18 Margaret Sanger’s Debate on Birth Control

Lindsay Rucker


Throughout the centuries of human history, the ability to control reproduction has been nonexistent.  Women would repeatedly endure the pains of childbirth and, if not dying in the process from the physical strain, frequently produce too many children for whom financial support was greatly lacking.  Margaret Higgins Sanger, an early twentieth-century activist, began the arduous task of educating women on safe and effective birth control and eventually, with the help of scientists, donors, and other activists, created the first oral contraceptive.

Born into an impoverished family of eleven, Sanger understood the need for the circulation of information regarding birth control, which, at the time, was illegal. After many arrests and public scrutiny, she was able to establish the first birth control clinic in 1923. This accomplishment would later lead to the establishment of the Planned Parenthood Federation of America.

However, it should also be noted that Margaret Sanger was, at a time, a member of the eugenics movement. With tuberculosis and syphilis ravaging through America, Sanger wished to sterilize those affected in order to establish a “cleaner” population. In her 1921 article, The Eugenic Value of Birth Control Propaganda, Sanger states that “the most urgent problem today is how to limit and discourage the over-fertility of the mentally and physically defective.” Sanger hoped to expel the “poverty-stricken classes” from the population.[1] At this time in America, those “poverty-stricken classes” were containing predominately non-white races. From this critique of the American population, with racism seemingly being present, Sanger’s intentions have been questioned.  It has become evident to many that her motives were rooted in racism. Though that may have been a factor, and I do not mean to belittle that as such in any way, I do believe a sexual revolution for women was also of high priority.

As stated before, Margaret Sanger, as a nurse living in the late 19th and early 20th centuries, was surrounded by the tuberculosis epidemic. Tuberculosis is a bacterial infection of the lungs transmitted through the air (i.e., through coughing, sneezing, spitting, etc..) Sanger was most concerned with transmission to offspring, as the cure for the disease had not yet been found. It is possible for tuberculosis to spread in utero through the umbilical cord or amniotic fluid consumption. It may also be spread during birth through “contact with infected amniotic fluid or genital secretions.”[2] Additionally, tuberculosis may be contracted through breastfeeding and through the air.

Similarly, syphilis was plaguing the world at this time. Syphilis, a sexually transmitted disease, causes infertility, miscarriage, and stillbirths. Though, in many fortunate cases, “some children born to syphilitic mothers will never show any signs of infection,” though they must be treated.[3]  Syphilitic individuals, if the infection should attack the nervous system, may experience myriad symptoms, “including headache, altered behavior, difficulty coordinating muscle movements, paralysis, sensory deficits, and dementia.”  As you will see in the document below, those affected with syphilis were categorized and discriminated against to a high degree.  Sanger wishes to stop these “feeble-minded” people from reproducing and dying in the process.  She wished to educate even these women of control reproduction and safe sex.

This same desire is evident in Sanger’s analysis of the plague that is poverty. Having been born into such a state, Sanger knew first-hand the horrible conditions in which the lower class lived. Thus, in her speech, she addressed the issue and its ties with child labor. In large families, it was custom to have children ten years old, sometimes even younger, working in factories. The conditions in which these children were working were incomparable to the conditions in which they lived. However, on account of such great poverty due to the lack of reproductive regulatory information spread, families were so impoverished that they had no other choice.

The debate from which the following speech is derived took place in New York City in December of 1921 and was chaired by Dr. S. Adolphus Knopf.  Margaret Sanger was debating John Winter Russell, a New York Lawyer on the subject: “Resolved: That the spreading of birth control knowledge is injurious to the welfare of humanity.” The following speech was Margaret Sanger’s first response to Russell’s argument. To retrieve the content of his argument and both of their succeeding speeches follow this link.

Debate on Birth Control – Margaret Sanger

Subject: “Resolved: That the spreading of birth control knowledge is injurious to the welfare of humanity.”[4]

Mr. Chairman, and ladies and gentlemen.[5] Mr. Russell and I seem to agree on some of the points of this argument at least, but as usual with most of the opponents of birth control, they have absolutely no intelligent argument.[6] (Laughter.) They always barricade themselves behind the Bible of the terrible vengeance of an offended nature. That is exactly what Mr. Russell is doing now.

