COPYRIGHT AND USE OF THIS THESIS This thesis must be used in accordance with the provisions of the Copyright Act 1968. Reproduction of material protected by copyright may be an infringement of copyright and copyright owners may be entitled to take legal action against persons who infringe their copyright. Section 51 (2) of the Copyright Act permits an authorized officer of a university library or archives to provide a copy (by communication or otherwise) of an unpublished thesis kept in the library or archives, to a person who satisfies the authorized officer that he or she requires the reproduction for the purposes of research or study. The Copyright Act grants the creator of a work a number of moral rights, specifically the right of attribution, the right against false attribution and the right of integrity. You may infringe the author’s moral rights if you: - fail to acknowledge the author of this thesis if you quote sections from the work - attribute this thesis to another author - subject this thesis to derogatory treatment which may prejudice the author’s reputation For further information contact the University’s Director of Copyright Services sydney.edu.au/copyright Contraceptive Sterilisation: A History of Tubal Ligation and Vasectomy in Twentieth Century Australia, 1926-86 Tiarne Barratt A thesis submitted in fulfilment of the requirements for the degree of Master of Philosophy Faculty of Arts and Social Sciences University of Sydney, 2015 Statement of Originality: I declare that the research presented here is my own original work and has not been submitted to any other institution for the award of a degree. Signed: (Tiarne Barratt) Date: 21 February 2015 Page 2 of 256 Abstract: This thesis considers the rise of contraceptive sterilisation throughout the twentieth century, using Australia as a case study to focus consideration of this global trend. From the 1920s to the 1980s, a series of gradual social changes took place that affected understandings and practices of tubal ligation and vasectomy, which led to sterilisation achieving worldwide popularity as a contraceptive by the 1980s. This diachronic rise in popularity is explored in relation to ideas of gender, sexuality, technology, and experiences of tubal ligation and vasectomy – this is not a thesis about public discussion, instead actual practices of sterilisation are the primary focus. The central argument of this thesis is that contraceptive sterilisation occurred throughout the twentieth century: largely removed from the public eye in the early decades, practices of tubal ligation and vasectomy began to alter in the 1950s and ‘60s – a period of rapid change that preceded the universal upswing of surgical contraception in the 1970s and ‘80s. In the twenty-first century, tubal ligation remains the most prevalent method of contraception in the world, yet sterilisation has rarely been the subject of historical analysis outside the realm of the eugenics movement. Additionally, it is often absent in histories of birth control, which are frequently dominated by the introduction of the pill and the “sexual revolution” of “the sixties”. In light of this, I argue that contraceptive sterilisation deserves considerably more scholarly attention than it currently receives and this thesis contributes to histories of birth control, sex, gender, medicine, technology and eugenics. Page 3 of 256 Preface: This thesis consists of entirely my own research and opinions. The material used to construct this argument includes archival documents from both public and private collections; an array of published primary sources such as medical journals; oral histories obtained for the purpose of this research; and related secondary source material. Where the work of others has been used, this is appropriately acknowledged and all secondary sources are accordingly cited in the footnotes of this thesis. The total word count for the thesis body – excluding footnotes – is 52,980. This falls into the range specified by the University of Sydney for Master of Philosophy theses of 40,000- 60,000 words. No material within this thesis has been submitted elsewhere for the award of a degree. At the outset of this research, approval was obtained from the Human Research Ethics Committee at the University of Sydney to undertake oral history interviews on the subject of ‘The Normalisation of Contraceptive Sterilisation in post-war Australia’ (Project No. 2013/534; approved 4 July 2013). Twenty interviews with doctors and patients of contraceptive sterilisation were conducted over the course of this research, which provide the bulk of primary research undertaken for the completion of this thesis. With full consent of the participants involved, some respondents are identified by name