There are few individuals in American history with as divided a legacy as Margaret Sanger. For many, she was a pioneer of women’s health, an important birth control activist, and founder of Planned Parenthood. For others, Sanger represents the immorality of feminism and insidious evil of reproductive choice. Yet others see Sanger as a eugenicist orchestrating a genocide against the Black American population. Radical, unconventional, and outspoken, Sanger is an endlessly useful character for modern day political ends. Which is it? Was Margaret Sanger good or evil? If we slow down, think like historians, and examine Sanger’s beliefs and actions within their historical context, we can get a bit closer to the reality.

The Controversial Life and Legacy of Margaret Sanger
Researched and written by Sarah Handley-Cousins, PhD
Recorded by Sarah Handley-Cousins and Averill Earls, PhD

Transcript for The Controversial Life and Legacy of Margaret Sanger

Sarah: There are few individuals in American history with as divided a legacy as Margaret Sanger. For many, she was a pioneer of women’s health, an important birth control activist, and founder of Planned Parenthood. For others, Sanger represents the immorality of feminism and the insidious evil of reproductive choice. Yet others see Sanger as a eugenicist orchestrating a genocide against the Black American population. Radical, unconventional, and outspoken, Sanger is an endlessly useful character for modern day political ends. Which is it? Was Margaret Sanger good or evil? If we slow down, think like historians, and examine Sanger’s beliefs and actions within their historical context, we can get a bit closer to the reality.

I’m Sarah

And I’m Averill

And we are your historians for this episode of Dig

Averill: We want to thank all of our Patreon supporters, and especially our fabulous Auger and Excavator level patrons: Hanna, Lauren, Colin, Edward, Iris, Susan, Denise, Agnes, Jessy, Karen, Maria, and Audrey! We can’t thank you enough. Listener, if you’re not yet a patron of this show, it’s easy: just go to to learn more

Sarah: In 2020, Planned Parenthood of Greater New York – the chapter of the national Planned Parenthood organization that serves the New York City area, announced that it would change the name of the Margaret Sanger Health Center to the Manhattan Health Center. The change was made in a tumultuous time, as listeners, you will no doubt clearly remember the upheaval of the spring of 2020. In March of that year, the country had largely shut down in response to the threat from the COVID-19 pandemic. Within months, and in the midst of a contentious presidential campaign, the country was grappling again with unchecked police brutality and racism in the wake of George Floyd’s murder at the hands of the Minneapolis police. Across the United States, institutions of all sorts were examining the practice of naming things after “great figures” of history. Where I teach at the University at Buffalo, for instance, the university had to decide whether to maintain its connection with Millard Fillmore, an American president who was both a native son of Western New York and the signer of the horrific Fugitive Slave Act. It was a time of great reckoning with our relationship to the past.

Averill: The decision to remove Sanger’s name was a complicated one. For some historic monuments and institutions, the decision to rename or remove imagery was fairly straightforward. For instance, the monument of Robert E. Lee, famed general of the Confederate Army of Northern Virginia, that stood in Richmond, Virginia, was somewhat clear cut: the people decrying its removal were either white supremacists or folks trying to split hairs. In leading an army against the United States government in the name of protecting slavery, Lee was straightforwardly in the wrong. Margaret Sanger, on the other hand, has a trickier legacy. She was a passionate health worker and educator who spent her life fighting to ensure women around the world could have access to reliable methods of birth control. Her tireless fight had effects on United States policy and medical research that women directly benefit from today. On the other hand, Sanger was a committed adherent of the damaging and now rejected science of eugenics, or the idea that you could use selective breeding to engineer societies. Some scholars, like Sanger biographer Ellen Chesler, were dismayed by the news that PPGNY would rename the clinic. And even representatives of Planned Parenthood of Greater New York expressed a little bit of ambivalence – they weren’t “obliterating” Sanger from the history of the organization, but removing her name from the health center.

Sarah: Throughout this series, we’re trying to grapple with one of the key elements of historical thinking: context. As history professors, we aim to get our students to think like historians – and we try to do that here on this podcast, as well. One of the ways I try to teach my students historical thinking is through something called the five C’s: causality, contingency, context, change over time, and complexity. We’re not going to unpack what each of these words mean today, but suffice it to say, they shape the way that historians think about the past. Context is similar to the idea that “the past is a foreign country” – in other words, that actions, ideas, items, and even words had meanings within a culture distinct from our own. Here’s an example. During the American Civil War, a red maltese cross was the symbol of the Union Army’s Fifth Corps. But now, the maltese cross (or Iron Cross) is closely associated with Neo-Nazis and far-right extremists. If I was reading, say, a diary from the Civil War era and saw that the writer had doodled a Maltese cross in it, it would be inappropriate for me to conclude that that person was a neo-Nazi – because within its proper context, that cross meant something completely different.

Averill: It’s also important to underscore that context isn’t a justification or excuse. Planned Parenthood of Greater New York was trying to strike a kind of balance – removing Sanger’s name from their health center while continuing to acknowledge and grapple with her legacy. We want to try to do the same. Sanger’s legacy is rightfully mixed. She was brash, made bad decisions, was sometimes unlikeable, and supported ideas that right-thinking people today forcefully reject. But we also need to learn  about and analyze all of those things within the context of their time so we can develop as clear, full, and accurate a picture of her life and work as we can. We’re not here to valorize or condemn, but rather, to try to understand.