Now, friends, I want to say let us get down to fundamental principles. Let us get together and look at life the way it is now, not as it might have been had Nature acted thus and so, not as it might be had God done thus and so, but as we find ourselves today. We have a few principles of life by which we must live and I claim that every one of us has a right to health, to liberty and to the pursuit of happiness.[7] I say furthermore that birth control is an absolutely essential factor in our living and having those three principles of happiness. (Applause.)

By birth control, I mean a voluntary, conscious control of the birth rate by means that prevent conception – scientific means that prevent conception. I don’t mean birth control by abstinence or by continence or anything except the thing that agrees with most of us, and as we will develop later on, most of us are glad that there are means of science at the present time that are not injurious, not harmful, and all conception can be avoided.[8] Now, let us look upon life as it really is, and we see society today is divided distinctly into two groups: those who use the means of birth control and those who do not.

On the one side, we find those who do use means in controlled birth. What have they? They are the people who bring to birth few children. They are the people who have all the happiness, who have wealth and the leisure for culture and for mental and spiritual development. They are the people who rear their children to manhood and womanhood and who fill the universities and the colleges with their progeny. Nature has seemed to be very kind to that group of people. (Laughter.)

On the other hand, we have the group who have large families and who have for generations perpetuated large families and I know from my work among these people that the great percentage of these people that are brought into the world in poverty and misery have been unwanted. I know that most of these people are just as desirous to have means to control birth as the women of wealth. I know she tries desperately to obtain that information, not for selfish purposes, but for her own benefit and for that of her children. In this group, what do we have? We have poverty, misery, disease, overcrowding, congestion, child labor, infant mortality, maternal mortality, all the evils which today are grouped in the crowd where there are large families of unwanted and undesired children.

Take the first one and let us see how these mothers feel. I claim that a woman, whether she is rich or poor, has a right to be a mother or not when she feels herself fit to be so. She has just as much right not to be a mother as she has to be a mother. It is just as right and as moral for people to talk of small families and to demand them as to want large families. It is just as moral.

If we let, as we are supposed to do, Nature take her course, we will say that we know that any woman from the age of puberty until the age of the period of menopause, that that woman could have anywhere from 15 to 20 children in her lifetime, and it will only take one relationship between a man and a woman to give her once a year to give her that large family. Let us not forget that.

Are we today, as women who wish to develop, who wish to advance in life, are we willing to spend all of our time through those years of development in bringing forth children that the world does not appreciate? Certainly, anyone who looks out to that will find that there is very little place in the world for children. And besides, if a woman does spend all her time in childbearing, do you know that even with a healthy woman, that if she does this, one out of ten of these women who let Nature take her course and have from 12 to 16 children die from childbearing, and furthermore, there are many cases where it is absolutely indispensable for a woman’s health, for her life, in fact, to have means to control birth. There are cases as Dr. Knopf said of syphilis, cases of tuberculosis; do you realize that out of every seven women who have tuberculosis today that four of them die, not from tuberculosis, my friends, but they die from pregnancy.  They die because they have not that knowledge of birth control because our physicians and all the others who should be disseminating information and safeguarding these women’s lives are not giving them the fundamental things to cure her disease but they allow her to become pregnant. They keep her in ignorance from this particular knowledge that should assist her in recovering her health. Not only with tuberculosis, but there are other diseases that are inimicable to the woman’s health and happiness. Heart disease is another thing that pregnancy absolutely stimulates and it means a woman’s death. Not long ago there was a young girl who came to me who had kidney disease. She was a telegraph operator. Her husband was a young working man, but he was not able to support a family. She had on two different occasions tried to have children, but she had kidney disease and they found her in convulsions, she had froth at her mouth and she was taken to the hospital in a serious and critical condition. When she did this, the only thing they could do to her was to resort to abortion and yet they send her back to her home, to her husband and family again in just the same way with no information of how to protect herself against another condition just as she had gone through.  That is what happens to our women today, even those who are suffering from diseases where they should be protected with means and knowledge of birth control.

