The Trap

Professor Ann Louise McIlroy, Professor of Gynaecology at the Royal Free Hospital for Women in London, was a central figure in the Stopes v. Sutherland libel trial. She described the cervical cap as “the most harmful method of which I have had experience,” [1] and she testified for the defendant in the High Court trial.

Some years after the trial, Dr Marie Stopes visited McIlroy at the Royal Free, albeit in disguise and using a false name. When Stopes asked for contraceptives, McIlroy allegedly fitted a device that was identical to that which she had condemned so roundly in the High Court.

The story of Stopes’ surprise visit has since acquired mythic qualities: it revealed McIlroy’s hypocrisy and gave Stopes the moral victory in place of the legal triumph she had sought, but which the courts had denied. The story regularly features in the biographies and hagiographies of Stopes, and why not? It’s a good story, but…

Is it true?

That is the question I will address in this article. My starting point is to look at the accounts given by three biographers: Ruth Hall (1977), June Rose (1992) and Clare Debenham (2018).

“A few years later, Marie claimed a moral revenge. Hearing that Professor McIlroy was now fitting woman with pessaries, she disguised herself as a very dirty charwoman and went along to the clinic: ‘After I was arranged on the examination couch underneath a coverlet, Professor McIlroy approached me wearing a rubber glove and told me to move my legs apart, pushing my legs in the desired direction through the coverlet. Before actually fitting the cap she did not even glance at organs or, even by a momentary view, examine the labia or vaginal orifice for discharge. She made no examination for venereal or other germs…A nurse supplied Dr McIlroy with a graded series of vaginal rubber caps, thrust the cap in, and almost immediately withdrew it, saying ‘Yes, that is your size!’ While the cap was being inserted, I felt extreme discomfort amounting to pain sufficiently acute to make it a great strain not to cry out or wince…”

Marie wrote the the Royal Free Hospital, demanding an apology and a retraction from Professor McIlroy for her earlier statements about the pessary. The secretary of the hospital wrote back: “Dear Madam, I am directed to acknowledge receipt of your letter of the 10^th inst, which has been considered by the Weekly Board. They are much surprised that you should have abused the privileges of the Hospital by obtaining advice under such circumstances. They are not concerned with the dispute to which you refer and as you make no complaint regarding your treatment, my Board see no object in continuing the correspondence.”

Ruth Hall Passionate Crusader (1977) page 232, and sourced from an “autobiographical fragment” dated 13 December 1927 in the British Library Stopes Collection.

June Rose used the same autobiographical fragment when she wrote her account:

…to Marie, Professor McIlroy’s attacks rankled. When she heard, four years later, that at the Royal Free Hospital Dr McIlroy herself was inserting the very vaginal caps she professed to find so harmful, Marie determined to find out. She first disguised herself as a ‘work-grimed charwoman’, then went along to the out-patients’ clinic. ‘When Professor McIlroy examined the grimy Marie Stopes, she did not even glance at the sex organs or, even by a momentary view, examine the labia or vaginal orifice for discharge. She made no examination for venereal or other germs…’ Marie left the clinic with a cap and later wrote to the Royal Free Hospital demanding an apology and a retraction from Dr McIlroy. The Secretary relied stiffly that that Hospital had considered her letter and believed her to have abused the privileged of the Hospital by obtaining advice under false pretences. She received no apology.”

June Rose Marie Stopes and the Sexual Revolution (1992) pages 170-171  and sourced from an “autobiographical fragment” dated 13 December 1927 in the British Library Stopes Collection.

Clare Debenham wrote:

“Under cross-examination by Patrick Hastings the Professor admitted that she had never witnessed any woman using a rubber check diaphragm. After the end of the trial Marie took her revenge on Professor McIlroy who she heard was fitting this contraceptive device at the Royal Free Hospital. In her book Ten Thousand Patients Marie describes how theatrically she disguised herself as a work-grimed charwoman and after a wait of three hours was conveniently fitted with the rubber check pessary by the same Professor McIlroy.”

