Bringing Contraception to Italy: A story of moral heroism

    Editor’s note: Luigi DeMarchi and Maria Luisa Zardini (formerly DeMarchi) were groundbreaking leaders of Italy’s contraceptive movement. Here, the couple tells the tale of their two decade struggle to overturn Italian laws banning distribution of information about birth control while braving multiple jail sentences and fines. From “Courageous Pioneers”, a book published in 2007 celebrating the successes of Dr. Clarence Gamble and Pathfinder’s efforts to bring reproductive health care and women’s rights to remote regions of the developing world. Foreword by former Secretary of the UN, Kofi Annan.

    Beginning in 1958, Maria Luisa DeMarchi began visiting women living in the borgate—poor areas on the outskirts of Rome—educating them about birth control and providing them with vaginal suppository contraceptives, which had been supplied free of charge by a manufacturer in Great Britain. She continued these visits for the next two decades, making weekly visits to over 550 clients annually—a total of over 7,000 visits.

    Bringing Contraception to Italy

    “Whoever publicly incites to practices against procreation or makes propaganda in their favor is punishable by detention of one year.”

    –Article 553 of the 1930 Italian Fascist Penal Code

    In the late 1940s, Italy was rebuilding itself from the destruction of World War II. With a 1947 peace treaty that reestablished its borders and a new constitution in 1948, Italy began to affirm its identity with the West, joining the North Atlantic Treaty Organization in 1949, the United Nations in 1955, and the European Economic Community (precursor to the European Union) in 1958.

    Social change was also moving forward. Workers began demanding higher wages and better social services. And they were sorely needed: one out of four people lived in poverty, and half of the poor had families of five children or more. More than 300,000 families lived in cellars, caves, or shacks. The population was rapidly expanding, reaching 45 million after the war. And with the collusion of both Italian law and the Vatican, which both had strict prohibitions against birth control, the trend seemed destined to continue.

    When we started our fight for planned parenthood, in 1953, Italian laws (introduced by the fascist dictatorship but renewed by the Catholic Church and Communist Party in 1945) forbade all information and assistance about contraception. We were acutely aware of the severe social, economic, and personal repercussions on couples who had no way to control the size of their families or improve their quality of life.

    We became active in the Associazone Italiana per l’Educazione Demografica (AIED), a family planning association founded to help publicize the concept of birth control and challenge prevailing Italian laws. However, AIED made little progress with conventional appeals to legislators. So, in 1956, we decided to take bolder steps.

    We opened the first center for sexual and contraceptive counseling—Rome Consultation Office for Birth Control—near the Vatican. Although the center was set up only to provide referrals to private practice physicians who were able to provide contraceptive information, the move was illegal and risky. The event was dramatic, and had a strong international resonance (“Sensation à Rome” was a headline in the French daily, L’Express). We were denounced by the police, but the government authorities preferred to avoid an open political battle, and dismissed the denunciation. A few months later, the Vatican daily newspaper, Observatore Romano, called for Luigi’s arrest. But once again, the authorities ignored them.

    The first person to arrive at the center was a policeman who had been sent to investigate. We explained about birth control, and how the center provided physician referrals. “Actually,” the policeman admitted, “I have four children—and I don’t want any more, myself.” He left with the name of a doctor. “I’ll tell my superiors everything is under control here,” he said on his way out.

    The publicity and press attention brought a flood of new clients: the office had 200 visitors, and we responded to 600 letters, in the first eight months. Most clients were educated and relatively affluent. Although we were pleased, we grappled with a larger problem: how could we get this information to the people who needed it most, those who were poor and did not read the newspapers?

    Collaboration With the Gambles

    In the summer of 1955, we began a correspondence with Dr. Clarence Gamble. He sent a start-up donation of $300 (which he later increased to $800) for the first year, and $1,000 annually thereafter. We learned that this was consistent with Dr. Gamble’s pattern of providing small initial donations to assist, but not overwhelm, grassroots initiatives.

    However, Dr. Gamble’s involvement went well beyond writing checks. We kept in close contact, and he provided the center with free vaginal diaphragms and jelly from the United States. He was a strong supporter of the salt-and-sponge contraceptive, which we agreed to distribute as well, but we met with very limited success.

    In 1958, a year after Pathfinder was incorporated in the United States, Dr. Gamble visited us at the center in Rome. By that time, business was fairly slow, and the office was winding down. Gamble suggested that if those most in need could not come to the center, why not bring the information to them? Although this was a radical idea in Italy, it was very much in line with Dr. Gamble’s experience in other countries. He was also thinking about conducting a contraceptive field trial to determine the efficacy and receptivity of various types of contraceptives. Dr. Gamble promoted localizing birth control, which no one else was doing at that time. He had the prescience to realize that our ideas were pioneering and deserved to be supported.

