The decline of the British birth rate was arguably the most important social change to occur in the last decades of the nineteenth century, but historians have shown remarkably little interest in the phenomenon. Most of the work done on the question has been by sociologists and reflects their assumption that the progressive adoption of birth control was largely a matter of the lower classes aping the behaviour of their 'betters'.

Originally published in 1978, this book argues against this interpretation. It contends that the great interest of the nineteenth-century birth control debate is that it reveals that there was not a growing consensus of opinion on the question of family planning but rather two cultural confrontations - the struggle of the middle-class propagandists of both left and right to manipulate for political purposes working-class attitudes towards procreation, and, on a deeper level, the clash of the differing attitudes of men and women towards the possibility of fertility control.

The purpose of this study is to place the idea and practice of birth control in their social and political context, and four major factors are focused upon to this end: the first is that the birth control issue played a key role in the confrontation between Malthusians, socialists, eugenists and feminists. Secondly, the whole question of contraception led to a conflict between doctors, quacks, midwives and ordinary men and women seeking to control their own fertility. Thirdly, men and women belong to different sexual cultures and necessarily respond in different ways to the possibility of family regulation, and finally, despite the claims of some that birth control was an innovation, it was the pre-industrial forms of fertility control - including abortion - which brought the birth rate down.