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The Troubling History of the Birth Control Revolution in the United States

Bintou Diarra, A.B Candidate | Medical Anthropology, Brown University | April 17, 2023

Many birthing people have complicated relationships with contraception. Not only do they vary widely in terms of efficacy, but many methods—like the birth control pill and the IUD—may come with unfavorable side effects, like a slight decline in mental health and hormonal acne. Deciding whether to get on birth control and which method is right requires the consideration of cost, potential side effects, and future plans for pregnancy. For Black birthing people in the United States, however, there is an additional factor that further convolutes the relationship with birth control—it’s troublesome, anti-Black history. 

As cornerstones of the eugenics movement in the United States, the contraceptive pill and contraceptive injection are among the methods with the most troubling legacies. The eugenics movement, which gained popularity in the 1920s, centers ‘improvement’ through the selective breeding of the human population. While it is not scientifically sound, its basis is scientific—it is an (incorrect) extension of Mendelian genetics that claims that abstract human qualities like intelligence are inherited in a simple fashion. 

It is important to note that while the eugenics movement was a nascent one, the beliefs underlying the movement were already deeply ingrained in the fabric of American society. The eugenics movement was the culmination of the pervasive beliefs and policies of the 1800s, which reflected racist and xenophobic attitudes.

The work of the figures we celebrate within the sphere of reproductive choice underscores the insidious workings of anti-Black racism within the move to increase birth control access. In the late 1800s and early 1900s, oppressive laws limited the distribution and usage of contraceptives. American birth control activist and founder of Planned Parenthood Margaret Sanger worked to change these circumstances for birthing people in the United States. Her endeavors, along with the beliefs that actuated her, demonstrate that her efforts at increasing the accessibility of a valuable tool, included the use of rhetoric that would become a dangerous weapon against people of marginalized backgrounds. 

Sanger’s devotion to legalizing the use of birth control stemmed from her background. Born in 1879, Sanger belonged to a family of eleven children. According to various sources, her childhood was largely shaped by her mother’s stress and the embodied effects of working to support the family. With her profession as a nurse in her young adult life came additional exposure to the struggles of women without access to birth control. While she wanted to increase birth control access for all women, Sanger was especially empathetic to the struggles of impoverished women specifically, who she believed were ill-equipped to handle life-altering events like pregnancy and childbirth. Unfortunately, the fixation on the benefit of not having children would accompany the limitation of people’s rights to have children, a reality that would impact Black birthing people the most. 

Her writings demonstrate the linkage between eugenic ideologies and birth control. In her speech, The Morality of Birth Control, Sanger asserts that the United States suffers from the issue of uncontrolled reproduction. In expounding her argument, Sanger divides the birthing people of the United States into three groups. The first group contains the “intelligent and wealthy members” of the upper class, who she describes as “[having] obtained knowledge of Birth Control and exercising it in regulating the size of their families”. She also names them as the “most respectable and moral members” of the community. She defines the second group as “equally intelligent and responsible”. To Sanger, members of this group desire to control the size of their families, but do not have access to the education, tools or resources to carry out this endeavor. 

In defining the third group, Sanger rests on noxious rhetoric that would be used to make the case for increased birth control access: “The third are those irresponsible and reckless ones having little regard for the consequence of their acts, or whose religious scruples prevent their exercising control over their numbers. Many of this group are diseased, feeble-minded, and are of the pauper element dependent entirely upon the normal and fit members of society for their support. There is no doubt in the minds of all thinking people that the procreation of this group should be stopped”. 

Ultimately, contraception was the perfect tool for eradicating the unfit members of society—a category which often included the members of our most marginalized populations. With Sanger’s assertions came notions of deservingness and fitness, muddled and subjective concepts that lended eugenicists an air of credibility in their assessment of Black people’s reproductive choices. 

In the case of the anti-Black history of birth control, Sanger’s alignment with the eugenics movement is merely the tip of the iceberg. The contraceptive injection Depo Provera was tested on Black women without them being informed of the potential side-effects. Compulsory sterilization laws, which Sanger publicly supported, would be mandated in over two-thirds of the United States. 

Too often, reproductive health movements center the right to choose, with only one choice in mind—the right to not reproduce. The history of birth control in the United States suggests the significance of honoring Black birthing people’s right to have children on their own terms.

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