modified the enthusiasm of communications theorists. A small percentage of viewers who share the opinions of negative characters, for example, will identify with them rather than the positive role models depicted and might have their prejudices reinforced rather than reformed. This phenomenon was nicknamed the “Archie Bunker effect” after the racist character in Norman Lear’s comedy All in the Family.43 Overall, however, the model’s intended impact was far more pronounced.



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Conclusion: Exporting Entertainment-­E ducation

The success of Sabido’s approach inspired numerous other entertainment-­ education efforts around the world, most of which dealt with family planning. The first project was launched in India after numerous exchanges between U.S. and Indian communications scholars and family planning advocates. In 1977, David Poindexter visited Sabido to learn about his methods. A few years later he met Inder K. Gujral, former Indian minister of information and broadcasting, at a communications conference in Strasbourg, France. After visiting India several times at the invitation of Gujral and his successor, S. S. Gill, Poindexter and Sabido held various workshops to teach the entertainment-­education strategy to Indian media professionals. The resulting series, Hum Log (We People) was broadcast in 1984.44 Although the seventeen-­ month series eventually achieved an unprecedented 90 percent share of the television audience, early episodes were far less popular. Feedback from forty viewing clubs complained that the storyline, which featured the differing perspectives of three generations of a family, was developing too slowly, that the messaging was heavy handed, and that poor acting and violent situations were spoiling the series. In response, writer Manohar Shyam Joshi spiced up the narrative with a subplot about corruption and broadened the family planning messages to address themes about the status of women, family harmony, cultural pluralism within the country, and the importance of Indian heritage. The series promoted the idea that the different religious groups in India could coexist and that the caste system was unfair and posited a shared Indian identity in opposition to Western values. In just one example of how audiences ignored or reworked the intended messages of the series according to their own beliefs, many viewers instead saw Indian identity as a mixture of Eastern and Western traditions. About 60 million people tuned in to an average broadcast, the largest ever to watch a television program in India at the time. A survey of 1,170 adults reported that 96 percent of those who had watched at least one episode liked it, 94 percent said it was entertaining, and 83 percent said it was educational. Even in the south of the country, where fewer viewers watched because they did not speak Hindi, the language of the broadcast, an overwhelming majority of those who were interviewed expressed their enthusiasm for the series. The producers and actors received 400,000 letters. Entertainment-­education soap operas often generated thousands of letters from viewers including many that suggested storylines and commented on the script. In response to this investment

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made by audiences, writers regularly incorporated their suggestions and gave more screen time to the most popular characters.45 The success of Hum Log can be traced to some of the same factors that were critical to the reception of Simplemente María and Acompáñame. Within three years of the launch of the series, the number of television sets in India doubled from 3.5 to 7 million and viewership rose from 37 to 60 million (fig. 10). Although melodramas were popular in India’s flourishing film market, Hum Log was the first soap opera that was broadcast on national television. In the following years, the genre dominated entertainment in this medium. The series thus exploited the novelty of the format in India and helped establish it as a commercially successful genre there. By 2004, over 200 entertainment-­education initiatives had been developed in more than twenty countries worldwide. Most were broadcast on radio or television in Latin America, Asia, and Africa and used the soap opera format. At least six agencies that received U.S. funding had become involved in the use of the technique to promote reproductive health, including the Academy for

Figure 10  A rural community in India watches the television, n.d. The poster above the television set appears to show an image of a woman and child, presumably advertising family planning. Original caption: “The silver screen flickers in the Indian night. Television can convey a particularly vivid health message, but in most developing countries television sets are rare outside the large towns.” Source: WHO/UNESCO.



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Educational Development (AED), Johns Hopkins University/Population Communication Services, Population Communications International (PCI), and the United Nations Children’s Fund (UNICEF).46 The vast array of entertainment-­ education productions they produced follow Sabido’s strategy and are couched in melodramatic narratives that feature role models and characters whose bad behavior and its consequences serve as a warning to the viewer. Although they have this in common with much of the messaging in media previously developed by the birth control movement—­from the films of the early twentieth century and the radio soap operas of World War II to the Disney cartoon and the Yoruba folk drama—­Sabido’s innovation also reintroduced a key ingredient that had long been missing from such material—­sex (see fig.11). As J. Mayone Stycos argued in 1977, “Just as modern advertising has spent the last half-­century infusing the subject of sex into areas where it has no business, family planners have been busily eradicating sex from the one place where it uniquely belongs.”47 From the first films that dramatized the threat of overpopulation to motivational movies that encouraged individuals to have fewer children, media producers working with the largest groups in the field, including the IPPF and USAID, limited their arguments to the economic benefits of smaller families rather than discussing the sexual freedom that contraception

Figure 11  Sex returns to the stage in the promotion of condom use to prevent HIV

transmission and pregnancy in theater for adolescents, Rio de Janeiro, Brazil. Original caption: “The theatre for Adolescents, in Rio de Janeiro, Brazil. Drama is an excellent vehicle for information about HIV/AIDS. Besides being particularly effective at holding an audience’s attention, it is often an acceptable way of bringing up sensitive or taboo issues that people find hard to talk about in other settings.” Source: WHO/A. Waak.

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could make possible. The success of the family planning telenovela may well reflect its particular suitability for the subject of contraception because the storylines of the genre center on sexual relationships and family life. As I explore in the concluding chapter, the use of entertainment media thus allowed family planning promoters to escape the elision of sexuality that had come to define birth control broadcasting.

Chapter 6

Twenty-­First-­Century Sex The Small Screen

Thanks to the use of sex in commercial broadcasts, entertainment media has offered a wealth of opportunities to incorporate family planning messaging over the last forty years. In the 1970s, researchers studying television began reporting that the number of references to sex was increasing each year in network programming. In the 1980s, the types of representations changed from allusions to sex or sexual innuendo to direct depictions of sexual acts. Even as the culture wars raged, the amount of sexual content on television continued to rise steeply. Studies recorded an average of ten portrayals of sex per hour of prime-­time television in the 1990s, and the age range of people who were depicted engaging in sexual activity increased to include high school and college-­age characters. By the year 2000, two out of every three shows included sexual material, creating a steady stream that was supplemented by commercial advertising. Yet the vast majority of these depictions excluded any mention of contraception or any possible consequences such as pregnancy or the spread of sexually transmitted diseases.1 Recognizing the potential in this trend toward sexualized programming, family planning promoters continued to nurture entertainment television as a core element of their media strategy in the years following Martha Stuart’s discussion series Are You Listening? and Norman Lear’s episodes of Maude. Unlike the Advertising Council campaign developed by Planned Parenthood, which had been cleansed of any sexual references, representations of sexual relationships were rampant across a wide range of entertainment television programming, including comedies, romantic storylines, and dramas. In addition, television occupied an increasingly important place in the lives of Americans.

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From the 1950s to the 1980s, the average number of hours of television watching within American households rose from thirty-­two to fifty hours a week. Even in the early years of the twenty-­first century, although its use is increasing rapidly, the Internet has not yet replaced the television. In 2002, just 16 percent of young people had a computer in their bedrooms, while more than half had a television. This makes prime-­time programming especially significant for adolescents, who receive a great deal of information about sex and relationships through entertainment broadcasting.2 Although television was used to promote family planning to adult viewers in the 1970s, public health advocates increasingly called for contraception promotion targeted toward adolescents. As the medium came under fire from critics on both the left and the right for promoting a distorted picture of sexuality to ever younger audiences, health professionals lobbied for depictions of responsible sexual behavior. Without a model for collaboration, however, television writers and producers who were interested in the issue worked independently of family planning promoters. The latter occasionally provided some encouragement but little practical advice. Members of the entertainment industry could develop messages to satisfy their own creative goals and were likely to be perceived by audiences as independently pursuing the subject. Yet few industry insiders jumped into the field at first. In 1978, Planned Parenthood began honoring media producers for their coverage of family planning issues with a Maggie Award (named for their founder Margaret Sanger). The first award focused only on entertainment television and was presented to Tandem/Tat Production House for episodes about teenage pregnancy on the sitcoms One Day at a Time, Good Times, and In the Beginning. Norman Lear had developed all three shows for CBS and he was the forerunner in the field until the 1980s. By then, the idea of using television to deliver messages about birth control generated little controversy among viewers; 78 percent thought it was an appropriate vehicle for such information. Planned Parenthood presented several Maggie awards annually across the full spectrum of media channels, including print, radio, and film as well as television, and for a wide variety of approaches, from documentary and news coverage to entertainment. Lear had left CBS early in the decade to cofound the advocacy organization People for the American Way, a nonprofit group established to counter right-­wing Christian evangelism. Following his departure, NBC surged ahead of CBS in the honors and won the majority of Maggie awards in the entertainment category, for episodes of the sitcom Family Ties in 1983 and 1984, the hospital drama St. Elsewhere in 1986, the miniseries A Year in the Life in 1988, and A Different World, a spin-­off from The Cosby Show, in



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1989. The following year, A Different World became one of the first network shows to address the HIV/AIDS epidemic.3 Despite the increasing coverage of the subject on some shows, self-­censorship by television executives and conservative pressure continued to restrict the promotion of contraception. The National Association of Broadcasters rescinded its ban on contraceptive advertising in 1982, but media outlets were slow to take advantage of the new opportunities. Well into the 1990s, even after the onset of AIDS, Fox was the only major television network to allow condom advertising in public service announcements, and only then if the commercials emphasized disease prevention and not the contraceptive properties of the condom. In 1995, the American Academy of Pediatrics released its first policy statement criticizing harmful and excessive depictions of sexual behavior. The academy asked broadcasters to adopt its recommendations for responsible content, including on the topic of contraception. It stated, “There is a major disconnect between what mainstream media portray—­casual sex and sexuality with no consequences—­and what children and teenagers need—­straightforward information about human sexuality and the need for contraception when having sex.”4 Media industry leaders cited public opposition as their motivation for self-­censorship, despite poll data that showed that an overwhelming majority of Americans supported the discussion and advertising of contraception on television. Vocal conservative groups were likely the reason for broadcasters’ hesitation. These groups were engaged in a broad campaign to promote complete abstinence for young people and attacked sex education programs in schools.5 At the same time, of course, television writers continued to traffic heavily in sexual imagery, language, and scenarios, without much attention to the possible consequences of sexual activity for their characters. In an effort to redress this imbalance, and inspired by the work of Miguel Sabido on prosocial telenovelas in Mexico, Population Communications International (the organization focused on family planning promotion that David Poindexter founded) launched a series of meetings in Los Angeles and New York in the mid-­1990s to promote sexual health messaging in television soap operas.6 As a result of these soap summits (as they were known), storylines on teen pregnancy and HIV/ AIDS were developed on General Hospital and One Life to Live. The writers of CBS entertainment’s The Bold and the Beautiful also worked with advisors at the U.S. Centers for Disease Control (CDC) to develop a narrative about a character who discovers he is HIV positive. The episodes won a Sentinel Health Award for Daytime Drama from the CDC, another initiative that was designed to encourage the use of health messages in entertainment media. In 2002, the federal agency formalized its collaborative work with the film and television

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industries by partnering with the Hollywood, Health & Society program at the University of Southern California’s Norman Lear Center to advise broadcasters on health messaging in entertainment media. Program staff continued to offer story ideas and factual information, but they left the creative work to broadcasting professionals, just as family planning promoters had relied on Lear and Sabido to develop an engaging media experience decades before. By the end of the twentieth century, after more than thirty years of organized efforts in Hollywood to promote the representation of family planning in the media, contraception had begun to appear more regularly, yet still in only a minority of productions. Although 67 percent of all prime-­time network shows featured sexual topics in 2000 (including an average of five scenes on the subject every hour), just 9 percent of the storylines related to sex included any reference to contraception or the possible consequences of sexual activity.7 That year, a major shift in attitudes was reported by The Media Project, which had been launched in 1980 by the Washington, D.C.–­based nonprofit Advocates for Youth to promote sexual responsibility in media broadcasts. The organization declared that industry professionals at all levels were increasingly willing to tackle the issue.8 As the director of the project summarized, “Writers, producers, and network executives are beginning to understand the teen audience and are beginning to assume some responsibility for providing them with accurate portrayals of many tough issues, including sexuality.”9 By this time, The Media Project had become one of several organizations working with the entertainment industry and was able to quickly respond to the new favorable climate. Operating on a relatively small annual budget of $325,000, the organization collaborated on numerous popular shows, including Dawson’s Creek, The Practice, Ally McBeal, Chicago Hope, Judging Amy, King of the Hill, Boy Meets World, and Moesha. These programs were broadcast by a range of networks and cable companies, from ABC and CBS to Lifetime, Fox, and UPN.10 The organization also handed out SHINE awards (for Sexual Health in Entertainment Media) to writers and producers and organized panels of young people to talk to creative teams about their own experiences and attitudes toward sex and contraception, providing both information on current trends and a test audience for industry professionals.11 By 2004, more than 100 shows a year were contacting the group for a consultation.12 As a result of these kinds of collaborations, the proportion of representations of young people engaging in sexual intercourse on television has remained steady since 1997–­1998, at around 3 percent, even as depictions of sex have continued to increase. Moreover, the number of young adults (aged seventeen to twenty-­four) depicted in sexual situations has decreased. Therefore, although viewers are more likely to see sex on television, the characters involved are less



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likely to be teenagers or young adults. The shift is especially significant given that young people are thought to identify more closely with young characters. Moreover, shows that are most often watched by teenagers give more attention to the consequences of sexual activity than television does overall.13 The efforts of a diverse community of public health professionals, health communication experts, family planning promoters, and media figures have thus successfully reintroduced birth control broadcasting into mainstream media. The public health community is well aware of the ethical questions raised by these attempts to influence programming, and articles on health communication practices frequently refer to concerns about interfering with broadcasting. Family planning promoters argue that the media is independently engaged in messaging that may be detrimental to health. As one study noted, “television has become a sex educator to America’s children,” often without complementary comprehensive sex education provided by teachers or parents, even as sexual content permeates the culture.14 Given this reality, they argue, it is ethical to engage in messaging that warns people of the risks and responsibilities of sexual activity. In addition, there is no evidence that greater sexual knowledge or access to birth control increases the likelihood that young people will have sex at an earlier age.15 Some programming, such as the TLC documentary Let’s Talk about Sex, which launched in April 2011, has been developed specifically to address the challenges of living in a highly sexualized culture with little access to comprehensive sex education. Since the 1980s, studies have found that teenagers regularly report that television and the media more generally are their primary sources of information about sex. At the outset of the twenty-­first century, teenagers aged fourteen to eighteen watch an average of two and three-­quarter hours of television daily. By the time students graduate from high school, they will have spent 15,000 hours watching television but only 12,000 hours in the classroom. Sex is pervasive in the programs these young people watch and has become a part of life for many. The United States has the highest teen birth rate among the fully industrialized nations, although the rate has slowly declined over the last twenty years. Teens are especially vulnerable to sexual coercion or assault and have the highest rates of sexually transmitted diseases. The American Academy of Pediatrics is convinced that representations of sexual activity on television are influential and damaging, and in 2001 and again in 2010 revised its 1995 policy statement on Contraception, Sexuality, and the Media to assert an increasingly urgent call for reform among broadcasters.16 TV Morals

Despite the progress that has been made in getting birth control on the air and in coupling contraception with representations of sexual activity, broadcasters

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will only go so far. Entertainment-­education strategies must complement the concerns of the broadcasters interested in developing them. Communications specialists know that it is easier to persuade producers and writers to tackle a topic before a show is successful. When a program becomes a ratings hit and broadcasters can charge higher rates for the commercial advertising breaks in that time slot, they are less likely to be interested in experimenting and less willing to risk offending sponsors. When a program does take on the issue of contraception, a storyline that begins provocatively is often resolved in a more traditional way. In the late 1990s, The Media Project worked with the creative team of the WB drama Felicity on an episode about birth control in which the lead character (and the viewers), were shown the correct way to put on a condom. Felicity, a first-­year college student, later decides that she is not ready to have sex with her older and more experienced boyfriend Noel, who is completely supportive of her decision. A few episodes later, thinking that Noel has left her to reunite with his previous girlfriend, Felicity loses her virginity to another student she hardly knows. She wakes up remorseful and tells Noel, leading to several episodes in which they struggle to come to terms with what happened. The sexual act was not represented, but when she is asked if she was “safe,” Felicity answers “of course,” implying that her partner used a condom. Although contraception makes it into the storyline, it is in reference to safe sex, meaning the prevention of disease, rather than the prevention of pregnancy. The choice to have sex is presented as a decision to regret, one that has negative consequences for the central character. The writers were able to use the idea of sexual debut to build dramatic tension, draw out the romantic plot, and include sex in the story, even though the takeaway message of this story arc leans toward abstinence as the better choice. In a similarly problematic example of the ways that family planning messages are used to advance dramatic storylines, an episode of the sitcom Friends that featured the topic of condoms may have done more to undermine condom use than promote it. Rachel and Ross, whose on-­again, off-­again relationship forms the main romantic plotline of the series, discover that Rachel is pregnant after a single sexual encounter. The characters state repeatedly that they used a condom. The show was the most watched program on television at the time the episode aired, particularly among young people aged twelve to seventeen, 1.67 million of whom tuned in for the episode about condom failure. Most interpreted its message as “lots of times, condoms don’t prevent pregnancy,” even though the statistic that condoms are 97 percent effective is repeated twice. Audience testing found that young viewers who discussed the episode with a parent received additional messages from them about the value



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of using condoms to prevent sexually transmitted disease and as an effective form of contraception. In contrast, viewers who did not talk to a parent about the program were likely to underestimate the efficacy of condoms. While the writers may have hoped that the episode would encourage young people to delay sexual activity, it may have decreased the likelihood that some viewers would use condoms at all. It seems that the writers of Friends were far more interested in the dramatic and comedic potential of sex-­related storylines than in any serious attempt to use them to convey a useful message.17 Although anti-­abortion critics charge the media industry with a liberal bias, in fact, broadcasting on that issue is also remarkably conservative. As feminist author and cultural critic Barbara Ehrenreich noted in a 2004 article that linked the suppression of abortion narratives on television and increasing restrictions on abortion, “Abortion is legal—­it’s just not supposed to be mentioned or acknowledged as an acceptable option.” In many television plots, a character considering an abortion often changes her mind and decides to have the baby or reveals her regret about having an abortion to another character. Alternatively, the character has a miscarriage, which relieves her of the decision. In guidelines for broadcasters, Advocates for Youth specifically advises against this commonly used device: “Miscarriage should not be used as a dramatic convenience for resolving an unwanted pregnancy.”18 The Limits of Family Planning Programming

The television industry has made some concessions to those who request responsible sexual programming. Researchers who study the impact of television have compiled increasing evidence that media depictions of sexuality can affect young people’s attitudes and behavior in very damaging ways. Yet health communication professionals disagree about both the most effective strategies for countering this cultural assault and their estimation of the actual impact of any program on the target audience. An MTV reality show based on the experiences of four young women who became pregnant at sixteen called 16 and Pregnant and its follow­up, Teen Mom, has generated criticism from social commentators for glamorizing the experience of teenage pregnancy by making the cast members into celebrities. Some have even suggested that girls are getting pregnant just to be on the show. Yet a spokesperson for the National Campaign to Prevent Teen and Unplanned Pregnancy claims that the series send a powerful message about preventing pregnancy. This organization has distributed 3,000 DVDs of the program and companion guides to chapters of the Boys and Girls Clubs of America. Other supporters comment about the depressing lives of the characters, and argue that this reality is a deterrent. As one journalist concluded, “no pamphlet or public

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service ad is more likely to encourage birth control than these MTV tableaus of maternal boredom, fatigue and loneliness.”19 While there is wide support in the public health community for the idea that the media plays a negative role in our society, skepticism endures about any positive role broadcasting might have. Admittedly, many entertainment-­ education initiatives have been undertaken without a comprehensive evaluation of potential impact. Some critics argue that the saturated media landscape of the United States makes such studies impossible or invalid. Communications experts appear to be caught between the need to prove the efficacy of their approach and a reluctance to admit that the media can influence the public just as advertising does. Even as they critique and counter negative or inaccurate messages, they rarely publicize the successful inclusion of positive messages in entertainment media in venues beyond scholarly publications for the public health community. This is particularly true of family planning messaging, which is more controversial than information related to the prevention of drunk driving or heart disease. In fact, health communication activities seem to operate somewhat surreptitiously in the United States. Of course, exposing the deliberately and carefully integrated messages that are hidden in popular programming is also likely to undermine its efficacy for audiences, who may resent attempts to turn their entertainment into didactic education. Some critics of entertainment-­education assume a high level of sophistication among viewers because of their exposure to a wide variety of media and argue that these audiences may be more skeptical of deliberately educational programming. U.S. viewers often claim that they expect the media to influence children and others around them but consider themselves immune from these effects. Yet even though the U.S. media market differs from emerging markets in other countries in its degree of fragmentation and sheer breadth of available broadcasting, it turns out that U.S. target audiences may not be as unique as communications scholars once thought. In fact, the entertainment-­ education approach is valued in the United States for the same reasons that it has been successful in so-­called developing nations: it can reach a wide audience, many of whom have limited access to health care, “pay less attention to print and broadcast news, and have more difficulty understanding what they read.”20 Such audiences may not exhibit the awareness of messaging that is often assumed of people with exposure to such a broad array of media.21 Indeed, a significant proportion of health communication work is done to correct the myths disseminated by commercial media, from misleading drug advertising to incomplete news coverage of scientific discoveries and dramatic exaggerations of medical situations for entertainment value. Evidence shows that audiences gather health-­related information from such untrustworthy sources.



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Most damaging is the charge that while entertainment-­ education can increase awareness and effectively deliver information, it can do little to foster long-­term changes in behavior. With media professionals reluctant to give over more than a small fraction of entertainment programming for education purposes, health messaging is likely to be quickly forgotten and perhaps is even undermined by contradictory representations within the programming of a television network or sometimes even on the same program. The beneficial effects of brief episodes of entertainment-­education may thus be short lived. Evaluations of the hospital drama ER after one episode about date rape and the morning-­after pill found that awareness of emergency contraception increased by 17 percent for several months. Yet it is only rarely that a television series will incorporate a long-­running storyline on a sexual health topic.22 The ability to act on information provided in birth control broadcasting may also depend on broader changes in society, not simply access to information about contraception and encouragement to use it. Sabido and his colleagues argue that “affective” broadcasting can change behaviors, not just inform viewers: “Witnessing the death from AIDS of a favorite soap opera character, and seeing the grief of his parents, infected widow, and child, may serve as a more powerful trigger for adopting a prevention behavior than rationally-­ structured media messages promoting condom use and other safer sex behaviors.”23 Although there are significant social obstacles to contraceptive use, including inequalities in relationships; embarrassment, fear, or nervousness; and difficulty obtaining reproductive health services, the media might be able to provide some tools for navigating sexual activity in the real world. One study has found that 60 percent of teens said they learned how to say no to a sexual situation from watching television, and 43 percent said they learned something about how to talk to a partner about safe sex. In a follow-­up survey of girls aged twelve to twenty-­one who watched the episode of Felicity about condom use, 35 percent said the demonstration was the first they had ever seen, although only 26 percent responded that they learned something new. Eighty-­six percent said that teens receive helpful information about such topics from television.24 A modified version of the entertainment-­education strategy has been used in the United States since the 1970s for a wide range of health issues that include early cancer screening, responsible drinking when driving, and the prevention of heart disease. However, the development of an entire television series to tackle a specific topic, such as Acompáñame or Hum Log, has not proven popular with commercial broadcasters, who are skeptical of the entertainment appeal of a primarily educational production. Instead, communication specialists work with writers and producers to introduce messages into existing productions, just as family planning promoters did with the narratives of abortion and vasectomy

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on the television program Maude in the 1970s. In those days, health messages were most usually confined to educational programs that addressed a related topic, such as the after-­school specials known informally as disease-­of-­the-­week shows.25 Today a much wider variety of broadcasting is suited to such messages, from hospital dramas and dramatic reconstructions about serious illnesses, injuries, and childbirth to talk shows and reality TV programs focusing on weight loss, phobias and addictions, and teenage pregnancy. Health communication professionals have capitalized on the popularity of health-­related broadcasting to promote their agendas, to counterbalance images on television programs of unhealthy activities such as smoking and drinking, and to correct misrepresentations of medical issues. For their part, broadcasters are happy to mine medical plotlines to satiate the appetites of their audiences for such material. They draw on the advice of health communication consultants to generate new ideas for topical storylines and to ensure the accuracy of their portrayals—­although they do not always incorporate the advice that is given. Entertainment-­education is likely to continue to play a central role in the future of health communication. Programming that can promise commercial success is much more likely to secure airtime (and audiences) than programming that relies on slim or nonexistent regulations and incentives to motivate broadcasters to feature educational content. Traditional educational strategies are also unlikely to make a major impact in the increasingly diverse commercial cultural landscape. This invests strategies like the ones Miguel Sabido used and those woven into the background of U.S. broadcasting with even greater significance. As communications scholars note, “Limited resources for health education and promotion provide little hope that the sophisticated, pervasive advertising messages, often based on emotional appeals, will be overcome by limited quantities of rational, factual materials.” Broadcasts that can attract devoted audiences and inspire viewers to modify their behavior may offer the best hope for health education media in the United States and elsewhere.26 A growing global market for U.S. culture has enabled entertainment-­ education produced in the United States to cross international borders. While many nations have undertaken their own media campaigns to promote contraception and other public health or prosocial messages, audiences also tune in to dramas produced in the United States that contain family planning storylines. The Bold and the Beautiful, for example, has an estimated 300 million viewers in 110 countries, including Egypt, India, China, the Philippines, and Uganda.27 Successful projects first undertaken in the United States can thus have a major international impact. The international applications of entertainment-­ education are particularly significant, given declining U.S. federal funding for



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family planning promotion abroad. Indeed, at the same time that the government began pulling back from such international efforts in the 1980s, U.S. commercial media was proliferating in other countries as the largest broadcasters consolidated their dominance globally. Contraception and the World Wide Web

The Internet is also a major factor in the diversifying landscape of media sources that can cross international borders. Like the “intimate public” created by the reach of radio, the World Wide Web offers a private experience for a large group. In fact, the medium provides an affordable platform from which to target multiple streams of messages to different communities. In many interactions between family planning promoters and Internet users, individual web surfers are online specifically to find such information and so are likely to be reached at an opportune moment, when they need or are especially receptive to information. Young people in particular, who can be isolated from health care services, may benefit from this easy access, although libraries and school districts are increasingly attempting to restrict sexual content in websites that are accessible on their computers, which may also screen out public health messaging. The Internet creates opportunities for discrete and sustained discussion and support among peers in venues that include message boards, chat rooms, e-­mail, and blog commentaries. The ability to preserve privacy is particularly important; more than 80 percent of young men and women cite confidentiality as the primary reason for searching online for information about sexual health.28 The Planned Parenthood Federation of America launched a comprehensive website for teenagers, www.teenwire.com, in 1991, and numerous other initiatives are aimed at young audiences. But the fastest-growing area of family planning promotion comes from outside organizations dedicated to reproductive health. In fact, Planned Parenthood and the issues of contraception and abortion have become a motivating force for independent media activities that both attack and defend the work of the family planning movement. The phenomenal polarization of the politics of birth control in the United States is thus contributing to a new wave of media in the twenty-first century. Unprecedented access to production tools such as digital video and editing software and inexpensive and wide-reaching technologies and social media platforms for disseminating media such as podcasts and video downloads have led advocates of family planning to develop their own broadcasts that promote sex education, contraception, and access to abortion. In 2011, Wesleyan Uncut, a student group at Connecticut University that promotes the discussion of sexual issues on campus, created a video called “I

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Have Sex” that garnered almost 210,000 views on YouTube and 23,000 followers on Facebook within a week of its release. After a screening of a documentary about illegal immigrants in the United States, students gathered to discuss effective social activism. Conversation turned to a recent and contentious congressional budget debate, and in particular an attempt to cut all federal funding for Planned Parenthood. This was proposed by Republican Mike Pence in the Title X Abortion Provider Prohibition Act that the House of Representatives had passed in February of that year. Although the Senate voted down the amendment in early March, the initial support for the measure signaled the escalation of anti-­abortion strategies in mainstream politics, fostered by the rising influence of right-­wing fringe groups such as the Tea Party. In response to the act, the student group developed a short film, which consists of clips of students holding up signs declaring “I Have Sex,” “My Friends Have Sex,” or “I Don’t Have Sex, But I Plan To” along with other statements about reproductive health. The signs are interspersed with subtitles asserting the importance of treating young people like adults, educating them, and allowing them to protect themselves. The group received Planned Parenthood’s Walk the Talk Award in recognition of the impact the video had in publicizing the Title X Abortion Provider Prohibition Act and in galvanizing opponents to voice their disapproval to their congressional representatives.29 Today, individuals and groups working outside Planned Parenthood have the freedom Martha Stuart sought in the 1980s to approach the issue of family planning and abortion rights from any angle they like. Wesleyan Uncut, for example, linked the attempt to end government funding for Planned Parenthood to a critique of corporate bailout packages and tax breaks for the oil industry. Although this diversification of messaging might not appeal to Planned Parenthood’s communications team, the organization’s identity is so clearly tied to women’s health and abortion rights and its own messaging strategies are so clear that independent media producers have easily replicated the tone and content of the organization’s own efforts. Instead of diluting their message, other projects like this one reinforce the core communications strategy of Planned Parenthood while at the same time expanding it for diverse audiences. For example, Wesleyan Uncut incorporated the organization’s official rebuttal to the proposal to cut funding (supporters “stand with Planned Parenthood”) in its film. The phrase echoes around the web in a variety of other media generated in the same period. Of course, Planned Parenthood cannot control the messages generated by others or prevent nefarious uses of its approach to communications, but by the same token, the organization can legitimately distance itself from work produced and circulated by others.