Sarah: As always, we wanted to acknowledge that our episodes rely on the scholarship of others. In this episode, I’ll be drawing heavily on Jean Baker’s biography of Margaret Sanger called Margaret Sanger: A Life of Passion. I also relied on work by Paul Lombardo, Karen Weingarten, and Nancy Ordover to help situate Sanger within the scientific and ideological world of eugenics.

Sarah: Now let’s dig in, shall we? (I’m so sorry.) First, let’s learn a little about Margaret Sanger’s early life. Margaret Sanger was born Maggie Higgins in Corning, New York, in 1879. Her parents, Michael and Anne Higgins, were Irish immigrants who had come to America seeking refuge from the Great Famine. Her father Michael was a stone and marble cutter, making a living creating gravestones. Her mother, Anne, kept the house and raised the Higgins children. Her entire life was marked by pregnancy, nursing, and mothering. She was pregnant eighteen times in thirty years of marriage, experiencing seven miscarriages and 11 live births. Anne Higgins – like her daughter Maggie – lived with chronic tuberculosis. I think it’s telling that Sanger opens one of her autobiographies, My Fight for Birth Control this way: “Mother bore eleven children; she died at forty-eight. My father lived until he was eighty.”[1]

Averill: Corning was a factory town centered nearly entirely on glass blowing. While it had once prospered from a variety of industries, transportation changes rendered the city a bit isolated and dependent on the glass business. In 1868, Corning political leaders had wooed a glass works company out of New York City and over to Corning. According to Jean Baker, “there were promises of excellent transportation, abundant coal and water, appropriate sand, and cheap Irish workers, the latter the human detritus leftover from canal and railroad building.” The late 19th c was a boom time for glass production as Thomas Edison’s new electric lighting required “Edison bulbs,” those elongated lightbulbs that you often see today in trendy homes, like Sarah’s. But a boom in demand for glass didn’t mean wealth for the folks making the bulbs.

Sarah: Child labor was central to the glass business. Children were used to sweep the floors and carry the extraordinarily dangerous molten blobs to the glass blowers. Maggie Higgins’ three older brothers attended school in the morning then went to the glass works, where their meager earnings helped keep the family afloat. Maggie and her sisters helped to keep things running at home. She helped her mother care for the little ones, cook dinner, and do laundry – when the last Higgins child was born, Maggie even helped to clean up the afterbirth.[2] Life was not easy for the working poor in Corning, and class differences felt stark even to a child. This was a defining part of Margaret Sanger’s recollections of her childhood: “Very early in my childhood I associated poverty, toil, unemployment, drunkenness, cruelty, quarreling, fighting, debts, jails with large families. The people who lived on the hilltops owned their homes, had few children, dressed them well, and kept their houses and their yards clean and tidy. Mothers of the hills played croquet and tennis with their husbands in the evening…They were young looking mothers, with pretty, clean dresses, and they smelled of perfume.” While the Sanger family was loving, they did not belong to the “hilltop” class. 

Averill: With its Irish immigrant population, Corning was heavily Catholic. Maggie’s mother, Anne, was faithful, but Michael was vehemently opposed to the church. Margaret’s autobiography describes him as an agnostic and free thinker passionately committed to free speech and critical of capitalism. Once, when he overheard Maggie and her sister reciting the Our Father, he asked Maggie what it was that she had said about bread:

“Why, Father, that was in the Lord’s Prayer: Give us this day our daily bread.”

“Who were you talking to?” He parried.

“To God,” I replied.

“Is God a baker?” he asked.

Maggie was hugely influenced by her father, who taught her to question everything, think critically and speak her mind. His mantra was “Do your own thinking.”

Sarah: For a time, Maggie was able to attend a girls boarding school called Claverack. It was a different world, one that exposed her to a more genteel society. Not only did she learn how to navigate upper crust society through proper dress and trendy hair styling, she also began to explore her sexuality. She had crushes on girls, though she describes them as being pure and non-erotic. She also had her first relationships with boys, which were decidedly very erotic. But in 1898, her older sister, who was paying her tuition out of her paycheck from a job in Buffalo, could no longer afford to keep Maggie in the school, and she was forced to drop out. Without graduating, Maggie also had to let go of her dream of attending Cornell to become a doctor. Instead, she tried her hand at teaching – which did not go well – and ultimately returned home to nurse her dying mother and care for her younger siblings. Now sexually active, Maggie was no longer happy to defer to her father’s household rules, and they clashed often when she tried to return home after late-night rendezvous.

Averill: In 1898, Maggie’s mother died of the tuberculosis that had plagued her for years. Maggie understood her death as intimately connected to her repeated pregnancies, miscarriages, deliveries, and years spent nursing. She was also deeply marked by a childhood spent in poverty, always acutely aware of your burden on your family and society. “Our childhood was one of longing for things that were always denied,” she wrote in one of her autobiographies, “we were made to feel inferior to the teachers, to elders, to all. We were burdens, and dependent on others for our existence.”

