The birth control movement in the United States was a social reform campaign beginning in 1914 that aimed to increase the availability of contraception in the U.S. through education and legalization. The movement began in 1914 when a group of political radicals in New York City, led by Emma Goldman, Mary Dennett, and Margaret Sanger, became concerned about the hardships that childbirth and self-induced abortions brought to low-income women. Since contraception was considered to be obscene at the time, the activists targeted the Comstock laws, which prohibited distribution of any "obscene, lewd, and/or lascivious" materials through the mail. Hoping to provoke a favorable legal decision, Sanger deliberately broke the law by distributing The Woman Rebel, a newsletter containing a discussion of contraception. In 1916, Sanger opened the first birth control clinic in the United States, but the clinic was immediately shut down by police, and Sanger was sentenced to 30 days in jail.
A major turning point for the movement came during World War I, when many U.S. servicemen were diagnosed with venereal diseases. The government's response included an anti-venereal disease campaign that framed sexual intercourse and contraception as issues of public health and legitimate topics of scientific research. This was the first time a U.S. government institution had engaged in a sustained, public discussion of sexual matters; as a consequence, contraception transformed from an issue of morals to an issue of public health.
Encouraged by the public's changing attitudes towards birth control, Sanger opened a second birth control clinic in 1923, but this time there were no arrests or controversy. Throughout the 1920s, public discussion of contraception became more commonplace, and the term "birth control" became firmly established in the nation's vernacular. The widespread availability of contraception signaled a transition from the stricter sexual mores of the Victorian era to a more sexually permissive society.
Legal victories in the 1930s continued to weaken anti-contraception laws. The court victories motivated the American Medical Association in 1937 to adopt contraception as a core component of medical school curricula, but the medical community was slow to accept this new responsibility, and women continued to rely on unsafe and ineffective contraceptive advice from ill-informed sources. In 1942, the Planned Parenthood Federation of America was formed, creating a nationwide network of birth control clinics. After World War II, the movement to legalize birth control came to a gradual conclusion, as birth control was fully embraced by the medical profession, and the remaining anti-contraception laws were no longer enforced.
Contraception in the nineteenth century
Birth control practices The practice of birth control was very common throughout the U.S. prior to 1914, when the movement to legalize contraception began. Longstanding techniques included the rhythm method, withdrawal, diaphragms, contraceptive sponges, condoms, prolonged breastfeeding, and spermicides.Engelman, pp. 3–4. Use of contraceptives increased throughout the nineteenth century, contributing to a 50 percent drop in the fertility rate in the United States between 1800 and 1900, particularly in urban regions.Engelman, p. 5. Fertility rate dropped from 7 to 3 children per couple. The only known survey conducted during the nineteenth century of American women's contraceptive habits was performed by Clelia Mosher from 1892 to 1912.Engelman, p. 11. The survey was based on a small sample of upper-class women, and shows that most of the women used contraception (primarily douching, but also withdrawal, rhythm, condoms and pessaries) and that they viewed sex as a pleasurable act that could be undertaken without the goal of procreation.Tone, pp. 73–75.Engelman, pp. 11–12.
Although contraceptives were relatively common in middle-class and upper-class society, the topic was rarely discussed in public.Engelman, pp. 5–6. Rarely in public: Engelman cites Brodie, Janet, Contraception and Abortion in 19th Century America, Cornell University Press, 1987. The first book published in the United States which ventured to discuss contraception was Moral Physiology; or, A Brief and Plain Treatise on the Population Question, published by Robert Dale Owen in 1831.Engelman, p. 6.Cullen DuPont, Kathryn (2000), "Contraception" in Encyclopedia of Women's History in America, Infobase Publishing, p. 53 (first book in America).Year of publication is variously stated as 1830 or 1831. The book suggested that family planning was a laudable effort, and that sexual gratification – without the goal of reproduction – was not immoral.Engelman, p. 6. Owen recommended withdrawal, but he also discussed sponges and condoms.Engelman, pp. 6–7. That book was followed by Fruits of Philosophy: The Private Companion of Young Married People, written in 1832 by Charles Knowlton, which recommended douching.Riddle, John M. (1999), Eve's Herbs: A History of Contraception and Abortion in the West, Harvard University Press, pp. 226–7. Knowlton was prosecuted in Massachusetts on obscenity charges, and served three months in prison.Engelman, p. 7. A third early American novel on both prevention of conception and abortion was the book The married woman's private medical companion: embracing the treatment of menstruation, or monthly turns, during their stoppage, irregularity, or entire suppression: pregnancy, and how it may be determined, with the treatment of its various diseases: discovery to prevent pregnancy, its great and important necessity where malformation or inability exists to give birth: to prevent miscarriage or abortion when proper and necessary, to effect miscarriage when attended with entire safety: causes and mode of cure of barrenness or sterility, written by A. M Mauriceau in the year 1847. Mauriceau was a doctor and his work was cited many times in early volumes of the Birth Control Review.
