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One hundred years ago today in 1916, Margaret Sanger started a revolution when she opened America’s first birth control clinic in the Brownsville neighborhood of Brooklyn, New York. It was an illegal move that got Sanger arrested, since even information about contraceptives was banned as “obscene” material under the Comstock Law of 1873. But it was the opening salvo in a decades-long fight to make contraception legal and accessible for American women.
Sanger founded the organizations that later became the Planned Parenthood Federation of America, but she was never actually an advocate for abortion rights. She thought abortion was wrong, and that “birth control” (a term Sanger coined because she hated more euphemistic phrases like “family limitation”) was the proper way for women to control their fertility and avoid suffering from illegal abortions or dying in childbirth.
But because Planned Parenthood is a favorite target of abortion foes, Sanger is often subject to smears from anti-abortion advocates and some Republicans who claim, falsely, that Sanger was a racist eugenicist who wanted to eliminate black people.
Margaret Sanger’s grandson, Alex Sanger, was and is a big admirer of his grandmother’s work. He wrote his senior thesis in college about her, and later quit his law practice to become the president of Planned Parenthood of New York City. Now, he’s carrying on his grandmother’s legacy as the chair of the International Planned Parenthood Council — which he calls the “UN of women’s health care,” since it’s the world’s largest international family planning organization and serves 50 million women in 172 countries every year.
I spoke with Alex Sanger about Margaret Sanger and the state of reproductive and sexual rights today — and why, on Planned Parenthood’s 100th anniversary, he hopes that in another hundred years we won’t need Planned Parenthood at all. Our conversation has been lightly edited for length and clarity.
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Emily Crockett: What do you remember about your grandmother?
Alex Sanger: She was just shy of her 87th birthday when she died in 1966; I was 19. But after I was about 13 or 14, she declined in health and mental capacity, and she was in a nursing home the last couple years of her life. So by the time I was old enough to ask her the questions I wanted to ask her, she was unable to answer them.
My strongest memory of her is — this is a woman on the move, constantly, even in her 80s. She would no sooner arrive at our house than she would hop on a train to New York and give a speech.
I actually saw her give her last speech, in New York in 1960. And she was about 81 at that point, in pretty poor health. But it was amazing. She stood up in the Waldorf Astoria ballroom, with at least 500 people there — and without a single note in front of her spoke for about 15 minutes about her struggles and about her vision. And it was extraordinary, as a 12- or 13-year-old, watching that.
EC: What kinds of struggles would she talk about?
AS: I mean, she saw women on the Lower East side of New York and in Brownsville, Brooklyn who were dying from self-induced abortions because they could not have any more children. They simply couldn’t. They couldn’t cope with the children they already had. She saw rampant infant mortality; the infant mortality rate was close to 40 percent in the slums of New York, and she considered this an affront to decency and civilization.
The city of New York’s solution was to open milk stations. And her solution was birth control.
When she opened that first clinic 100 years ago, women were lined up outside with baby carriages and multiple children. They were all religions, all backgrounds, all faiths. It was the great universal among women that they wanted to make something of their lives other than childbearing. They wanted the chance to have their children survive. They wanted the chance to be good mothers and nurture the children they had.
She went to jail multiple times, and finally — it took her 50 years — but she got the law changed in this country. [Griswold v. Connecticut, the Supreme Court case that legalized birth control for all women, was decided a year before Sanger died. Before that, she sparked court challenges that made birth control legal for physicians to prescribe.] And she spread, through the international Planned Parenthood, her beliefs around the world.
I’m obviously biased, but I can't think of anyone who's done as much for the welfare of humanity as my grandmother. A hundred years ago, women and children were dying in droves. And now they’re not. Women are in the workplace, and contributing to the fabric of our society and to the world, and hopefully a women is going to be our next president. This is made possible by women being able to control their fertility, have the children they want when they want them. And she was the one who started it.
EC: So, the first birth control wasn’t a hormonal pill. When women came to her clinic a hundred years ago, what was the experience like?
AS: She wrote this little pamphlet called Family Limitation the year before she opened the clinic. She described various douches and suppositories, recipes that women could use. When she opened the clinic, she was giving women the recipes, but also told them where to go to buy a diaphragm.