Sarah: Chafing at her father’s discipline and the limited opportunities of Corning, and lacking the academic credentials to get into Cornell’s new medical school, Maggie moved to White Plains to enter nursing school. While in school, she was especially drawn to gynecology and obstetrics. But while she enjoyed her studies and looked forward to a career in nursing, Maggie was convinced to drop out of nursing school when she met and married the artist and aspiring architect William Sanger. William was not hugely supportive of her work, and blamed it for the tuberculosis infection that Maggie now also suffered from. She had two sons, Stuart in 1903 and Grant in 1908, followed by a daughter, Peggy, in 1910. For a while, the Sangers lived in a beautiful suburban home that William Sanger designed – but it burned just months later. The house burning marked the end of Margaret’s attempt at suburban domesticity. She wrote, “I was not disappointed nor regretful. I knew I had finished something.”[3]

Averill: After losing their suburban home, the family moved back into New York City, settling in Greenwich Village, a neighborhood known for being home to the countercultural and politically radical. They arrived just before the Triangle Shirtwaist Factory Fire, a moment that helped to galvanize the American labor and socialist movements. The Sangers became ardent socialists, and were active in intellectual and activist circles in the Village.

Sarah:  Almost as soon as they arrived back in the city, Margaret went back to work as a nurse. She had never graduated from the White Plains nursing school, though, so she was not an RN. Instead, she became a travel nurse working out of the Henry Street Settlement House. Settlement houses were a sort of nerve-center for social services. Henry Street had been founded by Lillian Wald, a nurse who used travel nurses to provide public health services to the impoverished of the Lower East Side. Margaret enjoyed the work, and soon left to start her own nursing business. Always her favorite specialty, Margaret largely helped deliver babies and provide care for postpartum mothers and babies. 

Averill: It was this experience – providing care for the poor mothers of the Lower East Side – that helped cement Margaret Sanger as a birth control evangelist. The Lower East Side was crowded, dirty, full of impoverished people who drank, fought, and worked terribly hard for insulting wages. Her clients told her they knew that rich women could access birth control from their expensive, private doctors, telling her “it’s the rich that know the tricks, while we have all the kids.”[4] Not only did this strengthen her commitment to socialism, it helped her clarify what would become her argument in favor of birth control: without the ability to control fertility, people suffered. On a micro level, women suffered especially – on a macro level, all of society suffered as the population of the lower classes boomed.

Sarah: In My Fight for Birth Control, she describes what she saw on the Lower East Side like this. (And I’ll say, I want to give you the whole quote, then we’ll analyze it.) “Ignorance and neglect go on day by day; children born to breath but a few hours and pass out of life; pregnant women toiling early and late to give food to four or give children, always hungry borders taken into homes where there is no sufficient room for the family; little girls eight and ten years of age sleeping in the same room with dirty, foul smelling, loathesome men; women who weary, pregnant, shapeless bodies refuse to accommodate themselves to the husbands’ desires to find husbands looking with lustful eyes upon other women, sometimes upon their own little daughters, six and seven years of age. In this atmosphere, abortions and birth come the main theme of conversation. On Saturday nights, I have seen groups of fifty to one hundred women going into questionable offices well known in the community for cheap abortions…Sometmes an ambulance carried the victim to the hospital for a curetage, and if she returned home at all she was looked upon as a lucky woman.”[5] I know that was a long quote, but I think it’s a really interesting look into how Margaret Sanger saw life in the Lower East Side. She understands all the problems of life in the tenements as stemming from unchecked fertility. Women’s lives are painful, difficult and short. Because their mothers repeated pregnancies and hard lives, their children are inherently unhealthy; because they have too many children, women are trapped in a cycle of poverty and hunger; because they have so many children, their marriages suffer and their husbands develop wandering eyes – she even suggests that child sexual abuse could be a result. Last but not least, women seek out dangerous abortions from questionable providers, putting their lives at risk.

Averill: There’s a lot of truth in this section from My Fight For Birth Control, and we need to remember that. BIrth control was always available to upper class women; lower class women’s lives were shortened and made more difficult because of the lack of access to birth control. Large families did contribute to problems such as hunger and overcrowding in the tenements. But we also need to consider the source. In this memoir, published in 1931, Sanger is not only trying to control the story of her life’s work, she’s also trying to make the case for why birth control was a eugenics issue. (We’ll get more into this later.) It is clear she also cares about women and wants to improve their lives, but she’s also using their lives and experiences on the Lower East Side to frame birth control access as vital to creating a healthier, cleaner, more moral society. For Sanger, from the beginning, birth control was a women’s rights issue, but also a tool for building a better society.

Sarah: The experience that made Sanger into a birth control radical was the story of Sadie Sachs. Here again, we need to zoom out. Sanger told this story a million times during her life; it was the equivalent of when a politician tells a story over and over about their decision to enter politics. It’s very probably packaged, polished, and embellished, whether intentionally or accidentally. Any way, the story goes like this. In 1912, Margaret Sanger was called to tend to young Sadie Sachs, already mother of three, who was recovering after she had a botched abortion. Sadie and her husband Jake loved each other and their children, but on Jake’s low wages, they were struggling to care for their young children. Afraid that another pregnancy would strain things to the breaking point, the young woman asked the doctor what she could do to prevent another pregancy. While the doctor agreed that another attempted abortion would kill Sadie, he had no advice for preventing another pregnancy beyond celibacy. Sanger writes the doctor laughing while saying, “Oh ho! You want your cake while you eat it too, do you? Well, it can’t be done. I’ll tell you the only sure thing to do. Tell Jake to sleep on the roof!”