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The Internet can also be used to mobilize the support of individuals and promote the production of more media coverage. Planned Parenthood deftly illustrated the power of online protest early in 2012, when it channeled a firestorm of controversy over a breast cancer charity’s attempts to stop funding the organization. Social media commentators have variously described the incident as “a case study in how radically social media have changed the way institutions relate to those they purport to serve,” an illustration of how “social media can change the national conversation with head-­snapping speed,” and “a communications debacle” for the charity involved, the Susan G. Komen for the Cure foundation. In response to pressure from anti-­abortionists, including a recent appointee to their organization, Susan G. Komen for the Cure instituted new rules that included withholding funding from groups under congressional investigation. Planned Parenthood, which had become the subject of such an investigation as a result of a separate attempt to undermine their activities from within the government, was informed of the Komen foundation’s decision in December 2011. The Associated Press reported the story at the end of January 2012 in an interview with Planned Parenthood. Immediately, Planned Parenthood sent out a fund-­raising e-­mail to its mailing list that informed subscribers that the money that would be lost was used to finance breast cancer screening for low-­income women. People responded to the clash swiftly on Twitter and Facebook and at one count, such responses ran at eighty to one in favor of Planned Parenthood. Susan G. Komen for the Cure did not join the online debate until mid-­morning the next day, when the foundation posted a message to its supporters on Facebook, followed by comments via Twitter and a video statement by Nancy G. Brinker, CEO of the organization, later that night. Brinker defended the decision to withhold funding from Planned Parenthood and stated that the abortion issue had nothing to do with it. The foundation’s initial silence meant that Susan G. Komen for the Cure missed an opportunity to try to placate the swelling ranks of former supporters who were outraged by the decision. Brinker’s denial of the role of abortion politics in the controversy also proved unconvincing. A media frenzy ensued as news outlets and bloggers picked up the story and advocates for women’s health care began to speak out independently of either organization. Just days after the announcement first appeared, a woman with the account name “LindainLasVegas” uploaded a home movie to YouTube entitled “What Breast Cancer Is, and Is Not.” In the video, which the amateur filmmaker apparently made in her kitchen, Linda appears wearing a bathrobe, and as she describes the many treatments she has undergone for breast cancer, she shows the scars from her double mastectomy. The segment ends with her declaration that breast cancer

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is not political and that she can no longer support the Komen foundation. The video quickly attracted a large audience and was picked up and promoted by Arianna Huffington on the high-­profile Huffington Post website.30 Social media sites attracted personal statements from people who had participated in fund-­raising events for Susan G. Komen for the Cure and were now renouncing their affiliation with the organization. Some stated that while they would never personally choose an abortion, they did not agree with interfering in the reproductive choices of others. The organization’s managing director of community health programs resigned because of the attempt to cut Planned Parenthood’s funding, and even local affiliates of the foundation broke with national headquarters and publicly stated their disapproval. Three days after the story made the news, the Komen foundation issued an apology and a reversal of its position. Although anti-­abortion groups condemned Planned Parenthood for manipulating the media (as they saw it), some of these critics also suggested that “pro-­ lifers need to learn” from its example.31 These commentators, like some social media analysts, saw the incident as an education in media strategy, implying that controlling the message was the key to Planned Parenthood’s success. Yet the lesson that the fallout provided is far more potent. The imbalance in the response was clearly apparent. Few stepped in to fill the void created by the Komen foundation’s initial silence in order to defend the decision, and few were mobilized to defend the foundation once its spokespeople began to respond. The disparity was profound, despite the Komen foundation’s large pool of donors and the various groups that oppose abortion across the country. It is still inexpensive to broadcast on the Internet, and that medium is not yet dominated by large corporations with limited interest in controversial topics. Web contributors were thus able to quickly and decisively demonstrate widespread support for family planning, including access to abortion. Abortion: From Private Shame to Public Fame?

The World Wide Web is a powerful magnifier of the personal testimonial, transmitting the experiences of individuals far and wide in an instant. Family planning promoters have long recognized the value of sharing testimonials as a way to build support for their cause, from the letters published in Sanger’s Birth Control Review to the discussion groups of Martha Stuart’s television series Are You Listening? This strategy has been used repeatedly in the effort to preserve access to legal abortion in the United States. In 1972, before abortion was legalized nationwide by Roe v. Wade, the feminist magazine Ms. launched a petition called “We Had Abortions” in which fifty-­three well-­known American women



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stated that they had undergone the procedure. The list was published in the magazine’s first issue. In 2004, in response to a growing right-­wing campaign against abortion, feminist author Jennifer Baumgardner created a T-­shirt that featured the statement “I had an abortion” for the annual reproductive rights March for Women’s Lives in Washington, D.C. The T-­shirts were sold on the Planned Parenthood website and were featured in a book and a film of women talking about their abortion experiences. Baumgardner explicitly linked her campaign to the history of broadcasting personal testimonies in the birth control movement. Women were talking about their abortions when abortion law was reformed, she argued, and now that they were silent reproductive rights were in decline: “If more women are honest about their abortions, it will be harder to take away that right.”32 In interviews about the design, many pro-­ choice women considered a declaration on a T-­shirt to be celebratory and therefore inappropriate. They also thought it was likely to inflame opponents and damage the campaign for comprehensive reproductive health services. “The whole purpose of abortion rights,” one interviewee said, “is to ensure that a woman can make her own decision about her body, in private, without having to seek permission from anyone else—­not even her partner.” By making the practice public, the T-­shirts undermined the concept of a claim to privacy and potentially suggested that the decision to have an abortion was open to scrutiny and possible restriction.33 Planned Parenthood staff in regional chapters in Georgia, Idaho, North Carolina, and South Carolina criticized the campaign. Despite the controversy (and, most likely, because of the attention it generated for the pro-­choice position), Ms. magazine revived the T-­shirt campaign in 2006, and Baumgardner relaunched it in 2012 during the election season, when politicians made abortion a central issue in the contest for the Republican nomination for the presidency. As anti-­abortion groups have intensified their efforts to restrict services in states across the country, women in certain regions, particularly in rural areas or those without clinic facilities, have found it increasingly difficult to gain access to abortion. In response, personal testimony in support of legal abortion has surfaced in a wide variety of online forums, from a book of narratives titled Voices from Home: Stories of Planned Parenthood Patients that Planned Parenthood published online to the website My Abortion. My Life that is sponsored by a clinic that provides abortion care in Cleveland, Ohio. These examples and numerous personal accounts posted on Twitter and YouTube are part of a widespread movement to destigmatize abortion by making the private decision publicly known.34

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Conclusion

In keeping with the long history of birth control broadcasting, the media is a primary battleground in the latest culture war over women’s reproductive health in the United States. The representation of the history of the family planning movement has itself become an area of struggle. In an effort to discredit the campaign to legalize and promote access to contraception, opponents circulate distorted narratives of the activities of Margaret Sanger and her supporters online and in the press. Planned Parenthood has made limited use of its history to correct these inaccuracies, putting fact sheets that counter the accusations online, for example, but focusing major media efforts on contemporary battles instead.35 However, the Internet has given people outside the organization an opportunity to develop their own media to declare their support for family planning and access to legal abortion. In addition to campaigns coordinated by advocacy groups that support or oppose family planning and abortion, individuals have struck out on their own to promote their own perspectives on the issues. Many of the media projects that have resulted are based on personal experience but go beyond a simple testimonial to include media-­savvy communications strategies for greater impact and wider distribution. Some reappropriate popular culture or critique media coverage of the issues, while others incorporate historical materials or refer back to the campaigns of earlier years. The Margaret Sanger Papers Project, sponsored by the department of history at New York University, has published a series of volumes of Sanger’s letters and speeches and has also digitized much of the archival material and made it available for free online. This provides a valuable resource for visitors who want to learn whether the accusations made against Sanger and the family planning movement are accurate and those who are interested in sharing that history with others in online debates about the intentions and activities of family planning promoters. Together, these efforts constitute the latest phase of a media strategy begun at the outset of the birth control movement’s twentieth-­ century campaign. Since then, family planning promoters have used the mass media to bring debates about contraception and abortion to a broad and diverse public. In the twenty-­first century, with access to reproductive health services still not guaranteed in the United States, new media projects proliferate in every format, from movies to music, in conventional broadcasting and online. The diffusion of information through television depictions, Internet videos, Twitter updates, and blog posts ripples outward to a widening audience. While the family planning movement may have relinquished control over much of this publicity, its cause continues to benefit from a decentralized community that broadcasts birth control messages in a variety of media.

Notes

Chapter 1—Introduction

1. Beth Widmaier Capo, Textual Conception: Birth Control and Modern American Fiction (Columbus: Ohio State University Press, 2007). On the marketing of new contraceptive technologies, see Elizabeth Siegel Watkins, On the Pill: A History of Oral Contraceptives 1950–­1970 (Baltimore, MD: Johns Hopkins University Press, 1998), chapters 2–­4. For an earlier study of the role of the news media, see Cynthia Goldstein, “The Press and the Beginning of the Birth Control Movement in the United States” (Ph.D. diss., University of Pennsylvania, 1985). For the extensive publicity the movement received in local and national newspapers, see Peter C. Engelman, A History of the Birth Control Movement in America (Westport, CT: Praeger, 2011). 2. Norman Himes, Medical History of Contraception (Baltimore, MD: Williams & Wilkins, 1936); Janet Farrell Brodie, Contraception and Abortion in Nineteenth-­ Century America (Ithaca, NY: Cornell University Press, 1994); Andrea Tone, Devices and Desires: A History of Contraceptives in America (New York: Hill and Wang, 2001). Historian James Mohr has argued that the impetus for the criminalization of abortion came in part from the raised profile of the practice created by advertisements for abortifacients. See Abortion in America: The Origins and Evolution of National Policy, 1800–­1900 (New York: Oxford University Press, 1980), 42. Prior to the criminalization of abortion in the period 1830 to 1880, practices to restore menstruation before “quickening” (i.e., the movement of the fetus in the womb) were considered morally acceptable by laypeople and there was widespread recognition that even “respectable” married women engaged in such practices. 3. On the early years of birth control activism, see Robyn Rosen, Reproductive Health, Reproductive Rights: Reformers and the Politics of Maternal Welfare, 1917–­1940 (Columbus: Ohio State University Press, 2003). 4. See James Reed, From Private Vice to Public Virtue: The Birth Control Movement and American Society since 1830 (New York: Basic Books, 1978); Linda Gordon, Woman’s Body, Woman’s Right: A Social History of Birth Control in America (New York: Penguin Books, 1976); Joan M. Gaulard, “Woman Rebel: The Rhetorical Strategies of Margaret Sanger and the American Birth Control Movement, 1912–­1938” (Ph.D. diss., Indiana University, 1978); Reed, From Private Vice to Public Virtue. Other scholars have focused on the parallel efforts of scientific researchers to make birth control a respectable research topic. The title of part two of Tone’s Devices and Desires conveys this goal: “From Smut to Science.” See also Adele E. Clarke, Disciplining Reproduction: Modernity, American Life Sciences, and the “Problem of Sex” (Berkeley: University of California Press, 1998). 5. In the early years of legal birth control, clinic staff collected only minimal data on the number of people they advised annually and the types and amounts of contraceptive devices they distributed; see Julian L. Simon, “A Huge Marketing Task: Birth Control,” Journal of Marketing Research 5, no. 1 (1968): 21. The results of the Indianapolis study were reevaluated in the context of population control in the 1950s; see Clyde V. Kiser and P. K. Whelpton, “Resume of the Indianapolis Study of Social

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and Psychological Factors Affecting Fertility,” Population Studies 7, no. 2 (1953): 95–­110. 6. See Everett M. Rogers, A History of Communication Study: A Biographical Approach (New York: Free Press, 1997). Communication scholars usually trace their history to Wilbur Schramm’s department, although Karin Wahl-­ Jorgensen argues that a series of committees at the University of Chicago and postwar research at Harvard, Yale, Cornell, Columbia, and Berkeley should also be included in accounts of the emergence of the field. See Karin Wahl-­Jorgensen, “How Not to Found a Field: New Evidence on the Origins of Mass Communications Research,” Journal of Communication 54, no. 3 (2004): 560. 7. S. C. Ratzan, J. G. Payne, and C. Bishop, “The Status and Scope of Health Communication,” Journal of Health Communication 1, no. 1 (1996): 26. 8. There is not a clear delineation between these two groups. Indeed, many in the communications field had feminist intentions, and some feminists were more inclined toward persuasive methods than others. In fact, the subtleties of personal philosophies are not easily discerned even in the archives of particular individuals, as it was common for people to express their motives or agendas in various terms in order to appeal to the sympathies of their correspondents. 9. See, for example, Alexandra M. Lord, “‘Naturally Clean and Wholesome’: Women, Sex Education, and the United States Public Health Service, 1918–­1928,” Social History of Medicine 17, no. 3 (2004): 423–­441; John Parascandola, “VD at the Movies: PHS Films of the 1930s and 1940s,” Public Health Report 111, no. 2 (1996): 173–­ 175; Robert A. Aronowitz, “Do Not Delay: Breast Cancer and Time, 1900–­1970,” The Milbank Quarterly 79, no. 3 (2001): 355–­386; and Kristen Gardner, Early Detection: Women, Cancer, and Awareness Campaigns in the Twentieth-­Century United States (Chapel Hill: University of North Carolina Press, 2006). Prominent proponents of the “conspiracy of silence” view include James T. Patterson, The Dread Disease: Cancer and Modern American Culture (Cambridge, MA: Harvard University Press, 1989); and Susan Sontag, Illness as Metaphor (New York: Farrar, Straus & Giroux, 1978). Barbara Clow challenges this interpretation in Negotiating Disease: Power and Cancer Care, 1900–­1950 (Montreal: McGill University Press, 2001); and “Who’s Afraid of Susan Sontag? Or, the Myths and Metaphors of Cancer Reconsidered,” Social History of Medicine 14, no. 2 (2001): 293–­312. On the surveillance and control of populations, see Nayan Shah, Contagious Divides: Epidemics and Race in San Francisco’s Chinatown (Berkeley: University of California Press, 2001); Eithne Luibhéid, Entry Denied: Controlling Sexuality at the Border (Minneapolis: University of Minnesota Press, 2002); Alexandra Minna Stern, Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America (Berkeley: University of California Press, 2005); and Margot Canaday, The Straight State: Sexuality and Citizenship in Twentieth Century America (Princeton, NJ: Princeton University Press, 2009). 10. Martin S. Pernick, “Thomas Edison’s Tuberculosis Films: Mass Media and Health Propaganda,” Hastings Center Report 8, no. 3 (1978): 21–­27; Michael E. Teller, The Tuberculosis Movement: A Public Campaign in the Progressive Era (New York: Greenwood, 1988); Judith Walzer Leavitt, Typhoid Mary: Captive to the Public’s Health (Boston: Beacon Press, 1997); Nancy Tomes, The Gospel of Germs: Men, Women, and the Microbe in American Life (Cambridge, MA: Harvard University Press, 1999); Marianne Fedunkiw, “Malaria Films: Motion Pictures as a Public Health Tool,” American Journal of Public Health 93, no. 7 (2003): 1046–­1057; Kirsten Ostherr, Cinematic Prophylaxis: Globalization and Contagion in the Discourse of World



Notes to Pages 6–12 147

Health (Durham, NC: Duke University Press, 2005), chapters 2–­4. See also Alexandra Minna Stern and Howard Markel, “The Public Health Service and Film Noir: A Look Back at Elia Kazan’s ‘Panic in the Streets’ (1950),” Public Health Reports 118, no. 3 (2003): 178–­183. 11. McLuhan explored this idea in his most influential book, Understanding Media: The Extensions of Man (New York: McGraw-­Hill, 1964). 12. Carole McCann, Birth Control Politics in the United States, 1916–­1945 (Ithaca, NY: Cornell University Press, 1994), 21. 13. Simone M. Caron, “Birth Control and the Black Community in the 1960s: Genocide or Power Politics?” Journal of Social History 31, no. 3 (1998): 545–­569. For an account of the sexual exploitation of black women under slavery and in the U.S. South in the twentieth century, see Darlene Clark Hine, “Female Slave Resistance: The Economics of Sex” and “Rape and the Inner Lives for Black Women: A Culture of Dissemblance,” in Hine, Hine Sight: Black Women and the Re-­Construction of American History (Bloomington: Indiana University Press, 1997), 27–­36 and 37–­48, respectively. See also McCann, Birth Control Politics in the United States, 21; Lee Rainwater, assisted by Karol Kane Weinstein, And the Poor Get Children: Sex, Contraception, and Family Planning in the Working Class (Chicago: Quadrangle Books, 1960); Dorothy Roberts, Killing the Black Body: Race, Reproduction, and the Meaning of Liberty (New York: Pantheon Books, 1998); and Jennifer Nelson, Women of Color and the Reproductive Rights Movement (New York: New York University Press, 2003). 14. Betsy Hartmann, Reproductive Rights and Wrongs: The Global Politics of Population Control and Contraceptive Choice (Boston: South End Press, 1995); Matthew Connelly, Fatal Misconception: The Struggle to Control World Population (Cambridge, MA: Harvard University Press, 2008). 15. Johanna Schoen, Choice & Coercion: Birth Control, Sterilization, and Abortion in Public Health and Welfare (Chapel Hill: University of North Carolina Press, 2005), 15. 16. Laura Briggs, Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in Puerto Rico (Berkeley: University of California Press, 2002); Schoen, Choice & Coercion, 73. Even the Dalkon Shield, the intrauterine device that was informally tested on thousands of poor women only to be recalled after causing severe side effects that included sterilization, has been reappraised in an effort to more fully evaluate how women chose this technology and understood the benefits and risks. See Nicole J. Grant, The Selling of Contraception: The Dalkon Shield Case, Sexuality, and Women’s Autonomy (Columbus: Ohio State University Press, 1992). 17. John Cain, “Some Problems Faced by Broadcasters,” in Health Education by Television and Radio: Contributions to an International Conference with a Selected Bibliography, edited by Manfred Meyer (Munich: K. G. Saur, 1981), 26. Chapter 2—Battling Silence and Censorship

1. Quoted in Rochelle Gurstein, The Repeal of Reticence: A History of America’s Cultural and Legal Struggles over Free Speech, Obscenity, Sexual Liberation, and Modern Art (New York: Hill & Wang, 1998), 108. 2. On agitation, see Margaret Sanger, Birth Control: What It Is, How It Works, What It Will Do. The Proceedings of the First American Birth Control Conference Held at the Hotel Plaza, New York, November, 11, 12, 1921 (New York: The Birth Control Review, 1922), 91–­92, cited in James Reed, From Private Vice to Public Virtue: The Birth Control Movement and American Society since 1830 (New York: Basic Books, 1978), 102–­103.

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3. On the “gray market” that thrived in this period, see Andrea Tone, Devices and Desires: A History of Contraceptives in America (New York: Hill and Wang, 2001), chapter 2. On Sanger’s support for such activities, see Amy Sarch, “Dirty Discourse: Birth Control Advertising in the 1920s and 1930s” (Ph.D. diss., University of Pennsylvania, 1994), chapter 4. 4. Goldman to Sanger, December 7, 1917, Margaret Sanger Papers, Library of Congress, Washington, D.C., quoted in Joan M. Gaulard, “Woman Rebel: The Rhetorical Strategies of Margaret Sanger and the American Birth Control Movement, 1912–­1938” (Ph.D. diss., Indiana University, 1978), 41. 5. Gurstein, The Repeal of Reticence, chapter 4; Allan Brandt, No Magic Bullet: A Social History of Venereal Disease in the United States since 1880 (New York: Oxford University Press, 1987). 6. “Sex O’Clock in America,” Current Opinion 55, no. 2 (1913): 113–­114. 7. Kay Sloan, The Loud Silents: The Origins of the Social Problem Film (Chicago: University of Illinois Press, 1988), 5; Lary May, Screening Out the Past: The Birth of Mass Culture and the Motion Picture Industry (New York: Oxford University Press, 1980), chapter 3; Martin Pernick, “More than Illustrations: Early Twentieth-­Century Health Films as Contributors to the Histories of Medicine and of Motion Pictures,” 19–­35, and Susan Lederer, “Hollywood and Human Experimentation: Representing Medical Research in Popular Film,” 282–­306, both in Medicine’s Moving Pictures: Medicine, Health, and Bodies in American Film and Television, edited by Leslie Reagan, Nancy Tomes, and Paula Treichler (Rochester, NY: University of Rochester Press, 2007). 8. Originally the New York Board of Motion Picture Censorship but soon renamed to avoid association with censorship. Quote from “History,” National Board of Review website, http://www.nbrmp.org/about/history.cfm (accessed August 7, 2008). 9. The procedure was permitted only if a physician determined it was necessary to save the mother’s life. Leslie Reagan, When Abortion Was a Crime: Women, Medicine, and Law in the United States, 1867–­1973 (Berkeley: University of California Press, 1998). 10. Roosevelt quoted in Linda Gordon, Woman’s Body, Woman’s Right: A Social History of Birth Control in America (New York: Penguin Books, 1976), 142. See also Theodore Roosevelt, “Race Decadence,” The Outlook 97, no. 14 (1911): 764–­767; and Laura Lovett, Conceiving the Future: Pronatalism, Reproduction, and the Family in the United States, 1890–­1938 (Chapel Hill: University of North Carolina Press, 2007), chapters 4–­6. Although eugenicists supported the use of birth control among the lower classes, they allied with other conservatives to oppose making it available to all families. Although Sanger rejected the idea of denying the rich birth control and disagreed with some of the class and race prejudices of eugenicists, she tried to align with the field to help promote her cause. Yet before its reputation began to decline in the 1920s, the field’s most influential academics and scientists were reluctant to be associated with Sanger because of her controversial and highly publicized activities. Ellen Chesler, Woman of Valor: Margaret Sanger and the Birth Control Movement in America (New York: Simon & Schuster, 1992), 195–­198, 216–­217. 11. Jamie Hart, “Who Should Have the Children? Discussions of Birth Control among African-­American Intellectuals, 1920–­1939,” Journal of Negro History 79, no. 1 (1994): 71–­84; Jessie M. Rodrique, “The Black Community and the Birth Control Movement,” in Passion and Power: Sexuality in History, edited by Kathy Peiss and Christina Simmons with Robert A. Padgug (Philadelphia, PA: Temple University Press, 1989), 138–­154.