She discovered the diaphragm in Europe; she’d been in exile from this country because she was under indictment for violating the Comstock Laws. She visited clinics in Holland and in France, and began smuggling diaphragms into this country. People had also been quietly making them in this country, but only the middle class could get them through private druggists or pharmacists. The poor couldn’t. So her goal was to make this available for all women.
Hormonal contraception didn’t come until the early ‘50s. It was her idea to create a birth control pill, and she found the scientists, put together the money. It took her almost ten years, but the birth control pill was the result. She did that in her 70s — it was really extraordinary.
EC: Do you think she really lived to see the full fruits of what she had accomplished?
AS: Well, she thought she had. When she started out, there was a huge swath of society opposed to her. Every church was opposed to her, every denomination, not just the Catholics. And the government was opposed. The Comstock Laws made birth control “obscene” under the law.
The only people she had on her side were far-thinking radicals, and the poor women who lined up outside her clinics. It was thought by many in the mainstream of America that birth control was sinful and would lead to promiscuity, it would lead to sex outside of marriage, premarital sex. As if all of that hadn’t already been invented throughout human history!
By the time she died 50 years later — she actually died 50 years after opening the clinic, 50 years ago last month — society had changed and birth control was widely accepted and used. Yes, the Catholic Church continued to oppose it. But other denominations came around.
The United States government made family planning part of the War on Poverty, and it made support of family planning part of international foreign aid in the 1960s. President George H.W. Bush, when he was in the House of Representatives as a Republican, was the one who introduced a national family planning bill to subsidize birth control for women who couldn't otherwise afford it. He did this at the behest of President Nixon. So this was part of mainstream, both Republican and Democrat, politics and policies.
I think the abortion wars, which culminated in Roe v. Wade in 1973, had a spillover effect where those opposed to abortion also began to be opposed to birth control. And opposed to public funding of birth control for poor women.
A hundred years after the clinic opened, we have one of our candidates for president wanting to defund Planned Parenthood, which is providing birth control to poor women. Poor women rely on us, because they know they're going to get good, professional care. So this battle is not over, unfortunately.
EC: What have the battle lines over birth control been when it comes to faith?
AS: Some denominations have split into two wings. Protestant denominations are splitting on these and other cultural issues, gay marriage being one of them, and they’re all kind of lumped together. The Episcopal split has as much to do with the ordination of women and gay marriage as reproductive rights.
I keep on having to remind people that all this is going on at the leadership level of churches, and to some extent in the pews. But women of all denominations keep coming to our clinics.
I see it in Latin America, where is where I spend most of my time for international Planned Parenthood. These are Catholic countries, even though there’s a large evangelical subpopulation. And the women are Catholic, evangelical — they come to our clinic. But the governments are afraid of the Catholic Church, and so we do not get the robust public support that we should in Latin America.
EC: What about Margaret Sanger and abortion? Like you said, she observed unsafe abortions — but she also opposed abortion. Did she ever advocate for making abortion safe and legal?
AS: When she opened the clinic a hundred years ago — I’ll just read you this flyer that she had printed up in Brownsville. It was in three languages, English, Yiddish, and Italian, because the neighborhood was heavily immigrant.
And it says, “MOTHERS! Can you afford to have a large family?” Interestingly, it’s addressed to mothers, not women. “Do you want any more children? If not, why do you have them? DO NOT KILL. Do not take life, but prevent.”
She said repeatedly that she thought abortion was the wrong way to go, because life had begun. So women should use birth control and prevent life from coming into being. She wasn't an abortion crusader one way or the other; she was single-mindedly focused on birth control. She thought it was the humane and safer way for women to regulate their fertility, because she had seen so many women dying of illegal abortions.
Now, I don't expect the National Right to Life Committee to award my grandmother a medal of honor. (Laughs). But she held views that would be consistent with that.
At another point she did say to women, don’t have abortions, but if you’re going to do it, do it early — it’s safer. She was into what we’d call a harm-reduction model. But she preferred women not to get pregnant in the first place, to take control of their fertility.
EC: Some politicians today say that Planned Parenthood commits black genocide, or that Margaret Sanger was a eugenicist and that her intention was to kill black babies in the womb. What do you think about these kinds of claims?
AS: Well, it’s nonsense. And my grandmother fundamentally believed that every woman should have the right to make a choice about her fertility. Every woman.
Now, she also dabbled in eugenics. She was not a full believer in all of eugenics, and disagreed with some of the things eugenicists believe in. But at various points in her life, she was opposed to women who she felt were incapable of being mothers from becoming mothers.