Averill: You can probably guess what happened next. After Sanger got Sadie back to health, she didn’t hear from her again until Jake called her several months later, desperate. Sadie was terribly sick. By the time Margaret Sanger arrived, Sadie was already dead. She had, unsurprisingly, gotten pregnant again and tried to end it with over the counter medications and finally, another trip to a back-alley abortionist. Sanger was distraught. That night, unable to sleep, she had something of an epiphany. She looked out across the city thinking about all the “crowded homes; too many children; babies dying in infancy; mothers overworked;  baby nurseries; children neglected and hungry; mothers so nervously wrought they could not give the little things the comfort nor care they needed; mothers half sick all their lives; women made into drudges; children working in cellars; the father, desperate, drunken …” But as the sun rose, all this started to coalesce in her mind. “It was like an illumination. I could now see clearly the various social strata of our life; all its mass problems seemed to be centered around uncontrolled breeding. There was only one thing to be done: call out, start the alarm, set the heather on fire! Awaken the womanhood of America to free the motherhood of the world!”[6] She would never work as a nurse again. Instead, she would devote all her energy to fighting for legal and accessible birth control. “That decision,” she wrote, “gave me the first undisturbed sleep I had had in over a year. I slept soundly and free from dreams, free from haunting fears.”[7]

Sarah: Margaret Sanger was in the right place to foster her radicalism. Greenwich Village was teeming with socialists, freelovers, anarchists, peace activists, and suffragists. Sanger had no political experience; she had not been active in the women’s suffrage movement, for instance, where many women cut their teeth in lobbying and policy-writing. Instead, she listened to the speeches of well-known socialists around her, like Emma Goldman, Elizabeth Gurley Flynn, Bill Haywood, and emulated them. She helped distribute socialist leaflets and during the 1912 strike at the Lawrence textile factories, Sanger helped to orchestrate the transport of the children of the strikers to welcoming socialist homes in New York to help keep the strike going. She even taught the children to sing the “La Marseillaise” and socialist anthem, “The Internationale.”

Averill: After marinating in the radicalism of the village, Sanger ventured out with her first publication in 1914, the journal The Woman Rebel. The journal was meant to disseminate birth control information, to be sure, but was also intended to provoke the Comstock Laws – the laws that stopped “obscene” literature from being sent through the mail. After getting the first few issues pinged by the censors, she started wrapping the journal in brown paper, which made the censors have to search even harder to stop it from going out. One postal worker remembered having to hold mail up to the light to determine whether it was birth control information, writing “we are looking for copies of an eight page sheet called The Woman Rebel,” the Solicitor has declared it obscene and unmailable, but the bitch that edits it, named Margaret Sanger, has been trying to fool us by mailing it wrapped up in respectable newspapers and magazines.”[8] And in August 1914, the postal inspectors arrived at her home to notify her she was being charged with obscenity. That fall, The People vs. Margaret Sanger got underway.

Sarah: Undaunted, Sanger published another pamphlet on birth control while awaiting trial, this time called Family Limitation. In this pamphlet, she provided explicit instructions on how to douche after intercourse to prevent conception, where to find pessaries, instructions on how to insert a cervical cap, and even details about the importance of the female orgasm. It was vital information – but it was also undoubtedly obscene under the federal Comstock Law and smaller, state-specific “Little Comstock” laws. As one printer noted of the pamphlet, “This is a Sing-Sing job.”

A description of a pessary from Family Limitation | Public Domain / Wikimedia Commons

Averill: In October, when The People vs. Margaret Sanger was called, Sanger faced a difficult choice – face the charges and spend time in prison, or continue the work from abroad, on the lam. She chose the latter, and escaped to England. She wrote to friends and followers this message: “Comrades and Friends: Jail has not been my goal. There is special work to be done and I shall do it first. If jail comes after, I shall call upon all to assist me. In the meantime I shall attempt to nullify the law by direct action and attend the consequences later. Over 100,000 working men and women will hear from me.”[9] She used her time in England and Europe to learn. (Well, and also to experiment with free love, having sexual relationships with a number of men, including the British sexologist Havelock Ellis.) She learned about sexuality from Ellis, learned how to insert cervical caps from Dutch physician Johannes Rutgers, and wrote pamphlets on what she’d learned. She also mingled with Neo-Malthusianists, many who would become longtime comrades, friends, and some lovers. Neo-Malthusiansts were modern-day adherents of the work of Thomas Robert Malthus, the late 18th century writer who conjectured that someday, human population might outpace agricultural production, causing widespread famine that would kill off a huge proportion of humanity. Neo-Malthusians, including H.G. Wells and Marie Stopes, revived this 18th c theory in the early 20th century and expanded Malthus’s ideas about ‘continence’ (preventing ejaculation as a form of birth control) into something they called “sex hygiene,” a kind of sex education that emphasized controlling conception. 