Notes to Pages 15–19 149

12. Advertisement for Mother, I Need You, Variety, September 13, 1918, 46. 13. Mother, I Need You, a.k.a. The Curse of Eve, Corona Cinema Company, October 1917. Film description from the AFI Catalog, an online database: http://www.afi.com/ members/catalog/. 14. Eric Schaefer, Bold! Daring! Shocking! True! A History of Exploitation Films (Durham, NC: Duke University Press, 1999), 30–­31. 15. Robert C. McElravy, Review of Mother, I Need You, Moving Picture World, October 27, 1917, 522. 16. “Birth Control Plays Grip Renewed Activity of Producers in the Mid-­West,” New York Times, December 5, 1920, 99; Lauren Rabinovitz, For the Love of Pleasure: Women, Movies, and Culture in Turn-­of-­the-­Century Chicago (New Brunswick, NJ: Rutgers University Press, 1998); Janet Staiger, Bad Women: Regulating Sexuality in Early American Cinema (Minneapolis: University of Minnesota Press, 1995), chapters 5–­7. 17. Where Are My Children? (1917), Universal, 5 reels, U.S. print viewed at the George Kleine Collection, Library of Congress. There are two extant but incomplete versions of the film: the American one described here and a European version. See Kevin Brownlow, Behind the Mask of Innocence: Sex, Violence, Crime: Films of Social Conscience in the Silent Era (Berkeley: University of California Press, 1992), 53–­54. Heather MacGibbon discusses Weber’s work in “Screening Choice: The Abortion Narrative in American film: 1900–­2000” (Ph.D. diss., New York University, 2007). 18. For the importance of the square-­up in films dealing with controversial topics, see Schaefer, Bold! Daring! Shocking! True! 69–­71. 19. Quote in Gregory D. Black, Hollywood Censored: Morality Codes, Catholics, and the Movie (Cambridge: Cambridge University Press, 1994), 16. See also Garth S. Jowett, “A Capacity for Evil: The 1915 Supreme Court Mutual Decision,” in Controlling Hollywood: Censorship and Regulation in the Studio Era, edited by Matthew Bernstein (New Brunswick, NJ: Rutgers University Press, 2000), 16–­40. 20. Washington Post, June 2, 1916. 21. Lynde Denig, “‘Where Are My Children?’ The Attitude of Modern Women Towards Child-­Bearing Is Theme of Thought-­Provoking Universal Drama Made by the Smalleys,” Moving Picture World, April 29, 1916, 818; Brownlow, Behind the Mask of Innocence, 54. 22. “Lois Weber Smalley,” The Overland Monthly 68, no. 3 (1916): 200. 23. “Pennsylvania Turns Down ‘Where Are My Children?’” Motion Picture News, October 7, 1916, 2206. 24. “Notable Film Play Booked by Georgian,” The Atlanta Constitution, 5 November 1916, B3. 25. “Lois Weber Smalley,” 200. 26. Ibid.; Denig, “‘Where Are My Children?’” 27. Kay Sloan suggests that Sanger was inspired by her friend John Reed’s use of a play in New Jersey to promote labor union activities. Sloan, The Loud Silents, 87. 28. “An Honest Birth Control Film at Last!” Birth Control Review 1, no. 3 (1917): 11. The subheading for this section comes from this advertisement. 29. Birth Control, April 1917, Message Photo-­Play Company, 5 reels. Although the film is presumed lost, historian Martin Norden has reconstructed the content from a legal transcript held in the Margaret Sanger Papers at the Sophia Smith Collection, Smith College, Northhampton, Massachusetts. See Norden, “Reproductive Freedom, Revisionist History, Restricted Cinema: The Strange Case of Margaret Sanger and Birth Control,” in Cultural Sutures: Medicine and Media, edited by Lester D. Friedman

150

Notes to Pages 20–25

(Durham, NC: Duke University Press, 2004), 263–­279. See also Shelley Stamp, “Taking Precautions, or Regulating Early Birth Control Films,” in A Feminist Reader in Early Cinema, edited by Jennifer M. Bean and Diane Negra (Durham, NC: Duke University Press, 2002), 279–­297. 30. On attitudes of audiences toward film representation, see Sonya Michel, “Taking Risks for Pictures: The Heroics of Cinematic Realism in World War I,” in Borderlines: Genders and Identities in Peace and War, edited by Billie Melman (Routledge, 1998), 145. On Sanger’s use of publicity, see Brownlow, Behind the Mask of Innocence, 48. Although Sanger was born to a working-­class family, she was moving in professional circles by this time and had married into money. On the positive reception by reviewers, see Sloan, The Loud Silents, 87. 31. Description of opening scenes of the film from Margaret I. MacDonald, “‘Birth Control’: Margaret Sanger Appears in Five-­Reel Photoplay Production Explanatory of the Primary Objects of the Birth Control Movement,” Moving Picture World, April 21, 1917, 451. Sanger repeated this narrative throughout her career; it was likely a composite of many experiences rather than one moment. It is interesting to note that in the usual telling of the story, the woman is a European Jewish immigrant, Sadie Sachs. The film recasts the martyr as an Anglo-­American named Helen Fields. 32. Editorial Staff of the Alkaloida Clinic, Sexual Hygiene (Chicago, 1902), 184, quoted in Reed, From Private Vice to Public Virtue, 43. 33. Edward de Grazia and Roger K. Newman, Banned Films: Movies, Censors, and the First Amendment (New York: Bowker, 1982), 187; Sloan, The Loud Silents, 88; Cynthia Goldstein, “Early Film Censorship: Margaret Sanger, Birth Control, and the Law,” in Current Research in Film, Audiences, Economics, and Law, vol. 4, edited by Bruce A. Austin (Norwood: Ablex, 1988), 188–­200. The quotation is from the film’s distributor, Message Photo-­Play Company; quoted in de Grazia and Newman, Banned Films, 187. 34. The Hand That Rocks the Cradle, May 13, 1917, Universal Film Manufacturing Company, 6 reels. This film is presumed lost. Description from Edward Weitzel, “‘Hand That Rocks the Cradle[,]’ Six-­Reel Universal Subject Defending Birth Control[,] Has Forceful Arguments, But Is a Preachment, Not a Play,” Moving Picture World, June 2, 1917, 1508. 35. “Fred,” “The Hand That Rocks the Cradle,” Variety, May 18, 1917, 26; “The Hand that Rocks the Cradle,” National Board of Review of Motion Pictures Records, 1907–­ 1971, Box 104, New York Public Library, New York, New York. 36. Weitzel “‘Hand That Rocks the Cradle,’” 1458. 37. Peter Milne, “The Hand That Rocks the Cradle,” Motion Picture News, June 2, 1917, 3462. 38. Carole McCann, Birth Control Politics in the United States, 1916–­1945 (Ithaca, NY: Cornell University Press, 1994), 6. 39. The House without Children, Argus Enterprises, Inc., 6–­7 reels, based on a play by Robert H. McLaughlin; description from the AFI Catalog. On better baby contests, see Alexandra Minna Stern, “Making Better Babies: Public Health and Race Betterment in Indiana, 1920–­1935,” American Journal of Public Health 92, no. 5 (2002): 742–­752; and Lovett, Conceiving the Future, chapter 6. 40. Fit to Win was a reissue of Fit to Fight with some additional footage; Schaefer, Bold! Daring! Shocking! True! 24–­27. See also Stacie Colwell, “The End of the Road: Gender, the Dissemination of Knowledge, and the American Campaign against Venereal Disease during World War I,” Camera Obscura 10, 2 29 (1993): 91–­129; and John



Notes to Pages 25–31 151

Parascandola, “Syphilis at the Cinema: Medicine and Morals in VD Films of the U.S. Public Health Service in World War II,” in Medicine’s Moving Pictures: Medicine, Health, and Bodies in American Film and Television, edited by Leslie Reagan, Nancy Tomes, and Paula Treichler (Rochester, NY: University of Rochester Press, 2007), 73. 41. Alexandra Lord, “‘Naturally Clean and Wholesome’: Women, Sex Education, and the United States Public Health Service, 1918–­1928,” Social History of Medicine 17 (2004): 436. In contrast to the trend in message films, motherhood as a main aspiration for women virtually disappeared from movies produced for entertainment; Schaefer, Bold! Daring! Shocking! True! 166. 42. The total population of the United States at this time was 120 million; Black, Hollywood Censored, 53. 43. No More Children, Cliff Broughton Productions. Film description from Sanger to Dr. L. Lee Krauss, Bureau of Moral and Hygienic Education, Inc., March 9, 1932, Reel 65, Margaret Sanger Papers, Library of Congress. 44. The Road to Ruin, Cliff Broughton Productions, 6 reels, viewed at the Library of Congress. See also Brownlow, Behind the Mask of Innocence, 175–­176. 45. Sanger to Krauss, March 9, 1932. 46. Dr. L. Lee Krauss to Sanger, February 19, 1932, Reel 65, Margaret Sanger Papers, Library of Congress. 47. Her Unborn Child (1930), Windsor Picture Plays Inc., 65 min., based on a play by Howard McKent Brent. Print viewed at the Library of Congress. 48. These include the “Thirteen Points” of 1921, the launch of the Motion Picture Producers and Distributors Association of America (MPPDAA) in 1922 (renamed the Motion Picture Association of America [MPAA] in 1947), the “Formula” of 1924, the list of eleven “Don’ts” and twenty-­five “Be Carefuls” in 1927, and the first Production Code of 1930. 49. Lee Morrison to Sanger, May 18, 1934, Reel 65, Margaret Sanger Papers, Library of Congress. 50. Also released as What Price Passion?, Willis Kent Productions, 6 reels, 70 min. Print viewed at the Library of Congress. 51. F. R. to M. S., March 18, 1935, Reel 63, Margaret Sanger Papers, Library of Congress. 52. “The Accident of Birth,” Fortune, February 1938, 573. 53. Percy Clark to Margaret Sanger, 1936, quoted in Carole McCann, Birth Control Politics in the United States, 1916–­1945 (Ithaca, NY: Cornell University Press, 1994), 180. 54. National Committee on Federal Legislation for Birth Control, A New Day Dawns for Birth Control (New York: National Committee on Federal Legislation for Birth Control, 1937), 9. 55. Jason Loviglio, Radio’s Intimate Public: Network Broadcasting and Mass-­Mediated Democracy (Minneapolis: University of Minnesota Press, 2005), chapter 1. 56. Black entrepreneurs were excluded from the industry in the early years. Although some had tried since at least 1930 to purchase radio stations, none were successful until 1949, when Atlanta accountant and professor Jesse B. Blayton bought WERD. Donna L. Halper, “The First African-­American Radio Station Owner: Jesse B. Blayton, Sr.,” http://www.lwfaah.net/aaradio/1staa_radio.htm (accessed July 25, 2010). Although it is beyond the scope of this study, an analysis of birth control programming on black-owned radio stations could prove a productive avenue for further research. 57. On the triumph of commercial broadcasters over radio reformers, see Robert McChesney, Telecommunications, Mass Media, and Democracy: The Battle for Control of U.S. Broadcasting, 1928–­1935 (New York: Oxford University Press, 1995).

152

Notes to Pages 32–37

58. Edward T. Vane and Lynne S. Gross, Programming for TV, Radio, and Cable (Woburn, MA: Butterworth Heinemann Press, 1994), 1; Erik Barnouw, A Tower in Babel: A History of Broadcasting in the United States to 1933, vol. 1 (New York: Oxford University Press, 1966), 86. 59. Quoted in Hadley Cantril and Gordon M. Allport, The Psychology of Radio (New York and London: Harper & Bros., 1935), 50. 60. National Association of Broadcasters Code of Ethics (1929), reprinted in Frank J. Kahn, comp., Documents of American Broadcasting, 4th ed. (Englewood Cliffs, NJ: Prentice Hall, 1984), 70. 61. Quoted in Louise M. Benjamin, “‘Controversy for Controversy’s Sake’?: Feminism and Early Radio Coverage of Birth Control in the U.S.,” paper presented at the annual meeting of the International Communication Association, Dresden, Germany, June 16, 2006, http://www.allacademic.com/meta/p91228_index.html (accessed September 5, 2008), 10. See also Louise M. Benjamin, The NBC Advisory Council and Radio Programming, 1926–1945 (Carbondale: Southern Illinois University Press, 2009), 65–75. 62. “Planned Parenthood on the Air: Some Programs since 1930,” 1, Box 100, Folder 7, Planned Parenthood Federation of America Records, 1918–­1974, Sophia Smith Collection, Smith College Libraries, Northampton, Massachusetts (hereafter PPFA I). 63. The Payne Fund was a private foundation that paid for studies the Motion Picture Research Council (formerly called the National Committee for Study of Social Values in Motion Pictures) developed. The council was composed of social workers, sociologists, and others concerned about the negative impact of film on children. 64. Bill Jaker, Frank Sulek, and Peter Kanze, The Airwaves of New York: Illustrated Histories of 156 AM Stations in the Metropolitan Area, 1921–­1996 (Jefferson, NC: McFarland & Company, 1998), 65. 65. McChesney, Telecommunications, Mass Media, and Democracy, 118. 66. James Rorty quoted in Cantrill and Allport, The Psychology of Radio, 57. 67. Allan Brandt, No Magic Bullet: A Social History of Venereal Disease in the United States since 1880 (New York: Oxford University Press, 1987), 135; “Syphilis and Radio,” Time, 3 December 1934. See also Elizabeth Fee, “Sin vs. Science: Venereal Disease in Baltimore in the Twentieth Century,” Journal of the History of Medicine and Allied Sciences 43, no. 2 (1988): 150; and John Parascandola, Sex, Sin, and Science: A History of Syphilis in America (Westport, CT: Praeger, 2008), 91. 68. Morris S. Novik, “The University of the Air,” in Education on the Air and Radio and Education: Proceedings of the Sixth Annual Institutes for Education by Radio Combined with the Fifth Annual Advisory Assembly of the National Council on Radio in Education, edited by Levering Tyson and Josephine MacLatchey (Chicago: University of Chicago Press, 1935), 115. 69. Quoted in Fee, “Sin vs. Science,” 150. 70. McChesney, Telecommunications, Mass Media, and Democracy, 254. 71. Margaret Sanger, “Radio News!,” March 7, 1935, Box 100, Folder 3, PPFA I. 72. “Dr. Little’s Radio Presentation,” 1, Box 100, Folder 4, PPFA I. 73. “Family Planning: A Radio Talk,” n.p., Box 100, Folder 4, PPFA I. See also “Radio Interview between Mrs. Bess Augsburger and an Announcer,” 1, script, ca. 1941, Box 11, Folder 4, PPFA I. The script said, “In recent years we have heard a great deal about planning. Planning to conserve our natural resources—­forests, minerals, soil, power. Planning for health and social security.”



Notes to Pages 37–43 153

74. Jacqueline Tracy Orr, “Panic Diaries: Cybernetics, Psychiatry, and the Technoscientific Control of Social Dis-­ease” (Ph.D. diss., University of California, Berkeley, 1999), 36–­39. 75. M. Mumford to Dr. Morris, “Report on Radio Disk Possibilities,” 1939, Box 99, Folder 14, PPFA I. 76. Benjamin Potts to Charles Magill Smith, May 27, 1940, Box 99 Folder 14, PPFA I. 77. “The Great Betrayal,” Coughlin speech, March 22, 1931, in Ronald H. Carpenter, Father Charles E. Coughlin: Surrogate Spokesman for the Disaffected (Greenwood Publishing Group, 1998), 136. 78. Sanger quoted in “Birth Controllers on Parade,” Time, January 29, 1934. See also Steve Craig, “How America Adopted Radio: Demographic Differences in Set Ownership Reported in the 1930–­1950 U.S. Censuses,” Journal of Broadcasting & Electronic Media 48, no. 2 (2004): 179. 79. Transcript of Sanger, “Family Planning: A Radio Talk,” Box 100, Folder 4, PPFA I. 80. For example, see the transcript of W. E. Morris, M.D., “Radio Talk on Birth Control,” 1, March 11, 1940, Box 100, Folder 4, PPFA I. 81. David M. Kennedy, Birth Control in America: The Career of Margaret Sanger (New Haven, CT: Yale University Press, 1970), 140–­141. 82. Norman Himes, Medical History of Contraception (Baltimore, MD: Williams & Wilkins, 1936), xiii. Himes, who was employed by the National Committee on Maternal Health, argued that the desire for contraception long predated the propaganda movements. 83. “Planned Parenthood on the Air: Some Programs since 1930.” 84. Gerd Horten, Radio Goes to War: The Cultural Politics of Propaganda during World War II (Berkeley: University of California Press, 2002). 85. Margaret Sanger to friends of Planned Parenthood, January 22, 1943, Box 100, Folder 6, PPFA I. 86. Script excerpt from “Parenthood Forum,” 8, 1942, Box 100, Folder 6, PPFA I. On the Office of War Information broadcasts, see Horten, Radio Goes to War, 57. 87. “Let’s Put Planned Parenthood on the Air,” Box 99, Folder 15, PPFA I. 88. Robert Westbrook, “‘I Want a Girl, Just Like the Girl that Married Harry James’: American Women and the Problem of Political Obligation in World War II,” American Quarterly 42, no. 4 (1990): 589. See also Maureen Honey, Creating Rosie the Riveter: Class, Gender, and Propaganda during World War II (Amherst: University of Massachusetts Press, 1984); and Marilyn E. Hegarty, Victory Girls, Khaki-­Wackies, and Patriotutes: The Regulation of Female Sexuality during World War II (New York: New York University Press, 2007). 89. “Planned Parenthood in Wartime,” 2, my emphasis. 90. “Radio Interview between Mrs. Bess Augsburger and an Announcer,” 7. 91. Joanne Meyerowitz, “Women, Cheesecake, and Borderline Material: Responses to Girlie Pictures in the Mid-­Twentieth-­Century U.S.,” Journal of Women’s History 8, no. 3 (1996): 9–­35; Jennifer McAndrew, “All-­American Beauty: The Experiences of African American, European American, and Japanese American Women with Beauty Culture in the Mid-­Twentieth Century United States” (Ph.D. diss., University of Maryland, 2008); John D’Emilio and Estelle Freedman, Intimate Matters: A History of Sexuality in America (New York: Harper & Row, 1988), 239–­274. 92. “Planned Parenthood on the Air: Some Programs since 1930,” 6. 93. “Let’s Put Planned Parenthood on the Air,” PPFA I, Box 99, Folder 16.

154

Notes to Pages 43–49

94. James H. Scull to D. Kenneth Rose, “Analysis of Mailings,” 5, September 21, 1944, Box 100, Folder 1, PPFA I. For example, Helen Martin, public relations chair of the Planned Parenthood Association of the District of Columbia, hosted a weekly five-­ minute program on WINX in Maryland entitled “Planned Parenthood in Wartime.” See “A One-­Woman Radio Program,” Box 100, Folder 2, “Amateurs on the Air,” PPFA I. Chapter 3—The Medium Shapes the Message

1. Stephen M. Corey to Robert Maynard Hutchins, quoted in Karin Wahl-­Jorgensen, “How Not to Found a Field: New Evidence on the Origins of Mass Communications Research,” Journal of Communication 54, no. 3 (September 2004): 554. 2. Bernard Berelson, “American Attitudes on Population Policy,” Studies in Family Planning 1, no. 9 (1966): 5–­8. 3. My focus on media limits my study to a particular group in the birth control movement that moved away from the formal organizations that led family planning promotion. 4. Donald T. Critchlow, “Birth Control, Population Control, and Family Planning: An Overview,” Journal of Policy History 7, no. 1 (1995): 1–­21; Matthew Connelly, Fatal Misconception: The Struggle to Control World Population (Cambridge, MA: Harvard University Press, 2008). 5. Robert Gottlieb, Forcing the Spring: The Transformation of the American Environmental Movement (Washington, DC: Island Press, 2005), 71. On the rising number of academic journals devoted to the topic, see Laura Briggs, Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in Puerto Rico (Berkeley: University of California Press, 2002), 116. 6. J. Mayone Stycos, The Great Tabu: A Half Century of Population and Family Planning Communication (Honolulu: East-­West Communication Institute, 1977), 13. 7. Moore quoted in Phyllis Tilson Piotrow, World Population Crisis: The United States Response (New York: Praeger, 1973), 18. 8. Poll numbers from Gallup Polls (American Institute of Public Opinion), November 1945, December 1959, and May 1963, iPoll databank, http://webapps.ropercenter .uconn.edu/CFIDE/cf/action/home/index.cfm?CFID=2546487&CFTOKEN =66865055; and “America’s Mood in the Mid-Sixties,” results of February 1965 poll, data available at The Roper Center, University of Connecticut. 9. Piotrow, World Population Crisis, 48. 10. “Composite Report of the President’s Committee to Study the United States Military Assistance Program,” August 17, 1959, RG 59, Department of State Records, Central Files 1967–­1969, SOC 13-­3, Box 3124, U.S. National Archives, College Park, MD. Draper cofounded the Population Crisis Committee in 1965 and was later appointed to the governing body of IPPF and served as honorary vice-­chair of Planned Parenthood. President Eisenhower became more active on population issues after leaving government and in 1964 served as honorary co-­chair of Planned Parenthood with former president Harry Truman. 11. Arthur Krock quoted in Population Crisis: Hearings before the Subcommittee on Foreign Aid Expenditures of the Committee on Government Operations United States Senate, Eighty-­Ninth Congress, Second Session on S. 1676, A Bill to Reorganize the Department of State and the Department of Health, Education, and Welfare, April 7, 8, and 11, 1966, Part 4 (Washington, DC: Government Printing Office, 1966), 975. 12. On the strong effects model, see Charles K. Atkin, “Research Evidence on Mass Mediated Communication Campaigns,” in Health Communication Yearbook III



Notes to Pages 49–55 155

(New Brunswick, NJ: Transaction Books, 1979), 355. For the limited effects model, see Gerd Horten, Radio Goes to War: The Cultural Politics of Propaganda during World War II (Berkeley: University of California Press, 2002), 63. 13. Raymond A. Bauer, “The Obstinate Audience: The Influence Process from the Point of View of Social Communication,” American Psychologist 19, no. 5 (1964): 320; Everett M. Rogers, Communication Strategies for Family Planning (New York: The Free Press, 1973), 73. 14. “Planning Radio and Television to Tell Your Story: A Guide for 1953 Campaign Workers,” 3, Box 100, Folder 8, PPFA I. 15. Selection of transcripts of spot announcements for radio, Box 100, Folder 8, PPFA I. 16. “Planned Parenthood Is Your Business,” 6, Box 100, Folder 8, PPFA I. 17. “Planning Radio and Television to Tell Your Story: A Guide for 1953 Campaign Workers,” 4, quote on 6. 18. Tom Davis, Sacred Work: Planned Parenthood and Its Clergy Alliances (New Brunswick, NJ: Rutgers University Press, 2006), 61–­71. 19. William Boddy, Fifties Television: The Industry and Its Critics (Chicago: University of Illinois Press, 1992), 18. Planned Parenthood noted the growing support for educational television; by 1953, 242 licenses had been issued to educational stations. See “Planning Radio and Television to Tell Your Story: A Guide for 1953 Campaign Workers,” 8. 20. Lynn Spigel, “Installing the Television Set: Popular Discourses on Television and Domestic Space, 1948–­1955,” in Private Screenings: Television and the Female Consumer, edited by Lynn Spigel and Denise Mann, 3–­40 (Minneapolis: University of Minnesota Press, 1992), cartoon on 13. 21. Roger S. Hall, Taking Hold of Television (New York: National Publicity Council for Health and Welfare Services, 1954), quotes on 13 and 66. 22. Harriet H. Hester, H. L. Fishel, and Martin Magner, Television in Health Education (Chicago: American Medical Association, 1955), 3. 23. Ibid. Survey cited in Public Relations Society of America and the National Publicity Council for Health and Welfare, The Organization of Public Relations in Health and Welfare Organizations (New York: Public Relations Society of America, 1954), 9. For examples of broadcasting strategies, see “Planning Radio and Television to Tell Your Story: A Guide for 1953 Campaign Workers,” 5. 24. This was a significant increase from the 10 percent of households with televisions in 1951. See Kathryn Montgomery, Target: Prime Time: Advocacy Groups and the Struggle over Entertainment Television (New York: Oxford University Press, 1989), 16. 25. See Rickie Solinger, Pregnancy and Power: A Short History of Reproductive Politics in America (New York: NYU Press, 2005), 163; and Ziv Eisenberg, “‘You Cannot Show a Pregnant Woman on Television’: I Love Lucy and the Cultural Making of the Visible Belly Bump in Post-­World War II America,” paper presented at the Berkshire Conference of Women Historians, June 12, 2011, University of Massachusetts, Amherst. 26. Quotations from Hester, Fishel, and Magner, Television in Health Education, 27. For more on the medical profession’s attempts to control how it was represented and prevent physicians from demeaning the profession through commercial advertising, see Kelly A. Cole, “Exorcising ‘Men in White’ on Television,” in Cultural Sutures: Medicine and Media, edited by Lester D. Friedman (Durham, NC: Duke University Press, 2004), 93–­108. 27. “Planning Radio and Television to Tell Your Story: A Guide for 1953 Campaign Workers,” 7.

