The Complicated Legacy of Margaret Sanger
The founder of Planned Parenthood advanced women's rights immeasurably. But many of her views were far from progressive.
On September 14, 1879—145 years ago this coming Saturday—Michael Hennessey and Anne Purcell Higgins, Irish Catholics who had settled in Corning, N.Y., welcomed yet another baby into the world, a daughter. They named her Margaret.
Lest you imagine that Margaret, as the sixth child in the family, might have also been the last, think again. Her mother, Anne, would end up conceiving 18 times and giving birth to 11 live babies before dying of tuberculosis at the age of 50. And it was this life of prolific reproduction—a life shaped by the ecstasy and agony of pregnancy and birth and miscarriage—that would end up defining Margaret’s life.
In the historical canon of notable American women, Margaret Sanger—as she became known through her marriage to William Sanger—distinguished herself as being particularly complicated.
On the one hand, she was a staunch labor activist who fiercely believed that the ability to control family size was critical to safeguarding women from poverty and destitution. On the other hand, she had connections to the eugenics movement. And while eugenics was not her main mission as a birth control advocate, there is plenty of evidence that Sanger did buy into the notion of eugenics—at least to an extent.
“Sanger saw the value of birth control science in preventing birth defects,” wrote Debra Michals, a feminist historian, in a 2017 article for the National Women’s History Museum. “And although she disagreed with the racial and class focus of the eugenics movement, her association with it tarnished her reputation.”
Sanger’s primary mission was to give women the ability to make their own reproductive choices. And yes, in her pursuit of this mission, she made harmful, hurtful and ethically abhorrent statements in support of eugenics. But was she an evil racist driven purely by an inhumane desire to weed out the weak and create a racially homogeneous population? The evidence suggests that it wasn’t that simple. It rarely is.
The Suffering of Mothers
In 1902, Sanger completed a nursing program at White Plains Hospital and married William Sanger, who was working as an architect. The couple initially settled in Hastings-on-Hudson and had three children, but in 1910 the family moved south to New York City.
As she practiced her nursing, Sanger encountered tragic scenes of mothers, babies, or both perishing from complications during childbirth. It was likely these impressions—combined with the lasting memories of her own mother’s life—that galvanized her desire to use her healthcare training to educate women (mostly working class) on ways to avoid getting pregnant.
One incident in particular made a strong impression on Sanger; and it was a story she recounted many times:
“Mrs. Sadie Sachs” was a patient Sanger encountered as a nurse. According to Sanger, Sachs had nearly died after trying to self-administer an abortion. Afterwards, Sachs had asked her doctor how she and her husband could avoid getting pregnant. The doctor allegedly instructed her to tell her husband to “sleep on the roof.” When Sachs became pregnant again, she tried once more to end her pregnancy. That’s when Sanger was called. But by the time she arrived at Sachs’s bedside, the patient was in a coma. All that Sanger could do was hold the woman’s hand as she died.
“It was the dawn of a new day in my life,” Sanger later wrote in her autobiography. “I went to bed knowing that no matter what it might cost … I was resolved to seek out the root of evil, to do something to change the destiny of mothers, whose miseries were as vast as the sky.”
And indeed, it was the beginning of her life of unapologetic activism, as a healthcare practitioner but also as a writer of pamphlets and—for a short time—as a publisher of her own newspaper, a monthly called ‘The Woman Rebel,’ with a mission to educate women about reproduction and health.
Fighting Comstock
Margaret Sanger’s early fight for birth control was punctuated by her near-constant run-ins with the law, and especially with one particularly draconian set of laws: The Comstock Act.
The Comstock Act of 1873 made it illegal and punishable by fines, imprisonment, or both, to send six types of material through the mail: erotica, contraceptive medications or devices, abortifacients (substances that trigger abortions), sexual implements (sex toys), contraceptive information, and advertisements for contraception, abortion, or sexual implements.
So-called “little Comstock” laws also existed, which outlawed the sale of these items, and Anthony Comstock, a dry goods merchant who was the law’s chief proponent and namesake, personally served as a special agent for the U.S. Postal Service to help ensure enforcement.