Sarah: While Margaret was in England, having affairs and learning from British bohemians and radicals, her estranged husband William was facing his own trial for distributing Family Limitation. (I should say: the Sangers’ marriage had been strained for years, and Margaret, interested in the Greenwich Village trend of free love, had asked for an open arrangement. William resisted, but also had other sexual relationships. So when I say she was having affairs in England, it’s not with judgment but just a statement of reality. For the rest of her life, Margaret had meaningful, but temporary, short-term sexual relationships.) Anyway. William Sanger was on trial for circulating obscene materials. He did not flee, but rather stood before the court and made the case for birth control in Margaret’s stead. The case brought significant publicity to the cause. Maybe, Margaret began to think, it was time for her to face her own charges.

Averill: At the same time, the couple’s youngest child, Peggy, living most of the time at boarding school, was gravely ill. Margaret Sanger nursed her, but just four weeks after Margaret returned home from exile in England, Peggy died. Margaret was devastated, and Peggy’s death haunted her for the rest of her life. But it also strengthened her commitment to the cause and readiness to face Comstock law head on. But even as she prepared for trial, the government abruptly dropped the case. While the Attorney General was pissed, the US attorneys in New York reasoned that the charges were stale and it would be unpopular to prosecute a grieving mother. But Sanger wasted no time in giving the government reason to put her in jail. Within a few months, she had opened a birth control clinic in Brooklyn. Within hours of opening, 100 women and 20 men waited in line to be seen. “Nothing,” Sanger wrote, “not even the ghost of Anthony Comstock could have stopped them from coming.”[10] Similarly, nothing could stop the police from shutting the clinic down for violating New York’s own penal code, which outlawed even sharing information about birth control orally. While awaiting that trial, Sanger opened another clinic, this time in the Brownsville neighborhood of Brooklyn.

Women wait outside Sanger’s Brooklyn clinic | Public Domain / Wikimedia Commons

Sarah: This time, Margaret Sanger did not flee, and instead faced the charges with the help of attorney Jonah Goldstein.  But despite Goldstein’s impassioned defense, complete with twenty Sanger’s patients appearing as supporting witnesses, Margaret Sanger was found guilty and sentenced to thirty days in jail. Her time in jail, grieving the loss of Peggy, helped Sanger decide it was time to take the fight for birth control to a new level. Rather than just rabble-rousing, it was time, she reasoned, to aim higher.

Averill: Sanger wasn’t alone in the fight for birth control. Mary Ware Dennett, a veteran of the suffrage movement, was also working for the legal right to birth control and sex education. But while Dennett used the legal experience gleaned from her years lobbying for suffrage to challenge the constitutionality of the Comstock laws, Sanger refused to work through the legal system and instead focused on disseminating the medical and scientific legitimacy of birth control. Starting in 1917, she put her energies toward publishing her newest venture, The Birth Control Review, and in 1921, she founded the American Birth Control League (ABCL). The new journal provided her the space to rail against many subjects that she considered inappropriate, old fashioned, or standing in the way of women’s bodily autonomy, including her father’s old enemy, the Catholic Church. She also published on things she wanted to educate the public on, such as essays about the importance of pleasure and other aspects of sex education. But she also hit on another way to get people to take birth control seriously: the popular and well-accepted science of eugenics.

Sarah: We’ve discussed eugenics several times on the podcast, but I think it’s still useful to define it here. Eugenics was the science of manipulating the human population through selective breeding. The term was first coined by Francis Galton, a distant relative of Charles Darwin who believed that you could take the principles laid forth by Darwin’s theory of evolution and apply them to humans, encouraging “good” people to have more children (called “positive eugenics”) and stopping “unfit” people from having any children (known as “negative eugenics”). During the Progressive era (or the period between about 1890 and 1920) Americans saw eugenics as a solution to any number of things – international power and empire, Jim Crow racism, poverty, crime, overpopulation, immorality, you name it.

Averill:  If you think back to those passages we read earlier that included Sanger’s descriptions of life on the lower east side, you might already have picked up on how she saw a natural fit between her birth control movement and eugenics. As she looked around the tenement villages in the crowded, impoverished Lower East Side, Margaret Sanger chalked up all the social problems to unchecked, unwanted reproduction. Outbreaks of disease, hunger, joblessness, poverty, overcrowding, domestic violence, sexism, ignorance – I could go on – were all linked to women’s inability to prevent pregnancy. The science of eugenics, then, was the perfect way to package the fight for birth control. With proper sexual education and free access to effective birth control methods, all of those other problems would slowly but surely resolve.