156

Notes to Pages 55–58

28. For a concise summary of the project, see “Birth Control or Race Control? Sanger and the Negro Project,” Margaret Sanger Papers Project Newsletter 28 (Fall 2001), http:// www.nyu.edu/projects/sanger/secure/newsletter/articles/bc_or_race_control.html (accessed November 7, 2012). See also Johanna Schoen, Choice & Coercion: Birth Control, Sterilization, and Abortion in Public Health and Welfare (Chapel Hill: University of North Carolina Press, 2005); and Carol McCann, Birth Control Politics in the United States, 1916–1945 (Ithaca, NY: Cornell University Press, 1994). 29. Boddy, Fifties Television, 220. 30. Charles A. Siepmann, “Moral Aspects of Television,” Public Opinion Quarterly 24, no. 1 (1960): 15. On Minow, see Boddy, Fifties Television, 244. For critiques of the lack of diversity in the industry, see James L. Baughman, The Republic of Mass Culture: Journalism, Filmmaking, and Broadcasting in America since 1941 (Baltimore: Johns Hopkins University Press, 1992), 91–­116. 31. Julia Passanante Elman, “After School Special Education: Rehabilitative Television, Teen Citizenship, and Compulsory Able-­Bodiedness,” Television and New Media 20, no. 10 (2010): 2. 32. Boddy, Fifties Television, 198. 33. John D’Emilio and Estelle Freedman, Intimate Matters: A History of Sexuality in America (New York: Harper & Row, 1988), 277; Rodger Streitmatter, Sex Sells!: The Media’s Journey from Repression to Obsession (New York: Basic Books, 2004). By 1965, the pill was the most popular form of contraception. See C. F. Westoff and N. B. Ryder, “United States: Methods of Fertility Control, 1955, 1960, and 1965,” Studies in Family Planning 1, no. 17 (1967): 1–­5. On the history of the development of the pill, see Elizabeth Siegel Watkins, On the Pill: A History of Oral Contraceptives 1950–­1970 (Baltimore, MD: Johns Hopkins University Press, 1998); and Andrea Tone, Devices and Desires: A History of Contraceptives in America (New York: Hill & Wang, 2001), 203–­260. 34. Rickie Solinger, Wake Up, Little Susie: Single Pregnancy and Race before Roe v. Wade (New York: Routledge, 1992), 207 and 213. Although it had been possible for states to use federal grants for family planning programs since the 1930s, few had done so. 35. Quoted in Winfield Best to Raymond A. Lamontagne, 2 February 1967, Box 18, Folder “Radio and TV PPWP,” Martha Stuart Papers. 36. Martha Stuart, “Preliminary World’s Fair Report,” June 14, 1965, 1, Box 18, Folder “World’s Fair PPWP Booth,” Martha Stuart Papers, Arthur and Elizabeth Schlesinger Library on the History of Women in America, Radcliffe Institute for Advanced Study, Harvard University (hereafter Martha Stuart Papers). 37. Poll results cited in Bernard Berelson, “American Attitudes on Population Policy,” Studies in Family Planning 1, no. 9 (1966): 5. 38. See, for example, Stuart to Milton Wayne, ABC, November 18, 1966, and Stuart to Thomas Moore, president of ABC, January 9, 1967, Box 18, Folder “Stuart, Martha,” Planned Parenthood Federation of America Papers 1921–­1981, Sophia Smith Collection, Smith College, Northampton, Massachusetts (hereafter PPFA II). 39. Martin Luther King Jr. advocated black control of reproduction and rejected “population breeding as a weapon.” See King, Family Planning—­A Special and Urgent Concern (New York: Planned Parenthood-­World Population, 1966), 5. 40. Malcolm X implicitly endorsed family planning, although he was critical of the emphasis on curbing population growth among nations of people of color. Wylda B. Cowles, Memo to Dr. Alan F. Guttmacher concerning the Interview with Malcolm X,



Notes to Pages 59–65 157

May 29, 1962, cited in Robert G. Weisbord, “Birth Control and the Black American: A Matter of Genocide? Demography 10, no. 4 (1973): 581. 41. See Shirley Chisholm, Unbought and Unbossed (New York: Avon Books, 1970), 124–­136. 42. On family planning clinics in riot areas, see Weisbord, “Birth Control and the Black American,” 571; and Gary D. London, “Family Planning Programs of the Office of Economic Opportunity: Scope, Operation, and Impact,” Demography 5, no. 2 (1968): 928. 43. Stuart to Steve Bauman, NBC, December 27, 1966, Box 18, Folder F, “Stuart, Martha,” PPFA II. 44. Box 18, Folder “Stuart, Martha,” PPFA II. See also Lois R. Chevalier and Leonard Cohen, “The Terrible Trouble with the Birth-­Control Pills,” Ladies’ Home Journal, July 1967, 44–­45. 45. Lyndon B. Johnson, “Special Message to the Congress on Domestic Health and Education,” March 1, 1966, available online at The American Presidency Project, http:// www.presidency.ucsb.edu/ws/?pid=28111. 46. The 1967 Amendments to the Social Security Act, which had bipartisan support as a solution to poverty and illegitimate births, endorsed federal funding for family planning. The first direct federal grant for a local family planning program was awarded by the Office of Economic Opportunity in December 1964 to an organization in Corpus Christi, Texas. See Gary D. London, “Family Planning Programs of the Office of Economic Opportunity: Scope, Operation, and Impact,” Demography 5, no 2 (1968): 924. 47. Gallup Poll News Service, “America’s Mood in the Mid-­Sixties.” 48. Winfield Best to Raymond A. Lamontagne, February 2, 1967, Box 18, Folder “Radio and TV PPWP,” Martha Stuart Papers; William Clark to Winfield Best, September 1, 1966, Box 18, Folder “Stuart, Martha,” PPFA II. 49. Jean Hutchinson, “Using TV to Recruit Family Planning Patients,” Family Planning Perspectives 2, no. 2 (1970): 9, 11. 50. Walter C. Rogers, M.D., to John Robbins, “Jack Scanlon’s Proposed Media Campaign,” May 11, 1970, 2, Box 64, Folder 34, PPFA II. 51. Richard Lincoln to John C. Robbins, “Population Education Program,” May 18, 1970, Box 64, Folder 34, PPFA II. 52. Atkin, “Research Evidence on Mass Mediated Communication Campaigns,” 355, my emphasis. 53. See “Radio Spots,” Box 64, Folder 80, PPFA II. 54. Fred Jaffe to John Robbins, “Confidential Memorandum,” 1–­2, February 1, 1971, Box 62, Folder 50, PPFA II. 55. Robin Elliott, “Advertising Family Planning,” Family Planning Perspectives 3, no. 4 (1971): 65–­67. 56. Philip H. Dougherty, “Birth Control Campaign Set,” New York Times, October 5, 1971. 57. J. Mayone Stycos, “Desexing Birth Control,” Family Planning Perspectives 9, no. 6 (1977): 290. 58. “Premise and Method,” 2, Box 18, Folder “C for C, The First Four Years,” Martha Stuart Papers. 59. For the role the news media played in framing the debate, see Julie D’Accic, “Leading up to Roe v. Wade: Television Documentaries in the Abortion Debate,” in Television, History, and American Culture: Feminist Critical Essays, edited by Mary Beth Haralovich and Lauren Rabinovitz (Durham, NC: Duke University Press, 1999), 123.

158

Notes to Pages 65–71

60. Rickie Solinger, Pregnancy and Power: A Short History of Reproductive Politics in America (New York: New York University Press, 2005), 180–­181. 61. Stuart quoted in untitled document 5, Box 12, Folder “Women Who Didn’t Have An Abortion,” Martha Stuart Papers. 62. For a discussion of the importance of consciousness-­raising in feminist organizing, see Sara M. Evans and Harry C. Boyte, Free Spaces: The Sources of Democratic Change in America (Chicago: University of Chicago Press, 1992); Sandra Morgen, Into Our Own Hands: The Women’s Health Movement in the United States, 1969–­ 1990 (New Brunswick, NJ: Rutgers University Press, 2002); and Susan Wells, Our Bodies, Ourselves and the Work of Writing (Stanford, CA: Stanford University Press, 2010). 63. Leslie Reagan, When Abortion Was a Crime: Women, Medicine and Law in the United States, 1867–­1973 (Berkeley: University of California Press, 1998), 230. 64. Mrs. Theodore O. Wedel, letter to the editor, November 21, 1973, Box 64, Folder 46, PPFA II. 65. George Gerbner, “The Structure and Process of Television Program Content Regulation in the United States,” in Television and Social Behavior, vol. 1, Media Content and Control, edited by George A. Comstock and Eli A. Rubenstein (Washington, DC: Government Printing Office, 1972), 403. 66. For a full account of Poindexter’s work to win over broadcasters, see David O. Poindexter, “A History of Entertainment-­Education, 1958–­2000,” in Entertainment-­ Education and Social Change: History, Research, and Practice, edited by Arvind Singhal, Michael J. Cody, Everett M. Rogers, and Miguel Sabido (Mahwah, NJ: Lawrence Erlbaum Associates, 2004), 21–­38. 67. Unless otherwise specified, I am drawing from Kathryn C. Montgomery’s interviews with key figures at the Population Institute and CBS for my discussion of the origins and impact of Maude. See Montgomery, Target: Prime Time, 27–­50. The other programs that featured family planning in 1972 were All in the Family, M*A*S*H, and The Mary Tyler Moore Show. See Arvind Singhal, Michael J. Cody, Everett M. Rogers, and Miguel Sabido, eds., Entertainment-­Education and Social Change: History, Research, and Practice (Mahwah, NJ: Lawrence Erlbaum Associates, 2004), 25. 68. Richard A. Blake, quoted in Montgomery, Target: Prime Time, 37. 69. Box 64, Folder 46, PPFA II. Planned Parenthood documented the response as part of its efforts to evaluate the viability of a television campaign on family planning; see Montgomery, Target: Prime Time, 37. For an overview of the anti-­abortion movement, see Andrew H. Merton, Enemies of Choice: The Right-­to-­Life Movement and Its Threat to Abortion (Boston: Beacon Press, 1981) 70. Quoted in Montgomery, Target: Prime Time, 36. 71. See ibid., 174–­193. 72. Poindexter, “A History of Entertainment-­Education, 1958–­2000,” 25. 73. Les Brown, “A ‘Sesame St.’ for Adults on Health Care Tested,” New York Times, November 12, 1973. 74. “Task Force on Family Planning, Dinner Meeting, March 27, [1973],” Box 84, Folder 15, Children’s Television Workshop Archives (hereafter CTW Archives), Hornbake Library, University of Maryland; “Task Force on Family Planning, Morning Session, 28 March 1973,” Box 84, Folder 15, CTW Archives. 75. [Author name redacted] to CTW, October 4, 1973, Box 49, Folder 23, CTW Archives. 76. Faye D. Ginsburg, Contested Lives: The Abortion Debate in an American Community (Berkeley: University of California Press, 1989), 50; Rosalind Pollack Petchesky,



Notes to Pages 71–77 159

“Fetal Images: The Power of Visual Culture in the Politics of Reproduction,” Feminist Studies 13, no. 2 (1987): 263–­292. As Leslie Reagan has pointed out, the strategy had precedents. As early as 1910, a physician gave a lecture for women at a St. Louis settlement house that included an image, remarking “I think pictures like that of the six weeks’ embryo will keep many women from having an abortion done”; When Abortion was a Crime: Women, Medicine and Law in the United States, 1867–­1973 (Berkeley: University of California Press, 1998), 85. 77. Carole A. Stabile, “Shooting the Mother: Fetal Photography and the Politics of Disappearance,” Camera Obscura 10 (1992): 178–­205. See also Barbara Duden, Disembodying Women: Perspectives on Pregnancy and the Unborn (Cambridge, MA: Harvard University Press, 1993). 78. Johanna Schoen, “A Matter for Scientific Study and Medical Judgment: Abortion Providers, Anti-­ Abortion Activists, and the Debate over Pregnancy Termination Procedures,” 26 and 40, in author’s possession. Schoen’s forthcoming book on the history of abortion since legalization provides a detailed exploration of the ways anti-­abortionists represented this research. Johanna Schoen, Abortion after Legalization, 1970–­2000 (Chapel Hill: University of North Carolina Press, 2013). 79. Box 49, Folder 28, CTW Archives. 80. James Risen and Judy L. Thomas, Wrath of Angels: The American Abortion War (New York: Basic Books, 1998), 198. 81. For a detailed analysis of the distortions and representative strategies of the film, see Petchesky, “Fetal Images.” 82. Minto quoted in Brenda C. Coleman, “AMA Committee Criticizes ‘Silent Scream’ and Pro-­Choice Film as Biased,” December 5, 1985, AP News Archive, http://www .apnewsarchive.com/1985/AMA-Committee-Criticizes-Silent-Scream-and-Pro -Choice-Film-as-Biased/id-047d8c7a49f890ca19e97a3e615cb9d2 (accessed December 21, 2012). 83. Peter J. Donaldson, “Using Photographs to Strengthen Family Planning Research,” International Family Planning Perspectives 27, no. 3 (2001): 150. 84. Wilkes, Handbook on Abortion, 16. On the use of the fetus-­feet image in the pregnancy loss movement, see Leslie Reagan, “From Hazard to Blessing to Tragedy: Representations of Miscarriage in Twentieth-­Century America,” Feminist Studies 29, no. 2 (Summer 2003): 367. Chapter 4—“Most of the World’s People Need Planned Parenthood”

1. Planned Parenthood, “Birth Control Is a Godsend,” 5, 1953 Campaign Radio Series, Box 100, Folder 8,N PPFA I; Beryl Suitters, Be Brave and Angry: Chronicles of the IPPF (London: IPPF, 1973), chapters 1–­3. 2. Ellen Chesler, Woman of Valor: Margaret Sanger and the Birth Control Movement in America (New York: Simon & Schuster, 1992), 435. 3. Renamed the United Nations Population Fund in 1987. 4. On funding, see Elaine Moss, The Population Council: A Chronicle of the First Twenty-­Five Years, 1952–­1977 (New York: The Population Council, 1978), 78; Phyllis Tilson Piotrow, World Population Crisis: The United States Response (New York: Praeger Publishers, 1973), x; and R. T. Ravenholt, “The A.I.D. Population and Family Planning Program—­Goals, Scope, and Progress,” Demography 5, no. 2 (1968): 561. 5. Elaine Murphy, “Diffusion of Innovations: Family Planning in Developing Countries,” Journal of Health Communication 9 (2004): 123.

160

Notes to Pages 77–83

6. The first major field experiment that used the diffusion strategy in communication about family planning was undertaken in Taiwan. See Bernard Berelson and Ronald Freedman, “A Study in Fertility Control,” Scientific American 210 (August 1964): 29–­37. 7. Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, Population Reports, Series J, Family Planning Programs, no. 23 (January–­February 1981): 495. 8. J. Mayone Stycos, The Great Tabu: A Half Century of Population and Family Planning Communication (Honolulu: East-­ West Communication Institute, 1977), 4, Stycos’s italics. As noted earlier, Stycos was the founder and director of the International Population Program at Cornell University. 9. Bernard Berelson, “On Family Planning Communication,” Demography 1, no. 2 (1964): 102. 10. Ibid. 11. Ansley Coale and Edgar M. Hoover, Population Growth and Income Development in Low-­Income Countries: A Case Study of India’s Prospects (Princeton, NJ: Princeton University Press, 1958). 12. On the low status of contraceptive research and the attempts of researchers to legitimize their work by focusing on high-­technology scientific solutions, see Adele E. Clarke, Disciplining Reproduction: Modernity, American Life Sciences, and the “Problem of Sex” (Berkeley: University of California Press, 1998). 13. Connelly, Fatal Misconception: The Struggle to Control World Population (Cambridge, MA: Harvard University Press, 2008). 14. Jason L. Finkle and C. Alison McIntosh, “Ideology and Politics at Mexico City: The United States at the 1984 International Conference on Population,” Population and Development Review 11, no. 1 (March 1985): 1–­28. By 1994, the feminism that had emerged in the 1970s had become an integral part of international family planning rhetoric. The term “women’s rights” was used in documents produced at the Cairo meeting instead of the earlier paradigm of “couples and individuals,” despite the objections of the pope and many Islamic countries. See C. Alison McIntosh and Jason L. Finkle, “The Cairo Conference on Population and Development: A New Paradigm?” Population and Development Review 21, no. 2 (1995): 253n6. 15. For a full account of these developments, see Hilkka Pietilä, The Unfinished Story of Women and the United Nations (New York and Geneva: United Nations, 2007). 16. Paul Ehrlich, The Population Bomb, quoted in Johanna Schoen, Choice and Coercion: Birth Control, Sterilization, and Abortion in Public Health and Welfare (Chapel Hill: University of North Carolina Press, 2005), 216. 17. Agnes Smedley to Margaret Sanger, June 1924, quoted in Schoen, Choice and Coercion, 225. See also Barbara N. Ramusack, “Embattled Advocates: The Debate over Birth Control in India, 1920-­40,”Journal of Women’s History, 1, no. 2 (1989): 34–­64. 18. Sanger showed Indian physicians a film designed for health care professionals, The Biology of Conception and Mechanism of Contraception, which the Birth Control Clinical Research Bureau in New York had produced in 1922. She also provided fifty “gynaeplaque” models of pelvic organs, which Indian physicians found very helpful for explaining to illiterate village women how to use birth control. See Barbara Ramusack, “Authority and Ambivalence: Medical Women and Birth Control in India,” in Reproductive Health in India: History, Politics, Controversies, edited by Sarah Hodges (New Delhi: Orient Longman Limited, 2006), 20. 19. In the late 1940s the Ministry of Information worked with the Family Planning Association of India on a documentary film, Planned Parenthood, which promoted the



Notes to Pages 83–88 161

limitation of family size. One history of the IPPF described this as “the first experiment in the use of this medium” in India; see Suitters, Be Brave and Angry, 47. I have yet to locate further information on this production, but there is no evidence that it marked the beginning of a major media campaign. See also Vera Houghton, “Planned Parenthood in India,” Obstetrical and Gynecological Survey 7, no. 2 (1952): 198–­201. 20. Colville Deverell, “The International Planned Parenthood Federation—­Its Role in Developing Countries,” Demography 5, no. 2 (1968): 574. 21. KAP studies were also known as AUK studies, for Attitude, Use, and Knowledge. See J. Mayone Stycos, “Survey Research and Population Control in Latin America,” The Public Opinion Quarterly 28, no. 3 (1964): 367; and R. P. Worrall, “Family and Population Planning Communication: Ten Years of Experience,” in IEC Strategies: Their Role in Promoting Behavior Change in Family and Population Planning (Honolulu: East-­West Communication Institute, July 1977), cited in Everett M. Rogers, Douglas Solomon, and Ronny Adhikarya, Further Directions for USAID’s Communication Policies in Population (Stanford, CA: Institute for Communication Research, Stanford University, 1978), 205. 22. Rogers, Solomon, and Adhikarya, Further Directions for USAID’s Communication Policies in Population, 206. 23. Stycos, “Survey Research and Population Control in Latin America,” 368. 24. Schoen, Choice and Coercion, 216–­234. 25. For a fuller discussion of logo designs for family planning campaigns, see Frank Wilder, “Getting More out of the Mass Media: A Modern Guide for Modern Family Planning Programmes,” in Family Planning and National Development: Proceedings of the Conference of the International Planned Parenthood Federation, Bandung, June 1969, edited by R. K. B. Hankinson (London: International Planned Parenthood Federation, 1969), 9; and Wilbur Schramm, Communication in Family Planning, Reports on Population/Family Planning, no. 7 (New York: Population Council, 1971). 26. Schramm, Communication in Family Planning, 19. 27. Everett M. Rogers, Communication Strategies for Family Planning (New York: The Free Press, 1973), 84–­87. 28. Ibid., 88–­92. 29. Anthony and Elizabeth Isaacs, “The Use of Traditional Art Forms in Association with Mass Media for Social Development Programmes (With Special Reference to Family Planning Programs),” report prepared for the UNESCO/IPPF Expert Group Meeting on the Integrated Use of Folk Media and Mass Media in Family Planning Communications, November 1972, 12, available at the IPPF Archives, London. 30. Schramm, Communication in Family Planning, 7. 31. Rogers, Solomon, and Adhikarya, Further Directions for USAID’s Communication Policies in Population, 206. 32. Wilder, “Getting More out of the Mass Media,” 11. 33. Rogers, Solomon, and Adhikarya, Further Directions for USAID’s Communication Policies in Population, 206; Julian L. Simon, “A Huge Marketing Research Task: Birth Control,” Journal of Marketing Research 5, no. 1 (1968): 23. 34. Wilder, “Getting More out of the Mass Media,” 2. 35. Stycos, The Great Tabu, 18–­19. 36. On KAMP studies, see David Radel, “Communications Research and Communicating Research: The Population Field Encounters Old Problems and Attempts New

162

Notes to Pages 88–91

Solutions,” 5, paper presented at the conference Major Issues in World Communication, East-­West Center, Honolulu, Hawaii, January 2–­4, 1972, available in the IPPF Archives, London. 37. Communications scholar Gerhard D. Wiebe is considered the founding father of social marketing (that is, socially beneficial marketing) for his consideration of ways to “sell brotherhood” in the same manner as soap. See G. D. Wiebe, “Merchandising Commodities and Citizenship on Television,” Public Opinion Quarterly 15, no. 4 (1952): 679. 38. Wilder, “Getting More Out of the Mass Media,” 14. 39. Everett Rogers named the shift from providing information to attempting to persuade simply “The Contemporary Era” in his 1973 book, Communication Strategies for Family Planning. 40. Overview of motivational, technical, and sex education films, Box 6, Folder “IPPF Bogota Tapes,” Martha Stuart Papers. 41. “Rockefeller and Whitney Hire Disney to Make Goodwill Films,” Motion Picture Herald, January 10, 1942, 14. See also Julianne Burton-­Carvajal, “‘Surprise Package’: Looking Southward with Disney” and José Piedra, “Pato Donald’s Gender Ducking,” both in Disney Discourse: Producing the Magic Kingdom, ed. Eric Smoodin (New York: Routledge, 1994), 133. 42. Lisa Cartwright and Brian Goldfarb, “Cultural Contagion: On Disney’s Health Education Films for Latin America,” in Disney Discourse: Producing the Magic Kingdom, edited by Eric Smoodin (New York: Routledge, 1994), 172. 43. The colonial perspective evident in two of the Disney films, Saludos Amigos (1943) and The Three Caballeros (1945), is discussed in Burton-­Carvajal, “‘Surprise Package,’” 131–­147 and 148–­168, respectively. 44. Robert Eberwein, Sex Ed: Film, Video, and the Framework of Desire (New Brunswick, NJ: Rutgers University Press, 1999), 176. 45. Overview of motivational, technical, and sex education films, Box 6, Folder “IPPF Bogota Tapes,” Martha Stuart Papers. 46. Overview of motivational, technical, and sex education films, 8, 12, Box 6, Folder “IPPF Bogota Tapes,” Martha Stuart Papers. 47. On the changing attitudes in the field of communications regarding the use of fear for motivation, see J. T. Klapper, “Contributory Aspects of the Communication Situation” in Klapper, The Effects of Mass Communication (New York: Free Press, 1969); and Rogers, Communication Strategies for Family Planning. 48. Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 498–­499; “Notes on meeting held at 18 Lower Regent Street between Representatives from the IPPF and ICOGRADA (International Council of Graphic Design Associations),” June 2, 1969, IPPF Reel 0433, International Planned Parenthood Federation Archives, London (hereafter IPPF Archives). 49. International Planned Parenthood Federation, Office of Evaluation and Statistics, Survey of World Needs in Family Planning (London: The Federation, 1974). 50. The quotation “no-­one ever planned their family with a poster” is by Dr. Malcolm Potts, former medical director of IPPF’s Central Office, in Central Information and Education Committee, Working Party on Education and Training, “Background Paper,” 3, December 8–­12, 1975, IPPF Reel 0498, IPPF Archives. Central Information and Education Committee, Working Party on Education and Training, “Report,” 4, IPPF Archives.



Notes to Pages 91–95 163

51. Introductory paragraph of Discussion Paper (1), January 1973, quoted in Central Information and Education Committee, “Background Paper,” IPPF roll 0498, 17, IPPF Archives. 52. Donald J. Bogue, “Propaganda versus Information in Family Planning Programs,” in Mass Communication and Motivation for Birth Control, edited by Donald J. Bogue (Chicago: Community and Family Study Center, 1967), 179, Bogue’s emphasis. 53. Central Information and Education Committee, Working Party on Education and Training, “Background Paper,” 4–­5; Florangel Z. Rosario, “Why Aren’t We Communicating as We Ought To?” paper presented at the International Colloquium on Social Psychiatric Implications of Population Control, East-­West Center, Honolulu, Hawaii, May 11–­12, 1973, IPPF Archives. 54. W. P. Mauldin, N. Choucri, F. W. Notestein, and M. Teitelbaum, “A Report on Bucharest: The World Population Conference and the Population Tribune, August 1974,” Studies in Family Planning 5, no. 12 (1974): 357–­395; United Nations, Report of the World Conference of the International Women’s Year (New York: United Nations, 1976). 55. Paolo Freire, Pedagogy of the Oppressed (London: Continuum Publishing Company, 1970). As theorists evaluated the failure of reforms intended to improve access to schooling for impoverished populations, they reconsidered what kind of education would best equip all individuals to fulfill their potential. Although formal education had been massively expanded, drop-­out rates were high, teaching did not match job market needs, and illiteracy remained widespread because adults were excluded. 56. Central Information and Education Committee, Working Party on Education and Training, “Background Paper,” 12. 57. Ibid., 1–­2. 58. Rosario, “Why Aren’t We Communicating as We Ought To?” 3. 59. Central Information and Education Committee, Working Party on Publications and Information Flow, “Report,” January 26–­29, 1976, 8, Reel 0498, IPPF Archives. 60. On new strategies the IPFF considered, see “IPPF’S New Educational Policy: Implications for ESAE & OR,” 1, Reel 0498, IPPF Archives; and Irmela Köhler to Susan Perl, October 20, 1976, Reel 0498, IPPF Archives. 61. “FBI Probing AID Pacts with Airlie,” Washington Post, February 23, 1978. 62. Phyllis T. Piotrow, D. Lawrence Kincaid, Jose G. Rimon II, and Ward Rinehart, Health Communication: Lessons from Family Planning and Reproductive Health (Westport, CT: Praeger, 1997). The Population Information Program began at George Washington University and moved to Johns Hopkins in 1978. In 1982, it was renamed Population Communication Services. 63. Overview of motivational, technical, and sex education films, no date, Box 6, Folder “IPPF Bogota Tapes,” Martha Stuart Papers. 64. Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 498. 65. Countdown to Collision, viewed at the History of Medicine Division Collection, National Library of Medicine, Bethesda, Maryland. Examples of more moderate narratives include Planned Parenthood’s The Costly Crowd (ca. 1965), viewed at the National Library of Medicine, and Brazil: The Gathering Millions (1967). 66. Reviewers also took issue with the emphasis on the IUD in technical/instructional films. These productions glossed over discomfort associated with the fitting process and possible complications, and some included outdated or incomplete information. For example, some films referred to the Dalkon Shield long after it had been banned in the United States.