Birth control practices were generally adopted earlier in Europe than in the United States. Knowlton's book was reprinted in 1877 in England by Charles Bradlaugh and Annie Besant, with the goal of challenging Britain's obscenity laws.Engelman, pp. 7–8. They were arrested (and later acquitted) but the publicity of their trial contributed to the formation, in 1877, of the Malthusian League – the world's first birth control advocacy group – which sought to limit population growth to avoid Thomas Malthus's dire predictions of exponential population growth leading to worldwide poverty and famine.Engelman, pp. 8–9. By 1930, similar societies had been established in nearly all European countries, and birth control began to find acceptance in most Western European countries, except Catholic Ireland, Spain, and France."Contraception", in Women's Studies Encyclopedia, Volume 1, Helen Tierney (Ed.), Greenwood Publishing Group, 1999, p. 301. As the birth control societies spread across Europe, so did birth control clinics. The first birth control clinic in the world was established in the Netherlands in 1882, run by the Netherlands' first female physician, Aletta Jacobs.Engelman, pp. 9, 47. The first birth control clinic in England was established in 1921 by Marie Stopes, in London.Ahluwalia, Sanjam (2008), Reproductive Restraints: Birth Control in India, 1877–1947, University of Illinois Press, p. 54.
Anti-contraception laws enacted
Contraception was legal in the United States throughout most of the 19th century, but in the 1870s a social purity movement grew in strength, aimed at outlawing vice in general, and prostitution and obscenity in particular.Tone, p. 17.Engelman, pp. 13–14. Composed primarily of Protestant moral reformers and middle-class women, the Victorian-era campaign also attacked contraception, which was viewed as an immoral practice that promoted prostitution and venereal disease.Engelman, pp. 13–14. Anthony Comstock, a postal inspector and leader in the purity movement, successfully lobbied for the passage of the 1873 Comstock Act, a federal law prohibiting mailing of "any article or thing designed or intended for the prevention of conception or procuring of abortion" as well as any form of contraceptive information.Engelman, p. 15. Many states also passed similar state laws (collectively known as the Comstock laws), sometimes extending the federal law by outlawing the use of contraceptives, as well as their distribution. Comstock was proud of the fact that he was personally responsible for thousands of arrests and the destruction of hundreds of tons of books and pamphlets.Engelman, pp. 15–16.
Comstock and his allies also took aim at the libertarians and utopians who comprised the free love movement – an initiative to promote sexual freedom, equality for women, and abolition of marriage. The free love proponents were the only group to actively oppose the Comstock laws in the 19th century, setting the stage for the birth control movement.Engelman, p. 20.
The efforts of the free love movement were not successful and, at the beginning of the 20th century, federal and state governments began to enforce the Comstock laws more rigorously. In response, contraception went underground, but it was not extinguished. The number of publications on the topic dwindled, and advertisements, if they were found at all, used euphemisms such as "marital aids" or "hygienic devices". Drug stores continued to sell condoms as "rubber goods" and cervical caps as "womb supporters".Engelman, pp. 18–19.
Beginning (1914–1916)
Free speech movement
At the turn of the century, an energetic movement arose, centered in Greenwich Village, that sought to overturn bans on free speech.Engelman, pp. 23–27.Kersch, Kenneth Ira, Freedom of Speech: Rights and Liberties Under the Law, ABC-CLIO, 2003, pp. 109–110. Supported by radicals, feminists, anarchists, and atheists such as Ezra Heywood, Moses Harman, D. M. Bennett, and Emma Goldman, these activists regularly battled anti-obscenity laws and, later, the government's effort to suppress speech critical of involvement in World War I.Engelman, pp. 23–25. Prior to 1914, the free speech movement focused on politics, and rarely addressed contraception.Engelman, pp. 25–26.
Goldman's circle of radicals, socialists, and bohemians was joined in 1912 by a nurse, Margaret Sanger, whose mother had been through 18 pregnancies in 22 years, and died at age 50 of tuberculosis and cervical cancer.Baker, pp. 50–51 (Goldman circle).Engelman, pp. 29–30 (Goldman circle).Cox, p. 4 (pregnancies).Buchanan, p. 121 (tuberculosis and cancer).Chelsler, p. 41 (age 50). In 1913, Sanger worked in New York's Lower East Side, often with poor women who were suffering due to frequent childbirth and self-induced abortions.Baker, pp. 49–51. Kennedy, pp. 16–18. After one particularly tragic medical case, Sanger wrote: "I threw my nursing bag in the corner and announced ... that I would never take another case until I had made it possible for working women in America to have the knowledge to control birth."Patient was Sadie Sachs. The Selected Papers of Margaret Sanger, Volume 1, p. 185. The source of Sanger's quote is identified as: "Birth Control", Library of Congress collection of Sanger's papers: microfilm: reel 129: frame 12, April 1916. Sanger visited public libraries, searching for information on contraception, but nothing was available.Engelman, p. 34.Cronin, Mary (1996), "The Woman Rebel", in Women's Periodicals in the United States: Social and Political Issues, Endres, Kathleen L. (Ed.), Greenwood Press, p. 448.Cronin cites Sanger, An Autobiography, pp. 95–96.Cronin cites Kennedy, p. 19, who points out that some materials on birth control were available in 1913. She became outraged that working-class women could not obtain contraception, yet upper-class women who had access to private physicians could.Tone, pp. 79–80.