Back then they used words like “moron” and “imbecile,” these were actually scientific terms, and classifying people according to their IQ. And she said women in these classes were not capable of being mothers, and therefore shouldn’t be mothers. She also talked about women with certain inherited diseases like epilepsy or alcoholism — they shouldn't be mothers, because they’re going to pass these genes onto their children.
She never got into a class-based thing, ethnicity-based, religion-based. Never, ever, ever. But she was absolutely wrong when she said women of diminished intellectual capacities or certain medical conditions should not be able to reproduce. It’s deplorable. I totally disagree with her, and there we are.
It’s an old, old story, and it has nothing to do with what Planned Parenthood stands for or what I stand for. Imani Gandy [senior legal analyst at Rewire, a news site for reproductive justice issues] talks about this very eloquently — nothing could be further from the truth about the accusations about targeting African Americans.
She first opened a clinic in Harlem. I mean, no other organization wanted to deal with health care for the African-American community. And she gathered together the leaders of the Harlem community — Adam Clayton Powell, Sr., W.E.B. Du Bois, and others. She opened this clinic because she said African-American women deserve the same health care as white women.
And then she wanted to expand it down South. It was called, back then in the late ‘30s, the “Negro Project,” because that’s just the word they used back then. It had the support of Du Bois and Powell and other black leaders in the South. And it gets totally misconstrued. My grandmother was absolutely progressive on race, and wanted to enable black women to have the same power over fertility as white women were getting in her clinics.
So I’m proud of what she did trying to expand health care services to African-American women. She was the first to do it. And women of all races and ethnicities are in her debt because of what she did.
EC: Planned Parenthood has become the target of drastically increased political attacks in the last five years or so, but advocates have also started to go on offense to promote reproductive justice. What do you think about this political environment, and do you think we’re starting to turn a corner?
AS: I sure hope we're about to turn the corner. It is really up to Republican women and like-minded men to say to their party, “This has got to stop.” You are hurting women who need us.
If Republicans believe in every citizen being able to reach their potential, the female half of the population needs to be able to control their fertility. And Republicans should be supporting that as much as Democrats should.
When my grandmother was active, and even shortly after her death, she had as much luck with Republicans as Democrats. Barry Goldwater was one of her biggest supporters. And when New York decriminalized abortion in 1970, three years before Roe, there were just about as many Republican votes in the legislature as Democratic. The Republican governor signed it into law, Nelson Rockefeller.
Republicans were right with reproductive freedom, and supporting birth control, and supporting abortion rights, as Democrats were. This realignment of the parties, where we have one party in favor of reproductive rights in its platform and one opposed in its platform, is not a healthy thing.
And it’s got to be within the Republican Party. They’ve got to realize this is a losing proposition for them. They should be on the side of women, and maybe they wouldn’t have a two to one gender gap against them in this election.
EC: Anything else you want to add?
AS: Here we are on our 100th anniversary. I don’t want a bicentennial.
I want us to win this battle. I don't want my grandchildren to have to do this. Because of my grandmother, and the work the international Planned Parenthood does, we have made gigantic progress around the planet. And so much of the planet is so far ahead of this country in terms of reproductive freedom and the status of women, and maternal health, and child care.
We have got to bring this country together in creating a health care system that serves women and children, and gives women the power to control their fertility, and let them fully participate in this society. And I sure hope we can do that before the next hundred years is up.
EC: That’s a really interesting way to put it. When you say you don’t want a bicentennial, do you mean that in an ideal world we wouldn’t need Planned Parenthood because we’d have adequate coverage for the services it provides?
AS: Absolutely. We should not have Planned Parenthood exist at all, because we should have a national health care system that covers men, women, and children, where they get full options for all their health care, including reproductive.
We need full sex ed in schools, with age-appropriate information to enable young boys and girls to make smart decisions about sex. And we need rights that are guaranteed by law.
You know, in western Europe, we don’t need to operate health care clinics. Planned Parenthood advises the governments in western Europe. We help educators with sex ed curriculums. We help governments with their foreign aid programs, because many of them support family planning in third world countries.
But we don’t operate clinics in western Europe. And that’s a model that this country should aspire to. We should have a public health care system so that we don’t have to have this mix of public and private clinics.
Planned Parenthood should put itself out of business. That’s my dream.