164

Notes to Pages 96–101

67. Mexico in the Year 2000 (1979), History of Medicine Division Collection, National Library of Medicine. Demographic data from Rodolfo Tuiran, Virgilio Partida, Octavio Mojarro, and Elena Zúñiga, “Fertility in Mexico: Trends and Forecasts,” Population Bulletin of the United Nations: Completing the Transition, Special Issue 48/46 (2002): 484. 68. Juárez and Associates, “Evaluation of Airlie Foundation Film Production: A Final Report,” 18 December 1976, 168, in author’s possession. The report thus conceded some measure of success but was not willing to state that a specific film could be directly linked to changes in attitude (iv). 69. Film archived at the History of Medicine Division, National Library of Medicine. 70. Film archived at the History of Medicine Division, National Library of Medicine. 71. Juárez and Associates, “Evaluation of Airlie Foundation Film Production,” ii and 129. 72. The range comes from the figures cited in ibid., 29; and Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 497. The average cost of films for the government was calculated for films produced in 1972. 73. Films for Family Programs, 500. 74. Ibid., 493. 75. Everett M. Rogers, Douglas Solomon, and Ronny Adhikarya, Further Directions for USAID’s Communication Policies in Population (Stanford, CA: Institute for Communication Research, Stanford University, 1978), 178. Examples of illustrations from Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 499. 76. Nancy Dammann, “Know Your Audience,” in USAID, Bureau for Population and Humanitarian Assistance, Communicating Family Planning—­Speak, They Are Listening, Selected Readings (Honolulu: East-­West Institute, n.d.), 64. 77. Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 499. 78. Rogers, Solomon, and Adhikarya, Further Directions for USAID’s Communication Policies in Population, 179–­180. 79. Isaacs and Isaacs, “The Use of Traditional Art Forms in Association with Mass Media for Social Development Programmes,” 15. 80. See Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 499. 81. These issues were acknowledged early on in the study of professional communications but did not slow the development of family planning motivational media. See D. Cartwright, “Some Principles of Mass Persuasion: Selected Findings of Research on the Sale of United States War Bonds,” Human Relations 2, no. 3 (July 1949): 253–­ 267; and P. F. Lazersfeld, B. Berelson, and H. Gaudet, The People’s Choice: How the Voter Makes Up His Mind in a Presidential Campaign (New York: Columbia University Press, 1948). 82. Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 495. 83. Isaacs and Isaacs, “The Use of Traditional Art Forms in Association with Mass Media for Social Development Programmes,” 1. Although this first meeting focused specifically on family planning, the folk media approach was soon being considered for a wide range of development initiatives at other meetings on folk media in this period, including UNESCO’s Seminar and Workshop on Folk Media (New Delhi, 1974) and the East-­West Communication Institute Seminar on Traditional Media (Honolulu,



Notes to Pages 102–108 165

1975). See Rogers, Solomon, and Adhikarya, Further Directions for USAID’s Communication Policies in Population, 162. 84. G. H. Begbie, “Health Messages through Folk Media: A Critical Review,” Nursing Journal of India 76, no. 11 (1985): 287–­95; G. H. Begbie, “Health Messages through Folk Media. II. Evaluation of the Programmes,” Nursing Journal of India 76, no. 12 (1985): 319–­322; Victor T. Valbuena, “Using Folk Media in Development Programmes,” Media Asia 15, no. 3 (1988): 153. 85. Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 494. 86. The film cost $22,000 to make, or $440 per minute. Ibid., 497. Unless otherwise noted, all details of the film’s preparation, production, and reception are drawn from the producers’ account; Isaacs and Isaacs, “The Use of Traditional Art Forms in Association with Mass Media for Social Development.” Quote from page 15. 87. Ibid., 25; Francis Oluokun Okediji and William Ogionwo, Experiment in Population Education and Attitude Change: An Evaluation of the Film “My Brother’s Children” in Two Rural Nigerian Communities (Lagos: Ibadan University Press, 1973), 7. 88. Isaacs and Isaacs, “The Use of Traditional Art Forms in Association with Mass Media for Social Development Programmes,” 28, 32. 89. Family Planning Programs,” 502; Okediji and Ogionwo, Experiment in Population Education and Attitude Change, 58. 90. Okediji and Ogionwo, Experiment in Population Education and Attitude Change, 53. 91. Ibid., 28, 41–­42. 92. Ibid., 53. 93. As discussed in the previous chapter, Stuart had worked at Planned Parenthood in the 1960s before developing Are You Listening?, her own television series about social issues, including reproductive health. 94. Martha Stuart to William L. Bondurant, September 1, 1982, Box 13, Folder “AYL Abortion Babcock Proposal,” Martha Stuart Papers. 95. Rogers, Solomon, and Adhikarya, Further Directions for USAID’s Communication Policies in Population, 177; Martha Stuart, “Videotape and the Indonesian Family Planning/Population Program,” 5–­6, 1978, Box 14, Folder “Other Proposals,” Martha Stuart Papers. 96. On the disappearance of the doctor from advertising, see Jonathan Metzl, “The Pharmaceutical Gaze: Psychiatry, Scopophilia, and Psychotropic Medication Advertising, 1964–­1985,” and Marc Cohen and Audrey Shafer, “Images and Healers: A Visual History of Scientific Medicine,” both in Cultural Sutures: Medicine and Media, ed. Lester D. Friedman (Durham, NC: Duke University Press, 2004), 15–­35 and 197–­214, respectively; Sandra Morgen, Into Our Own Hands: The Women’s Health Movement (New Brunswick: Rutgers University Press, 2002); and Sheryl Ruzek, The Women’s Health Movement: Feminist Alternatives to Medical Control (New York: Praeger, 1978). 97. Profamilia to Martha Stuart, September 6, 1971, Box 6, Folder “IPPF Bogota Tapes,” Martha Stuart Papers. 98. “Review of ‘Indochina Refugees,’” Library Journal, 107 (June 15, 1982): 1205; Mary Stout, Review of Parents and Children Who Have Adopted Each Other, Library Journal 107, no. 15 (1982): 1627. 99. IPPF untitled document, 16, Box 6, Folder “IPPF Bogota Tapes,” Martha Stuart Papers. 100. Profamilia to Martha Stuart.

166

Notes to Pages 108–113

101. Ibid. 102. Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 500. 103. Overview of motivational, technical, and sex education films, 12, Box 6, Folder “IPPF Bogota Tapes,” Martha Stuart Papers. 104. As a 1981 overview of films by the Population Information Program (one of the largest producers of such films) acknowledged, motivational films “usually need to be made locally.” Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, 494. Chapter 5—Soap Opera as Soap Box

1. Sabido quoted in Arvind Singhal and Rafael Obregon, “Social Uses of Commercial Soap Operas,” Journal of Development Communication 10, no. 1 (1999): 71. 2. Population Information Program, The Johns Hopkins University, Films for Family Planning Programs, Population Reports, Series J, Family Planning Programs, no. 23 (January–­February 1981): 501. 3. Arvind Singhal, Michael J. Cody, Everett M. Rogers, and Miguel Sabido, eds., Entertainment-­Education and Social Change: History, Research, and Practice (Mahwah, NJ: Lawrence Erlbaum Associates, 2004), 12n8. 4. Although historians cite a range of factors to explain the downward trend in Mexico’s birth rate, the population movement and health communication specialists credit the family planning campaign with the dramatic shift that took place in this time frame. See William N. Ryerson, “History of Entertainment-­Education,” 2, unpublished paper June 1999, in author’s possession; and Katherine Elaine Bliss, “La Salud Reproductiva en México, 1928–­1975: La Influencia Internacional en la Política Doméstica,” unpublished paper, April 13, 2006, 1, in author’s possession. 5. See Sarah Buck, “Activists and Mothers: Feminist and Maternalist Politics in Mexico, 1923–­1953” (Ph.D. diss., Rutgers University, 2002), 233–­238. 6. Katherine Elaine Bliss, “Between Risk and Confession: State and Popular Perspectives of Syphilis Infection in Revolutionary Mexico,” and Anne-­Emanuelle Birn, “Revolution, the Scatalogical Way: The Rockefeller Foundation’s Hookworm Campaign in 1920s Mexico,” both in Disease in the History of Modern Latin America: From Malaria to AIDS, edited by Diego Armus, 183–­208 and 158–­182, respectively (Durham, NC: Duke University Press, 2003); Katharine Bliss, “The Science of Redemption: Syphilis, Sexual Promiscuity and Reformism in Revolutionary Mexico City,” Hispanic American Historical Review 79, no. 1 (1999): 1–­40; Katharine Bliss, Compromised Positions: Prostitution, Public Health and Gender Politics in Revolutionary Mexico City (University Park: Pennsylvania State University Press, 2002); Claudia Agostoni, Monuments of Progress: Modernization and Public Health in Mexico City, 1876–­1910 (Boulder: University Press of Colorado, 2003); Claudia Agostoni, “Popular Health Education and Propaganda in Times of Peace and War in Mexico City, 1890s–­1920s,” American Journal of Public Health 96, no. 1 (2006): 52–­61; Anne-­Emanuelle Birn, Marriage of Convenience: Rockefeller International Health and Revolutionary Mexico (Rochester, NY: University of Rochester Press, 2006). In the 1930s, Mexican eugenicists used radio to deliver lectures to the general public on topics such as “Physical Culture and Eugenics” and “Prenatal Advice”; see Alexandra Minna Stern, “Responsible Mothers and Normal Children: Eugenics, Nationalism, and Welfare in Post-­Revolutionary Mexico, 1920–­1940,” Journal of Historical Sociology 12, no. 4 (1999): 369–­397.



Notes to Pages 114–116 167

7. Stern, “Responsible Mothers and Normal Children,” 376, 381. 8. Ibid., 370, 387. For an overview of the history of family planning in Mexico, see Carlos Brambila, “Mexico’s Population Policy and Demographic Dynamics: The Record of Three Decades,” in Do Population Policies Matter? Fertility and Politics in Egypt, India, Kenya, and Mexico, edited by Anrudh Jain (New York: Population Council, 1998), 157–­191. 9. Bliss, “La Salud Reproductiva en México,” 11. 10. Mary Kay Vaughan, “Modernizing Patriarchy: State Policies, Rural Households and Women in Mexico, 1930–­1940,” in Hidden Histories of Gender and the State in Latin America, edited by Elizabeth Dore and Maxine Molyneux (Durham, NC: Duke University Press, 2000), 194–­214. 11. Sarah Buck, “The Meaning of the Women’s Vote in Mexico, 1917–­1953,” in The Women’s Revolution in Mexico, 1910–­1953, edited by Stephanie Mitchell and Patience A. Schell (New York: Rowman & Littlefield, 2007), 73–­83; and Jocelyn Olcott, “‘Worthy Wives and Mothers’: State-­Sponsored Organizing in Post-­Revolutionary Mexico,” Journal of Women’s History 13, no. 4 (2002): 106–­131. Women’s appropriation of maternalism (as defined by Seth Koven and Sonya Michel) and the transnational influence of republican motherhood has been studied by several historians of Mexico. See Koven and Michel, eds., Mothers of a New World: Maternalist Politics and the Origins of Welfare States (New York: Routledge, 1993) For the history of motherhood in Mexico, see Nichole Sanders, “Mothering Mexico: The Historiography of Mothers and Motherhood in Twentieth-­Century Mexico,” History Compass 7, no. 6 (2009): 1542–­1553; and Buck, “Activists and Mothers,” 265–­305. 12. John W. Sherman, “The ‘Mexican Miracle’ and Its Collapse,” in The Oxford History of Mexico, edited by Michael C. Meyer and William H. Beezley (Oxford: Oxford University Press, 2000), 575–­608. Sherman points out that the Green Revolution, the transformation of agricultural practices that revolutionized and increased global food production (which many of the communications specialists who later focused on family planning communications promoted), impoverished many rural Mexicans because of the mechanization of agricultural work. 13. Bliss, “La Salud Reproductiva en México,” 3; Gabriela Soto Laveaga, “‘Let’s Become Fewer’: Soap Operas, Contraception, and Nationalizing the Mexican Family in an Overpopulated World,” Sexuality Research and Social Policy 4, no. 3 (2007): 23; Box 206, Folder 6, PPFA II. 14. Dr. Arturo Aldama to Mr. Lammot DuP. Copeland, November 2, 1962, Box 206, Folder 6 “Asociacion Pro-­Salud Maternal (Rice-­Wray),” PPFA II. 15. For a full account of the development of the pill, see Lara V. Marks, Sexual Chemistry: A History of the Contraceptive Pill (New Haven, CT: Yale University Press, 2001). 16. Rice-­Wray quoted in Bliss, “La Salud Reproductiva en México,” 15. 17. The report stated that approximately twenty women were admitted because of complications from abortion every 100 live hospital births. J. Mayone Stycos, “Survey Research and Population Control in Latin America,” Public Opinion Quarterly 28, no. 3 (1964): 371. 18. Ofelia Mendoza, Report to the Executive Committee of the IPPF, Western Hemisphere Region, November 14, 1963, Box 204, Folder 16, PPFA II. 19. Beryl Suitters, Be Brave and Angry: Chronicles of the IPPF (London: IPPF, 1973), chapter 13; Tom Davis, Sacred Work: Planned Parenthood and Its Clergy Alliances (New Brunswick, NJ: Rutgers University Press, 2006), 119.

168

Notes to Pages 117–120

20. Donald J. Bogue, “Propaganda versus Information in Family Planning Programs,” in Mass Communication and Motivation for Birth Control, edited by Donald J. Bogue (Chicago: Community and Family Study Center, 1967), 179; Soto Laveaga, “‘Let’s Become Fewer’”; Suitters, Be Brave and Angry, 383. 21. Suitters, Be Brave and Angry, 392. 22. Historians have overemphasized the importance of female passivity in Mexican culture. Recent scholarship has pointed to examples of women’s activities in political life. See for example Joanne Hershfield, Imagining La Chica Moderna: Women, Nation, and Visual Culture in Mexico, 1917–­1936 (Durham, NC: Duke University Press, 2008), which traces the image of a modern woman in Mexican media that was comparable to the American flapper. On the long tradition of female activism in Mexico, see Kristina A. Boylan, “Gendering the Faith and Altering the Nation: Mexican Catholic Women’s Activism, 1917–­1940,” in Sex in Revolution: Gender, Politics, and Power in Modern Mexico, edited by Jocelyn Olcott, Mary Kay Vaughan, and Gabriela Cano (Durham, NC: Duke University Press, 2006), 199–­222. 23. J. Mayone Stycos, “Survey Research and Population Control in Latin America,” Public Opinion Quarterly 28, no. 3 (1964): 368. 24. I draw here on historian Gabriela Soto Laveaga’s interpretation of the limitations of the campaign; see Soto Laveaga, “‘Let’s Become Fewer.’” 25. Celeste González de Bustamente, “Dependence and Development: The Importance of TV News in the History of Mexican Television,” Revista Galáxia 18 (2009): 256; L. A. Lesch, “Mission to Mexico: To Study the Use of Radio and Television in Literacy Work,” 7, UNESCO report, 1969, http://unesdoc.unesco.org/ images/0015/001563/156377eb.pdf (accessed November 8, 2012); Heidi Noel Nariman, Soap Operas for Social Change: Toward a Methodology for EntertainmentEducation Television (Westport, CT: Praeger, 1993), 9–10; Arvind Singhal and Everett M. Rogers, Entertainment-Education: A Communication Strategy for Social Change (Mahwah, NJ: Lawrence Erlbaum Associates, 1999), 51. 26. Unless otherwise noted, all information on the telenovela and Sabido’s use of it is from “Formulation of the Entertainment-­Education Strategy for Development Communication in Mexico,” chapter 1 of Nariman, Soap Operas for Social Change. 27. Critiques of popular, or lowbrow, culture are extensive from a wide range of theoretical and political standpoints, from class-­and gender-­based prejudices against crude or trivial entertainment to Marxist analysis of its oppressive social function in suppressing dissent. The classic account of the emergence of the high/low divide is Lawrence Levine’s Highbrow/Lowbrow: The Emergence of Cultural Hierarchy in America (Cambridge, MA: Harvard University Press, 1990). 28. Arvind Singhal and Rafael Obregon, “Social Uses of Commercial Soap Operas,” Journal of Development Communication 10, no. 1 (1999): 74. Pharmaceutical companies have had no such qualms about financing extensive media campaigns to stimulate demand for their products: direct-­to-­consumer advertising began in the United States in 1981. See Francis B. Palumbo and C. Daniel Mullins, “The Development of Direct-­to-­Consumer Prescription Drug Advertising Regulation,” Food and Drug Law Journal 57, no. 2 (2002): 423–­444. 29. For a full account, see Singhal and Rogers, Entertainment-­Education: A Communication Strategy for Social Change, chapter 2. Unless otherwise indicated, I am drawing on this source for my analysis of entertainment-­education. 30. On radio listenership, see Lesch, “Mission to Mexico,” 7.



Notes to Pages 121–127 169

31. Singhal and Obregon, “Social Uses of Commercial Soap Operas,” 70. Later in his work, Sabido also cited Eric Bentley’s dramatic theory, which laid out the components of melodrama and how they could be used to impact audiences, and neuroscientist Paul D. MacLean’s triune brain theory, which identified three ways human beings process messages—­through intelligence, emotion, and sexual urges. See Miguel Sabido, “The Origins of Entertainment-­Education,” in Entertainment-­ Education and Social Change: History, Research, and Practice, ed. Arvind Singhal, Michael J. Cody, Everett M. Rogers, and Miguel Sabido (Mahwah, NJ: Lawrence Erlbaum Associates, 2004), 61–­74. Sabido developed his own theory of tones to describe the different emotions that performance styles could generate. 32. Singhal and Obregon, “Social Uses of Commercial Soap Operas,” 73. For Sabido’s account of the theoretical basis for his approach, see his chapter “The Origins of Entertainment-­Education,” in Entertainment-­Education and Social Change: History, Research, and Practice, edited by Arvind Singhal, Michael J. Cody, Everett M. Rogers, and Miguel Sabido (Mahwah, NJ: Lawrence Erlbaum Associates, 2004), 61–­74. 33. Singhal and Obregon, “Social Uses of Commercial Soap Operas,” 69. 34. Paul Felix Lazarsfeld, Bernard Berelson, and Hazel Gaudet, The People’s Choice (New York: Columbia University Press, 1948). 35. Unless otherwise indicated, all information about Ven Conmigo comes from Singhal and Rogers, Entertainment-­Education, chapters 2 and 3. 36. I have drawn extensively on two accounts for my discussion of Sabido’s work in general and Acompáñame specifically: Singhal and Rogers, Entertainment-­Education; and Nariman, Soap Operas for Social Change. 37. Soto Laveaga makes this important connection in “‘Let’s Become Fewer,’” 27. 38. Singhal and Rogers, Entertainment-­Education, 38. 39. Enrollment in family planning clinics that year increased by 33 percent, compared to a 1 percent decrease the previous year. Population Media Center, “PMC Program Fundamentals—­ Sabido Method,” http://www.populationmedia.org/programs/sabido .html (accessed 15 September 2007). 40. Singhal, Cody, Rogers, and Sabido, Entertainment-­Education and Social Change, 28. Sabido’s other programs include Vamos Juntos (When We Are Together, 1979–­1980), which promoted responsible parenthood; El Combate (The Fight, 1980), on adult literacy; Caminemos (Let’s Walk Together, 1980–­1981), about sexual responsibility for teenagers; Nosotras Las Mujeres (We the Women, 1981), which promoted equal status for women; and Por Amor (For Love, 1981–­1982), on family planning. 41. Frank Kavanaugh, “The Present and Future Role of Television in Communicating Family Planning,” in USAID, Bureau for Population and Humanitarian Assistance, Communicating Family Planning: Speak—­They Are Listening, Selected Readings (Honolulu: East-­West Communication Institute, n.d.), 32; Nariman, Soap Operas for Social Change, 3. 42. Singhal and Obregon, “Social Uses of Commercial Soap Operas,” 75. 43. Singhal, Cody, Rogers, and Sabido, Entertainment-­Education and Social Change, 14. 44. Unless otherwise indicated, the information on Hum Log comes from chapter 4, “The Hum Log Story in India,” in Singhal and Rogers, Entertainment-­Education. 45. Singhal and Rogers, Entertainment-­Education, 38. 46. Sarah. N. Keller and Jane D. Brown, “Media Interventions to Promote Responsible Sexual Behavior,” The Journal of Sex Research 39, no. 1 (2002): 68; Singhal, Cody, Rogers, and Sabido, Entertainment-­Education and Social Change, 7. 47. Stycos, “Desexing Birth Control,” 290.

170

Notes to Pages 129–133

Chapter 6—Twenty-­F irst-­C entury Sex

1. D. T. Lowry and J. A. Shidler, “Prime Time TV Portrayals of Sex, ‘Safe Sex’ and AIDS: A Longitudinal Analysis,” Journalism & Mass Communication Quarterly 70, no. 3 (1993): 628–­637; Rebecca L. Collins, “Sex on Television and Its Impact on American Youth: Background and Results from the RAND Television and Adolescent Sexuality Study,” Child and Adolescent Psychiatric Clinics of North America 14, no. 3 (2005): 372. On sex in television advertising, see C. J. Pardun and K. R. Forde, “Sexual Content of Television Commercials Watched by Early Adolescents,” in Sex in Promotional Culture: The Erotic Content of Media and Marketing, edited by T. Reichert and J. Lambiase (Mahwah, NJ: Lawrence Erlbaum Associates, 2006), 125–­139. 2. Richard Butsch, The Making of American Audiences: From Stage to Television, 1750–­1990 (Cambridge: Cambridge University Press, 2000), 251; Kate Langrall Folb, “‘Don’t Touch That Dial!’ TV as a—­What!?—­Positive Influence,” SIECUS Report 28, no. 5 (2000): 16–­18, 16; Beth Pellettieri, “Television and the Internet: Important Sources of Sexual Health Information for Youth,” Advocates for Youth website, 2004, http://www.advocatesforyouth.org/index.php?option=com_content&task=view &id=438&Itemid=177 (accessed November 8, 2012). 3. Poll numbers from Planned Parenthood Federation of American and Louis Harris Associates, Public Attitudes about Sex Education, Family Planning, and Abortion (New York: L. Harris, 1985), results also available at The Roper Center, University of Connecticut; Planned Parenthood, “PPFA Maggie Awards for Media Excellence—­ 1978 to 2005,” http://www.plannedparenthood.org/about-us/newsroom/ maggie-awards/ppfa-maggie-awards-media-excellence-1978-2005.htm (accessed November 8, 2012). 4. The Council on Communications and Media, “Sexuality, Contraception and the Media,” Pediatrics 126, no. 3 (2010): 576. 5. On efforts to restrict sex education, see Jeffrey P. Moran, Teaching Sex: The Shaping of Adolescence in the 20th Century (Cambridge, MA: Harvard University Press, 2000), chapters 5–­7; and Alexandra Lord, Condom Nation: The U. S. Government’s Sex Education Campaign from World War I to the Internet (Baltimore, MD: Johns Hopkins University Press, 2009), chapters 6–­8. 6. Arvind Singhal and Everett M. Rogers, Entertainment-­Education: A Communication Strategy for Social Change (Mahwah, NJ: Lawrence Erlbaum Associates, 1999), 9. 7. Folb, “‘Don’t Touch That Dial!’’ 16. 8. Ibid. 9. Ibid. 10. MacGregor, “Media Project Teaches Safe Screen Sex.” 11. Folb, “‘Don’t Touch That Dial!’” 16; Beth Pellettieri, “Television and the Internet.” 12. The Henry J. Kaiser Family Foundation, “Entertainment Education and Health in the United States,” Henry J. Kaiser Family Foundation Issue Brief (Spring 2004), http://www.kff.org/entmedia/upload/entertainment-education-and-health-in-the -united-states-issue-brief.pdf (accessed November 8, 2012). 13. Dale Kunkel, Keren Eyal, Keli Finnerty, Eria Biely, and Edward Donnerstein, Sex on TV 4 (Kaiser Family Foundation, 2005), 58–­59, http://www.kff.org/entmedia/ upload/Sex-on-TV-4-Full-Report.pdf (accessed November 8, 2012). 14. Victor C. Strasburger, Barbara J. Wilson, and Amy B. Jordan, Children, Adolescents, and the Media (Los Angeles: Sage Publications, 2009), 250–­251. 15. American Academy of Pediatrics, Committee on Public Education, “Sexuality, Contraception, and the Media,” Pediatrics 107, no. 1 (2001): 191–­194.



Notes to Pages 133–140 171

16. Strasburger, Wilson, and Jordan, Children, Adolescents, and the Media, chap. 6. See also American Academy of Pediatrics, Committee on Communications, “Sexuality, Contraception, and the Media,” Pediatrics 95, no. 2 (1995): 298–­300; American Academy of Pediatrics, Committee on Public Education, “Sexuality, Contraception, and the Media,” Pediatrics 107, no. 1 (2001): 191–­195; and American Academy of Pediatrics, The Council on Communications and Media, “Sexuality, Contraception and the Media,” Pediatrics 126, no. 3 (2010): 576. 17. All information about Friends is from Rebecca L. Collins, Marc N. Elliott, Sandra H. Berry, David E. Kanouse, and Sarah B. Hunter, “Entertainment Television as a Healthy Sex Educator: The Impact of Condom-­Efficacy Information in an Episode of Friends,” Pediatrics 112, no. 5 (2003): 1115–­1121. 18. Beth Pellettieri, “Television and the Internet”; Barbara Ehrenreich, “Owning Up to Abortion,” New York Times, 22 July 2004. 19. Kyla C. Grant, “For Some Students, ‘Teen Mom’ Isn’t a Cautionary Tale,” abcnews, October 14, 2010, http://abcnews.go.com/Entertainment/teen-moms-celebs-campus/ story?id=11872306#.UJwrsMXXZ1I (accessed November 8, 2012); Jan Hoffman, “Fighting Teenage Pregnancy with MTV Stars as Exhibit A,” New York Times, April 10, 2011; Alessandra Stanley, “. . . And Baby Makes Reality TV,” New York Times, January 21, 2011. 20. Vicki Beck, “Working with Daytime and Prime-­Time Television Shows in the United States to Promote Health,” in Entertainment-­Education and Social Change: History, Research, and Practice, edited by Arvind Singhal, Michael J. Cody, Everett M. Rogers, and Miguel Sabido (Mahwah, NJ: Lawrence Erlbaum Associates, 2004), 212. 21. J. L. Sherry, “Media Saturation and Entertainment-­ Education,” Communication Theory 12, no. 2 (2006): 206–­224. 22. Sarah. N. Keller and Jane D. Brown, “Media Interventions to Promote Responsible Sexual Behavior,” Journal of Sex Research 39, no. 1 (2002): 69. 23. Arvind Singhal and Everett M. Rogers, “The Status of Entertainment-­Education Worldwide,” in Entertainment-­Education and Social Change: History, Research, and Practice, edited by Arvind Singhal, Michael J. Cody, Everett M. Rogers, and Miguel Sabido (Mahwah, NJ: Lawrence Erlbaum Associates, 2004), 13. 24. Collins, Elliott, Berry, Kanouse, and Hunter, “Entertainment Television as a Healthy Sex Educator,” 1115; Folb, “‘Don’t Touch That Dial!’” 16–­18. 25. For an in-­depth discussion of the recent use of entertainment-­education on U.S. television, see Beck, “Working with Daytime and Prime-­Time Television Shows in the United States to Promote Health.” “Medicalized Edutainement” is Julie Elman Passanate’s term for the “disease of the week” shows she analyzes in “After School Special Education: Rehabilitative Television, Teen Citizenship, and Compulsory Able-­Bodiedness,” Television and New Media 20, no. 10 (2010): 260–­292. 26. Lawrence Wallack and Kathryn Montgomery, “Advertising for All by the Year 2000: Public Health Implications for Less Developed Countries,” Journal of Public Health Policy 13, no. 2 (1992): 218. 27. Beck, “Working with Daytime and Prime-­Time Television Shows in the United States to Promote Health,” 208. 28. Keller and Brown, “Media Interventions to Promote Responsible Sexual Behavior,” 70; Pellettieri, “Television and the Internet.” 29. Sondra Jedziniak, “Wes Students Rally to Support Planned Parenthood—­With Creativity,” Middletown Patch, April 25, 2011; Michele Koufopoulos, “‘I Have Sex,’—­ Wesleyan Students Speak Out for Choice,” The Faster Times, March 15, 2011; Olivia

172

Notes to Pages 142–144

Drake, “Planned Parenthood Awards Students for ‘I Have Sex’ Video,” The Wesleyan Connection, April 13, 2011. 30. Arianna Huffington, “Planned Parenthood, Social Media, and a Win for Women’s Health,” Huffington Post, 7 February 2012, http://www.huffingtonpost.com/arianna -huffington/komen-planned-parenthood_b_1260631.html (accessed November 8, 2012); Kivi Leroux Miller, “The Accidental Rebranding of Komen for the Cure,” Kivi’s Nonprofit Communications Blog, February 1, 2012, http://www.nonprofit marketingguide.com/blog/2012/02/01/the-accidental-rebranding-of-komen-for-the -cure (accessed November 8, 2012); Jennifer Preston and Gardiner Harris, “Outcry Is Fierce to Cut in Funds by Cancer Group,” New York Times, February 2, 2012. 31. On the anti-­abortion movement’s need for an equivalent level of engagement with social media, see Kate Nocera, “Did Susan G. Komen Turn Itself into a Lightening Rod?” Politico Pro, February 1, 2012. Quote from Jill Stanek, “How Planned Parenthood & Social Media Crushed Susan G. Komen,” Jill Stanek: With Her Typing Fingers on the Pro-­Life Pulse (blog), February 6, 2012, http://www.jillstanek.com/2012/02/ how-planned-parenthood-used-social-media-to-crush-komen/ (accessed November 8, 2012). 32. “We Had Abortions,” Ms. Magazine, Fall 2006, http://www.msmagazine.com/fall 2006/abortionmag.asp (accessed November 8, 2012); Laura Barcella, “The A-Word,” Salon.com, September 20, 2004; Jennifer Baumgardner, “The Shirt,” Abortion & Life website, http://abortionandlife.com/p/the-shirt/ (accessed November 8, 2012); Jennifer Baumgardner, “We’re Not Sorry. Still,” On the Issues Magazine, Winter 2012, http://www.ontheissuesmagazine.com/2012winter/2012winter_Baumgardner.php (accessed November 8, 2012). 33. Rebecca Hyman, “Full Frontal Offense,” bitchmedia, 2004, http://bitchmagazine .org/article/full-frontal-offense (accessed November 8, 2012). 34. Kate Cosby Cockrill, “Who Owns the Story of Abortion?” ANSIRH Blog, March 2, 2011, http://blog.ansirh.org/2011/03/who-owns-the-story-of-abortion/ (accessed November 8, 2012); Voices from Home, Planned Parenthood website, http://www .plannedparenthoodaction.org/positions/share-your-story-1046.htm; My Abortion. My Life website, http://myabortionmylife.org/. 35. See, for example, Katherine Dexter McCormick Library, Planned Parenthood Federation of America, “Opposition Claims about Margaret Sanger,” http://www.planned parenthood.org/files/PPFA/OppositionClaimsAboutMargaretSanger.pdf (accessed January 4, 2013); and Planned Parenthood Federation of America, “Griswold v. Connecticut—The Impact of Legal Birth Control and the Challenges that Remain,” http:// www.plannedparenthood.org/files/PPFA/fact_griswold_2010-09.pdf (accessed January 1, 2013).