throughout, while the identity of all other participants has been protected by anonymising any identifying personal details. Page 4 of 256 Contents Abstract 3 Preface 4 Acknowledgements 6 List of Figures 7 List of Abbreviations 8 Introduction 9 Chapter One: Sterilisation Technologies 35 Chapter Two: Sterilisation in the Early Twentieth Century, 1926-1950 77 Chapter Three: Sterilisation during the “Sexual Revolution”, 1951-1969 121 Chapter Four: The Contraceptive Popularity of Sterilisation, 1970-1986 165 Conclusion 211 Appendix A: Questionnaire – ‘The Normalisation of Contraceptive Sterilisation’ 219 Bibliography: - Oral histories 221 - Unpublished primary sources 222 - Published primary sources 226 - Secondary sources 238 Page 5 of 256 Acknowledgements: I would like to thank Alison Bashford for the supervision, guidance and encouragement she has provided me with over the course of this research. Her thoughtful insights, ongoing feedback, and resolute support motivated me to continue to think, question, refine, and explore this subject – our countless conversations over the past two years have been invaluable. Additionally, I would like to thank Claire Lowrie, Barbara Caine and Penny Russell for their auxiliary supervision and constructive comments on earlier drafts of this work, and the University of Sydney History Department for their continuing support. I have been extremely lucky to have had the ongoing support and motivation of my family and friends throughout this process, and for that I am endlessly thankful to them. The love, patience, and encouragement of my partner Emily has been invaluable; the understanding and friendship of Felicity has kept me sane; I thank Linda for her tireless help and support. I am extremely grateful to all the people who volunteered to share their time and memories with me via oral history, I would not have been able to uncover this story without their help and I thank them for their extraordinary contribution to this research. In particular, Bruce Errey, Stefania Siedlecky, Barbara Simcock, and Ian Stewart, who opened their professional lives and histories to me, and shaped this thesis. Finally I would like to thank various members of staff at the University of Melbourne Archives; the University of Sydney Medical and Fisher libraries; the State Libraries of New South Wales and Victoria; the Veech Library at the Catholic Institute of Sydney; the History of Medicine Library at the Royal Australasian College of Physicians; Family Planning New South Wales and Queensland; and the National Archives of Australia. Countless individuals assisted me with this research, often going above and beyond what was required of them. Page 6 of 256 List of Figures: Figure I.1: Medibank claims sterilisation data [1970s] 13 Figure 1.1: Madlener Operation [1950] 44 Figure 1.2: Pomeroy Ligation Section [1950] 44 Figure 1.3: Male Anatomy and Sterilization: Vasectomy [1950] 68 Figure 1.4: Notes on Vasectomy, Bruce Errey Private Collection [1970s] 69 Figure 2.1: Vasectomy Patient Card, Victor Hugo Wallace Archive [1934] 103 Figure 2.2: Six Case Studies of Contraceptive Vasectomy [1942-9] 104 Figure 3.1: Vasectomies Performed by V.H. Wallace [1934-76] 129 Figure 4.1: Contraceptive Sterilisation Operations processed by Medibank [1973-8] 169 Figure 4.2: Influence of Queensland Media on Vasectomy Prevalence [1972] 181 Figure 4.3: Trouble Parking? [1970-9] 185 Figure 4.4: Sterilization, Family Planning Australia [1979] 198 Page 7 of 256 List of Abbreviations: ACR – Australasian Catholic Record AMA – Australian Medical Association BEPC – Bruce Errey Private Collection BMA – British Medical Association BMJ – British Medical Journal CHC - Combined Hormonal Contraceptives ESV – Eugenics Society of Victoria FPA – Family Planning Association GP – General practitioner IUD – Intrauterine device MJA – Medical Journal of Australia ML – Mitchell Library NHC – Norman Haire Collection NSV – No-scalpel Vasectomy NSW – New South Wales QLD – Queensland RFH – Rachel Forster Hospital RHA – Racial Hygiene Association [of New South Wales] VHWC – Victor Hugo Wallace Collection VIC – Victoria WWC – Women’s Welfare Clinic Page 8 of 256 Introduction Memorable for his colourful personality, radical opinions, and pioneering work in sexology, sex reform, and birth control, Norman Haire (1892-1952) is a well-known figure in Australian histories of sex and sexuality.1 He is less known for his role as an early twentieth century practitioner of sterilisation. In 1950 Haire received a letter from a reader of the Australian Woman magazine – to which he was a regular contributor – enquiring about the contraceptive popularity of sterilisation: Anonymous: Dear Dr. Terriss: I read your Woman article of July 4 dealing with an operation on the Fallopian