The only weapon that women have and the most uncivilized weapon that they have to use if they will not submit to having children every year or every year and a half, the weapon they use is abortion. We know how detrimental abortion is to the physical side as well as to the psychic side of the woman’s life, and yet there are in this nation because of these generalities and opinions that are here before us, that are stopping the tide of progress, we have more than one million women with abortions performed on them each year.[9]

What does this mean? It means it is a very bad sign if women have to indulge in it, and it means they are absolutely determined that they cannot continue bringing children into the world that they cannot clothe, feed, and shelter. It is woman’s instinct, and she knows herself when she should and should not give birth to children, and it is just as natural to trust that instinct and to let her be the one to say and much more natural than it is to leave it to some unknown God for her to judge her by. I claim it is a woman’s duty and right to have for herself the right to say when she shall and shall not have children.

We know that the death rate, maternal death rate, has not been falling in the United States of America, although the death rate from other diseases has been falling. That shows that women is given the last consideration in scientific and medical lines. But then women will never get her own freedom until she fights for it, and she has to fight hard to hold and keep it. We know too that when the children that come to this mother against her will and against her desire. When they come into the world, that we have an appalling number of 300,000 babies each year in this country who die each year before they reach one year of age – 300,000 if you please, and it is safe to say and anyone who has gone among these mothers of these children – it is safe to say that the great percentage of these children that are born have been unwanted. The mother knows that that child should not come to birth, when the five or six or seven that she has have not enough to eat. That takes common sense and every working woman has that common sense.

We have these 300,000 babies, this procession of little coffins, and we shake our heads sadly and say “something must be done to reduce this number,” but nevertheless we go right on allowing 600,000 parents to remain in ignorance of how to prevent 300,000 more babies coming to birth the next year, only to die from poverty and sickness.

We speak of the rights of the unborn. I say that it is time to speak of those who are already born. I also say and know that the infant death rate is effected tremendously by those who arrive first, and those who arrive last. The first child that comes – the first or second or third children who arrive in a family, have a far better chance than those who arrive later.

Those are facts. They are not generalities or opinions. The United States Government stands behind these facts. Then we also, through our maternity centers and child welfare means and other means, we finally rescue some of these children, and do not allow them to die under one year of age, and then when the mother is pregnant again – if maternity was not forced upon her – she would be able to bring that child through. Another one begins to come, and when we find that this child that was rescued from dying during its first year now succumbs before its fifth year, and then we have 150,000 children who die before they reach the fifth year of age. And so we can enumerate all of these conditions which are so despicable and so difficult in this country because we will not get to fundamentals. We will not deal with the cause of things while we are anxious to deal with the cure. When a mother does finally bring her children through the adolescent period, what is the next thing she has for that? We find in the South that where children come according to Nature, every year and one-half, that as soon as they are able they are shuffled and hustled on in to take the place and compete with their father in the factories. That is the place that society has for the children of the poor. We find in other States, too where it is only a question of a few years later that also the children, as soon as they are able to take their place in industry, are pushed out of the home, not because the mothers of these children are not just as anxious to see them in the universities and colleges, but because of the pitiless earnings that she must have to support those who are coming behind them.  Most of us know this. We know something about the actual conditions of life as it is among us. In some of the factories of the Lowell and Fall River, Mass., it was found that of the children who work and toil there, under ten years of age, that 85% of them come from families of either – their mothers have given birth to eight children – and we find in the South very much the same thing, excepting a higher percentage of 90 to 93% of the children there.[10]

That is not the only thing. We have a condition not only as these that I have related, but we have conditions again that is more disastrous to the race than child labor or infant mortality, and that is the transmission of venereal disease to the race that is to come.