    We decided that Maria Luisa should begin door-to-door visits to the borgate, the tenements and tin shacks clustered on the outskirts of Rome, continuing her visits even through her first pregnancy. After delivering her first child, Maria Luisa renewed her visits with vigor in the spring of 1959.

    Meeting the Women of the Borgate

    The families in the borgate lived hardscrabble, often brutal, lives. Most of the men worked as manual laborers. The macho ethic was strong: many men felt that sex on demand was the right of a husband, and they would often resort to physical violence to keep control of their wives and children. Alcohol abuse made their behavior worse.

    These patterns went unchecked by police intervention. Wives were afraid of being beaten when the men returned from an arrest, and they could not afford to lose income when the husband was in jail. Many women were exhausted by the endless cycle of poverty, deprivation, violence, and childbirth, and by their inability to control any of it. Most had no idea what birth control was, although they suspected that there was some “magic solution”—they had noticed that wealthy women had few children. “What do rich women have that we don’t?” they would ask Maria Luisa.

    Typically, women in the borgate married young—often as early as 14—and on average, bore at least five children. Often, in desperation, they would resort to home abortion remedies. They would use a tube inserted through the vagina to the cervix and left in place for at least 24 hours, or take certain types of boiled herbs and plants. These methods were ineffective, unsterile, and highly risky to women’s health. Though they might be in pain and bleeding from a botched abortion, women would often refuse to go to the hospital, because they knew that the doctors would do everything to maintain the pregnancy. Many women died. No one would ever admit that the deaths were from abortion—never.

    Here are just a few of their stories:

    Esperia: Married at age 14, she had given birth to seven children and 14 abortions by the time Maria Luisa met her. “My daughter will never have a life like mine,” she vowed. She would not leave her daughters alone with her husband, because she knew he would sexually abuse them.

    Felicetta: Married at age 14, by age 28 she had eight living children, two of whom had tuberculosis. The family lived in a single basement room, awash with dirty water and infested with mice. Her husband noted, “I wanted to have the same number of girls and boys, so I stopped after eight.”

    Filomena: At age 33, with a third-grade education, Filomena was the mother of five living children, and she had endured eight abortions. She said, “Don’t worry about my religious beliefs. I’m not afraid of hell, and here’s why: I have hell right here, summer and winter… I need [birth control] so much, something that takes away this worry.”

    Many of these women worked as maids during the day, so Maria Luisa timed her arrivals for Sundays or evenings. The first visit was always the easiest because all of the women were interested in learning how to limit their families. But after that, husbands often became suspicious, and visits became more difficult. Many of the men felt that contraceptives were an affront to their manhood. They worried that without the fear of pregnancy, their wives would “be free to go with someone else.”

    The husbands were not alone in their distrust of contraception. According to Italian law, Maria Luisa technically risked arrest every time she made a home visit. Before Maria Luisa began her work we obtained a letter from Parliament indicating that members of Parliament were “aware” of her work. She kept this letter with her at all times in case she was arrested.

    Tangling With the Vatican

    In the end, the authorities interfered very little with Maria Luisa’s work. We suspected that they left her alone because they wanted to avoid any more unwelcome publicity about contraception. The Vatican, however, had a different approach. About five years after she had begun her routine of home visits, neighbors alerted Maria Luisa to a mysterious man who parked daily outside her home, taking pictures of people as they came and went. She found out that he had been sent by the Pontificia Opera di Assistenza, the charity office of the Vatican. The photos he took of Maria Luisa were distributed to priests, who circulated them to women in their parishes. “This woman will approach you about birth control,” they warned. “What she will give you is dangerous to your health, and can give you cancer.”

    Despite the law and the Vatican’s opposition, Maria Luisa continued her work, funded by Pathfinder, for the next two decades. Ultimately, she made weekly visits to over 550 clients annually—a total of over 7,000 visits. We were convinced that these women really needed help—and that we could provide it. Maria Luisa provided the women with education and information about birth control, as well as vaginal suppository contraceptives, which had been provided free of charge by a manufacturer in Great Britain.

    Maria Luisa kept careful records, including extraordinary case histories of the women she served. Dr. Gamble had trained her in statistical survey methods, and she sent him detailed reports of her work, including quarterly reports on the efficacy of different contraceptives. In 1969, she published her data and case histories in a groundbreaking book, Inumane Vite. The title (which means “Inhuman Lives”) was a response to the Pope’s condemnation of contraception the previous year in his encyclical Humanae Vitae.

