04/08/2026
She counted her mother’s pregnancies the way other children counted stars.
Growing up in Corning, New York, in the 1880s, young Margaret Higgins watched her mother, Anna, a devout Catholic woman, endure eleven pregnancies in rapid succession. Each birth drained her further. By age fifty, Anna’s body was simply spent. She died exhausted, worn out by a life that had never given her any say over how many times she would be pregnant.
Margaret drew a straight, unforgiving line between her mother’s death and the complete absence of choice.
That line became her life’s work.
As a trained nurse, Margaret Sanger moved to New York City and became a visiting nurse in the overcrowded tenement neighborhoods of the Lower East Side. Day after day, she entered homes where poverty and endless pregnancies fed each other in a brutal cycle she recognized all too well. Immigrant women, desperate and exhausted, would pull her aside in cramped kitchens or dimly lit hallways and whisper the same question:
“What’s the secret? How do you stop it?”
They assumed educated women like her knew something they didn’t. The truth was devastating: there was no legal way to tell them.
The Comstock Law of 1873 classified any information about contraception as “obscene material.” Distributing it through the mail was a federal crime. Doctors were forbidden from discussing birth control. Pamphlets explaining family planning could send their authors to prison. The knowledge existed — quietly, among the privileged — but it was deliberately kept from the women who needed it most.
In 1914, Sanger launched The Woman Rebel, a radical feminist publication that openly defied these laws. She was indicted under the Comstock Act and fled to England to avoid immediate arrest. While abroad, she arranged for friends to distribute her pamphlet Family Limitation. Upon her return, she faced trial. Then tragedy struck: her five-year-old daughter Peggy died of pneumonia. Public sympathy forced the charges to be dropped.
She kept fighting anyway.
In 1916, Sanger opened the first birth control clinic in the United States in the Brownsville section of Brooklyn. Nine days later, police raided it. She was arrested and sentenced to thirty days in jail. The arrest made national headlines and drew powerful supporters to her cause. She appealed the conviction and lost, but the court’s ruling created a narrow legal opening: physicians could now prescribe contraceptives for “medical reasons.”
She used that crack in the law to open a new, doctor-staffed clinic in 1923 — the precursor to what would eventually become Planned Parenthood.
For the next several decades, Sanger organized, wrote, lobbied, traveled the world, and pushed relentlessly against legal, medical, and religious opposition. In 1936, a federal court ruled that physicians could legally prescribe birth control. In 1960, the birth control pill — which she had helped fund and champion — was approved by the FDA.
From illegal pamphlet to FDA-approved medication: forty-six years of unyielding pressure.
Margaret Sanger’s legacy, however, is not simple or clean.
She associated with the eugenics movement of her era, which promoted controlling reproduction among people its advocates labeled “unfit.” That movement carried deep ties to racism, class prejudice, and ableism. Sanger’s entanglement with these ideas was complex and has rightly drawn intense scrutiny, criticism, and reevaluation. Institutions she helped found have removed her name. Historians continue to debate how her full record — both her groundbreaking advocacy for women’s bodily autonomy and her associations with harmful ideologies — should be weighed and remembered.
History rarely offers uncomplicated heroes.
Sanger died in 1966 at age 86. The Comstock Laws she had spent her life battling were not fully repealed until 1971 — five years after her death.
She never lived to see the final wall fall.
She pushed against it anyway, every single day of her adult life.
From watching her mother die young and broken by endless pregnancies, to distributing banned information at great personal risk, to opening the first clinic, to helping bring the birth control pill into existence — Margaret Sanger helped give millions of women something previous generations could only dream of: the power to decide for themselves when, whether, and how often they would become mothers.
She changed the fundamental relationship between women and their own bodies.
And she did it knowing the personal cost would be high and the moral ledger would remain complicated.