Sarah: But it wasn’t an easy relationship with other eugenicists. Theodore Roosevelt, for instance, took issue with Sanger’s fight for birth control, which he interpreted as contributing to the “race suicide” happening in the United States, this racist idea that the white American population was being overtaken by rapid reproduction of people of color. The solution to race suicide was for good white families to have more and more children. Roosevelt believed that positive eugenics was key to preventing “race suicide,” framing reproductive labor  as women’s patriotic duty in the same way that it was men’s patriotic duty to march off to war. Roosevelt, along with leading eugenicsts like Charles Davenport, were especially concerned with the relatively low birth rates of … wait for it … male graduates from Ivy League colleges, who weren’t having enough sons. Davenport wrote in 1915: “A Harvard class does not reproduce itself, and in 200 years, 1000 graduates of today will have only fifty descendants and on the other hand, 1000 Romanians in two hundred years will come to 100,000 – hence to govern the fifty descendants of Harvard sons.”[11] 

A cover of Birth Control Review | Public Domain / Wikimedia Commons

Averill: Sanger clapped back in the pages of The Birth Control Review, arguing that birth control was a way of ensuring positive eugenics. “As for increasing the fertility of the upper classes,” Margaret Sanger wrote, “it is certain that the majority of such parents even now have as many children as any rational eugenicist could ask them to do….Admitting that they give birth to fewer children, the fact is that they bring, relatively, to maturity almost as many as the poor succeed in doing.” By having (relatively speaking) fewer children, the upper classes could better ensure the quality of their children because they were born into healthy, happy families, raised by happy, healthy mothers, and given every privilege of education and experience. To their charge that Harvard and Yale graduates weren’t having enough children, she retorted: “The best thing that the modern American college does for young men or young women is to make of them highly sensitized individuals, keenly aware of their responsibility to society. They cannot be deluded into thinking quantity superior over quality.”

Sarah: In this way, Sanger harnessed eugenics and birth control together. Rather than a threat to eugenics, as folks like Roosevelt and Davenport believed, Sanger argued that birth control was actually a vital part of the movement to craft a more fit society. She would take articles by eugenicists critical of birth control and republish them, just so she could offer stinging retorts. She published essays by other eugenically-minded birth control activists, like physician Anna Blount, a very well known Chicago Progressive, suffragist, and obstetrician. In 1915, by then a founding member and chair of the Eugenics Education Society of Chicago, Blount wrote in the Birth Control Review that the eugenicist was the true radical: “His vision is of the voluntary control of the quality of future humanity. He would purge the world of imbeciles, epileptics, and the insane by ceasing to breed them…Why struggle to find wonderful ways of managing prisons and almshouses, when in three generations we can make prisons and almshouses well-nigh unnecessary?” BIrth control was already in use by the “best” people, Blount argued. It was now time to provide it to the poor. “Exactly because birth control is here for the wise and provident,” the doctor wrote, “we need it also for the isolated and ignorant; we need it, voluntary or enforced, if necessary by celibacy or segregation, for the seriously defective.” And on the first page of every issue of the Birth Control Review, the editors included a list of other birth control organizations around the world, many of which were chapters of the Neo-Malthusian League.

Averill: Into 1920s and 30s, Sanger more fully embraced eugenics, joined eugenics organizations  and became a regular speaker at Neo-Malthusian conferences. But while Sanger used the popular acceptance eugenics to sell birth control, she questioned accepted eugenic doctrine and insisted birth control, rather than sterilization, was the answer. First, Sanger refused to sign on to the central tenet of American eugenics: that ‘fit’ white Americans must have more children to bring about a white “race regeneration” and save the country from the threat of “race suicide.” She believed that all women would benefit from the ability to regulate their reproductive capacity for themselves, arguing that “A woman’s first duty was to herself and that was her first duty to the state.”[12] If given the choice, she maintained, women would solve the social problems of overpopulation simply by having the right to control their own reproduction. She was skeptical of forced sterilization and instead tried, and failed, to get the bigwigs of American eugenics to support legal, accessible birth control instead. She believed that sterilization was a close-minded way of approaching the problem, writing: “I personally believe the sterilization of the feeble-minded, insane, and syphilitic, are superficial deterrents when applied to the growing numbers of unfit.”[13] She also drew the line at denying anyone the right to sexual expression, which she believed was a fundamental right. (In fact, later in her life, she discussed sexuality at length with Gandhi, who taught celibacy as a form of liberation, and disagreed with him strongly.) Birth control, then, was the best path forward.

Sarah: But most hardline eugenicists found Sanger and birth control ridiculous. Charles Davenport, the most high profile eugenicist in the United States, said of Sanger: “I have no doubt that she may feel very strongly about eugenics. I have very grave doubt that she has any idea what eugenics is …The whole birth control movement is a quagmire out of which eugenics should keep.” Paul Papenoe, who was at work to pass laws banning blind Americans from marrying, wanted nothing to do with Sanger. He wrote: “If it is desirable fore us to make a campaign for contraception we are abundantly able to do so, without enrolling a lot of sob sisters, grandstand players, and anarchists to help us.”[14] Nonetheless, framing birth control as a eugenic issue helped legitimize the movement, and helped secure the ABCL funding from the Rockefeller Foundation, a significant funder of eugenic-related work.[15]

Averill: But Sanger’s position changed over her life-long quest for accessible, legal birth control. After the Buck v Bell decision lent judicial legitimacy to forced sterilization, Sanger came fully on board with forced sterilization, believing that it might be an effective, and temporary, way to deal with the “unfit” populations that already existed. But her primary focus, as always, was birth control. In 1936, a court case called US v. One Package of Japanese Pessaries made it legal for physicians to provide their patients with contraceptives. This was a huge victory, but for Sanger, it appeared as just a beginning. It wasn’t enough to open clinics in New York City or publish journals; now it seemed pressing to find ways to get birth control into the hands of every woman who might need it, even in the most rural areas. Starting in 1937, Sanger teamed up with Clarence Gamble, an extraordinarily wealthy birth control advocate and physician, to create new forms of more effective birth control, as well as innovative ways of getting it to women. Gamble saw an opportunity in Puerto Rico, the American territory. Pitching it as a way to control the “unambitious and unintelligent groups” on the island, Gamble was able to lobby the Puerto Rican legislature to legalize birth control on the island – paving the way for him to test out new forms and delivery methods. (Later, the scientists that developed the birth control pill would also look to Puerto Rico, exploiting the less educated, underserved population to acquiesce to trialing the pills.) Later, Gamble would run trials in Appalachian communities in Kentucky and West Virginia, as well as in rural North Carolina.

