Margaret Sanger brought European ideas on and methods of birth control to the United States, increasing the respectability of the topic as part of the public health debate.
In the early twentieth century, social reform advocates in the United States and Europe voiced great concern over the condition of working-class women and children. Reformers worked to introduce changes such as protective labor legislation for women and children to alleviate negative conditions, but Margaret Sanger attempted more radical reform through a single issue: birth control.
At that time, both contraceptives and abortion were illegal in the United States, and most women had no access to reliable contraception. The so-called Comstock law
In the 1880’s, most members of the largely male and middle-class medical community attacked the practices of birth control and abortion on the grounds that they were immoral and they challenged the perception of motherhood as the proper role of women. Doctors saw women, especially middle-class women, who sought contraception as selfish, immoral, and threatening. As a profession, they opposed the study of contraceptive methods, although they did try to help infertile women to conceive. Without access to birth control measures, many women, burdened by too many children and weakened by frequent pregnancy, turned to illegal abortionists who practiced in unhygienic conditions. The resulting deaths provided further ammunition for those who attacked abortion as unsafe.
Sanger was introduced to the harsh impact of these views on poor women while she was working as a visiting nurse in the neighborhoods of New York City’s lower East Side. Women with large families and repeated pregnancies begged for some means to avoid having additional children. When doctors refused them, Sanger took the matter into her own hands, embarking on a series of confrontational attempts to bring the pressing need for birth control to the attention of society.
Sanger traveled to Europe, where she learned the most effective methods of birth control available at the time. In 1914, after her return to the United States, she published and distributed a pamphlet titled Family Limitation,
Sanger’s strategy was to raise the level of debate over birth control to a scientific plane, where the value of contraception to public health could be demonstrated. She based her ideas on the model of Europe, where attitudes toward birth control were advanced compared with those in the United States. Although contraception had not yet been accepted fully by all European governments or all European physicians, the idea of birth control enjoyed a more tolerated position in Europe. The first organization devoted to the promotion of birth control practices, the Malthusian League,
Sanger wanted to present the European ideas and methods to Americans in 1921, despite the fact that it was illegal to discuss birth control publicly. In seeking to have birth control treated with the same degree of respect and importance that it was accorded in much of Europe, Sanger needed the support of physicians, scientists, and other respected members of American society. Her strategy was to create a public forum to demonstrate effective techniques of contraception to physicians, and in this way to disassociate birth control from the stain of immorality. Her vehicle was a professional conference.
The First American Birth Control Conference
Although this public discussion of birth control was couched in scientific terms, it did not slip past the notice of Sanger’s powerful opponents. On November 13, 1921, the last day of the conference, Sanger was to introduce Harold Cox, a former member of the British parliament, who would lead a mass meeting at Town Hall titled “Birth Control: Is It Moral?” The event had been widely publicized and a large crowd was expected, but when Sanger and Cox arrived at the meeting hall, they found their way barred by police. On the orders of New York Archbishop Patrick J. Hayes, Captain Thomas Donohue marshaled police to break up the meeting before any law had been broken. Sanger telephoned police headquarters and discovered that no warrant or order had been issued for the action, so she defied the officers, made her way inside the hall, and insisted on speaking until she and suffragist Mary Winsor were arrested. Released the next day and eventually acquitted of all charges, Sanger publicly condemned the attack on her right to free speech as well as church interference in public affairs.
The incident provided a groundswell of public support for Sanger and her cause. Many wealthy women publicly declared support for Sanger, as did members of the press and the legal profession, who defended her right to free speech. Sanger had effectively turned the archbishop’s attempt to suppress her speech into a powerful publicity vehicle. The mass meeting was rescheduled for November 18, 1921, at the Park Theatre, and a far larger crowd turned out for it than had been expected for the original meeting.
Only a few years after this event, Sanger organized another conference in New York City: the Sixth International Neo-Malthusian and Birth Control Conference
Unlike the 1921 American conference, the 1925 international conference was not marred by censorship efforts. Its success became the impetus for greater American involvement in the international birth control movement.
At both the 1921 and the 1925 birth control conferences, American physicians were exposed to the most advanced European theories and methods of birth control. These conferences established birth control as a scientific concern and an issue of public health, overriding perceptions of it as an obscene and illegal practice. As wealthy and influential Americans began to support Sanger, the United States emerged as a leader in the international birth control movement.
