The health of women and families occupied reformers such as Margaret Sanger, the leading advocate of birth control. Working as a nurse mainly among poor immigrant women in New York City, she witnessed the damage that unrestrained childbearing produced on women’s health. According to Sanger, contraception—the use of artificial means to prevent pregnancy—would save the lives of mothers by preventing unwanted childbearing and avoiding unsafe and illegal abortions, and would keep families from having large numbers of children they could not afford. Moreover, Sanger believed that if women were freed from the anxieties of becoming pregnant, they would experience more sexual enjoyment and make better companions for their spouses. Her arguments for birth control also had a connection to eugenics. Contraception, she believed, would raise the quality of the white race by reducing the chances of immigrant and minority women reproducing so-called unfit children.

Sanger and her supporters encountered enormous opposition. It was illegal to sell contraceptive devices or furnish information about them. Nevertheless, in 1916 Sanger opened up the nation’s first birth control clinic in an immigrant section of Brooklyn. The police quickly closed down the facility and arrested Sanger. Undeterred, she continued to agitate for her cause and push to change attitudes toward women’s health and reproductive rights.