Birth Control in America: The Career of Margaret Sanger
David M. Kennedy
Summary by Myong Cho
This article is about the birth control movement led by Margaret Sanger, who was a trained nurse and became the crusader to make birth control knowledge for the first time in early twenty century, how Mrs. Sanger had fought a long struggle controversial war against medical professional society for decades. Mrs. Sanger who was the tireless birth control advocate created the term"birth control" significantly marked two separate eras in American medical and social history.
Birth control took 30 years to receive an official endorsement from medical professional society since 1916 when Sanger set up the first birth control clinic in Brooklyn (where New York State Panel Code made the distribution of birth control device impossible), and was arrested (for "maintaining a public nuisance") serving thirty days in working house. In 1960s a half century later, birth control became supported by government and many institutions, and oral contraceptives were taken by millions of women around the world. The U.S. Presidents publicly embraced birth control as family planning. This remarkable transformation was not the simple technical result of laboratory innovation that created the Pill. Rather it was the result of long fought social, legal and political battles led by Sanger. The battles that preceded and brought into a reality in medical professions led the laboratory produce the Pill.
In 1910s, Sanger first thought that women once shown by a nurse or physician how to properly use a diaphragm (birth control device) could teach one another with no further need of consulting the medical profession. However, she was convinced by Dr. J. Rutgers, who directed a government-supported birth control clinic in Holland, that contraception was a medical matter. Therefore, she sought support from the medical profession after returning to the United States, and the long controversial war against American Medical Society began. There are two major oppositions to birth control movement led by Sanger in 1910s-30s, one from medical society and the other was moral issue.
The front reason why physicians would not sanction birth control devices was because they were medically unsafe and morally destructive. However, the main cause of physician resistance was the medical profession's new sense of professionalism and its opposition to quacks who had so preyed upon the American public. The other controversial aspect was the eugenic argument for birth control, that is controlling the births of certain groups to "improve" the general population. Sanger herself was a eugenicist claiming that birth control would end poverty, disease and virtually all evils in the world, and using racial and class terms in her writings elsewhere. In fact, birth control devices were first tried for poor people and the first birth control clinical bureau opened by Sanger and operated by her hired physician, Dr. Bocker in 1923 was expecting to reach working-class woman. Continuing moral and religious objections to so-called artificial birth control also blocked its extension. Although technically speaking birth control already made unquestionable advances in early twenty century, the birth control technology still remains inextricably bound to the social setting, and acceptance remains far from universal.
Some of the bench marks in the history of birth control movement in American Medicine are shown below:
1915: At Dr. J. Rutgers's clinic Sanger had learned the indispensability of medical support to the success of birth control.
1916: The New York County Medical Society took the first formal action on birth control of any organized American medical body. The society renounced any connection between birth control, as a purely medical matter, and social and economic problems.
1921: At the First American Birth Control Conference, Sanger announced her intention to open a birth control clinic that would be a "first-class center for medically supervised study of contraceptive techniques, and to prove to the world and to the medical profession in particular the desirability and efficacy of birth control. Dr. Dickinson who had been the lonely and exceptional supporter to birth control from the medical professional and later became the president of American Gynecological Society addressed that the greatest obstacle to medical support for contraception was ignorance of an acceptable technique. Therefore, he proposed new research to investigate safer, more effective techniques.
1923-24: Sanger opened the Clinical Research Bureau of Birth Control in 1923, and Dr. Bocker who ran the clinic gathered information on various contraceptive techniques.
1930's: Sanger and others tried to bring birth control to rural Southern Negroes and the masses of the Orient, pressure for cheat, simple contraceptive devices increased. Medical technology had to take on a social dimension. One estimated expenditure for contraceptive advertising in 1932-33 was $935,000. Fortune magazine reported in 1938 that American women spent over $210,000,000 annually for contraceptive materials, and that the medically approved portion of business in female contraceptives is pitifully small...as a result... millions of women have been duped and thousands of secret tragedies have been enacted. By 1935, the pressure to take some position on birth control had become overwhelming in American Medical Society (AMA), and finally AMA appointed a committee to investigate contraceptive practices and related problems. In 1937, the committee submitted a report which virtually endorsed birth control, and finally accepted the position Sanger had been promoting for two decades that other than pathologic conditions were valid indications for contraception. Sanger received the Town Hall award in 1937 for her contribution to birth control movement in medical society.