Index

Page numbers in italics refer to illustrations. ABC (American Broadcasting Company), 132 abortifacients, 2, 145n2 “Abortion: A Look into the Illegal Abortion Racket” (Confidential File segment), 65 “Abortion and the Law” (CBS Reports segment), 65 abortion services, 6–­8; and anti-­abortion movement, 50, 66, 68–­75, 72, 73, 135, 140–­143; and Birth Control (1917 film), 21, 21; birth control confused with, 39; and Chile, 116, 167n17; criminalization of, 14, 50, 74, 115–­116, 145n2, 148n9, 167n17; and films, 14–­19, 21, 21, 27–­29, 97–­98; and global gag rule, 10–­11, 110; and international family planning movement, 10–­11, 97–­98, 110; and Internet, 139–­144; legalization of, 46, 51, 64, 69, 135, 142, 159n78; limiting access to, 10–­11, 110, 135, 140, 143; and Maude (television series), 67–­69, 71, 137–­138, 158n67; and Mexico, 115–­116, 167n17; and Ms. magazine petition, 142–­143; and murder of abortion providers, 72; in nineteenth century, 2, 14, 145n2; and Planned Parenthood, 17, 46, 50–­51, 66, 69–­74; and radio, 39, 50–­51; and “sex pictures,” 29; and stigma/secrecy, 51, 64, 66; and television, 46, 64–­74, 135, 137–­138 abstinence, sexual, 25, 35, 131, 134 Academy for Educational Development (AED), 126–­127 Acompáñame (Come along with Me, telenovela), 122–­123, 126, 137 adolescents and sexuality, 127, 130–­137; and Internet, 139 adoption, 50 Adorno, Theodor, 4 advertising, 4, 6, 9; anti-­smoking ads, 62, 64; consumer advertising, 49, 57, 61, 88,

168n28; erotic imagery in, 42; and films, 17, 20, 26; and international family planning movement, 86, 88, 107; and Mexico, 114, 117–­118; and national advertising campaign, 60–­64; and newspapers/ magazines, 47–­48, 58; in nineteenth-­ century media, 2, 12, 145n2; pharmaceutical advertising, 119, 136, 168n28; and population control movement, 47–­49; and radio, 31, 34–­35, 41–­42; and sexuality, 127, 129, 136, 138; and television, 52–­57, 60–­66, 75, 118, 126, 131, 136, 138, 155n26 Advertising Council, 60–­61, 63, 70, 74, 129 Advocates for Youth, 132, 135 affective storytelling, 64, 123–­124, 137. See also emotional appeal Africa, 76–­77, 126. See also names of individual African countries African Americans, 7, 59; and eugenics theory, 15; and Negro Project (BCFA), 55; and radio, 39; and “Talented Tenth,” 15. See also entries beginning with black agricultural development, 4, 36, 49, 88, 96; and Green Revolution, 77, 167n12; and Mexico, 112, 167n12 AIDS epidemic. See HIV/AIDS Airlie Foundation, 94–­99 Alaskans, Native, 106 Alcántara, Celia, 122 alcohol use, 56, 62, 122, 138 All in the Family (television series), 67–­68, 124, 158n67; and “Archie Bunker effect,” 124 Ally McBeal (television series), 132 “Almost Daylight” (radio script), 38 America (periodical), 68 American Academy of Pediatrics, 131, 133; Contraception, Sexuality, and the Media statement, 133

173

174 Index 

American Birth Control League (ABCL), 18, 30, 33, 36–­37; conference of, 33; petition of, 36; and Sanger, 30, 37. See also Birth Control Federation of America (BCFA) American Cancer Society, 14 American Civil Liberties Union (ACLU), 33 American Marconi, 31 American Medical Association, 39, 53–­54 American Socialist Party, 33 American Society for the Control of Cancer, 36 Anglo-­Saxon women. See white middle-­ class women animated cartoons, 1, 60, 89–­90, 100, 127, 162n43 anti-­abortion movement, 50, 66, 68–­74, 140–­143; campaign against so-­called partial birth abortion, 72; image of feet of fetus, 74–­75; images of aborted fetuses, 68, 70–­74, 72, 73, 158n76, 159n78; and Internet, 140–­142; and letter-­writing strategy, 70, 72, 73; photo of artificial womb experiment, 70–­72, 72; and sexuality, 135; and television, 135 anti–­birth control, 24–­25, 24 anti-­imperialist critiques, 10 anti-­obscenity reformers, 2, 14 anti-­smoking ads, 62, 64 The Archers (radio soap opera), 112 archetypes, universal, 121 Are You Listening? (television series), 64, 65, 129, 142, 165n93 Argentina, 120, 122 arsonists, 59 Asia, 1, 76–­77, 90, 126 Asociación Pro-­Bienestar de la Familia Mexicana, 115 Associated Press, 141 Atlanta (Ga.), 151n56 Atlanta Constitution, 18 atomic bomb, 50 audiences, 3, 6, 9; and age factors, 30, 32–­33, 35, 53; audience fatigue, 24; Depression-­ era, 29; and films, 14–­19, 22–­25, 28–­29, 89, 95–­96, 99–­101, 104–­106, 150n30, 151n42; and folk media, 101–­102, 104–­ 106; “general public” as, 22; Hispanic audiences, 120; and India, 125–­126;

innovative members of, 49, 77, 160n6; and international family planning movement, 86–­88, 90, 95–­96, 99–­102, 104–­109; and Internet, 144; literacy of, 13, 61, 85–­86, 88, 120, 122–­123, 160n18, 163n55; live audiences, 68; media literacy of, 19, 99–­100, 105, 150n30; and messages confirming existing beliefs, 100, 119, 125; and Mexico, 111, 114, 118–­124; mixed audiences, 25, 53, 105–­106; as passive receptors, 49; and Peru, 122–­123; and population control movement, 48–­49; and radio, 30–­ 35, 37–­39, 51–­52; and sex hygiene films, 14–­16, 25; and “sex pictures,” 29; and sexuality, 130, 132–­136, 138; and symbolic representations, 19, 99–­100, 150n30; talking during showing, 104–­105; target audiences, 7, 17, 62, 86–­88, 100–­101, 105, 112, 135–­136; and telenovelas, 112, 119–­124, 169n31; and television, 46, 48, 53, 59, 61–­64, 66–­69, 112, 118–­126, 130, 132–­136, 138, 169n31; test audiences, 132, 134–­135; and videos, 107–­108 AUK (attitude, use, and knowledge) research, 161n21. See also KAP research Australia, 106 Australian Broadcasting Corporation, 112 Aylesworth, M. H., 35 Babbin, Jacqueline, 70 Ball, Lucille, 54 Bandura, Albert, 120–­121 Bangladesh, 78 Barton, Bruce, 47 Batingaw (The Bell, 1974 film), 112 Baumgardner, Jennifer, 143 Baziri tribe (Somalia), 87 BBC (British Broadcasting Corporation), 8, 112, 123; BBC World Radio, 104 Bell, George H., 22–­23 Bentley, Eric, 169n31 Berelson, Bernard, 4, 78–­79, 121 Bernays, Edward, 91 Birth Control (1917 film), 19–­23, 74, 149n29, 150n31; banned in New York City, 22; and “certificate of genuineness,” 19; documentary elements in, 23; interview in, 19–­21; public debut cancelled,



Index 175

22; Sanger as star of, 19–­23, 20, 21, 150n31; Sanger’s conversion narrative in, 21–­22, 150n31; stills from, 20–­21, 20, 21 “Birth Control, a Matter of Public Policy” (radio program), 33 “Birth Control—­A Woman’s Right and a Human Right” (radio program), 33 Birth Control Clinical Research Bureau, 23, 114, 160n18 Birth Control Federation of America (BCFA), 3, 37–­38, 40, 55; fund-­raising campaigns of, 40; Negro Project (1939–­ 1943), 55. See also Planned Parenthood Federation of America “Birth Control Legislation” (radio program), 36 birth control movement, 1–­8, 10, 144; backlash against films, 24–­25, 28–­29; backlash against radio programming, 38–­ 40; and Birth Control (1917 film), 19–­23, 20, 21, 149n29, 150n31; black leaders’ qualified support of, 15, 55; eugenicists’ support of for “unfit” people, 14, 19, 148n10; and films, 16–­29; and The Hand That Rocks the Cradle (1917 film), 22–­ 23; and India, 82; and radio, 30, 32–­33, 35–­41; and single men/women, 42; and Where Are My Children? (1916 film), 16–­19, 149n17; and World War II, 40–­43. See also contraception; family planning movement The Birth Control Review (Sanger newsletter), 13, 19, 142 The Birth of a Nation (1915 film), 23 birth rate: declining, 14, 62, 113, 166n4; flourishing during World War II, 40; in Mexico, 113–­115, 166n4; teen birth rate, 133 black leaders, 7, 15, 55, 58–­59; black nationalist leaders, 7, 15, 58–­59; black radio entrepreneurs, 151n56; and eugenics theory, 15; and Negro Project (BCFA), 55; and television, 55, 59 Black Panthers, 58 black single mothers, 57, 64, 65 Blayton, Jesse B., 151n56 Blue Hills (1949 radio series), 112 Bogota (Colombia), 108

Bogue, Donald J., 4, 91 The Bold and the Beautiful (television soap opera), 131, 138 The Bold Ones (television series), 66 Bombay (India), 86, 114–­115 Boston (Mass.), 12, 65 Boy Meets World (television series), 132 Boys Clubs of America, 135 A Brand New Life (television series), 66 Brazil, 100, 112, 116, 120, 127 Breen, Joseph, 28 Brieux, Eugene, 13 Briggs, Laura, 8 Brinker, Nancy G., 141 Bromley, Dorothy Dunbar, 39 Brooklyn (N.Y.), 13 Buffalo (N.Y.), 33 Bureau of Moral and Hygienic Education, 27 Bush, George H. W., 67 Bush, George W., 11 Byrne, Ethel, 13 Cain, John, 8 Canada, 106 cancer, 5–­6, 141; breast cancer, 5, 141–­142; cancer charity, 141–­142; cancer screening, 137; cervical cancer, 5; and telenovelas, 122 capital punishment, 16 Carlin, E. Stephen, 41 Cartwright, Lisa, 89 Catholic Encyclopedia, 116 Catholics, 8; Catholic Legion of Decency, 28–­29; and films, 28–­29, 43, 95; and India, 82; and international family planning movement, 82, 95, 108; and Mexico, 113–­117, 122, 124; papal encyclical proscribing contraception, 60, 116–­117; polling of, 58; and population control movement, 48, 51, 82, 160n14; and radio, 35, 43, 51–­52; and telenovelas, 122, 124; and television, 68–­70, 122, 124; and videos, 108 CBS (Columbia Broadcasting System): and radio, 35, 37, 77; and television, 48, 59, 65, 67–­68, 71, 130–­132, 158n67 CBS Reports (television program), 48, 65

176 Index 

censorship, 10, 12; and film industry guidelines, 14, 28, 151n48; of films, 3, 14–­19, 22, 24–­25, 28–­30, 43, 148n8; and nudity, 29; and “pictorial representation in public places,” 16; and Production Code (1930), 28–­29, 151n48; and radio, 32–­33, 35, 37, 43; self-­censorship, 131; of sex hygiene films, 25, 28; of “sex perversions,” 28–­29, 151n48; states/municipalities granted power of, 16, 22–­23, 28; and television, 3, 56–­57, 131; and Where Are My Children? (1916 film), 17–­18 censorship boards, 16 Centers for Disease Control (CDC), 6, 131–­ 132; Sentinel Health Award for Daytime Drama, 131 Central America, 97, 116. See also names of individual Central American countries Centro de Investigaciones de la Fisiologia de la Mujer: Asociación Pro-­Salud Maternal, 115 the charlatan (as character type), 15 Chicago Hope (television series), 132 A Child Is Born: The Drama of Life before Birth (Nilsson), 71 Children’s Television Workshop (CTW), 69–­70, 72, 73 child spacing, 39, 43, 50–­51 Chile, 116, 167n17 China, 138 Chisholm, Shirley, 59 Christian evangelism, 130 Cita en Santo Domingo (Rendezvous in Santa Domingo, ca. 1973 film), 98 civil rights movement, 56, 58–­59, 156nn39–­40 class, 6, 8, 168n27; class warfare, 22; and eugenics theory, 14, 22, 148n10; and films, 22; and Mexico, 117. See also poor people; white middle-­class women Cleveland (Ohio), 26, 59, 143 Clinical Research Bureau, 23, 30, 37. See also Birth Control Federation of America (BCFA) clinics, family planning, 7; and abortion services, 46, 59, 71–­72, 143; clinic era, 85; collection of data by, 145n5; and films, 28, 97; first, 13; government-­supported, 40, 82; harassment/violence against, 46,

59, 71–­72; and India, 82, 84–­86; and international family planning movement, 82, 84–­87, 97; and Iran, 85; and Mexico, 115, 117, 122–­123, 169n39; and national advertising campaign, 60–­61; physician-­ run, 23, 39; private clinics, 115; and radio, 39–­40, 42; and single men/women, 42; and telenovelas, 122–­123, 169n39; and television, 60–­61, 70–­71, 122–­123, 169n39; vasectomy clinics, 86; during World War II, 42 Clinton, Bill, 11 coercive practices, 7, 61, 92, 133 Cold War, 47, 51, 80 Colombia, 106–­108, 116, 120 Colorado, 64 Columbia University, 146n6 commercialism, 4, 6; lack of, 112; post–­ World War II, 46; and radio, 31, 34–­36, 52; and sexuality, 129, 134, 136, 138–­139; and telenovelas, 120, 124; and television, 52, 56–­57, 62, 64, 69, 120, 124, 134, 136, 138–­ 139. See also advertising; sponsorship Commission on Population Growth and the American Future, 67 Communicable Disease Center, 6. See also Centers for Disease Control (CDC) communication experts, 1, 3–­6, 9, 11, 45–­ 46, 49–­50, 146n6, 146n8; and films, 95, 99–­100, 104; and folk media, 101, 104; and India, 125; and international family planning movement, 77–­79, 84, 87–­93, 95, 99–­100, 104, 107, 109; and Mexico, 112, 117, 119–­120, 124; and population control movement, 4, 45–­46, 49, 84; and sexuality, 134, 136–­138; and telenovelas, 112, 119–­120, 124–­125; and television, 54, 58, 62–­64, 112, 119–­120, 124–­125, 134, 136–­138; during World War II, 4, 44–­45, 49. See also names of individual communications experts Communications Act (1934), 36; Communications Code, 52 communication strategies, 4–­6, 9, 45, 49, 57, 62, 117, 144; diffusion-­of-­innovations model, 49, 77, 88, 108–­109, 112, 121, 160n6; emotional appeal, 38, 53, 70, 73–­ 74, 89, 91–­92; and “engineering consent,”



Index 177

91; entertainment-­education strategy, 112–­113, 118–­128, 134, 136–­138, 168n29; exaggeration, 90–­91, 93, 136; face-­to-­face outreach, 86; fear-­inducing approaches, 62, 90, 93, 95; and humor, 62, 74, 89; and international family planning movement, 77, 79, 85–­88, 93, 122; leafleting, 85; limited effects model, 49, 119; and motivation, 88–­89, 91–­92, 96, 100, 105–­ 106, 108–­109, 122, 127, 162n39, 164n81, 166n104; participatory communication, 106; repurposing materials for different groups, 88; social marketing, 88, 162n37; strong effects model, 49, 124; two-­step flow of communication, 121–­122; word-­ of-­mouth, 85, 115 communism, 6, 47, 80 Comstock, Anthony, 2, 63–­64; death of, 13 Comstock Act (1873), 2, 12–­13, 17, 23, 27, 57; applied to radio, 32; overturned, 39 CONAPO (Coordinación Nacional de Planificación Familiar), 117, 123 condoms, 36, 81, 112, 127, 131, 134–­135, 137; and disease prevention, 131, 134–­ 135, 137; failure of, 134–­135 Confidential File (television program), 65 confidentiality, 139 Congress, U.S., 2, 36, 57, 67, 72, 123, 140; House Judiciary Committee, 39; House of Representatives, 140; and Internet, 140–­ 141; Senate, 140 Connecticut University, 139–­140 Connelly, Matthew, 81 conservationists, 47 conservatism: and abortion services, 46, 135, 140; and decline in birth control films, 25; and eugenics theory, 148n10; and international family planning movement, 10–­11, 81, 92, 109–­110; and sexuality, 135; and television, 52–­53, 57, 63–­64, 131, 135 consumerism, 4, 51, 88, 90, 119, 168n28; consumer advertising, 49, 57, 61, 88, 168n28; consumer capitalism, 51; consumer culture, 88 consumption (disease), 21 contraception, 1–­3, 5, 7–­8, 10, 12, 144; ban on advertising lifted, 131; condoms, 36, 81, 112, 127, 134–­135, 137; contraceptive

pills, 46, 57, 59, 77, 80–­81, 115; Dalkon Shield, 147n16, 163n66; decline in use of, 86–­87; Depo-­Provera injection, 80–­81; distribution of, 3, 23, 59, 78, 95, 145n5; emergency contraception, 137; Enovid, 57; failures of, 86, 134–­135; and films, 17, 21, 78–­79, 78, 132; foam, 81; and folk media, 101; and India, 82–­84; and international family planning movement, 77–­86, 91, 95, 101; and Internet, 139–­142; IUDs (intrauterine devices), 77, 81, 99–­100, 108, 147n16, 163n66; and Kenya, 85; legal access to, 1, 6–­7, 9–­10, 46, 80; legitimization of, 78–­79; and Mexico, 113–­116, 122–­123; morning-­after pill, 137; and Negro Project (BCFA), 55; and norethindrone, 115; papal encyclical proscribing, 60, 116–­117; and population control movement, 47, 57, 76, 80–­82; prescriptions for, 80, 114; and radio, 32, 35, 40, 51; and sexuality, 127–­128, 130–­139; side effects of, 80, 86, 93, 109; silencing of subject, 9, 12, 95, 114; subsidized, 46, 57, 59, 62, 76, 156n34, 157n46; and telenovelas, 113, 122–­123; and television, 69–­70, 113, 122–­123, 131, 134–­138; and vasectomies, 67, 86, 106, 108, 112. See also contraceptive information contraceptive information: and Comstock Act, 2, 12–­13, 22–­23; dissemination of, 2, 9, 12–­13, 22–­23, 58–­60, 77–­78, 117; and films, 17, 21–­24, 27, 92, 97, 105–­106; and global gag rule, 10–­11, 110; and international family planning movement, 77–­79, 83, 85–­86, 88, 91–­92, 94–­95, 97, 105–­106, 108, 110; and Internet, 139; and KAP research, 83–­84, 87–­88, 161n21; and Mexico, 115–­117, 122; and misinformation, 39, 70, 93; in nineteenth century, 2, 12; and population control movement, 48, 77; and radio, 38–­39, 41–­43; and telenovelas, 122; and television, 60–­61, 122, 131–­132, 137; and videos, 108; women’s letters seeking, 13, 142 copyright fees, 32 Cornell University, 64, 146n6; International Population Program, 64 Corpus Christi (Tex.), 157n46

178 Index 

the corrupter (as character type), 15 The Cosby Show (television series), 130–­131 Coughlin, Charles E., 38–­39 Countdown to Collision (1973 film), 95 criminals, 14, 17 critics, 3, 9; and films, 18, 23, 25; and international family planning movement, 79, 81, 88, 90, 109; and Internet, 142; and Mexico, 118; of New Deal, 36; and population control movement, 81; and radio, 34, 42, 51–­52; and sex hygiene films, 25; and sexuality, 130, 135–­136; and telenovelas, 124; and television, 46, 56, 62, 64, 68, 70, 124, 130, 135–­136. See also reviewers Cronkite, Walter, 65 the crusader (as character type), 15 cultural exchange, 89, 99 cultural relativism, 10 Current Opinion (periodical), 13 Dalkon Shield, 147n16, 163n66 Damaged Goods (1913 play), 13 Damaged Goods (1914 film), 14 dance, 101–­102 date rape, 137 Dawson’s Creek (television series), 132 Debs, Eugene V., 33 The Defenders (television series), 65 Delaware, 42 Delhi (India), 82 demographers, 45, 47, 80, 115 Dennett, Mary Ware, 2 Depo-­Provera injection, 80–­81 Detroit (Mich.), 36, 59 developing nations, 79, 81, 83, 86, 90, 95–­96, 136. See also names of individual developing nations Dewey, John, 34 didacticism, 23, 63–­64, 66, 84, 101, 108, 122, 136 A Different World (television series), 130–­131 diffusion-­of-­innovations model, 49, 77, 88, 108–­109, 112, 121, 160n6 diphtheria, 40 disabled people: crime/delinquency blamed on, 14; and “defective” offspring, 17, 22, 26; and films, 17; as “unfit” for reproduction, 14, 22, 26

Disney, Walt, 89. See also Walt Disney Studios District of Columbia, 57 divorce, 25–­26 Dixie Cup Corporation, 47, 91 documentaries, 65, 91, 130; documentary elements in films, 23; and India, 160n19; and international family planning movement, 100, 160n19; and Internet, 140 Donald Duck (in Family Planning), 1, 89 “Don’ts”/”Be Carefuls” (1927), 151n48 Dos Caminos (Two Roads, 1979 film), 97–­98 dramatic performances. See narrative storytelling dramatic theory, 169n31 Draper, William H. Jr., 48, 94, 154n10 drug trafficking, 14 drug use, 56, 62 drunk driving, prevention of, 136–­137 Du Bois, W.E.B., 15, 55 Dutchess County League of Planned Parenthood, 52 dysentery, 93 East-­West Communication Institute Seminar on Traditional Media, 164n83 Eberwein, Robert, 89 Echeverria, Luis, 116–­118 Eclipse of Reason (1987 film), 73 education, 4–­5, 8; adult education program, 122–­123; educational message reassuring to censors, 18; and films, 15–­16, 18, 21, 25, 27, 43, 96–­98, 100, 103; and folk media, 101, 103; and India, 125; and international family planning movement, 80, 90, 92–­94, 96–­98, 100–­101, 103, 106, 163n55; and Internet, 139–­140; marriage education, 50; and Mexico, 96, 111–­113, 119, 121–­124; peer education, 121; and population control movement, 48, 59; and radio, 30–­31, 33–­36, 38, 42–­43, 52, 57–­ 58; sex education, 46, 70, 113, 131, 133, 139; and sex hygiene films, 25; and “sex pictures,” 29; and sexuality, 136–­138, 140; and telenovelas, 112, 121, 123–­124; and television, 52–­54, 56–­60, 63–­64, 68–­69, 119, 121, 123–­125, 136–­138, 155n19. See also entertainment-­education strategy Education on the Air conference (1935), 35



Index 179

edutainment, 112. See also entertainment-­ education strategy Egypt, 106, 138 Ehrenreich, Barbara, 135 Ehrlich, Paul, 47, 82 Einstein, Albert, 34 Eisenhower, Dwight D., 48, 60, 154n10 elephants, 85 elites, 2, 83, 95, 104, 115 Elliot, Robin, 63 Elman, Julie Passanante, 56 embryo transplantation, 67 emotional appeal, 38, 53, 70, 73–­74; and affective storytelling, 64, 123–­124, 137; and folk media, 101; and international family planning movement, 89, 91–­92, 101; and telenovelas, 121, 123–­124, 169n31 The End of the Road (1918 film), 25 endoscopy, 71 Enovid, 57 entertainment: and films, 16, 18, 23, 29, 43, 89, 100, 105, 111–­112, 151n41; and India, 125–­126; and radio, 30–­31, 34; and “sex pictures,” 29; and sexuality, 128–­132, 136–­137; and soap operas, 125–­126; and telenovelas, 112, 122, 125, 168n27; and television, 53, 62, 64–­69, 112, 122, 125–­ 126, 129–­132, 136–­137, 168n27. See also entertainment-­education strategy entertainment-­education strategy, 112–­113, 118–­128, 168n29; ethics of, 123–­124; exporting, 125–­128; and sexuality, 134, 136–­138; and telenovelas, 112–­113, 118–­ 124, 168n26, 169n40 environmentalists, 47 epidemics, 114. See also names of individual diseases ER (television series), 137 erotic imagery, 42 ethical issues, 7, 27; and international family planning movement, 79, 81, 91; and persuasion, 5, 61, 79, 91–­92; and population control movement, 81; and radio, 31–­32; and sexuality, 133; and telenovelas, 123–­124; and television, 61, 123–­124, 133 eugenics, 5, 14–­15, 61, 148n10; and Birth Control (1917 film), 22; and films, 17, 19, 22; and Mexico, 113