All of which is how Sanger found herself many times on the wrong side of the law.
The Birth of Birth Control Clinics
In 1914, Sanger was arrested for the first time on charges that included violating the Comstock Act by distributing contraceptive information. She fled briefly to the U.K., but returned home to the U.S. before too long to continue her mission of making birth control a reality. She was, as we like to say at The Persistent, persistent.
Now back in the U.S., Sanger opened the first birth control clinic in the country—the Brownsville Clinic—in a working-class neighborhood of Brooklyn. It was 1916. From the clinic, Sanger and her team of nurses and social workers mostly dispensed advice to the women who showed up. But just 10 days after opening, it was shut down because it was found to be in violation of—you guessed it—the Comstock Act. A female officer working undercover had blown the whistle—the signal for a battalion of police officers to stage a raid.
The Brownsville Clinic may not have been open for very long, but it was very successful at educating women about contraception thanks to the media storm its closure prompted. Plus, it had been popular: On its first day of operation, staff at the clinic reportedly saw about 150 patients. By the 10th day, the Brownsville Clinic had met with 450 women.
After one night in prison following the closure, Sanger was released on bail. She appealed her case, and although the presiding judge upheld the Comstock Act, he did determine that a doctor’s responsibility was to prevent ill health. By that logic, if contraception could prevent disease, then contraception might well be the best recommendation to keep a sexually-active person healthy.
A few years later, in 1921, Sanger founded the American Birth Control League, a precursor organization to Planned Parenthood. The league had three governing principles: That children should be: “conceived in love,” “born of the mother’s conscious desire,” and “only begotten under conditions which render possible the heritage of health.”
Sanger reached out to physicians to organize and run birth control clinics under the direction of the League, and she started to enjoy a surge of support from wealthy suffrage leaders who until then had squarely focused their efforts on a woman’s right to vote. (The 19th Amendment had passed in 1920.)
Tentative Progress
The next decades brought a loosening of the Comstock Act because—when it came to enforcing the laws—things got complicated.
In 1936, for example, Judge Augustus Noble Hand—presiding over a reproductive rights case concerning diaphragms that was unrelated to Sanger—wrote that the Comstock Act was designed to ban contraception in cases in which the sole purpose was to prevent a healthy woman from having a baby. But it was not designed to ban contraception in other situations—the prevention of diseases for example. He also argued that contraception should be permissible in order to prevent the need for an abortion; so that a termination could be avoided.
With Judge Hand’s ruling, the Comstock Act’s birth control provisions were deemed to violate the U.S. Constitution. But although this marked a victory for birth control advocates, it changed little for the average American woman.
For most, reliable and safe birth control remained hard to come by. Getting a diaphragm required a prescription, and many women didn’t even have access to a physician. In light of Jim Crow laws, women of color in particular were frequently afraid of—and didn’t trust—doctors. And many women were just too scared or embarrassed to undergo an internal examination.
Contraceptive products such as vaginal jellies and foaming tablets were available over-the-counter, but not reliable. Douching was cheap and accessible, but it was dangerous. The most popular brand of douche was Lysol—an antiseptic soap that, up until 1953, contained cresol, a compound that was reported in some cases to cause inflammation, burning, and even death.
Gradually, throughout the 1940s and 1950s, a nationwide network of birth control clinics expanded. In 1942, the organization originally founded as the American Birth Control League became the Planned Parenthood Federation of America. As women’s labor force participation ticked up, bolstered in no small part by World War II, the notion of birth control—the ability to plan when to start a family—became less of a cultural taboo. The stigma was lifting.
Looking Ahead to a Miracle Pill
As birth control clinics gained their foothold, Sanger’s goals became far more ambitious: What would really transform women’s lives—what would really secure their independence and wellbeing—would be some sort of magic pill.
