Choices

 

Margaret Sanger opened a clinic in this building in 1930, and it operated in New York City for 43 years. It is now a National Historic Landmark

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 Her mother was pregnant eighteen times. Eleven children were born. Seven ended in loss. At fifty, her body gave out. Her daughter watched—and decided no woman should be forced to endure that again.

Margaret Sanger didn't grow up talking about politics or ideology. She grew up watching exhaustion hollow out the woman she loved most.

Watching pregnancy stack on pregnancy with no pause, no protection, no permission to stop. Her mother, Anne Purcell Higgins, was pregnant eighteen times. Eleven children survived. Seven pregnancies ended in miscarriage or stillbirth.

Anne died at just fifty years old, her health destroyed by decades of continuous childbirth.

Margaret never forgot what that looked like. A vibrant woman reduced to exhaustion. A body used up. A life that could have been longer, could have been easier, cut short by biology that was treated as destiny.

That was the lesson Margaret Sanger learned before she ever chose a cause.

At the turn of the 20th century, this wasn't unusual. Women were expected to endure pregnancy as fate. Pain was moralized. Exhaustion was normalized. Death in childbirth was mourned quietly and accepted publicly as God's will.

Choice was not part of the vocabulary.

Margaret became a nurse, working in New York City's poorest neighborhoods in the early 1900s. In tenement after tenement, she saw the same story repeat itself. Women worn down by endless pregnancies. Babies born into hunger. Mothers begging for help they were legally forbidden to receive.

Birth control information was illegal.

Under the Comstock Laws—federal legislation passed in 1873—even explaining how pregnancy occurred could land someone in jail. Contraception was labeled obscene material, the same legal category as pornography. Doctors risked prosecution for providing information. Nurses were silenced. Women paid the price.

Margaret watched one patient nearly die after a self-induced abortion. When the woman begged doctors for information to prevent another pregnancy, they turned her away with a shrug. "Just tell your husband to be more careful," one said.

A few months later, the woman attempted another self-induced abortion. She died of infection.

That death hardened something in Margaret Sanger. She didn't see birth control as political rebellion. She saw it as survival.

In 1914, she began publishing a newsletter called The Woman Rebel, openly defying federal law by discussing contraception. She coined a phrase that would define her life's work: birth control. Not to shock, but to clarify. Women needed control—over their bodies, over their futures, over their lives.

Authorities responded swiftly. Her husband was arrested and jailed for distributing her materials. Margaret was indicted under the Comstock Laws. She fled to Europe briefly to avoid prosecution, studying birth control methods used in other countries.

She returned to the United States in 1916, undeterred.

On October 16, 1916, Margaret Sanger opened the first birth control clinic in the United States in Brownsville, Brooklyn. Women lined up around the block—immigrant women, poor women, exhausted women who'd been waiting for someone to finally offer help.

The clinic lasted nine days before police raided it. Margaret was arrested. Convicted. Sentenced to thirty days in jail.

She considered it proof she was doing something necessary.

Over the following decades, Margaret fought through courts, legislatures, and public opinion that treated her like a criminal for suggesting women deserved control over their own fertility. She allied with physicians, scientists, and wealthy funders who believed women deserved more than endless endurance.

Her advocacy helped chip away at laws treating contraception as contraband. She founded what would eventually become Planned Parenthood. She helped fund research that led to the development of the birth control pill.

But Margaret Sanger was not universally admired, even in her own time. She was confrontational, uncompromising, and willing to work with anyone who shared her goals—including people and movements whose other beliefs were deeply problematic.

Like many reformers of her era, her legacy includes views and alliances that remain controversial and debated today. She operated in a time when eugenics was disturbingly mainstream in American progressive circles, and some of her rhetoric reflected that era's failings.

These aspects of her history are important to acknowledge. They don't erase her achievements, but they complicate them in ways that matter.

Yet the core of her mission never changed: She wanted women to be able to say no.

No to another pregnancy that might kill them. No to bodies breaking down under the weight of endless childbirth. No to lives decided entirely by biology and laws written by men.

In 1936, a federal court ruling in United States v. One Package allowed doctors to receive contraceptive materials through the mail, effectively overturning major portions of the Comstock Laws. In 1960, the FDA approved the first oral contraceptive—the birth control pill. In 1965, the Supreme Court's Griswold v. Connecticut decision legalized contraception for married couples nationwide.

By the time contraception became widely available, the idea that women could plan their families no longer seemed radical. It seemed overdue.

Millions of women made choices their grandmothers never had the chance to consider. They pursued education without fear of derailing it with unexpected pregnancy. They worked careers. They spaced their children for health and economic stability. They limited family size because they wanted to, not because biology forced them.

Margaret Sanger lived long enough to see contraception legalized nationwide. She died in 1966 at age 86, just months after the Griswold decision guaranteed Americans' right to birth control.

She did not live to see the debates end. But then again, she never expected them to.

Reproductive rights remain contested, politicized, fought over in legislatures and courts. Access to contraception—something she spent her life making legal—is still not universal. Some want to reverse the protections she helped establish.

But her story endures because it was never abstract. It began with one exhausted mother dying at fifty. One observant daughter watching and deciding that suffering should not be tradition.

Margaret Sanger did not believe motherhood was wrong. She believed forced motherhood was.

That distinction reshaped the lives of generations.

Her mother, Anne, was pregnant eighteen times. Today, a woman can choose whether to become pregnant at all. She can decide when, how many, and whether her body can handle it. She can say no without breaking the law or risking her life for information that should never have been criminal to share.

That's Margaret Sanger's legacy. Not perfect. Not uncontroversial. But undeniable.

Her mother's body gave out after eighteen pregnancies. Margaret spent her life ensuring other women wouldn't face the same fate—that biology wouldn't be destiny, that exhaustion wouldn't be inevitable, that choice would finally be possible.

She was arrested for opening a clinic. Jailed for publishing information. Prosecuted for believing women deserved control over their own bodies.

And she won. Not completely. Not permanently. But enough that millions of women have lived different lives than their grandmothers could have imagined.

Margaret Sanger (1879-1966). Nurse. Activist. Founder of what became Planned Parenthood. The woman who made birth control legal in America.

Her mother died at fifty from too many pregnancies. Margaret made sure other mothers could choose differently.

That's not a perfect legacy. But it's a powerful one.

And it started with an eleven-year-old girl watching her mother's eighteenth pregnancy and thinking: This shouldn't be the only option.

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