Margaret Sanger Clinic

How this New York clinic helped transform reproductive health care

In October of 1918, Margaret Sanger opened the first birth control clinic at 46 Amboy Street in Brooklyn, New York. Back then, as now in some ways, reproductive rights and abortion were hotly contested issues. Even the discussion in public of these topics, not to mention contraception, the treatment of sexually transmitted diseases and single-parent pregnancies, was a problem. Abortion at that time was completely illegal in the United States, but so was sharing information about reproductive issues.

Sometimes referred to as the Brownsville Clinic (referring to the Brooklyn neighborhood where it opened) and, later, the Margaret Sanger Clinic, this pioneering operation was also the beginning of Planned Parenthood, a nonprofit entity that today provides reproductive and sexual health care in hundreds of health clinics all over the United States and around the world.

Sanger was a nurse, sexual health educator, activist and writer, but not a physician. From today’s lens, she was also a complicated figure who adhered to some pseudoscientific and discriminatory beliefs.

Sanger came from a working-class family where she was one of 11 children. Her mother died at the age of 50, which Sanger attributed to the strain of her mother’s numerous childbirths and seven miscarriages.

Later, working as a nurse on the Lower East Side, Sanger witnessed more tragedies related to reproductive health, including women suffering from the effects of botched abortions. (Sanger was generally opposed to abortion except to save the life of the mother, and saw birth control as the best way to prevent its need.)

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When she opened the Brownsville clinic — with assistance from her sister Ethel Byrne, a nurse; and a friend named Fania Mindell, an activist, artist and translator — she and her staff provided information about birth control. At that time, the options were limited to barrier methods, such as condoms and diaphragms, or behavioral changes with respect to sexual activity.

Birth Control activist Margaret Sanger (1879-1966) with Fania Mindell inside Birth Control Clinic, Brownsville, Brooklyn, ...

Margaret Sanger with Fania Mindell inside their clinic in 1916. Photo by Circa Images/GHI/Universal History Archive/Universal Images Group via Getty Images

But just 10 days after they opened, New York City Police shut the clinic down for violating the Comstock Act — a set of statutes passed by Congress in 1873 that called for “the suppression of trade in, and circulation of, obscene literature and articles of immoral use.” It was also illegal to send any materials related to sex education, pornography, contraceptives, abortion drugs, and similar materials through the U.S. Mail. The act was named for Anthony Comstock, a postal inspector and activist who worked to censor or eliminate materials he considered obscene.

Follow-up laws passed in the early 20th century made it illegal to lend, sell or give “obscene” publications, as well as articles related to birth control or contraception, or to move such materials across state lines.

In the 1910s, Sanger wrote dozens of articles on sexuality and reproductive health for various left-wing publications, such as the socialist New York Call, and eventually published a monthly newsletter called The Woman Rebel. She was frequently in legal trouble, too, for violating the Comstock Act. Sanger had long been an advocate of getting this critical health information to those who could not otherwise access it. She argued that poor Americans needed to be able to plan their families — perhaps even more so than wealthier citizens — because their low salaries, job instability, poor housing, and other social circumstances might make it difficult to have a child at a particular time. The health and lives of these Americans, she believed, would be far better with proper reproductive planning and education. The socioeconomic divide with regard to reproductive care — for example, having the means to travel out of state to obtain a legal abortion — persists to this day.

The Brownsville clinic was in the heart of a working-class immigrant neighborhood. The nurses and social workers spoke Yiddish, English, Italian, Russian and many other languages. They advertised their services in the immigrant press but without the explicit mention of the terms “birth control” or “contraception.” Sanger told the press of her plans for opening similar clinics all over New York and in a slew of large cities across the nation.

During its first day of operation, the clinic staff met with 150 women; by its 10th and final day, it had seen 450 women. Many of these women found it easier to discuss reproductive issues with other women than with male doctors.

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On Oct. 26, 1916, a female police officer working undercover came to the clinic. Once she was satisfied that the law had been broken, she signaled for a battalion of policemen to raid the clinic, shut it down, and arrest its founder. Sanger was released on bail the following morning and attempted to re-open the clinic on Nov. 14, but she was arrested once more for creating a public nuisance. She tried to reopen the clinic two days later, but it was shut down permanently after the police ordered her landlord to tear up her lease and evict her.

Sanger’s trial was a national media event. When the judge offered to free her if she did not re-open a clinic, she refused and was sent to jail for 30 days. So was her sister Ethel, who went on a hunger strike that made headlines, especially after jailers force-fed her. Sanger’s conviction was ultimately upheld, but in denying her appeal, a New York State Court of Appeals judge named Frederick Crane also broadened the circumstances under which physicians could offer reproductive health services and birth control advice to married couples.

These rules were further liberalized in the 1930s, but they still left non-physicians like Sanger — including nurses and peer counselors — unable to offer such advice. Nonetheless, Sanger was successful in bringing the issue into the daylight.

Like many Progressive Era reformers, Sanger held some morally repugnant views, including her support for eugenics. In 1926, for example, she spoke on birth control at a Ku Klux Klan rally in New Jersey. In 1927, she loudly agreed with the U.S. Supreme Court’s decision in Buck v. Bell, in which the court allowed for mandatory sterilizations of the “unfit,” such as people with mental disabilities or mental health problems. Tens of thousands of Americans were forcibly sterilized because of this decree.

In 1921, Sanger founded the American Birth Control League, which grew by leaps and bounds under her leadership and distributed educational materials on women’s health and reproductive issues. By 1953, the league was supplanted by the Planned Parenthood Federation of America. Sanger was its first president. In 1965, the Supreme Court decided in Griswold v. Connecticut that the personal and private use of contraception is a constitutional right.

Sanger died in 1966, but Planned Parenthood continues its work despite numerous activist, existential and judicial threats. Today, there are more than 600 Planned Parenthood clinics in the United States — and it all began in Brownsville.