Europe, 4, 76 everyman (in Family Planning), 89 exaggeration, 90–­91, 93, 136 expert testimonials, 54–­55 exploitation, 8; exploitation films, 29 Facebook, 140–­141 The Facts Speak Louder: Planned Parenthood’s Critique of “The Silent Scream” (1985 pamphlet), 73–­74 Family Limitation (Sanger), 12 “family planning,” 36–­37, 152n73 Family Planning (1967 film), 1, 89–­90; translations of, 1, 90 Family Planning Council (Nigeria), 102–­103 family planning movement, 2–­5, 7–­11, 144; and abortion services, 17, 46, 50–­51, 64, 66–­67, 69–­70, 72–­75; black intellectuals’ qualified support of, 15, 55; and economic arguments, 36–­39, 50–­51, 59, 63, 82; and Internet, 139–­142; national advertising campaigns, 60–­64; opposition to, 46, 48, 51–­52, 57, 69–­72, 92; and overpopulation, 45–­49, 51, 57–­59; parting ways with feminism, 46, 154n3; and personal testimonials, 142–­144; and radio, 40–­43, 49–­52, 54, 58, 61; and sexuality, 127–­130, 133–­134, 136–­137; and television, 46, 49–­50, 52–­64, 66–­67, 69–­ 70, 72–­73, 129–­130, 133–­134, 136–­137, 155n19; and War on Poverty, 59. See also birth control movement; contraception; international family planning movement family size: and Birth Control (1917 film), 19–­20; and child spacing, 39, 43, 50–­51; and Family Planning (1967 film), 1; and films, 1, 17, 19–­20, 22, 96–­97, 103; and folk media, 103; and India, 84, 160n19; and international family planning movement, 79, 81, 84, 87–­90, 92, 96–­97, 103, 127, 160n19; limitation of, 5, 13, 19–­20, 51, 61–­62; and Mexico, 114, 117, 122; and population control movement, 47, 50, 59, 80, 84; and radio, 36–­37, 51; shrinking size of white middle-­class families, 3; and telenovelas, 122; and television, 61–­63, 122 Family Ties (television series), 130 fascism, 40–­41, 61

180 Index 

fear-­inducing approaches, 62, 90, 93, 95 Federal Communications Commission (FCC), 36, 52, 54, 56, 68–­69; Fairness Doctrine, 68–­69; public hearings held by, 56 Federal Radio Act (1927), 32 Federal Radio Commission (FRC), 31, 33–­ 34, 36. See also Federal Communications Commission (FCC) Felicity (television series), 134, 137 female empowerment, 2–­3, 5–­7, 10, 37, 46, 146n8; and international family planning movement, 79–­82, 92–­93, 98, 160n14 “female hygiene” euphemism, 12, 39 female passivity, 117, 168n22 feminism, 5–­8, 10, 37, 46, 146n8, 154n3; and consciousness-­raising groups, 66; critiques of anti-­abortion movement, 74; and international family planning movement, 80–­81, 92, 106–­109, 160n14; and Mexico, 113; second-­wave, 81; and “speaking out,” 66; and television, 56, 64, 66, 71, 135; Third World, 81 fetus, rights of, 71 field workers, 77, 86, 94, 101 films, 1, 3, 5–­6, 9–­10, 13–­29, 43; and abortion services, 14–­18, 72–­73; adapted to regions, 94–­95, 99–­100, 109, 166n104; boycotting of, 28; censorship of, 3, 14–­19, 22, 24–­25, 28–­30, 43, 148n8; and close-­ ups, 55, 99–­100; in color, 104; cost of, 98, 101, 164n72, 165n86; distribution of, 98–­99; and “Don’ts”/”Be Carefuls” (1927), 151n48; earliest films lost, 9; failures of, 98–­101; “fallen woman” genre of, 15–­16, 41; film scripts, 8–­9, 87–­88; and flashbacks, 100; and “Formula” (1924), 151n48; and India, 85, 87–­88, 100, 112, 126, 160nn18–­19; industry guidelines for, 14, 28, 151n48; and international family planning movement, 78–­79, 78, 85, 87–­92, 94–­105, 107, 109, 160nn18–­19, 163n66, 164n68, 166n104; and intertitles, 23, 28; and master-­take approach, 104; and Mexico, 95–­96, 113–­114, 118, 120, 164n68; and morality, 15–­16; newsreels, 85; and Nigeria, 102–­106, 165n86; and Philippines, 112; “pictures with a purpose,” 15; Production Code (1930), 151n48; radio compared to, 31–­34,

39–­40, 50; sex hygiene films, 13–­16, 25, 28, 35; “sex pictures,” 29; and sexuality, 127, 130, 132; socially oriented, 15–­16; sound films, 25–­29; soundtracks of, 94–­ 95; square-­ups of, 16, 22; and symbolic representations, 19, 99–­100, 150n30; television compared to, 46, 49, 53, 56–­57; and Thailand, 78, 112; and “Thirteen Points” (1921), 151n48; and voiceovers, 73, 96–­97, 100. See also titles of individual films Findlay, Morgan, 57 Finkbine, Sherri, 65 Fit to Fight (1918 film), 25 Fit to Win (1919 film), 25 flappers, 25, 168n22 Fleishman, Norman, 69 fluoridation campaign, 91 foam (contraceptive), 81 folk media, 101–­106, 109, 164n83 Food and Drug Administration (FDA), 46, 57 food shortages, 47, 51, 76, 88, 103 footprints, 75 Ford Foundation, 4, 87, 104 foreign assistance, nonmilitary. See USAID foreign travelers, physical examinations of, 5 “Formula” (1924), 151n48 Fortune magazine, 39, 43 Fox television network, 131–­132 “Freedom from Fear” (radio program), 41–­42 free speech, 11, 16, 110 Freire, Paulo, 92–­93, 163n55 Friends (television series), 134–­135 Gandhians, 82 Garvey, Marcus, 15 Gaudet, Hazel, 121 gender, 6–­7, 10, 168n27; and female passivity, 117, 168n22; and films, 96–­98, 104; and folk media, 102, 104; gender inequalities, 7, 118, 122; and India, 125; and international family planning movement, 80, 85–­86, 92–­93, 96–­98, 102, 104; and macho behavior, 117; and Mexico, 114, 117–­118, 122, 168n22; and telenovelas, 122; and television, 56, 122, 125; during World War II, 41–­42. See also female empowerment; feminism; entries beginning with women



Index 181

General Electric, 31 General Hospital (television soap opera), 131 genocide: cultural genocide, 101; and Holocaust, 61; race genocide, 58 George Washington University, 163n62 “The German Mother” (radio program), 41 Germans, 40–­41, 61 Gill, S. S., 125 Gilman, Mildred, 41 Girls Clubs of America, 135 global gag rule, 10–­11, 110 Goldfarb, Brian, 89 Goldman, Emma, 2, 13, 17–­20 gonorrhea, 13, 35 Good Neighbor initiative, 89 Good Times (television series), 130 gossip, 121 Great Depression, 29, 31, 37 Green Revolution, 77, 167n12 Griswold v. Connecticut, 57 Guatemala, 91 Gujral, Inder K., 125 Guttmacher, Alan, 70 “gynaeplaque” models of pelvic organs, 160n18 Hampton Institute (Hampton, Va.), 59 Handbook on Abortion (Wilke and Wilke), 70–­72, 75 The Hand That Rocks the Cradle (1917 film), 22–­23; banned in New York City, 23; Sanger’s conversion narrative in, 22; square-­up of, 22 Harvard University, 146n6 Hays Office, 28–­29, 43 Head, Murdoch, 94 health communication, 4–­5, 8; and films, 16, 89–­90, 99; and India, 82–­83, 160n18; and international family planning movement, 79, 82–­83, 88–­90, 93–­94, 99; as “medicalized edutainment,” 56; and Mexico, 113, 166n4; and radio, 35; and sexuality, 131–­133, 135–­138; and telenovelas, 112–­113, 166n4; and television, 53–­54, 56–­57, 62–­63, 131–­133, 135–­138 heart disease, 62, 136–­137 Here’s to Your Health (television program), 53 Her Unborn Child (1930 film), 28

Heston, Charlton, 62 heterosexuality, 10 Himes, Norman, 153n82 Hindi language, 125 Hitler, Adolf, 40–­41, 61 HIV/AIDS, 10, 127, 131, 137 Holland, Jerome K., 59 Holocaust, 61 homosexuality, 10 The House without Children (1919 film), 24–­25, 24; “better babies” event at movie theater, 24, 24; pronatalist message of, 24 Hovland, Carl I., 4 Huffington, Arianna, 142 Huffington Post website, 142 Humanae Vitae encyclical (Pope Paul VI), 60 human rights, 33, 92 Hum Log (We People, television series), 125–­126, 137 humor, use of, 62, 74, 89 hunger strikes, 13 “I Have Sex” (video), 139–­140 I Love Lucy (television series), 54 IMEC (Instituto Mexicano de Estudios de la Comunicación), 119–­120 immigrants, 5–­6; contagious diseases blamed on, 6; crime/delinquency blamed on, 14; Eastern European, 14, 150n31; Goldman as, 19; illegal, 140; Mexican, 114; as “unfit” for reproduction, 14 imperialism, 7, 81 India, 78–­80, 82–­86; and family planning clinics, 82, 84–­86; and films, 78, 85, 87–­88, 100, 112, 126, 160nn18–­19; and government funding, 83–­85; independence (1947), 83; and international family planning movement, 78–­80, 82–­86, 114–­115, 125; and KAP research, 83–­84, 87, 161n21; and logo (inverted red triangle), 84–­85; and maternal/child health, 82–­83; Ministry of Information, 160n19; opposition to birth control movement in, 82; population census (1961), 84; and population control movement, 48, 82, 84; and radio, 85; and soap operas, 125–­126; and television, 125–­126, 126, 138; and vasectomy clinics, 86; and videos, 106

182 Index 

Indianapolis study, 3, 145n5 indigenous media, 79, 100, 110, 120. See also folk media “Indochina Refugees” (video), 107–­108 Indonesia, 78, 106 Industrial Workers of the World (IWW), 13 infectious disease, 6, 113–­114. See also names of individual diseases infertility, 50 “influentials.” See innovators influenza pandemic, 114 information campaigns. See contraceptive information infotainment, 112. See also entertainment-­ education strategy the innocent (as character type), 15 innovators, 49, 77, 88, 108–­109, 112, 121, 160n6 International Communications Association, 4 international expositions, 15 international family planning movement, 1, 3, 5–­7, 9–­11, 51, 74–­110; and economic arguments, 76, 80–­83, 90, 92–­93, 96–­97; and Family Planning (1967 film), 1, 89–­90; and family planning clinics, 82, 84–­87; federal funding for, 10–­11, 48, 76–­78, 80–­81, 83, 94–­95, 110, 126–­127, 138–­139; and female empowerment, 79–­ 82, 92–­93, 98, 160n14; and feminism, 80–­81, 92, 106–­109, 160n14; and field workers, 77, 86, 94; and films, 1, 78–­79, 78, 89–­92, 94–­98, 107, 109, 163n66, 164n68, 166n104; and folk media, 101–­ 106, 109, 164n83; and global gag rule, 10–­11, 110; and India, 78–­80, 82–­86, 114–­115, 125; and Internet, 139; and KAP research, 83–­84, 87–­88, 161n21; and logos, 84–­85; and maternal/child health, 82–­83, 85; and medical profession, 80, 85, 88, 92, 94, 107; and Mexico, 95–­96, 113–­118, 122–­123, 166n4; and misinformation, 93; opposition to, 92–­ 93; and radio, 85–­86, 87, 90–­91, 107; and sexuality, 138–­139; and telenovelas, 113, 122–­123, 166n4; and television, 86, 106–­108, 122–­123, 126–­127, 138–­139; and videos, 106–­109

International Planned Parenthood Federation (IPPF), 9, 75–­77, 81–­83, 154n10, 162n50; and community participation, 82, 94; conferences, 90–­91, 114–­116; and female empowerment, 82; and films, 89–­90, 94–­102, 104, 109; and folk media, 101–­102, 104, 164n83; and India, 82–­83, 160n19; and Kenya, 85; and Mexico, 114–­116; and misinformation, 93; and Nigeria, 102, 104; and sexuality, 127; transformation of, 92–­ 98, 163n55; and videos, 108; Working Party on Education and Training, 93. See also international family planning movement Internet, 130, 139–­144 In the Beginning (television sseries), 130 Iran, 85 Isaacs, Anthony and Elizabeth, 101–­104, 165n86 Islamic countries, 160n14 IUDs (intrauterine devices), 77, 81, 108, 147n16, 163n66; close-­up of, 99–­100 Jaffe, Fred, 63 Jamaica, 78, 84, 106 Jesuits, 68 Jews: and Holocaust, 61; as immigrants, 19, 150n31 Johns Hopkins University, 99, 163n62; Population Communication Services, 127 Johnson, Lyndon, 59 Jones, Eleanor, 30 Joshi, Manohar Shyam, 125 Journal of Communication, 4; Communication and Mental Health issue, 4 Judging Amy (television series), 132 Jung, Carl, 121 juvenile delinquency, 50 KAMP studies, 88 KAP (knowledge, attitude, and practice) research, 83–­84, 87–­88, 117, 161n21; and KAP-­gap, 87–­88; “paradox” of, 87 Kennedy, John F., 77 Kenya, 84–­85 Kinematrade, 29 King, Martin Luther Jr., 58, 156n39



Index 183

King of the Hill (television series), 132 Kinsey, Alfred, 46, 57 Korea, 84, 86 Koven, Seth, 167n11 Krauss, L. Lee, 27

macho behavior, 117 MacLean, Paul D., 169n31 magazines, 1, 6, 61, 72; films compared to, 16. See also titles of individual magazines malaria, 6, 77, 88, 93, 99 Malaysia, 78 Malcolm X, 58, 156n40 March for Women’s Lives (2004), 143 Marcus Welby, M.D. (television series), 66 Margaret Sanger Papers Project, 144 Marxist criticism, 168n27 The Mary Tyler Moore Show (television series), 158n67 M*A*S*H (television series), 158n67 masks, 101–­102 maternalism, 167n11 Maude (television series), 67–­69, 71, 123, 129, 137–­138, 158n67 McCann, Carole, 6 McCormick, Katherine, 80 McDonald, Ella, 70 McLuhan, Marshall, 6, 147n11 The Media Project (Advocates for Youth), 132, 134; SHINE (Sexual Health in Entertainment Media) awards, 132 media shapes messages, 2, 6, 10, 147n11; medium distracts from message, 99 medical profession, 2–­3; and criminalization of abortion, 14, 145n2, 148n9; and films, 22, 27; and international family planning movement, 80, 85, 88, 92, 94, 107; and Mexico, 114; and radio, 39; Sanger’s collaboration with, 2–­3, 5, 27, 46, 80; and television, 53–­55, 66, 155n26. See also physicians melodramas, 15, 18, 112, 114, 121, 126–­127, 169n31 menstruation, 97; renewing of, 14, 145n2 message films, 25, 151n41 Message Photoplay Company, 22 Methodist Church, 67; Population Communication Center, 67 Mexican Association of Public Relations Firms and Media, 117 Mexican Institute for the Study of Communication. See IMEC

labor union activities, 14, 33, 149n27 Ladies’ Home Journal, 59 Lasswell, Harold D., 4 Latin America, 1, 76–­78, 89–­90, 95–­99, 126; and telenovelas, 116, 118, 120. See also names of individual Latin American countries The Laws of Population (film), 19 The Lawsons (1944 radio series), 112 Lazarsfeld, Paul F., 4, 121 Lear, Norman, 67–­69, 124, 129–­130, 132 legal system, 1, 6–­7, 9–­10; banning couples from having children, 26–­27; depicted in films, 22–­24, 26–­27; expanded birth control exemption in New York State, 23; New York Court of Appeals, 23; Sanger’s trial as chance for publicity, 13. See also Supreme Court (U.S.); titles of individual laws and cases lesbianism, 67 Let’s Talk about Sex (television program), 133 Library of Congress, 9 Life magazine, 48, 71 Lifetime cable channel, 132 Lima (Peru), 122–­123 limited effects model, 49, 119 literacy/illiteracy, 13, 61, 88, 163n55; and international family planning movement, 85–­86, 99–­100, 105, 160n18; literacy classes, 120, 122–­123; and Mexico, 113, 121–­123; and telenovelas, 120–­123; visual literacy, 99–­100, 105 Little, Clarence Cook, 36 lobbyists, 34–­35 logos, 84–­85 London blitz, 40, 48 Lord, Alexandra, 25 Lord, Daniel, 28 Los Angeles (Calif.), 67, 69, 131 Loviglio, Jason, 30 Lowe, David, 65

184 Index 

Mexico, 111–­128; constitution of, 124; decline in birthrate in, 113, 166n4; and films, 95–­96, 113–­114, 118, 120, 164n68; hidden history of birth control in, 113–­118; and international family planning movement, 95–­96, 113–­118, 122–­123, 166n4; and “Mexican miracle,” 114; Ministry of Education, 123; national adult education program, 122–­123; and nationalism, 114, 167n11; National Publicity Council, 117; and population control movement, 113–­ 118, 166n4; Population Law (1936), 114; Public Health Department’s Propaganda and Education Section, 113; and radio, 118, 120; revolution, 114; Sanitary Code, 114; shift from pronatalist policy, 113–­114, 116–­117; and telenovelas, 112–­113, 118–­ 124, 131, 168n26; and television, 111–­113, 118–­124; and videos, 106 Mexico City (Mexico), 115, 123 Mexico in the Year 2000 (1979 film), 95–­96, 164n68 Michel, Sonya, 167n11 Midwest, 16, 49 midwives, 2, 52 Mindell, Fania, 13; hunger strike of, 13 Minow, Newton F., 56 Minto, Lee, 74 Miracle of Life (1926 film), 25 miscarriages, 74–­75, 135 Moesha (television series), 132 Mohr, James, 145n2 monopoly, 33–­34, 36 Montgomery, Kathryn C., 158n67 Moore, Hazel, 114 Moore, Hugh, 47–­48, 91 morality: boycotting of films due to, 28; and films, 15–­16, 22, 25, 28; and folk media, 101; and population control movement, 48, 57; and radio, 42; and sex hygiene films, 25, 35; and telenovelas, 124; and television, 133–­135; during World War II, 42 “More People, More Problems” (in Visíon), 116 morning-­after pill, 137 Morocco, 78 Morrow, Prince, 13 mortality, maternal/infant, 81, 103, 114

mosquitoes, 99 Mother, I Need You (1918 film), 15 motherhood: and films, 14–­15, 17, 19, 21, 24–­25, 151n41; and Mexico, 114–­115, 167n11; and “selfish women,” 14–­15, 17, 19, 21, 25; “voluntary motherhood,” 2 Motherhood: Life’s Greatest Miracle (1925 film), 25 Mother’s Day (Mexico), 114 Motion Picture Association of America (MPAA), 151n48 Motion Picture Producers and Distributors Association of America (MPPDAA), 151n48. See also Motion Picture Association of America (MPAA) Motion Picture Research Council, 152n63 motion pictures. See films motivation, 88–­89, 91–­92, 96, 100, 105–­106, 108–­109, 122, 127, 162n39, 164n81, 166n104. See also persuasion movie theaters, 9, 15–­16, 19, 22, 24, 29; and The House without Children (1919 film), 24, 24; in Washington, D.C., 24, 24, 26 Moving Picture World, 15, 18 “Mrs. Average Citizen Asks Some Questions” (radio program), 33 Ms. magazine, 142–­143 MTV, 135–­136 Mumford, Martha, 38 municipalities and censorship, 16, 22–­23 Murrow, Edward R., 48 Mutual Film Corp. v. Ohio, 16 My Abortion. My Life (website), 143 My Brother’s Children (1970 film), 102–­106, 165n86 Mysore (India), 82 narrative storytelling: affective storytelling, 64, 123–­124, 137; and Birth Control (1917 film), 19, 150n31; and films, 15, 17–­19, 27–­28, 89–­90, 95–­98, 100, 103, 105; and folk media, 101–­103, 105; and India, 125; and international family planning movement, 79, 85, 89–­93, 95–­98, 100–­103, 105, 109; and radio, 37–­39, 41–­42, 50–­51; and sexuality, 131, 134–­135, 137–­138; and telenovelas, 119–­124; and television, 55, 64, 70, 119–­125, 131–­132, 134–­135, 137–­138



Index 185

Nathanson, Bernard, 72–­73 National Abortion Federation, 71 National Academy of Sciences, 57 National Association of Broadcasters, 32, 56, 131 National Association of Radio and Television Broadcasters, 54; Television Code (1952), 54 National Autonomous University (Mexico), 119 National Board of Review of Motion Pictures, 14, 23, 148n8 National Committee for Study of Social Values in Motion Pictures, 152n63. See also Motion Picture Research Council National Committee on Education by Radio, 34 National Committee on Federal Legislation for Birth Control, Inc., 30 National Committee on Maternal Health, 153n82 National Compaign to Prevent Teen and Unplanned Pregnancy, 135 National Council of Churches, 67; Broadcasting and Film Commission, 67 National Legion of Decency, 28–­29 National Multiple Sclerosis Society, 91 National Tuberculosis Association, 14, 38 Nation of Islam, 58 “The Nazi Estate of Matrimony” (radio program), 41 Nazism, 40–­41, 61 NBC (National Broadcasting Company), 33, 35–­36, 41; Advisory Council, 33; Continuity Division, 41; and television, 53, 59, 130 New Deal rhetoric, 36–­37, 40, 152n73 New Jersey, 32, 149n27; Newark, 32, 36 newspapers, 1, 13, 35, 39–­40, 58, 61; films compared to, 16, 19; and Mexico, 114, 116; radio compared to, 33, 40 New York Board of Motion Picture Censorship, 148n8. See also National Board of Review of Motion Pictures New York City, 67, 131; and censorship of films, 22–­23; commissioner of licenses, 22–­23; Zoological Society, 47 New York Dramatic Mirror, 16

New York Society for the Suppression of Vice, 2 New York State, 42; Court of Appeals, 23; health commissioner, 35 New York Times, 17, 47–­48 New York University, 144 Nigeria, 102–­106, 165n86 Nilsson, Lars, 71 No More Children (1929 film), 26–­28, 26 Norden, Martin, 149n29 norethindrone, 115 nursery rhymes, 32; “There was an old woman,” 32 nurses: African American, 55; and films, 21, 21, 97–­98; and international family planning movement, 97–­98; and Negro Project (BCFA), 55; and radio, 39, 41 nutrition, 77, 99 N. W. Ayer Advertising, 38 Obama, Barack, 11 obscenity: and anti-­obscenity reformers, 2, 14; and Comstock Act, 2, 13, 39; as “lewd materials,” 2, 13; and radio, 32 Office for Coordination of Commercial and Cultural Relations between the American Republics, 89. See also Office of the Coordinator of Inter-­American Affairs (OCIAA) Office of Economic Opportunity, 157n46 Office of the Coordinator of Inter-­American Affairs (OCIAA), 89 Office of War Information (OWI), 41, 43, 61 Ogunmola, Kola, 104 One Day at a Time (television series), 130 One Life to Live (television soap opera), 131 One Pack of Japanese Pessaries, U.S. v., 39 opinion leaders, 49, 63 Osborn, Fairfield, 47 Our Plundered Planet (Osborn), 47 The Overland Monthly, 18 overpopulation, 1, 4, 7, 44–­49, 51, 59; and economic development, 48; and films, 95–­96, 103, 127; and India, 48, 82, 84; international, 48, 76, 80, 82, 84, 92, 95–­ 96, 103; and population bomb, 47, 51, 55, 62–­63, 70, 74, 82; and radio, 51; and television, 48, 62–­63, 70. See also population control movement

186 Index 

Packwood, Robert, 67 Pakistan, 78, 84, 86 Palestinian refugees, 106 pamphlets, 12–­13, 58, 72–­73, 85, 91, 113. See also names of individual pamphlets Pan American Assembly on Population, 116 the parent (as character type), 15 “Parents Are Human Too” (radio program), 50 Parran, Thomas, 35–­36; as surgeon general, 35 participatory communication, 106 patents, 31 paternalism, 6–­7, 55, 89, 114, 162n43 Patesumpan Untarai (Dangerous Relations, film), 112 patriarchy, 114 Paul VI, pope, 60 Payne Fund, 34, 152n63 PBS (Public Broadcasting Service), 69–­70, 106 Pence, Mike, 140 People for the American Way, 130 people of color, 7, 109, 156n40; physical examinations of, 5. See also African Americans; race/ethnicity; entries beginning with black Perry, Armstrong, 34 persuasion, 3–­5, 7–­8, 45, 146n8; ethics of, 5, 61, 79, 91–­92; and films, 95; and international family planning movement, 79, 83, 86–­88, 91–­92, 106, 162n39; and Mexico, 111, 116, 119; and population control movement, 45, 49; and radio, 40; and telenovelas, 119, 121; and television, 61–­63, 74, 119, 121 Peru, 119–­120, 122–­123 Petchesky, Rosalind, 71 Petrova, Olga, 32 pharmaceutical advertising, 119, 136, 168n28 Philippines, 112, 138 physical examinations, 5 physicians, 3; and abortion services, 14–­15, 148n9; and Birth Control (1917 film), 21, 21; and birth control clinics, 23, 39; and contraception prescriptions, 23; and films, 14–­15, 17, 21–­22, 21, 22, 27–­28;

and India, 83, 160n18; and international family planning movement, 83, 86–­88, 94–­95, 107, 160n18; and Mexico, 114–­115; and Negro Project (BCFA), 55; physician-­ patient communication, 4; in Poughkeepsie (N.Y.), 52; prescribing contraception by, 57; and radio, 39, 52; Sanger’s collaboration with, 2–­3, 5, 27, 46; stance against birth control movement, 21, 27; and television, 53–­55, 59, 61, 65, 155n26; white physicians in Negro Project (BCFA), 55. See also medical profession; names of individual physicians Pierce, Walter N., 36 pills, contraceptive, 46, 57, 59, 77, 80–­81; and norethindrone, 115 pin-­up girl, 41–­42 Piotrow, Phyllis Tilson, 94 Pius XII, pope, 52 “planned parenthood,” 37 Planned Parenthood (c. late 1940s film), 160n19 Planned Parenthood Federation of America, 3, 9, 37; and abortion services, 17, 46, 50–­51, 66, 69–­75; clinic-­based approach of, 85; and films, 98; and funding, 140–­ 142; and girls “about to be married,” 42; increase in general popularity, 56, 58; Information and Education Department, 45, 60–­61, 63, 68, 74; and Internet, 139–­144; Los Angeles chapter, 69; Maggie Award, 130; Margaret Sanger Award in Human Rights, 58; national advertising campaigns, 60–­64; and Negro Project (BCFA), 55; and overpopulation, 45–­46, 48, 57–­59, 103; Public Information Department, 41; and radio, 40–­43, 49–­50, 52, 54, 61; Seattle chapter, 55, 73–­74; and sexuality, 129–­130; and Spanish-­language programming, 60; and television, 46, 49–­50, 52, 54–­64, 66–­69, 155n19; Walk the Talk Award, 140; website of, 139, 143; and World’s Fair (New York City, 1965), 58; during World War II, 40–­43. See also International Planned Parenthood Federation (IPPF) “Planned Parenthood Is Your Business” (radio program), 51