We know that the mothers and fathers of today produce the race of tomorrow, and we know that unless we have a clean child and a clean stream of blood pouring through that child, that the race of tomorrow is a doomed, foregone conclusion.[11] We know, too, that out of this terrible scourge of venereal disease that we have 90% of the insanity in this country, due to syphilis.  Anyone who is dealing with fundamental would know that these people should use means to protect themselves against having children. They should absolutely in due regard to themselves, to their children and to the race, not allow a child to be born while that disease is running riot in the system, and then we have that terrible consequence which is insanity.

We have 50% of the stillbirths of this country, in other words, dead babies, that are dead when they are born – 50% are due to this disease. You may think that these things are taken care of, but if I told you that they are not – syphilitic women today are allowed to bring forth progeny even in the face of all officialdom, and all the kind and humane things and other kind of things that are doled out to women today – that women are bringing forth children when they themselves are syphilitic.

Not long ago we took a syphilitic woman to 43 hospitals in the city and every one of them said, “We will cure her disease. Leave her here. We will do the best we can for her, but don’t ask us to give her the information to control birth. That is not our office. That is not for us,” and so that little syphilitic woman went back again to her home and will become pregnant only to abort again, which was a great kindness.

Nature sometimes brings the syphilitic to birth before their full time or brings them to birth dead. In other states of syphilis, that is not so, and we have feeble-minded as well as insane. We have here 400,000 feeble-minded people in the United States, that any authority on this subject would say to you, “Not one of them should have been born.” They never should have been born and sometimes these parents are perfectly normal, and yet this taint has gone through the blood and has left this perfectly, normal, physical person who arrives at the adult age with all its physical functions, and yet it has the mentality of a child eight years of age. The feeble-minded man or woman is of no use to itself or society, and it would be better if we were living in a real civilization that they should not have been born. Only 40,000 of this 400,000 are entered in institutions and the others are living among us, producing and reproducing their progeny and providing abundant material and opportunity for the continuance of charities and other institutions for ages and generations more to come.

We found also in one institution – a so-called reformatory where they take the girls of the underworld – prostitutes – in Geneva, III., they find that 50% of these girls coming into the underworld – the prostitutes – was of this cause, that she belonged to the feeble-minded, and again we find that 89% of these came from large families…[12]

You can’t get away from it, my friend. Large families and poverty and misery go hand in hand. No, what do we try to do for all these conditions? How do we look upon them? We are on a track. Motherhood has been tracked. We find that most of the social agencies of the country are trying to legislate these things out of existence. That is all. They run off to Albany and to Washington and they make eight-hour laws for women in industry, but they never think of the poor mother in the homes who might have eight hours. Can you think of the mother in the home with eight hours? She has to go out of the home, out into industry to be protected by that law. Do you realize that mothers and women never have a night’s rest from the time that they are pregnant, some of them until the doors of nature closes their maternal functions? They never know what it is to have one whole night’s rest. They are up nights with babies. Is this freedom or liberty? Hasn’t she a right to herself – hasn’t she a duty to herself to say when and under what conditions she shall be a mother?

We try to reduce our infant mortality rate by our milk stations and all of the other things going on today. Thousands and thousands of dollars are spent for this condition, and to a certain degree some of it is taken care of, but it does not get at the root. When we came to the maternal mortality we find also huge funds that are spent on nurses going into the homes of the poor, telling the mother of the eight children how to have her ninth. (Laughter.) Most of us know that that mother wants to know how not to have her tenth. That is the welcome assistance that they can give that woman, but that will be the last stone to be turned.

Also our child labor – we make laws in Washington against child labor, hoping we will wipe that out of our existence. For fifty years they have been trying to wipe child labor off the book in the United States, but they have not succeeded and they will never succeed until they establish birth control clinics in those districts where these women are, where they put in birth control clinics, like they have in Holland – in every industrial section in the United States where women can come to trained nurses and physicians and get from them scientific information whereby they may control birth.

