Margaret Sanger (1879 – 1966) was an American birth control activist, sex educator, and nurse. Sanger popularized the term ‘birth control,’ opened the first birth control clinic in the United States, and established Planned Parenthood. Sanger’s efforts contributed to the landmark U.S. Supreme Court case which legalized contraception in the United States.
Sanger is a frequent target of criticism by opponents of birth control and has also been criticized for supporting eugenics (‘racial hygiene’), but remains an iconic figure in the American reproductive rights movement. Sanger’s early years were spent in New York City. In 1914, prompted by suffering she witnessed due to frequent pregnancies and self-induced abortions, she started a monthly newsletter, ‘The Woman Rebel.’ Sanger’s activism was influenced by the conditions of her youth—her mother had 18 pregnancies in 22 years, and died at age 50 of tuberculosis and cervical cancer.
In 1916, Sanger opened the first birth control clinic in the United States, which led to her arrest for distributing information on contraception. Her subsequent trial and appeal generated enormous support for her cause. Sanger felt that in order for women to have a more equal footing in society and to lead healthier lives, they needed to be able to determine when to bear children. She also wanted to prevent back-alley abortions, which were dangerous and usually illegal at that time. In 1921, Sanger founded the American Birth Control League, which later became the Planned Parenthood Federation of America. In New York, Sanger organized the first birth control clinic staffed by all-female doctors, as well as a clinic in Harlem with an entirely African-American staff. In 1929, she formed the National Committee on Federal Legislation for Birth Control, which served as the focal point of her lobbying efforts to legalize contraception in the United States. From 1952 to 1959, Sanger served as president of the International Planned Parenthood Federation.
Margaret Sanger was born as Margaret Higgins in Corning, New York. Her father, Michael Hennessy Higgins, was a Catholic who became an atheist and an activist for women’s suffrage and free public education. In 1912, after a fire destroyed their home in Hastings-on-Hudson, the Sanger family moved back to New York City, where Margaret began working as a nurse in the East Side slums of Manhattan. Margaret and her husband William became immersed in the radical bohemian culture that was then flourishing in Greenwich Village. They became involved with local intellectuals, artists, socialists, and activists for political reform, including John Reed, Upton Sinclair, Mabel Dodge, and Emma Goldman. Starting in 1911, Sanger wrote a series of articles about sexual education entitled ‘What Every Mother Should Know’ and ‘What Every Girl Should Know’ for the socialist magazine ‘New York Call.’ By her days’ standards, the articles were extremely frank in their discussion of sexuality, and many readers were outraged by them. Other readers, however, praised the series for its candor, one stated that the series contained ‘a purer morality than whole libraries full of hypocritical cant about modesty.’
In 1913, Sanger worked as a nurse at Henry Street Settlement in New York’s Lower East Side, often with poor women who were suffering due to frequent childbirth and self-induced abortions. Searching for something that would help these women, Sanger visited public libraries, but was unable to find information on contraception. These problems were epitomized in a story that Sanger would later recount in her speeches: while working as a nurse, she was called to one Sadie Sachs’ apartment after Sachs had become extremely ill due to a self-induced abortion. Afterward, Sadie begged the attending doctor to tell her how she could prevent this from happening again, to which the doctor simply gave the advice to remain abstinent. A few months later, Sanger was once again called back to the Sachs’ apartment — only this time, Sadie was found dead after yet another self-induced abortion. Sanger would sometimes end the story by saying, ‘I threw my nursing bag in the corner and announced … that I would never take another case until I had made it possible for working women in America to have the knowledge to control birth.’ Although Sadie Sachs was possibly a fictional composite of several women Sanger had known, this story marks the time when Sanger began to devote her life to help desperate women before they were driven to pursue dangerous and illegal abortions.
In 1914, Sanger launched ‘The Woman Rebel,’ an eight-page monthly newsletter which promoted contraception using the slogan ‘No Gods, No Masters.’ Sanger, collaborating with anarchist friends, popularized the term ‘birth control’ as a more candid alternative to euphemisms such as ‘family limitation’ and proclaimed that each woman should be ‘the absolute mistress of her own body.’ In these early years of Sanger’s activism, she viewed birth control as a free-speech issue, and when she started publishing ‘The Woman Rebel,’ one of her goals was to provoke a legal challenge to the federal anti-obscenity laws which banned dissemination of information about contraception.
Sanger was indicted on three counts of violating obscenity laws and a fourth count of ‘inciting murder and assassination.’ The incitement charge was based on an article in ‘The Woman Rebel.’ Afraid that prosecutors might focus on the incitement charge, and that she might be sent to prison without an opportunity to argue for birth control in court, she fled to England under the alias ‘Bertha Watson’ to avoid arrest. While she was in Europe, Sanger’s husband distributed a copy of ‘Family Limitation’ (a manuscript Sanger was working on) to an undercover postal worker, resulting in a 30 day jail sentence. Sanger’s ally Upton Sinclair wrote an open letter of support for Sanger and her husband in ‘The Masses’ and during her absence, a groundswell of support grew in the United States, and Margaret returned home in 1915. Noted attorney Clarence Darrow offered to defend Sanger free of charge, but, bowing to public pressure, the government dropped the charges in early 1916.