Index 187

Playboy magazine, 46 Poindexter, David, 67, 123, 125, 131 police: clinics raided by, 13; in radio scripts, 38; and Sanger, 20, 20; and television, 64 politics/politicians, 6, 10–­11, 57, 140; and films, 98; and folk media, 101; and India, 82–­83; and international family planning movement, 98, 101, 108; and Mexico, 168n22; and population control movement, 45–­48; and radio, 31–­32; and television, 64, 66; and videos, 108 polls, 59–­60; and Catholics, 58; in Fortune magazine, 39, 43; Gallup polls, 40, 48, 58, 154n8; and overpopulation, 46, 48, 154n8; and radio, 36; and television, 131 pollution, 95–­96 poor people, 5–­8, 147n16; and Birth Control (1917 film), 19–­22, 21, 150n31; contagious diseases blamed on, 6; crime/delinquency blamed on, 14; and films, 17–­22, 95–­96, 150n31; and India, 82, 160n18; and international family planning movement, 80–­82, 90, 95–­96, 163n55; and Mexico, 114, 116–­118, 124; physical examinations of, 5; and population control movement, 45, 57, 80–­81, 95–­96; and radio, 30, 39; and structural inequalities, 118; and telenovelas, 124; as “unfit” for reproduction, 14, 19, 22 popular culture, 6, 42, 125, 144, 168n27 population bomb, 47, 51, 55, 62–­63, 70, 74; and India, 82. See also overpopulation The Population Bomb (Ehrlich), 47 The Population Bomb (Moore pamphlet), 47 Population Communication International (PCI), 127, 131 Population Communication Services, 163n62 population control movement, 7, 10, 45–­ 49, 57–­59, 145n5; and Draper, 48, 94, 154n10; economic arguments for, 80–­82; end of, 48, 92; and films, 94–­96, 164n68; and India, 48, 82, 84; international, 7, 10, 45, 47–­48, 69, 75–­76, 80–­82, 84, 91–­92, 94–­96, 113; and maternal/infant mortality, 81; and Mexico, 113–­118, 166n4; opposition to, 48, 81; racist motivations of, 7, 57–­59, 62, 156nn39–­40;

and telenovelas, 113, 166n4. See also overpopulation Population Council, 1, 4, 47, 77–­79, 89 Population Crisis Committee, 154n10 Population Information Program (PIP), 94, 163n62, 166n104. See also Population Communication Services Population Institute, 67–­69, 158n67 Population Reference Bureau, 74 pornography, 70 postal delivery of “lewd materials,” 2, 13, 32; applied to radio, 32 posters, 6, 58, 72, 99, 126; and international family planning movement, 77, 84, 90–­ 91, 162n50 Potts, Benjamin, 38 Potts, Malcolm, 162n50 Poughkeepsie (N.Y.), 52 poverty. See poor people The Practice (television series), 132 pregnancy, 21–­22, 27; of eight-­year-­old, 70; and international family planning movement, 91, 97; and radio, 41–­42; and sexuality, 130–­131, 134–­135, 138; teen pregnancy, 135; and telenovelas, 122; and television, 54, 61, 63, 65–­68, 70, 122, 130–­131, 134–­135, 138; during World War II, 41–­42 prejudices, 6–­8, 168n27; and eugenics theory, 148n10; and telenovelas, 124 prenatal care, 7 President’s Committee to Study the United States Military Assistance Program, 48 privacy, 139, 143 Production Code Administration, 25; Production Code (1930), 28–­29, 151n48; seal of approval of, 29 Profamilia, 108 Progressive Era films, 9, 13 pronatalism, 7, 24, 58; and fascism, 40–­41; Mexico’s shift from, 113–­114, 116–­117 propaganda/propagandists: and films, 18, 20, 23, 29, 73; and international family planning movement, 89, 91, 93; and Mexico, 113, 115; and radio, 33–­34, 38–­ 42, 153n82; and Sanger, 20, 30, 113; and television, 61; during World War II, 4, 40–­42, 44–­45, 61

188 Index 

prophylactics. See contraception propriety, 3, 57. See also respectability of birth control prostitution, 13–­14; and films, 14, 16, 27; films about “white slavery,” 14; and Mexico, 113; and physical examinations, 5 Protestants, 3, 14. See also white middle-­ class women proverbs, 101 Providence (R.I.), 65 public health initiatives, 5–­6; fluoridation campaign, 91; and India, 84; international, 77, 84, 88, 113; and Internet, 139; and Mexico, 113; and population control movement, 57; and radio, 35, 39–­40; and sexuality, 130, 133, 136, 138; and television, 62, 130, 133, 136, 138 Public Health Service (PHS), 25, 43, 91; “Outline of an Industrial Health Program,” 43 publicity: and abortion services, 46; and Birth Control (1917 film), 19, 22–­23; and films, 16–­17, 19, 22–­24, 27; and India, 83; and international family planning movement, 78–­79, 85–­86; and Mexico, 115–­117; and newspapers, 39; publicity stunts, 46; and radio, 39–­40, 43, 51; and Sanger, 12–­13, 19, 23, 39, 48, 58, 83, 150n30; taboos against, 78; and television, 53–­54, 58 public opinion, 5; and abortion services, 46; changing climate of, 39–­40; first radio poll on birth control, 36; and India, 83–­84, 161n21; and KAP research, 83–­84, 87–­88, 161n21; and Mexico, 115–­ 116; and population control movement, 46, 49; post–­World War II, 46; and radio, 36–­37, 40, 42; and television, 56, 58; and videos, 107; during World War II, 42, 45 public service programs, 36, 52–­54, 56, 66; and Mexico, 118; and national advertising campaign, 60–­64; and sexuality, 131. See also education Puerto Rico, 8, 116, 120 “Punthi Path” (ballad), 86 puppet shows, 79, 101 pure water/food supply, 40 purity crusaders, 2

“quickening,” 145n2 race/ethnicity, 6–­8; and eugenics theory, 15, 148n10; and everyman (in Family Planning), 90; and international family planning movement, 90; and Mexico, 117; and Negro Project (BCFA), 55; and population control movement, 7, 57–­59, 62, 81, 156nn39–­40; racial discrimination, 62; racial progress, 15, 59; racism, 8, 62, 81; representation of biracial children, 55–­56; and segregation, 8; and television, 55–­56, 62. See also African Americans; entries beginning with black Race Suicide (1937 film), 29 race suicide argument, 14, 17–­19, 21, 39, 45 radio, 1, 3, 5, 8–­10, 29, 30–­44, 49–­52; and amateur enthusiasts, 31; and Australia, 112; and bandwidths, 34; and black entrepreneurs, 151n56; and censorship, 3, 32–­33, 35, 37, 43; children as audience for, 30, 35, 38–­39; and competition, 31, 34, 36; and entertainment-­education strategy, 118, 120, 123, 126; first radio poll on birth control, 36; and India, 85; and industry code of ethics, 31–­33; and international family planning movement, 85–­86, 87, 90–­91, 104, 107; and “intimate public,” 30, 139; and lecture format, 30, 35, 37–­38, 49; licensing of, 32; and live transmissions, 31–­32; and Mexico, 118, 120; and monopoly, 33–­34, 36; opposition to birth control, 38–­40; and patents, 31; and prerecorded programs, 37, 42; programs rebroadcast internationally, 76–­77; and question-­and-­answer format, 37–­38; radio disks, 37; radio scripts, 8–­9, 38, 40–­43, 50–­51; and Roosevelt’s fireside chats, 30–­31, 36; and sexuality, 130; and skits, 38; and sponsorship, 31, 35–­36; and storytelling, 37–­39, 41–­42, 50–­51; television compared to, 46, 49, 52–­54, 56–­57; template scripts, 42–­43; and War of the Worlds (radio play), 37; widespread use of, 39, 86, 120; and World War II, 40–­44, 127 radionovelas, 118 radio stations, 9, 31–­43, 51–­52; and black entrepreneurs, 151n56; broadcast



Index 189

schedules of, 9; small stations, 31, 33–­35, 40; during World War II, 40–­42. See also names of individual radio stations Ravens Hollow (film company), 94 RCA (Radio Corporation of America), 31, 33 Reader’s Digest, 35, 116 Readers’ Guide to Periodical Literature, 48–­49 Reagan, Leslie, 66, 158n76 Reagan, Ronald, 10–­11, 81, 110 Reed, John, 149n27 the refuser (as character type), 15, 17 regulation, governmental, 3; and films, 14, 28–­29, 43; and Mexico, 118; and New Deal, 36; and radio, 31–­32, 34, 43; and television, 54, 56, 68, 138. See also censorship The Regulation of Natality or the Standard of the Homes (Sanger), 113 reincarnation, 103 “The Relation of Birth Control to Democracy” (radio program), 36 religion: and films, 28; as grounds for opposing birth control, 15; and Her Unborn Child (1930 film), 28; and population control movement, 48; and radio, 32, 38–­39, 42–­43, 52; and television, 52–­ 53, 67, 70. See also Catholics; Protestants “repeal of reticence,” 13, 28 Republicans, 81, 140, 143; Republican National Committee, 67 respectability of birth control, 2–­3, 145n2, 145n4 reviewers, 9, 23; and Birth Control (1917 film), 20; and films, 15, 17–­20, 23, 95, 98, 104–­105, 163n66, 164n68; and international family planning movement, 95, 98, 104–­105, 108, 163n66; moral stance against abortion, 15; and television, 68; and videos, 108. See also critics Rice, John, 35 Rice-­Wray, Edris, 115 Richard K. Manoff advertising agency, 63 The Road to Ruin (1928 film), 27 The Road to Survival (Vogt), 47 roaring twenties, 25 Rochester (N.Y.), 65 Rockefeller, John D. III, 47, 67

Roe v. Wade, 46, 69, 142 Rogers, Everett, 162n39 Roosevelt, Franklin D., 30–­31, 40, 89; fireside chats of, 30–­31, 36 Roosevelt, Theodore, 14–­15, 18 rumors, 39, 93, 109 rural areas, 77–­78, 78, 86, 94–­95, 97, 160n18; and abortion services, 143; and Brazil, 116; and folk media, 101–­106; and India, 84–­85, 112, 126; and Mexico, 96, 167n12; and videos, 106–­107 Russia, 120 Sabido, Miguel, 111–­113, 118–­125, 127, 131–­132, 137–­138, 168n26, 169n31, 169n40 Sachs, Sadie, 150n31 Saint Francis Hospital (Poughkeepsie, N.Y.), 52 Saludos Amigos (1943 animated cartoon), 162n43 San Francisco (Calif.), 70 Sanger, Margaret, 2–­3, 5, 7, 10, 144; and ABCL, 30, 37; appearing with white gag over mouth, 12; and Birth Control (1917 film), 19–­23, 20, 21, 74, 149n29; and Clinical Research Bureau, 23, 30, 37, 114; collaboration with medical profession, 2–­3, 5, 27, 46, 80; conversion narrative of, 21–­22, 150n31; and eugenics theory, 22, 148n10; and films, 17–­22, 27, 29–­30, 74, 149n27; flees to England to avoid prosecution, 12–­13; incarceration of, 13, 19–­ 20, 20, 23; and India, 82–­83, 160n18; and international family planning movement, 76–­77, 80, 113; and Maggie Award, 130; marriage of, 150n30; and Mexico, 113; and Negro Project (BCFA), 55; nursing career of, 21, 21; personal papers of, 8; and radio, 33, 36–­39; socialist/working-­ class roots of, 19, 150n30; use of phrase “family planning,” 36–­37, 152n73 San Juan (P.R.), 116 Schaefer, Eric, 15 Schlesinger, Arthur, 12 Schoen, Johanna, 8, 71–­72, 159n78 Schramm, Wilbur, 4, 84, 146n6 seatbelt use, 62

190 Index 

Seattle (Wash.), 55, 73–­74 Sesame Street (television program), 69–­70 sewing machines, 120 sex hygiene films, 13–­16, 25, 35; censorship of, 25, 28; character types in, 15; sexual abstinence in, 25, 35 “sex pictures,” 29 sexuality, 5–­7, 127–­144, 127; black sexuality, 7; and fallen women in films, 15–­16, 41; and folk media, 101; Kinsey reports on, 46, 57; and Mexico, 113–­114, 118; premarital sex, 70; and radio, 35, 41–­42; and telenovelas, 127–­128; and television, 57, 62–­64, 67, 70, 74–­75, 118–­119, 127–­ 138; during World War II, 41–­42 Sexuality and the Human Female (Kinsey), 57 Sexuality and the Human Male (Kinsey), 57 sexually transmitted diseases, 14, 133, 135. See also names of individual sexually transmitted diseases sexual revolution, 46, 57, 75 “sexual slavery,” 7 Sherman, John W., 167n12 “Should War Brides Have Babies?” (radio program), 42 Siepmann, Charles, 56 The Silent Scream (1984 film), 72–­74 Simplemente María (Simply Mary, telenovela), 119–­124, 126 Singapore, 84 16 and Pregnant (reality television program), 135–­136 The $64,000 Question (television program), 56 slavery, 7 Sloan, Kay, 149n27 slums, 96, 116; and films, 18, 20–­22; and India, 82 smoking: anti-­smoking ads, 62, 64, 138; promotion of, 91 soap operas, 30, 41, 49, 112, 118–­121, 125–­ 127, 131, 137; and soap summits, 131. See also telenovelas; titles of individual soap operas social change, 80, 88, 92, 95–­96, 121 social engineering, 61 social hygiene movement, 13

socialism, 19, 33–­34, 150n30 social learning theory, 120–­121 social marketing, 88, 162n37 social media, 139, 141–­142 Social Security Act, amendments to, 157n46 social workers, 42, 50, 152n63 sociologists, 4, 49–­50, 121, 152n63; European sociologists, 4; Nigerian sociologists, 104; rural sociologists, 49 Somalia, 87 songs, 79, 85–­86, 101–­102 Soto Laveaga, Gabriela, 168n24, 169n37 South America, 116. See also names of individual South American countries South (U.S.), 8, 39, 57 Soviet Union, 47, 51 Spanish language, 60, 94–­96, 116 sponsorship: and radio, 31, 35–­36; and television, 52–­53, 56–­57, 65, 134 Stanford University, 120 starvation, 47, 51 State Department, U.S., 76; Voice of America, 76–­77 states, 2, 6; and censorship, 16, 28 St. Elsewhere (television series), 130 sterilization, 5, 7–­8, 10, 26, 147n16; birth control confused with, 39 Stern, Alexandra Minna, 113–­114 stigma, 78–­79, 93, 113; and abortion services, 51, 64, 66, 143 Strasbourg (France) conference, 125 strip poker, 27 strong effects model, 49, 124 structural inequalities, 118 Stuart, Martha, 58–­59, 65, 66, 69, 81, 129, 140, 142, 165n93; and affective storytelling, 64, 124; and videos, 106–­108 Stycos, J. Mayone, 64, 78, 127 suburbia, 53 suicide in films, 27 Supreme Court (U.S.), 16, 39, 46, 57, 69, 142 Supreme Feature Film Service, 18 Survey of World Needs in Family Planning (IPPF), 90–­91 Susan G. Komen for the Cure, 141–­142 Sweden, 65, 77 Sweeney, William O., 104 syphilis, 13, 35, 113; treatment for, 13



Index 191

taboos, social, 5, 14, 78 Taiwan, 86, 160n6 Tandem/Tat Production House, 130 Tea Party, 140 Teen Mom (reality television program), 135–­136 telenovelas, 112–­113, 118–­124, 131, 168n26, 169n40; and epilogues, 123; ethics of, 123–­124; and Peru, 119–­120, 122–­ 123; and “values grid,” 124. See also soap operas; titles of individual telenovelas Televisa station (Mexico), 118–­119, 121–­124 television, 1, 5, 8–­10, 44, 46, 48–­49, 52–­69; and abortion services, 46, 64–­74, 135; absence of diversity in, 56; as affective medium, 64, 123–­124, 137; and camera close-­ups, 55; and censorship, 3, 56–­ 57, 131; and entertainment-­education strategy, 112–­113, 118–­124, 126, 168n26, 169n40; high costs of programming, 52–­ 53; and India, 125–­126, 126; and international family planning movement, 86, 99, 104, 106–­108, 126–­127; and lecture format, 54–­55; licensing of, 155n19; and live audiences, 68; and Mexico, 111–­113, 118–­124; and morality, 133–­135; national advertising campaigns, 60–­64; as “personal experience,” 53; and Philippines, 112; power to “highlight sincerity,” 54–­55; quiz show debacle (1958), 56, 67; and race/ethnicity, 55–­56; and sexuality, 57, 62–­64, 67, 70, 74–­75, 118–­119, 127–­ 138; and sponsorship, 52–­53, 56–­57, 65, 134; and telenovelas, 112–­113, 118–­124, 168n26; television scripts, 8–­9, 49, 54, 68; and violence, 118–­119; widespread use of, 54, 118, 120, 125–­126, 130, 133, 155n24 television stations, 52, 55, 58, 60; educational stations, 155n19; and Mexico, 118 temperance, 16 Thailand, 78, 112 thalidomide, 65 “Thirteen Points” (1921), 151n48 This I Believe (radio program), 77 The Three Caballeros (1945 animated cartoon), 162n43 Time magazine, 47

Title X Abortion Provider Prohibition Act (2011), 140 TLC cable channel, 133 triune brain theory, 169n31 Truman, Harry, 154n10 T-­shirt campaign, 143 Tú (You, 1976 film), 96–­97 tuberculosis, 6, 40 TV-­Radio Bulletin (Advertising Council), 60 Twitter, 141, 143–­144 two-­step flow of communication, 121–­122 Uganda, 138 ultrasound, 71, 73 UNESCO, 99, 101–­102, 164n83 “unfit” people, 14, 19, 22, 26, 148n10 United Nations, 77, 81–­82, 92, 160n14; Children’s Fund (UNICEF), 127; Conference on Human Rights (Teheran, 1968), 81; Decade for Women (1976–­1985), 81; Fund for Population Activities (UNFPA), 77, 99, 110, 113, 117, 124; International Women’s Day, 81–­82; International Women’s Year (1975), 81; World Conference of the International Women’s Year (Mexico, 1984), 81, 92; World Population Conference (Bucharest, 1974), 81, 92–­93, 95, 106. See also UNESCO Universal Film Mfg. Company, 16–­17 University of California, Berkeley, 146n6 University of Chicago, 4, 91, 146n6 University of Illinois, 4, 146n6 University of Southern California: Hollywood, Health & Society program, 132; Norman Lear Center, 132 University of the Air, 34 UPN television network, 132 urbanization, 81, 96, 103, 105 USAID (Agency for International Development), 77, 94–­96, 98, 127; and global gag rule, 10–­11, 110 “Vámonos Haciendo Menos” (Let’s Become Fewer) campaign, 117–­118, 122, 168n24, 169n37 Variety, 20 vasectomies, 67, 106, 108, 112, 137; vasectomy clinics, 86

192 Index 

Ven Conmigo (Come with Me, telenovela), 121–­123 venereal diseases, 5, 22; and radio, 35–­36; and sex hygiene films, 13–­14, 25, 29, 89; and television, 67; during World War II, 5 victimization, 15, 62 videos, 9, 106–­109; and Internet, 139–­142, 144 viewers. See audiences violence, 67, 71, 117–­119, 125 Visíon (Spanish-­language magazine), 116 visual communication, 6, 53–­56; and anti-­abortion movement, 68, 70–­74, 72, 73, 158n76, 159n78; representation of biracial children, 55–­56. See also films; television vivisection, 14 Vogt, William, 47 Voice of America, 76–­77 Voices from Home: Stories of Planned Parenthood Patients (online publication), 143 Wahl-­Jorgensen, Karin, 146n6 Wall Street Journal, 47 Walt Disney Studios, 1, 89–­90, 99, 127, 162n43 War of the Worlds (1938 radio play), 37 War on Poverty, 59 Washington Post, 17 Wattleton, Faye, 59 WB television network, 134 wealthy women, 17, 20–­21. See also white middle-­class women Weber, Lois, 16–­19, 22–­23 “We Had Abortions” (Ms. petition), 142–­143 Wells, H. G., 37 WERD (Atlanta radio station), 151n56 Wesleyan Uncut, 139–­140 Westbrook, Robert, 41–­42 Westinghouse, 31–­32 WEVD (socialist radio station), 33–­35, 52; University of the Air, 34 “What Breast Cancer Is, and Is Not” (video), 141–­142 Where Are My Children? (1916 film), 16–­19, 149n17

white middle-­class women, 3, 7; and Birth Control (1917 film), 19–­20, 20; and films, 17–­22, 24–­25, 24; as “fit to marry,” 24–­25; and The House without Children (1919 film), 24–­25, 24; and race suicide argument, 14, 17–­19, 21, 39, 45; Sanger as, 19–­20, 150n30; as “selfish” for choosing abortion/birth control over motherhood, 14–­15, 17, 19, 21, 25; and Where Are My Children? (1916 film), 17–­18 Wiebe, Gerhard D., 162n37 Wilder, Frank, 87 Wilke, Barbara, 70, 72, 75 Wilke, Jack, 70, 72, 75 women, Indian, 82 women’s movement, 46, 64, 80. See also feminism women’s rights, 5, 7, 33, 71, 146n8; and international family planning movement, 160n14; reproductive rights, 7, 10, 58–­59; and work opportunities, 21, 25, 41–­42. See also female empowerment women’s suffrage, 14 “Women versus Hitlerism” (radio program), 41 Women Who Have Had an Abortion (television program), 66 WOR (Newark radio station), 36 working class, 19, 49, 150n30 World Health Organization, 6 World’s Fair (New York City, 1965), 58 World War I, 25 World War II, 4–­5; and communication experts, 4, 44–­45, 49; and draft, 41; gender expectations during, 41–­42; and London blitz, 40, 48; and pin-­up girl, 41–­42; and radio, 40–­44; and venereal diseases, 5 WRNL (Richmond, Va., radio station), 41 WWJ (Detroit radio station), 36 Yale University, 146n6 A Year in the Life (television miniseries), 130 Year of Crisis (television program), 48 Yoruba culture (Nigeria), 102–­106, 127 Young, Owen D., 33 YouTube, 140–­141, 143

About the Author

Manon Parry, PhD,  is an exhibition curator and historian and an assistant professor at the University of Amsterdam, where she teaches courses on media studies, American studies, and public history. She is coeditor, with Ellen S. More and Elizabeth Fee, of Women Physicians and the Cultures of Medicine (Johns Hopkins University Press, 2008), which won the Archivists and Librarians in the History of the Health Sciences Publication Award for Best Print Publication in 2012. Dr. Parry has curated gallery and online exhibitions on a wide range of topics, as well as traveling exhibitions that have visited more than three hundred venues in the United States, Argentina, Canada, Germany, Turkey, and Guam. An online exhibition accompanying this book that includes examples of family planning media as well as teaching materials for classroom use is available at www .broadcastingbirthcontrol.com.

Available titles in the Critical Issues in Health and Medicine series: Emily K. Abel, Suffering in the Land of Sunshine: A Los Angeles Illness Narrative Emily K. Abel, Tuberculosis and the Politics of Exclusion: A History of Public Health and Migration to Los Angeles Marilyn Aguirre-­Molina, Luisa N. Borrell, and William Vega, eds. Health Issues in Latino Males: A Social and Structural Approach Susan M. Chambré, Fighting for Our Lives: New York’s AIDS Community and the Politics of Disease James Colgrove, Gerald Markowitz, and David Rosner, eds., The Contested Boundaries of American Public Health Cynthia A. Connolly, Saving Sickly Children: The Tuberculosis Preventorium in American Life, 1909–­1970 Tasha N. Dubriwny, The Vulnerable Empowered Woman: Feminism, Postfeminism, and Women’s Health Edward J. Eckenfels, Doctors Serving People: Restoring Humanism to Medicine through Student Community Service Julie Fairman, Making Room in the Clinic: Nurse Practitioners and the Evolution of Modern Health Care Jill A. Fisher, Medical Research for Hire: The Political Economy of Pharmaceutical Clinical Trials Alyshia Gálvez, Patient Citizens, Immigrant Mothers: Mexican Women, Public Prenatal Care and the Birth Weight Paradox Gerald N. Grob and Howard H. Goldman, The Dilemma of Federal Mental Health Policy: Radical Reform or Incremental Change? Gerald N. Grob and Allan V. Horwitz, Diagnosis, Therapy, and Evidence: Conundrums in Modern American Medicine Rachel Grob, Testing Baby: The Transformation of Newborn Screening, Parenting, and Policymaking Mark A. Hall and Sara Rosenbaum, eds., The Health Care “Safety Net” in a Post-­Reform World Laura D. Hirshbein, American Melancholy: Constructions of Depression in the Twentieth Century Timothy Hoff, Practice under Pressure: Primary Care Physicians and Their Medicine in the Twenty-­first Century Beatrix Hoffman, Nancy Tomes, Rachel N. Grob, and Mark Schlesinger, eds., Patients as Policy Actors Ruth Horowitz, Deciding the Public Interest: Medical Licensing and Discipline Rebecca M. Kluchin, Fit to Be Tied: Sterilization and Reproductive Rights in America, 1950–­1980 Jennifer Lisa Koslow, Cultivating Health: Los Angeles Women and Public Health Reform Bonnie Lefkowitz, Community Health Centers: A Movement and the People Who Made It Happen Ellen Leopold, Under the Radar: Cancer and the Cold War Barbara L. Ley, From Pink to Green: Disease Prevention and the Environmental Breast Cancer Movement Sonja Mackenzie, Structural Intimacies: Sexual Stories in the Black AIDS Epidemic David Mechanic, The Truth about Health Care: Why Reform Is Not Working in America

Alyssa Picard, Making the American Mouth: Dentists and Public Health in the Twentieth Century Heather Munro Prescott, The Morning After: A History of Emergency Contraception in the United States David G. Schuster, Neurasthenic Nation: America’s Search for Health, Happiness, and Comfort, 1869–­1920 Karen Seccombe and Kim A. Hoffman, Just Don’t Get Sick: Access to Health Care in the Aftermath of Welfare Reform Leo B. Slater, War and Disease: Biomedical Research on Malaria in the Twentieth Century Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok, Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities Matthew Smith, An Alternative History of Hyperactivity: Food Additives and the Feingold Diet Rosemary A. Stevens, Charles E. Rosenberg, and Lawton R. Burns, eds., History and Health Policy in the United States: Putting the Past Back In Barbra Mann Wall, American Catholic Hospitals: A Century of Changing Markets and Missions Frances Ward, The Door of Last Resort: Memoirs of a Nurse Practitioner