Margaret Sanger

Margaret Sanger: The Fight to Make Birth Control Legal

Margaret Sanger's mother died at fifty, worn down by eighteen pregnancies and eleven surviving children. Her daughter spent the next five decades making sure other women would not have to choose between motherhood and their own survival — building, in the process, both the modern birth control movement and one of the more genuinely contested legacies in American reform history.

A Nurse on the Lower East Side

Margaret Louise Higgins was born September 14, 1879, in Corning, New York, to Michael Higgins, a free-thinking stonecutter and socialist, and Anne Purcell Higgins, an Irish immigrant whose repeated pregnancies Sanger watched destroy her health. After attending Claverack College and training as a nurse at White Plains Hospital between 1900 and 1902, Sanger married the architect William Sanger and eventually settled with him in New York City. Working as a visiting nurse on the Lower East Side, she treated poor immigrant women who begged her for ways to avoid another pregnancy and watched some die from botched, illegal abortions performed in desperation. One patient, Sadie Sachs, died after a self-induced abortion in 1912; Sanger later described the case as the turning point that pushed her from nursing into activism.

Defying the Comstock Act

In 1914 Sanger launched a magazine, *The Woman Rebel*, deliberately printing contraceptive information in violation of the federal Comstock Act, which classified such material as obscene. Indicted for the magazine, she fled to England rather than stand trial, using the time abroad to study contraceptive methods and connect with European reformers. Her pamphlet *Family Limitation*, distributed in the hundreds of thousands of copies across numerous editions, gave working-class women practical instructions the law otherwise denied them. On October 16, 1916, Sanger opened the first birth control clinic in the United States in Brownsville, Brooklyn, with her sister, the nurse Ethel Byrne. Police shut it down within nine days and arrested both women; at trial in January 1917, Sanger refused a plea deal and served thirty days in a workhouse rather than accept a lesser punishment on lesser terms, treating the sentence as a public argument for women's right to control their own bodies. A 1918 ruling from the New York Court of Appeals, won on appeal from the case, allowed physicians to prescribe contraceptives for health reasons — a narrow opening Sanger spent the next decade widening.

Building an Institution

Sanger founded the Clinical Research Bureau in 1923, an all-female-staffed clinic offering direct contraceptive care, and built the American Birth Control League into a national network; by 1930 roughly a dozen affiliated clinics were serving thousands of new patients annually. In 1930 she opened a clinic in Harlem with an all-Black advisory board and staff, an effort that drew the endorsement of W. E. B. Du Bois, and in 1939 she helped launch what became known as the "Negro Project" to extend contraceptive access into poor Black communities in the South — a program she defended at the time by insisting, in a frequently misquoted letter, that "we do not want word to go out that we want to exterminate the Negro population," precisely because she anticipated the accusation. Her organizations merged in 1939 into the Birth Control Federation of America, renamed Planned Parenthood Federation of America in 1942 — a softer name Sanger herself reportedly disliked as evasive. The landmark 1936 federal appellate ruling in *United States v. One Package of Japanese Pessaries* effectively legalized physician-dispensed contraception nationwide, closing the legal fight Sanger had opened with her 1914 arrest.

The Eugenics Record

Sanger's alliance with the eugenics movement is the least comfortable and most necessary part of her record, and it should be stated plainly rather than minimized. Beginning in the 1920s she deliberately used eugenic language and eugenic conferences to make birth control respectable to audiences — physicians, legislators, elite reformers — who found female sexual autonomy alarming but found "improving the race" persuasive. In 1920 she wrote that birth control was "nothing more or less than the facilitation of the process of weeding out the unfit [and] of preventing the birth of defectives," language drawn directly from the eugenics movement's vocabulary of the period, and her 1922 book *The Pivot of Civilization* argued in similar terms. This was not a fringe association: eugenics was mainstream, respectable science among Progressive Era elites of both parties, and Sanger's embrace of it was calculated as much as sincere — historians who have examined the record closely note that unlike many eugenicists of her era, she consistently favored voluntary contraception over state-mandated sterilization, rejected arguments that poverty was hereditary rather than environmental, and opposed targeting people by race or ethnicity specifically. That distinction matters, but it does not erase the fact that she spent years courting a movement whose core premise — that some human beings were biologically less fit to reproduce than others — she never fully repudiated in the language she chose to use.

Later Years and the Pill

In the early 1950s Sanger persuaded the wealthy suffragist Katharine McCormick to fund biologist Gregory Pincus's research into an oral contraceptive, work that led to the drug marketed as Enovid — the first birth control pill. She helped found what became the International Planned Parenthood Federation in 1952 and served as its first president. She lived to see the Supreme Court's 1965 *Griswold v. Connecticut* ruling establish a constitutional right to contraception for married couples, and died September 6, 1966, in Tucson, Arizona, at eighty-six.

Why Margaret Is Called a Genius

Sanger's genius was tactical and organizational: she understood, decades before it was conventional wisdom, that a right existed only once it had an institution, a legal precedent, and a funded clinic behind it, and she built all three from nothing against an active federal obscenity law, going to prison rather than concede the argument. That is a real and specific kind of courage — not intellectual originality so much as an unusual tolerance for legal risk in service of a cause most respectable society found indecent to discuss. The honest counter-case is the eugenics record itself: Sanger did not merely operate within a eugenicist culture, she actively recruited its rhetoric and its institutions to advance her own cause, describing some of the people she claimed to be helping in the demeaning vocabulary of "unfit" and "defectives," and that choice has left a legitimate, unresolved stain on an otherwise landmark career — one that cannot be waved away by noting, correctly, that she also rejected forced sterilization and served Black patients directly.

Legacy

The organization Sanger founded now serves millions of patients across dozens of countries, and the pill she helped fund reshaped family life, work, and reproductive autonomy for women worldwide. Planned Parenthood itself moved to publicly distance the organization from aspects of its founder's record in 2015, a sign that the reckoning over her legacy remains active rather than settled, even within the institution she built.