Now we look upon all these things just about in the same way. We try to palliate most all of them. Take one instance – our immigration laws. The United States Government makes that most rigid laws. It scans over the vessels carefully to see that no one should enter who is an idiot, who is insane, and who is a pauper. They make those rigid laws and rules for those who shall come in, but after you are once on the inside, you can produce and reproduce and repopulate the earth with syphilitic and diseased and insane people as far as the government is concerned. This is the short-sighted side of our whole life. We are very generous and sympathetic, but we are oversentimental, and the time has come to use our minds and to apply our intelligence to life and to the conditions of life as we find them today.

Now, Mr. Russell has said some things that are very interesting to me. He tells us that we cannot have pleasure without pain. It is a man who is speaking.  (Laughter and Applause.)  It is very peculiar that Nature only works on the one side of the human family when it comes to that law. She applies all the pain to the woman. It is absurd – a perfectly absurd argument in the face of rational intelligence (applause) to talk about marriage being for one purpose.

Now I claim – and I differ with Mr. Russell on that – I claim that the sex relationship has distinctly two functions. It has its love function and it has its maternal and paternal function. One is quite independent of the other, and one is just as moral as the other, and if it were not so, then the laws of this country ought to divorce the woman who is not able to have children. Absolutely! And we know it does not. We know that the time the children are created that there is not 1% of humanity that is born or created with that thought in mind. Very few people think at the time of creation that they are going to create. Most of us are brought into the world by accident and that is exactly what birth control is going to change. That is going to make humanity a conscious and voluntary thing.

When we talk of race suicide, it would take almost a whole afternoon to tell you how futile that argument is. We know perfectly well, those of us who have studied the question that in those countries where birth control knowledge has been at the disposal of the people that, although the birth rate has gone down, that the death rate has also gone down. Consequently, the population has been accelerated and there has been a better population because it has been a better and healthier population. If Mr. Russell wants to talk about the race and does not want race suicide, he better come over quickly to the ranks of birth control. (Applause.)

Lindsay Rucker is a first-year student at Wake Forest University. 