Some countries in northwestern Europe had more liberal policies towards contraception than the United States at the time, and when Sanger visited a Dutch birth control clinic in 1915, she learned about diaphragms and became convinced that they were a more effective means of contraception than the suppositories and douches that she had been distributing back in the United States. Diaphragms were generally unavailable in the United States, so Sanger and others began importing them from Europe, in defiance of United States law.
In October of 1916, Sanger opened a family planning and birth control clinic in Brooklyn, the first of its kind in the United States. Nine days after the clinic opened, Sanger was arrested for breaking a New York state law that prohibited distribution of contraceptives, and went to trial in early 1917. Sanger was convicted; the trial judge held that women did not have ‘the right to copulate with a feeling of security that there will be no resulting conception.’ Sanger was offered a more lenient sentence if she promised to not break the law again, but she replied: ‘I cannot respect the law as it exists today.’ For this, she was sentenced to 30 days in a workhouse. An initial appeal was rejected, but in a subsequent court proceeding in 1918, the birth control movement won a victory when Judge Frederick E. Crane of the New York Court of Appeals issued a ruling which allowed doctors to prescribe contraception. The publicity surrounding Sanger’s arrest, trial, and appeal sparked birth control activism across the United States, and earned the support of numerous donors who would provide her with funding and support for future endeavors.
After World War I, Sanger shifted away from radical politics, and she founded the American Birth Control League (ABCL) in 1921 to enlarge her base of supporters to include the middle class. The founding principles of the ABCL were as follows: ‘We hold that children should be (1) Conceived in love; (2) Born of the mother’s conscious desire; (3) And only begotten under conditions which render possible the heritage of health. Therefore we hold that every woman must possess the power and freedom to prevent conception except when these conditions can be satisfied.’
After Sanger discovered that physicians were exempt from the law that prohibited the distribution of contraceptive information to women—provided it was prescribed for medical reasons—she established the Clinical Research Bureau (CRB) in 1923 to exploit this loophole. The CRB was the first legal birth control clinic in the United States, and it was staffed entirely by female doctors and social workers. The clinic received a large amount of funding from John D. Rockefeller Jr. and his family, which continued to make donations to Sanger’s causes in future decades, but generally made them anonymously to avoid public exposure of the family name, and to protect family member Nelson Rockefeller’s political career since openly advocating birth control could have led to the Catholic Church opposing him politically.
In 1922, Sager she traveled to China, Korea, and Japan. In China she observed that the primary method of family planning was female infanticide, and she later worked with Pearl Buck to establish a family planning clinic in Shanghai. Sanger visited Japan six times, working with Japanese feminist Kato Shidzue to promote birth control. This was ironic since ten years earlier Sanger had accused Katō of murder and praised an attempt to kill her. In 1926, Sanger gave a lecture on birth control to the women’s auxiliary of the Ku Klux Klan in Silver Lake, New Jersey. She described it as ‘one of the weirdest experiences I had in lecturing,’ and added that she had to use only ‘the most elementary terms, as though I were trying to make children understand.’ Sanger’s talk was well received by the group, and as a result, ‘a dozen invitations to similar groups were proffered.’
In 1928, conflict within the birth control movement leadership led Sanger to resign as the president of the ABCL and take full control of the CRB, renaming it the Birth Control Clinical Research Bureau (BCCRB), marking the beginning of a schism in the movement that would last until 1938.
In 1929, Sanger formed the National Committee on Federal Legislation for Birth Control in order to lobby for legislation to overturn restrictions on contraception. That effort failed to achieve success, so Sanger ordered a diaphragm from Japan in 1932, in order to provoke a decisive battle in the courts. The diaphragm was confiscated by the United States government, and Sanger’s subsequent legal challenge led to a 1936 court decision which overturned an important provision of the Comstock laws which prohibited physicians from obtaining contraceptives. This court victory motivated the American Medical Association in 1937 to adopt contraception as a normal medical service and a key component of medical school curricula.
In 1937, Sanger became chairman of the newly formed Birth Control Council of America, and attempted to resolve the schism between the ABCL and the BCCRB. Her efforts were successful, and the two organizations merged in 1939 as the Birth Control Federation of America. Although Sanger continued in the role of president, she no longer wielded the same power as she had in the early years of the movement, and in 1942, more conservative forces within the organization changed the name to Planned Parenthood Federation of America, a name Sanger objected to because she considered it too euphemistic.