Marie Stopes’ Sexual Revolution and the Birth Control Movement (2018) by Clare Debenham, page 111.

The gist of the story is that Stopes was kept waiting for ages, that the encounter between the Professor and the disguised Stopes was transactional with little in the way of conversation, that McIlroy did not examine Stopes for disease prior to fitting the device, that she handled Stopes roughly and that she used the same device she had criticised Stopes for using.

Another version of the story.

Let’s now compare these accounts with the encounter described in Peter Neushul’s article, The Popularization of Birth Control Technology.

Disguising herself as a charwoman, Stopes made it through the reception room by insisting “in a hoarse cockney voice that I had been told to see Professor McIlroy herself.” She used the name Marian Parker, age fifty-seven, of 17 Hill Road, Penge, S.E., and was told to see Professor McIlroy.

After a five to ten minute wait, Stopes met with McIlroy and informed her that “I had had a ‘Sessarean’ section and I was not very strong. My first baby had died; I had been pregnant two other times and could not have any more. My husband was a van driver and after the ‘Sessarean’ section it took me nearly six months to get about again, and I could not have any more babies.”

Throughout the meeting with McIlroy, Stopes spoke in a “slightly husky cockney voice and dropping aspirates.” Stopes recalled that “her face was close to mine, within three or four inches, but there was not the slightest wavering of recognition or doubt to who she was looking at appeared to cross her face.”

When McIlroy tried to get Stopes to convince her husband to use a condom, Stopes replied, “Well, I got one of my kids that way one broke-and besides my husband does not like them.” McIlroy then examined Stopes by “merely putting her finger in the vagina and estimating the size.” Shortly thereafter McIlroy called for a box of diaphragms (“Fetch the sizes”), selected one, thrust it in, concluded that it was her size, and gave her an identical dry one. McIlroy said, “You see, what you do is to scrunch it up in your hand, and then slip it in as far as it will go using the center finger. Leave it in all night and you ought to douche before taking it out next morning.”

In an obvious effort to get McIlroy to prescribe a cervical cap, Stopes retorted, “[T]hat is awfully big, aint it. The Nurse showed me something, but hers was less than half this size.”

Professor McIlroy pinched the cap together in her hand, reducing it to about the size of a cervical cap and said, “I suppose you mean one like that.” Stopes responded, “That’s more like it; this looks so big.” McIlroy replied, “Oh that kind, you cannot use that because it is very troublesome; you see it has to be fitted  very time by a Nurse or Doctor, whereas this one you can fit yourself.” Stopes concluded, “I said: ‘Oh, all right, where do I pay’.”

After her visit Stopes wrote a speech condemning McIlroy for going back on her word, In her notes, Stopes conceded that “she may reply that the cap she fitted is not exactly identical to ours” She also noted that “to emphasise the difference is but splitting hairs in the face of the photograph showing the extreme degree of similarity.” [Stopes had a photo taken of a cervical cap and diaphragm side by side].

In fact, there was a big difference between the diaphragm and the cervical cap, one that Stopes sought to gloss over when she blasted McIlroy for prescribing the very “rubber cap” that she had testified about at the trial. Stopes written account, published in the CBC newsletter, also criticised McIlroy for not taking “anything like the same care and precautions in the insertion of the cap that are the routine at our Birth Control Clinic; that she made no effort whatever to detect infection or venereal disease in the critical regions.”

[Note: Emphasis added]

The Popularization of Birth Control Technology (1998) by Peter Neushul, Technology and Culture (pages 265-6) based on Stopes’ account in Box 52, B.19 in Stopes’ papers in the Wellcome Library.

Lest you think that I have picked a version that shows Stopes in the least favourable light, I would point out that Neushul’s version is based on Stopes’ own account in the Wellcome Library [2], so the question is: which of Stopes’ different versions is correct?