Accounts vary on whether it was Sanger or someone else who first conceived of the notion of a pill that would prevent pregnancy. It might’ve been one of the two doctors who would go on to spearhead its development. It could’ve been Katharine Dexter McCormick, a fabulously wealthy philanthropist and suffragist who provided the vast majority of the funding that enabled the first oral contraceptive—Enovid—to be launched on the American market.
Whoever it was, in 1960, “the pill”—whose simple nickname is testament to its revolutionary nature—became a reality. And without Sanger and this small group of relentlessly-committed advocates, scientists and funders, it likely would have taken much, much longer.
On September 6, 1966. Margaret Sanger died in a care home in Tucson, Ariz., just shy of her 83rd birthday. In a lengthy obituary, The New York Times hailed her as the “originator of the phrase ‘birth control’ and its best known advocate.” The Times noted her “unfailing charm” and “persuasive wit” and praised her for dedicating her life to “freeing women from what she saw as sexual servitude.”
The Darker Side of the Sanger Story
Around the time of her death, a darker side of Sanger’s story was also coming to light: Her ties to the eugenics movement, whose stated mission was to “breed” out “undesirable” populations through sterilization and limit certain individuals’ ability to reproduce.
Sanger reportedly presented at conferences on eugenics. She also talked and wrote about birth control being used to enable "the process of weeding out the unfit [and] of preventing the birth of defectives."
Historians don’t entirely agree on exactly how involved Sanger was in the eugenics movement, and what her motivations ultimately were for pursuing her goals of making birth control a reality, but it is clear that she bought into the argument that some humans should be able to reproduce and some shouldn’t.
Sanger, since her death, has also been decried as a racist. But the accusations aren’t uncontested. Indeed, there’s also evidence that Sanger worked closely with civil rights leaders, including the NAACP founder W.E.B. DuBois to get safe contraception to African-Americans.
“The Negro race has reached a place in its history when every possible effort should be made to have every Negro child count as a valuable contribution to the future of America," she once wrote, according to the American Civil Liberties Union. “Negro parents, like all parents, must create the next generation from strength, not from weakness; from health, not from despair.”
Nonetheless, her complicated legacy led to a 2020 decision by Planned Parenthood of Greater New York to remove Sanger’s name from one of its Manhattan clinics.
“The removal of Margaret Sanger’s name from our building is both a necessary and overdue step to reckon with our legacy and acknowledge Planned Parenthood’s contributions to historical reproductive harm within communities of color,” Karen Seltzer, the organization's board chair said in a statement at the time.
“Margaret Sanger’s concerns and advocacy for reproductive health have been clearly documented, but so too has her racist legacy. There is overwhelming evidence for Sanger’s deep belief in eugenic ideology, which runs completely counter to our values at [Planned Parenthood of Greater New York],” Seltzer added.
Esther Katz, a retired associate professor of history at New York University and founder of the Margaret Sanger Papers Project, which aims to collate and edit Sanger’s historical papers and letters, told The Washington Post at the time that Sanger believed that if a woman gave birth to a large number of children, the younger children would be weaker.
Accepting the Complexity
It would be deeply wrong not to acknowledge, teach and talk about the elements of Sanger’s life that were unethical. It would also be wrong to allow the sinister parts of her story to blot out the contributions she made to women’s empowerment: Today, the birth control pill is the most commonly-prescribed form of contraception in the U.S. with about one-quarter of women aged 15 to 44 who currently use contraception, stating that the pill is their method of choice.
But the woman herself is hard to square. Was she good? Was she bad? A hero? A villain? It’s tempting to sum her up in binary terms, but doing so isn’t constructive. After all, it’s through appreciating human nuances and complexities that we ultimately learn to build on past success and avoid history’s mistakes.
Perhaps we are best served by embracing the messiness of the difficult women who came before us, and by acknowledging them for what they were: visionary, flawed, principled, misguided, and extremely determined to have an impact that would endure well beyond their lifetimes.
Josie Cox is a journalist, author, broadcaster and public speaker. Her book, “WOMEN MONEY POWER: The Rise and Fall of Economic Equality,” was released in March.
Emma Haslett
Emma Haslett
Julia Craven