While researching information on contraception Sanger read various treatises on sexuality in order to find information about birth control. She read ‘The Psychology of Sex’ by the English psychologist Havelock Ellis and was heavily influenced by it. While traveling in Europe in 1914, Sanger met Ellis. Influenced by Ellis, Sanger adopted his view of sexuality as a powerful, liberating force. This view provided another argument in favor of birth control, as it would enable women to fully enjoy sexual relations without the fear of an unwanted pregnancy. However, Sanger was opposed to excessive sexual indulgence. She stated ‘every normal man and woman has the power to control and direct his sexual impulse. Men and women who have it in control and constantly use their brain cells thinking deeply, are never sensual.’ Sanger said that birth control would elevate women away from a position of being an object of lust and elevate sex away from purely being for satisfying lust, saying that birth control ‘denies that sex should be reduced to the position of sensual lust, or that woman should permit herself to be the instrument of its satisfaction.’
Sanger wrote that masturbation was dangerous. She stated ‘In my personal experience as a trained nurse while attending persons afflicted with various and often revolting diseases, no matter what their ailments, I never found any one so repulsive as the chronic masturbator. It would not be difficult to fill page upon page of heart-rending confessions made by young girls, whose lives were blighted by this pernicious habit, always begun so innocently.’ She believed that women should utilize that control to avoid sex outside of relationships marked by ‘confidence and respect.’ She believed that exercising such control would lead to the ‘strongest and most sacred passion.’ However, Sanger was not opposed to homosexuality and praised Ellis for clarifying ‘the question of homosexuals… making the thing a—not exactly a perverted thing, but a thing that a person is born with different kinds of eyes, different kinds of structures and so forth… that he didn’t make all homosexuals perverts—and I thought he helped clarify that to the medical profession and to the scientists of the world as perhaps one of the first ones to do that.’
As part of her efforts to promote birth control, Sanger found common cause with proponents of eugenics, believing that they both sought to ‘assist the race toward the elimination of the unfit.’ Sanger was a proponent of negative eugenics, which aims to improve human hereditary traits through social intervention by reducing reproduction by those considered unfit. Sanger’s eugenic policies included an exclusionary immigration policy, free access to birth control methods and full family planning autonomy for the able-minded, and compulsory segregation or sterilization for the profoundly retarded. In her book ‘The Pivot of Civilization,’ she advocated coercion to prevent the ‘undeniably feeble-minded’ from procreating.
In contrast with eugenicists who advocated euthanasia for the unfit, Sanger wrote, ‘we [do not] believe that the community could or should send to the lethal chamber the defective progeny resulting from irresponsible and unintelligent breeding.’ Similarly, Sanger denounced the aggressive and lethal Nazi eugenics program. In addition, Sanger believed the responsibility for birth control should remain in the hands of able-minded individual parents rather than the state, and that self-determining motherhood was the only unshakable foundation for racial betterment. Sanger also supported restrictive immigration policies. In ‘A Plan for Peace,’ a 1932 essay, she proposed a congressional department to address population problems. She also recommended that immigration exclude those ‘whose condition is known to be detrimental to the stamina of the race,’ and that sterilization and segregation be applied to those with incurable, hereditary disabilities.
Sanger believed that lighter-skinned races were superior to darker-skinned races, but would not tolerate bigotry among her staff, nor any refusal to work within interracial projects. Her contemporaries in the African-American community supported her efforts. In 1929, James H. Hubert, a black social worker and leader of New York’s Urban League, asked Sanger to open a clinic in Harlem. Sanger secured funding from the Julius Rosenwald Fund and opened the clinic, staffed with African-American doctors, in 1930. The clinic was directed by a 15-member advisory board consisting of African-American doctors, nurses, clergy, journalists, and social workers. The clinic was publicized in the African-American press and African-American churches, and received the approval of W. E. B. Du Bois, founder of the NAACP. Sanger’s work with minorities earned praise from Martin Luther King, Jr., in his 1966 acceptance speech for the Margaret Sanger award.
From 1939 to 1942 Sanger was an honorary delegate of the Birth Control Federation of America, which included a supervisory role — alongside Mary Lasker and Clarence Gamble — in the Negro Project, an effort to deliver birth control to poor African Americans. Sanger wanted the Negro Project to include black ministers in leadership roles, but other supervisors did not. To emphasize the benefits of involving black community leaders, she wrote to Gamble ‘we do not want word to go out that we want to exterminate the Negro population and the minister is the man who can straighten out that idea if it ever occurs to any of their more rebellious members.’ This quote has been mistakenly used by Angela Davis, to support her claims that Sanger wanted to exterminate black people. However, New York University’s Margaret Sanger Papers Project, clarifies that Sanger, in writing that letter, ‘recognized that elements within the black community might mistakenly associate the Negro Project with racist sterilization campaigns in the Jim Crow South, unless clergy and other community leaders spread the word that the Project had a humanitarian aim.’
Sanger’s family planning advocacy always focused on contraception, rather than abortion. It was not until the mid-1960s, after Sanger’s death, that the reproductive rights movement expanded its scope to include abortion rights as well as contraception. Sanger was opposed to abortions, both because they were dangerous for the mother in the early 20th century and because she believed that life should not be terminated after conception. In her book Woman and the New Race,’ she wrote, ‘while there are cases where even the law recognizes an abortion as justifiable if recommended by a physician, I assert that the hundreds of thousands of abortions performed in America each year are a disgrace to civilization.’
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