A Woman With A Plan: The Real Story Of Margaret Sanger
Sanger sought and won scientific validation for various contraceptive methods, including the birth control pill, whose development she supported and found the money to fund. In so doing, she helped lift the religious shroud that had long encased reproduction and secured the endorsement of contraception by physicians and social scientists. From this singular accomplishment, which some still consider heretical, a continuing controversy has ensued.
Sanger always remained a wildly polarizing figure, which clarifies the logic of her decision after World War I to jettison “birth control” and adopt the more socially resonant term “family planning.” This move was particularly inventive but in no way cynical, especially when the Great Depression brought attention to collective needs and the New Deal created a blueprint for bold public endeavors.
Some have falsely charged that Sanger defined family planning as a right of the privileged but a duty or obligation of the poor. To the contrary, she showed considerable foresight in lobbying to include universal voluntary family planning programs among public investments in social security. Had the New Deal incorporated basic public health and access to contraception, as most European countries were then doing, protracted conflicts over welfare and health care policy in the U.S. might well have been avoided.
Having long enjoyed the friendship and support of Franklin and Eleanor Roosevelt, Sanger also had ample reason to believe the New Dealers would fully legalize and endorse contraception as a necessary first step to her long-term goal of transferring responsibility and accountability for voluntary clinics to the public health sector. What she failed to anticipate was the force of opposition family planning continued to generate from a coalition of religious conservatives, including urban Catholics and rural fundamentalist Protestants, that held Roosevelt Democrats captive much as today’s evangelicals have captured the GOP.
The U.S. government would not overcome cultural and religious objections to public support of family planning through its domestic anti-poverty and international development programs until the late 1960s, after the Supreme Court protected contraceptive use under the privacy doctrine created in Griswold v. Connecticut. At this time, Planned Parenthood clinics became major government contractors, since there were few alternative primary health care centers serving the poor. Today, one in four American women funds her contraception through government programs, many of them still run by Planned Parenthood — a number likely to rise under the Affordable Care Act.
Sanger’s eagerness to mainstream her movement explains her engagement with eugenics, a then widely popular intellectual movement that addressed the manner in which human intelligence and opportunity is determined by biological as well as environmental factors. Hard as it is to believe, eugenics was considered far more respectable than birth control. Like many well-intentioned reformers of this era, Sanger took away from Charles Darwin the essentially optimistic lesson that humanity’s evolution within the animal kingdom makes us all capable of improvement if only we apply the right tools. University presidents, physicians, scientists, and public officials all embraced eugenics, in part because it held the promise that merit would replace fate — or birthright and social status — as the standard for mobility in a democratic society.
But eugenics also has some damning and today unfathomable legacies, such as a series of state laws upheld in 1927 by an eight-to-one progressive majority of the U.S. Supreme Court, including Justices Oliver Wendell Holmes and Louis Brandeis. Their landmark decision in Buck v. Bell authorized the compulsory sterilization of a poor young white woman with an illegitimate child on grounds of feeble mindedness that were never clearly established. This decision, incidentally, was endorsed by civil libertarians such as Roger Baldwin of the ACLU and W.E.B. Dubois of the NAACP, both of whom Sanger counted among her supporters and friends.
For Sanger, eugenics was meant to begin with the voluntary use of birth control, which many still opposed on the grounds that the middle class should be encouraged to have more babies. She countered by disdaining what she called a “cradle competition” of class, race, or ethnicity. She publicly opposed immigration restrictions and framed poverty as a matter of differential access to resources like birth control, not as the immutable consequence of low inherent ability or character.
As a nurse, Sanger also understood the adverse impacts of poor nutrition, drugs, and alcohol on fetal development and encouraged government support of maternal and infant health. She argued for broad social safety nets and proudly marshaled clinical data to demonstrate that most women, even among the poorest and least educated populations, eagerly embraced and used birth control successfully when it is was provided.
At the same time, Sanger did on many occasions engage in shrill rhetoric about the growing burden of large families of low intelligence and defective heredity — language with no intended racial or ethnic content. She always argued that all women are better off with fewer children, but unfortunate language about “creating a race of thoroughbreds” and other such phrases have in recent years been lifted out of context and used to sully her reputation. Moreover, in endorsing Buck v. Bell and on several occasions the payment of pensions or bonuses to poor women who agreed to limit their childbearing (many of whom enjoyed no other health care coverage), Sanger quite clearly failed to consider fundamental human rights questions raised by such practices. Living in an era indifferent to the obligation to respect and protect individuals whose behaviors do not always conform to prevailing mores, she did not always fulfill it.
The challenge as Sanger’s biographer has been to reconcile apparent contradictions in her beliefs. She actually held unusually advanced views on race relations for her day and on many occasions condemned discrimination and encouraged reconciliation between blacks and whites. Though most birth control facilities conformed to the segregation mores of the day, she opened an integrated clinic in Harlem in the early 1930s. Later, she facilitated birth control and maternal health programs for rural black women in the south, when local white health officials there denied them access to any New Deal-funded services.
Sanger worked on this last project with the behind-the-scenes support of Eleanor Roosevelt and Mary McLeod Bethune, founder of the National Council for Negro Women and then a Roosevelt administration official. Their progressive views on race were well known, if controversial, but their support for birth control was silenced by Franklin’s political handlers — at least until he was safely ensconced in the White House for a third term, when the government rushed to provide condoms to World War II soldiers.