  1. “The Public Papers of Margaret Sanger: Web Edition.” Accessed November 12, 2019. https://www.nyu.edu/projects/sanger/webedition/app/documents/show.php?sangerDoc=238946.xml.ootnote.
  2. “Tuberculosis.” Text. Accessed November 18, 2019. https://medlineplus.gov/tuberculosis.html.
  3. “STD Facts - Syphilis (Detailed),” September 23, 2019. https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm.
  4. “The Public Papers of Margaret Sanger: Web Edition.” Accessed October 28, 2019. https://www.nyu.edu/projects/sanger/webedition/app/documents/show.php?sangerDoc=236701.xml.
  5. Mr. Chairman refers to Dr. S Adolphus Knopf, an internationally acclaimed lung surgeon with a specialty in the treatment of Tuberculosis. Dr. Knopf aided in the establishment of the National Tuberculosis Association (presently the American Lung Association,) “published over 400 works,” and helped Margaret Sanger in founding Planned Parenthood. It should be noted too, that in his work with Tuberculosis patients, he encouraged sterilization. As such, he assisted in the coordination of the First National Conference for Race Betterment – eugenics. “Sigard Adolphus Knopf.” In Wikipedia, June 27, 2018. https://en.wikipedia.org/w/index.php?title=Sigard_Adolphus_Knopf&oldid=847761677.
  6. Mr. Winter Russell, with whom Margaret Sanger is debating, was a lawyer in New York City in the early twentieth-century America. His arguments are left out of this excerpt from the debate. To access the affirmative argued by Russell, see https://archive.lib.msu.edu/DMC/AmRad/debatebirthcontrol.pdf, Accessed November 3, 2019.
  7. Here Margaret Sanger alludes to the Declaration of Independence as was common in many first-wave feminist writings (See Elizabeth Cady Stanton’s Declaration of Sentiments.) This document, stating that all men are created equal and calling attention to the unalienable right to life, liberty, and the pursuit of happiness, was just as central to the suffragist argument as it was to the creation of America.
  8. Abstinence is the absence of sex, resulting in 100% birth control. Continence is the self-restraint to halt sexual intercourse and thus, in the same way, resulting in 100% birth control. Margaret Sanger argues that these two are “not agreeable” for most of the population as it is human nature to have sex. Therefore, her call to action is the creation and circulation of a scientifically created form of birth control that is not harmful but is still effective. “Definition of ABSTINENCE.” Accessed November 11, 2019. https://www.merriam-webster.com/dictionary/abstinence. “Definition of CONTINENCE.” Accessed November 11, 2019. https://www.merriam-webster.com/dictionary/continence.
  9. Abortion in the early 20th century, being illegal, was commonly performed by the inexperienced. This resulted in many physical damages on account of the procedure. If performed incorrectly, death, as is still a possibility could be an outcome. Other complications such as “hemorrhage, fever, infection,” cut or torn cervix, sterilization, blood clots, or severe damage to the uterine wall could threaten the life of the patient. However, arguably more severe are the psychological effects of abortion. Anxiety, depression, disordered eating, alcoholism, drug abuse, and suicide or attempted suicide are a few of the many documented psychological consequences of abortion. Post-Abortion Bible Study. “Abortion Risks Abortion Dangers and Abortion Complications.” Accessed November 20, 2019. https://ramahinternational.org/abortion-risks-dangers/. Pourreza, Abolghasem, and Aziz Batebi. “Psychological Consequences of Abortion among the Post Abortion Care Seeking Women in Tehran.” Iranian Journal of Psychiatry 6, no. 1 (2011): 31–36.
  10. Francis Cabot Lowell founded a cotton mill in what is now Lowell, Massachusetts. In the mill, new technology like the water-driven power loom were used by the young women, known as “mill girls,” who worked in the factory. Lowell’s establishment instituted what is known as the “Lowell System,” manufacturing from raw materials to final good under the same roof. This system “revolutionized textile manufacturing,” making it far “more efficient,” “cost effective,” and “less dehumanizing to its workers.” Due to Lowell’s success, along with being the namesake of the mill town, many other people followed his lead in establishing mills throughout the industrial revolution. The factories of Fall River, following in the footsteps of Lowell, MA, operated in the same way. The mill girls were usually from farms and small villages in families who were experiencing economic difficultly. The young women, from the age of fifteen to thirty, worked from twelve to fourteen hours daily and typically lived in boardinghouses on the factory’s property.“Role of the Massachusetts Textile Mills in the Industrial Revolution,” January 9, 2017. https://historyofmassachusetts.org/massachusetts-textile-mills/. Lowell, Mailing Address: 67 Kirk Street, and MA 01852 Phone:970-5000 Contact Us. “The Mill Girls of Lowell - Lowell National Historical Park (U.S. National Park Service).” Accessed November 19, 2019. https://www.nps.gov/lowe/learn/historyculture/the-mill-girls-of-lowell.htm.
  11. Here, Margaret Sanger’s eugenicist ideas are evident. See introduction for more information on her involvement with the eugenics movement.
  12. Being that prostitution was illegal in Switzerland until 1942, it was highly unregulated in the centuries prior. Thus, the spread of sexually transmitted diseases and infections was, and still is, a serious problem – one that not much could be done to halt. Therefore, Margaret Sanger’s accusation of 50% belonging to the “feeble-minded,” referring to those with syphilis in particular, could be accurate. In addition, information about birth control was provided beginning in 1955 by gynecologists to predominately female patients. With that being said, when Sanger was debating, similar to the United States, birth control information was not being spread, and when that distribution did begin it only reached those who were female and could afford to visit the gynecologist. “Prostitution in Switzerland.” In Wikipedia, September 15, 2019. https://en.wikipedia.org/w/index.php?title=Prostitution_in_Switzerland&oldid=915841048. Rusterholz, Caroline. “Reproductive Behavior and Contraceptive Practices in Comparative Perspective, Switzerland (1955–1970).” The History of the Family 20, no. 1 (January 2, 2015): 41–68. https://doi.org/10.1080/1081602X.2014.983139.