Sarah: Despite the very legit qualms we have today about the ethics of these trials, Sanger and Gamble took them as a success. But there was at least one problem Sanger recognized: the Southern clinics born out of their efforts were closed to Black women. Though Sanger was anti-segregation, and had worked with Black doctors and activists in birth control meetings across the United States, she didn’t work to challenge the segregation of birth control clinics in the South. Instead, she enlisted prominent Black activists including W.E.B. DuBois, Ida B. Wells, and Franklin Frazier to join a Negro Advisory Council in 1939 to help her and Gamble design a program to deliver birth control to Southern Black Americans. This initiative was nicknamed “The Negro Project.

Averill: She had already successfully worked with DuBois early in the 1930s as she established a birth control clinic in Harlem at the urging Black social services organization, the New York Urban League. DuBois, also a eugenicist, even wrote an essay for the Birth Control Review linking uncontrolled reproduction among Black Americans to the reproductive labor of slavery. In his essay, DuBois also pointed to the fears that some Black Americans had about birth control, “even intelligent [Black] people have a good many misapprehensions and a good deal of fear at openly learning about it.” He concluded the essay by saying that humans were like vegetables, where quality should be valued over quantity.

Sarah: In 1939, Gamble and Sanger disagreed about how to proceed with the effort to get birth control to southern Blacks. While they agreed they needed clinics, Sanger also wanted to hire a large number of Black ministers with social science training to travel through the south educating the population about contraception. As she’d learned from W.E.B. DuBois, many Black Americans were distrustful of birth control and interpreted it as a threat from manipulative white doctors trying to experiment on or control Black population – and this was before the world found out about the ethical breaches of Tuskegee Syphilis Study. Long experience, though, certainly demonstrated that white doctors weren’t necessarily to be trusted. Sanger warned Gamble this might be a problem in a letter in 1939. She questioned Gamble about why he didn’t support hiring a Black doctor to head up the project, and says that while Black people can have good relationships with white doctors, they might trust a Black one more. I’m going to quote here from the letter, which uses out of date language: “They can get closer to their own members, and more or less lay their cards on the table, which means their ignorance, superstitions, and doubts. They do not do this with the white people and if we can train the Negro doctor at the Clinic he can go among them with enthusiasm and with knowledge, which, I believe, will have far-reaching results.” She followed it by telling Gamble that ministers could help allay fears: “I 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.”

Averill: Certainly this language isn’t ideal – her dismissive referral to Black activists as “rebellious members” is patronizing. But her intention is to find ways to make the Negro Project work effectively for Black Americans, especially by hiring Black folks as doctors and birth control educators. In the end, though, the project’s funders rejected the idea of hiring ministers as sex ed teachers. They did have Black staff in clinics located at Fisk University and in the Bethlehem Center settlement house in Nashville, but they didn’t serve the number of patients the organizers had hoped for. Sanger remained invested in birth control for Black Americans and spoke about the need for integration in an interview in 1941 for the Black newspaper, the Chicago Defender.

Sarah: Through the 1930s and 1940s, several of Sanger’s various organizations began to merge. Her American Birth Control League and research organization the Birth Control Clinical Research Bureau merged into the Birth Control Federation of America, later renamed Planned Parenthood Federation of America, a huge organization devoted to women’s health, sex education, and birth control. Sanger served as honorary president and chair for twenty years. By the 1950s, she had also helped to expand PPFA into the International Planned Parenthood Federation, organized with delegates from around the world along with her co-chair,  Lady Rama Rau in Mumbai in 1952.[16] In her later years, Margaret Sanger retired to Arizona, but remained deeply involved with the fight for birth control, helping with fundraising efforts and then in one final revolutionary act. In 1950, wealthy widow Katherine McCormick struck up a friendship with Margaret Sanger and asked for her advice for donating money toward a birth control project. Where was there the most need? What project might have the most impact? Sanger was thrilled, and eventually the two landed on the development of oral contraceptives. WIth Sanger’s help, they visited labs and investigated various experiments to see where they should put the money, finally landing in 1953 on the lab of Dr. Gregory Pincus. Over the next fifteen or so years, McCormick donated around $2 million dollars. The first oral contraceptive was approved by the FDA in 1960. Six years later, Margaret Sanger died.