    Taking Birth Control to the Courts

    In 1964, the Pill came to Italy, but it was not authorized for sale by pharmacies. We organized a demonstration of family planning supporters in St. Peter’s Square during the Pope’s Easter address. Featuring gigantic banners proclaiming, “Yes to the Pill!” and “No to the Population Bomb!” the event was given first-page prominence in many newspapers—including The New York Times.

    We finally succeeded in challenging the prevailing law against contraception, which dated back to the fascist era. Luigi was put on trial for a lecture he gave in Florence on “Social and Health Harms of Unchecked Fertility,” and his case went to the Supreme Court. The court rejected his position on the grounds that providing information about contraception was a violation of public morals. For the next six years, we and our legal team continued to appeal the ruling.

    In 1970, we again defied the law in our efforts to make affordable contraception accessible to all Italians. With the help of a progressive minister of health and Pathfinder funding, we opened birth control clinics, first in Rome and then Milan. This brought another trial in the Supreme Court—but this time, we won.

    In an historic ruling, the court reversed the longstanding prohibition on disseminating contraceptive information. The court noted that the law had been created under fascist rule, at a time when the government wanted to increase population. Acknowledging that times had changed, the court held that it was now more important to limit births, and overturned its previous ruling.

    Although Pathfinder did not provide direct financial support for the court case, it supported us and maintained close contact with us throughout the ordeal. When the Supreme Court handed down its ruling, Dr. Gamble’s wife, Sarah, wrote us, “We are all of us full of joy over your magnificent victory. When the world seems so full of difficulties and disappointments, this has been a glorious success to think about.”

    Moving forward

    We continued to work with Pathfinder on family planning issues for 15 years after this hard-earned court victory. With Pathfinder’s help, we were able to find innovative ways to promote contraception and engage people on an emotional and personal level. One of the most interesting projects we worked on, developed with Pathfinder funds, was the introduction of “photo stories” and telenovelas, similar to soap operas, which appeared weekly on television in three cities.

    Using well-known Italian actors, and drawing on motivational psychology, the stories presented birth control as an effective way to satisfy deep emotional needs. Newlyweds could start married life unencumbered by worries about accidental pregnancy, or ward off threats, such as being exploited by a boss because of financial straits caused by an ever-growing family. The series was the first of its kind in the world and was highly successful. The sale of contraceptives in the areas covered by the broadcasts increased by 34 percent.

    Italy today

    Today, Italy has one of the lowest birth rates in the world—9.7 births per 1,000 people. Contraceptives and family planning services are widely available now, and abortion has been legal since 1978. Italian birth rates have constantly declined during the 20th century, in spite of early fascist efforts to increase them and stubborn attitudes of the Vatican against birth control. When people are really motivated to limit their fertility, they can do it. Therefore, motivation is the crucial factor in population control.

    Popular moods and mores are much more independent from religious and political intimations than political scientists usually think. With perseverance and compassion, and financial and technical assistance from generous donor organizations such as Pathfinder, people can control their family size, leading to healthier, more productive lives.

    Professor Milton Siegel, who for 24 years was the Assistant Director-General of the World Health Organization, speaks to Dr. Stephen Mumford in 1992 to reveal that although there was a consensus that overpopulation was a grave public health threat and would be a major cause of preventable death not too far in the future, the Vatican successfully fought off the incorporation of family planning and birth control into official WHO policy. This video is available for public viewing for the first time. Read the full transcript of the interview here.

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    2 COMMENTS

    1. Jail the Pope for his cover ups of pedophile rapist priests and his veto of WHO policy to fund & distribute condoms world wide & provide for life saving abortions, NOT PREVENTING DEADLY DISEASES nor Preventing Ectopic and other deadly pregnancy conditions causes 6 million women to die globally each year… seize the assets of Banco Ambrosiano to pay for such prevention & life saving efforts for women & protect children from priestly rapes

    2. A very good article and 'herstory' of women's work in Italy! Despite the overwhelming patriarchal doctrines, women worked tirelessly to save other women's lives. This is now a success story with Italy having the lowest birthrate in the world! I call that resilience and defiance of these courageous women who went from house to house to provide mothers with the means to prevent more pregnancies. My mother (in Holland) a good catholic as she was, gave birth to 10 children and had many abortions. She told me in 'in confidence' that she was pregnant 20 times! I hold the vatican accountable for this violence against women. Preventing them from using contraception was just criminal. I also hold the men accountable for their macho values and beliefs. What's love got to do with this? Nothing, nothing at all! I thank the women of Italy for giving their daughters and grand daughters a better future.

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