…five to ten minute wait…

There is an obvious discrepancy in the time Stopes was kept waiting. Was it ten minutes or three hours? If three hours was correct, it meant that Stopes falsified it as a five to ten-minute wait in the different version. Why did she do this? To me, that doesn’t make sense, and I think it is more likely that the five to ten-minute wait was the accurate account and that the waiting time grew to three hours for the hatchet piece in Birth Control News.[3]

…to use a condom…

Neushul’s account reveals part of the conversation between doctor and patient and information sought and received. This was glossed over in the other accounts. And for all of the hypocrisy implied by Hall, Rose and Debenham, McIlroy’s behaviour was consistent with her testimony in the libel trial. For instance, take this exchange during her cross-examination by Mr Patrick Hastings K.C.:

Hastings: “Supposing a woman were to come to you and suppose she says: ‘Now I have had three or four children; it is really too much for me, coming too quickly, getting a child every year.’ Would you advise her to use contraceptives?”

McIlroy: “I would advise her not to have sexual intercourse.”

Hastings: “In other words, Dr. McIlroy, are not we now getting to the crux of the question; you would advise her not to have relations with her husband?”

McIlroy: “Yes.”

Hastings: “Would you take into consideration that might be the ruin of two lives?”

McIlroy: “If I thought so, I would advise contraceptive methods.”

The Trial of Marie Stopes (1967) Muriel Box, editor. Femina Books. Page 218.

McIlroy agreed with Hastings’ suggestion that she was “in principle opposed to the use of contraceptives wherever possible.” She said she was “not opposed to contraceptive methods in medical cases” and added: “I recommend them.” The first method she recommended was the condom. In response to Hastings’ questions as to how to treat hypothetical patients, McIlroy said on four occasions that she would advise contraceptive methods. During Stopes’ visit, she recommended contraceptives.

The cap and the diaphragm.

At this point, it is important to understand the similarities and differences between a cervical cap and a diaphragm. Both devices are “barrier” contraceptives which can be supplemented by using secondary methods (such as a spermicide). In this context, both were hemispherical domes made of rubber.

The cervical cap was the primary method of contraception used at the Mothers’ Clinic. Stopes’ Pro-Race brand cervical cap. The diagram at right is from page 27 of the sixth edition of Stopes’ book Wise Parenthood [4] and it shows the rubber cap (c) occluding the entrance to the womb (s). Stopes explained how it was held in place: “It adheres by suction assisted by the spring of the firm rim against the circular muscles and remains firmly in place, whatever movement the woman may make.” In Sex and Destiny, Germaine Greer described how it “was pushed snugly over the cervix so that all the air was pushed out and it adhered by suction”.

In contrast, the diaphragm is held in place by pushing outwards against the walls of the vagina. In Sex and Destiny, Greer described the fit as “crude, being merely the largest circumference which can be got to stay taut inside the vagina after it had been inserted by pressing it between finger and thumb and making sure that it is pushed up well behind the pubic bone.”

…you cannot use that because it is very troublesome…

Neushul’s account makes it clear that McIlroy was going to fit Stopes’ with a diaphragm and suggests that Stopes made an “obvious attempt” to get her to fit a cap. When McIlroy realised that Stopes was referring to the cap, she replied:

“Oh that kind, you cannot use that because it is very troublesome; you see it has to be fitted every time by a Nurse or Doctor, whereas this one you can fit yourself.”

The Popularization of Birth Control Technology (1998) by Peter Neushul, Technology and Culture (pages 265-6) based on Stopes’ account in Box 52, B.19 in Stopes’ papers in the Wellcome Library.

Remember that for McIlroy, this was just another day at the office. She wasn’t aware that Stopes was trying to entrap her, or even that she was talking to Stopes. Yet her unguarded answer that “is is very troublesome” was consistent with her testimony during the trial that she had “never met a woman yet who was able to fit on the pessary” and her objections to the cervical cap in the meeting of the Medico-Legal Society on 7th June 1921:

“The most harmful method of which I have had experience is the use of the pessary. It does not remain in place. It can pass back natural discharges.”

Professor Louise McIlroy speaking at the Medico-Legal Society 7th July 1921.

…the photograph showing the extreme degree of similarity…

Below is a photoengraving of the photograph that Stopes took of the cap and the diaphragm side by side. Can you identify which is which?