Averill: So, what are we left with in terms of Margaret Sanger’s legacy? It’s mixed, and always will be. While forced sterilizations did continue in a more limited capacity in the United States, eugenics fell out of favor after it became clear that it was the science that had been used to orchestrate and justify the horrors of the Holocaust. Starting in the 1970s, anti-choice groups reacting to the Roe v. Wade decision seized on Sanger’s eugenic writing to try to emphasize her commitment to scientific theories now linked to the Nazis. Also in the 1970s, Black Americans also started to draw attention to Sanger’s eugenic writings, particularly her work with the Negro Project. In 1982, Angela Davis wrote a chapter in her book Woman, Race and Class on birth control and racism, citing Margaret Sanger’s 1939 letter to Charles Gamble along with a quote from a report called “Birth Control and the Negro,” issued by the Birth Control Federation of America. The first quote, from Sanger to Gamble, as a reminder, reads: “I 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.” Instead of reading it as Margaret Sanger conveying her desire to earn Black southerners’ trust, Davis presents the quote out of context and suggests that Sanger, Gamble, and the Birth Control Federation of America were orchestrating the eradication of Black Americans through the use of birth control, handed out by manipulated Black clergy co-conspirators.

Sarah: The second quote, drawn from a Federation report, is presented as the the words of the Federation, reads: “the mass of ignorant Negroes still breed carelessly and disastrously, so that the increase among Negroes, even more than the increase among whites, is from that part of the population least intelligent and fit, and least able to rear their children properly.”[17]  The problem is, the Federation was actually quoting the essay written by W.E B. DuBois for the Birth Control Review in 1930. Plucked out of their larger sources and stripped of any context, these quotes are endlessly repeated and misinterpreted – for instance, in 1995, Dinesh D’Souza, the king of butchering history for political ends, used the quotes to suggest Sanger thought of Black Americans as “human weeds.” These are just two examples – this is a really common conspiracy theory out there on the internet. Even recently, I heard someone very earnestly repeat this very argument in an academic setting. In the context of a discussion on Black maternal health, this woman was rightly noting the ways that Black people (women especially) are consistently failed by white physicians, particularly in the area of maternal health, and this version of Sanger fit in with their own experience. I don’t say this to correct or shame that person, but rather to show just how widespread this version of Sanger’s history is – and how useful it is.

But the reality, as we’ve presented here, is much more complex. Sanger was absolutely a eugenicist who believed that birth control might present the key to creating a more perfect society – a society without disabled, poor, and unruly people. In her quest to make birth control accessible and legal, she violated her own principles of women’s rights and bodily autonomy by giving vocal support to harmful policies of forced sterilization. She was patronizing in her language, and sometimes her radicalism in one area of her life didn’t exactly mean radicalism in others. (She went to jail rather than give up disseminating birth control information, for instance, but didn’t do much to fight Jim Crow violence or segregation.) But she believed that like white women, Black women also deserved unfettered access to contraceptives, and tried to find the best possible way to make that happen. Despite that belief, she was also so committed to spreading her message to any who would hear that she spoke before a KKK women’s auxiliary group in 1926. She cared deeply about impoverished people – she had been one as a child! – but channeled that concern into a reform that didn’t always provide immediate, necessary relief in the form of food, clothing, or shelter. All this to say, context is key here – but it’s not a savior. Sanger was a hero in some ways, villain in others. So while some historians were disappointed that Margaret Sanger’s name came down from that clinic in Manhattan, I think it was ultimately the best choice for PPFA. We don’t have to reject Sanger entirely, but we definitely shouldn’t put her on a pedestal, either.


Baker, Jean H. Margaret Sanger: A Life of Passion. New York: Hill and Wang, 2011.

Lamp, Sharon. “‘It is For the Mother:’ Feminist Rhetorics of Disability During the American Eugenics Period.” Disability Studies Quarterly 26 (2006).

Ordover, Nancy. American Eugenics: Race, Queer Anatomy, and the Science of Nationalism. Minneapolis: University of Minnesota Press, 2003.

Sanger, Margaret. My Fight for Birth Control. New York: Farrar & Rinehart, 1931.

Thompson, Lauren MacIvor. “The Offspring of Drunkards: Gender, Welfare, and the Eugenic Politics of Birth Control and Alcohol Reform in the United States.” The Journal of Law, Medicine & Ethics 49 (2021): 357-364.

Weingarten, Karen. “The Inadvertant Alliance of Anthony Comstock and Margaret Sanger: Abortion, Freedom, and Class in Modern America.” Feminist Formations 22 (Summer 2010): 42-59.


[1] Margaret Sanger, My Fight for Birth Control (New Yokr: Farrar & Rinehart, 1931), 4.

[2] Jean Baker, Margaret Sanger: A Life of Passion (New York: Hill & Wang, 2011), 16.

[3] Sanger, My Fight, 42.

[4] Sanger, My Life in Birth Control, 49.

[5] Sanger, My Life in Birth Control, 48-49.

[6] Sanger, My Fight for Birth Control, 56.

[7] Sanger, My Fight for Birth Control, 57.

[8] Baker, Margaret Sanger, 82.

[9] Baker, 89.

[10] Baker, 115.

[11] Baker, 144.

[12] Baker, 147.

[13] Baker, 147.

[14] Baker, 164.

[15] Ellen Chesler, Woman of Valor: Margaret Sanger and the Birth Control Movement in America (New York: Simon & Schuster, 2007), 293.

[16] Baker, 274.

[17] Davis, 361.


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