The day before the first American conference, Sanger officially formed the American Birth Control League
The controversy over the Roman Catholic Church’s attempt to suppress the 1921 Town Hall meeting demonstrated American respect for the right to free speech, even in the case of an “immoral” subject. This incident drew protests even from those who did not support birth control but believed that Cox and Sanger had the right to speak. In the end, the archbishop’s actions generated tremendous publicity for Sanger and the fledgling ABCL, most of it favorable. Many physicians who participated in the conference retained ties with the ABCL, serving on medical advisory boards and conducting scientific research. Upper-class women became actively involved in the organization of birth control clinics all over the country.
Sanger utilized the conferences themselves to counter opposition to birth control among doctors and to bring physicians into the movement. To ensure their support, she vigorously pursued federal legislation for a “doctors-only bill” that would limit the dispensing of birth control devices to physicians. Nevertheless, widespread acceptance of birth control as a health issue followed slowly, as did the removal of many legal obstacles.
Sanger was able to open the first legal, doctor-staffed birth control clinic in the United States in 1923. It was the first of many such clinics. It was through Sanger’s efforts, using vehicles such as the 1921 and 1925 conferences, that medical staffs were able to gain the skills necessary to operate the clinics and conduct the contraceptive research that would affect the lives of women and their families the world over. Because of Sanger’s work, ordinary women eventually were able to limit the size of their families without stigma, without risking their health, and without violating the law.
The 1925 Sixth INMBC conference also dramatically underscored the changes that had taken place in American thought and attitudes since 1921. No police or church activity barred the smooth progression of the second, more widely attended conference, which paved the way for the growth of a strong international movement. Birth control advocates continued to meet and to share ideas and techniques. Among the immediate results of the 1925 conference were the formation of the International Federation of Birth Control Leagues and the convening of the 1927 World Population Conference in Geneva, which Sanger also organized. In later years, as interest in population control swelled after World War II, these early advocates, joined by younger allies, formed the International Planned Parenthood Federation in 1952.
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Chesler, Ellen. Woman of Valor: Margaret Sanger and the Birth Control Movement in America. New York: Simon & Schuster, 1992. Biography of Sanger presents previously unpublished information gathered from interviews and archives. Addresses Sanger’s personal life as well as her role as leader of the movement for women’s reproductive rights. -
Gordon, Linda. Woman’s Body, Woman’s Right: A Social History of Birth Control in America. Rev. ed. New York: Penguin Books, 1990. A feminist reading of the American birth control movement. Does not cover the conferences but provides a critical look at Margaret Sanger and the professionalization of the birth control movement by doctors and eugenicists. Includes footnotes, references, and index. -
Katz, Esther, ed.“The Woman Rebel,” 1900-1928. Vol. 1 in The Selected Papers of Margaret Sanger. Champaign: University of Illinois Press, 2002. Sanger’s collected diaries, journals, speeches, personal correspondence, and more are assembled to tell the story of her tumultuous life and place her within the context of her times. Includes an introduction by the editor, chronology, substantial notes, bibliography, and index. -
Ledbetter, Rosanna. A History of the Malthusian League, 1877-1927. Columbus: Ohio State University Press, 1976. Provides background on the birth control movement in Europe, explaining the early work of the neo-Malthusians and their impact. Includes footnotes, references, and index. -
Reed, James. From Private Vice to Public Virtue: The Birth Control Movement and American Society Since 1830. New York: Basic Books, 1978. Provides background on the American birth control movement. Especially useful for coverage of the relationship between the medical profession and the birth control movement. Includes footnotes, references, and index. -
Reed, Miriam, ed. Margaret Sanger: Her Life in Her Words. Fort Lee, N.J.: Barricade Books, 2003. Collection of Sanger’s writings includes materials presenting her views on socialism, prison reform, and pacifism in addition to birth control and sex education. Chronological order shows the progression of Sanger’s thinking as well as the impact her activism had over time. -
Sanger, Margaret. The Autobiography of Margaret Sanger. 1938. Reprint. Mineola, N.Y.: Dover, 2004. Sanger discusses her personal life and the birth control movement, including both conferences. Includes index. -
_______. International Birth Control Conference. 4 vols. New York: American Birth Control League, 1925-1926. Presents abstracts of the papers given at the 1925 Sixth INMBC conference and also identifies the participants.
National Birth Control League Forms
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