The answer is that “A” and “C” are cervical caps and “B” is the diaphragm. [5] They certainly look similar, but so what? A still photograph of one part of the fit does not show the dynamic by which the device stays in place.

…made no effort whatever to detect infection or venereal disease…

How would Stopes know? She was, after all, a doctor of philosophy, not medicine. In my experience, a medical doctor of McIlroy’s calibre and experience would have observed her patient and would have used all of her senses to form a view. Yes, it’s a speculation, and if correct, there would have been few, if any, external signs that an examination had taken place.

Conclusion

How is it that this false myth has taken hold when an examination of the facts provided by Stopes reveals that it is patently false? In defence of the three biographers, the papers relating to Stopes are voluminous and held is difference locations, so possibly they might have not been aware of the source that Neushul used.

On the other hand, the words they use to describe the devices are confusing: Hall used “pessaries”, “vaginal rubber caps”, “cap” and “cap”. Rose used: “the very vaginal caps she professed to find so harmful” and “cap”. Debenham used: “rubber check diaphragm”, “this contraceptive device” and “rubber check pessary”. One would have thought that a biographer of Stopes would have known the difference and would have written with greater clarity.

In his 1998 paper, Peter Neushul concluded:

Unfortunately, Stopes’s calculated effort to smear McIlroy is perpetuated by her biographers, including the most recent, who repeats the propaganda that McIlroy was “inserting the very vaginal caps she professed to find so harmful.”

The Popularization of Birth Control Technology (1998) by Peter Neushul, Technology and Culture (pages 265-6) based on Stopes’ account in Box 52, B.19 in Stopes’ papers in the Wellcome Library.

The “most recent” biographer at the time of Neushul’s paper was June Rose. The most recent at the time of writing this article is Clare Debenham, whose Marie Stopes’ Sexual Revolution and the Birth Control Movement was published in March last year and the false myth continues.

All of the forgoing text is the smaller part of the significant point to this article: Professor Louise McIlroy D.B.E., LL.D., M.D., F.R.C.P., F.R.C.O.G. was a truly great woman, whose contribution to The Royal Free Hospital for Women and to British medicine was enormous. She deserves better than to have her memory besmirched by the lies of an unscrupulous enemy.

I have written this article in the hope that the falsity of the “Stopes visits McIlroy” myth will come to the attention of a wider audience and, who knows, perhaps the next biography of Dr Marie Stopes will report the correct version.

I won’t be holding my breath!

Notes

[1] Stopes herself asserted that McIlroy had no experience of the cervical cap. During the trial this exchange tool place:

Hastings: “Have you ever had a case of a woman who has worn one of these pessaries?”

McIlroy: “I have never met a woman yet who was able to fit on the pessary.”

Hastings: “I wonder if you could answer my question: have you ever met a case yet of any woman who has worn one?”

McIlroy: “No.”

[2] While the accounts are attributed to their various authors, their source information comes from Stopes herself. Hall and Rose base theirs on
an “autobiographical fragment” dated 13 December 1927 in the Stopes Collection at the British Library, while Neushul bases his on
Stopes’ account in Box 52, B.19 in Stopes’ papers in the Wellcome Library. Debenham does not cite her source. I make this point to make it clear that I am not “shopping” for the account that suits my purposes: the discrepancies arise from Stopes own accounts and what each author selected for inclusion.

[3] See “Professor McIlroy and the Cap Method,” by Marie C. Stopes. Birth Control News 8 (February 1930) pages 145-48.

[4] See: Wise Parenthood: A Practical Sequel to Married Love (1918) by Marie Carmichael Stopes. You will find a copy of the book at: https://archive.org/details/cihm_990552/page/n7

[5] The author of this article has seen Stopes’ own photograph in the Wellcome Library in London and this photoengraving is an accurate representation of the devices. Stopes wrote on one photograph: “A & C Pro-Race type of rubber cap advised b Dr. Stopes. B actual cap fitted by Professor McIlroy in Dr Stopes at the Royal Free Hospital.”

Photo-credit: Photo by Skitterphoto from Pexels