“Family Limitations” (1914), by Margaret Higgins Sanger

In 1914, Margaret Sanger published “Family Limitations,” a pamphlet describing six different types of contraceptive methods. At the time Sanger published the pamphlet, the federal Comstock Act of 1873 had made distributing contraceptive and abortion information through the US postal service illegal. The Comstock Act classified contraceptive information as obscene and limited the amount of information available to individuals about preventing pregnancies. In 1915, Sanger’s husband was charged with violating the Comstock Act for distributing “Family Limitations” and was sent to jail for 30 days. The case sparked many birth control activists to lobby for the repeal of the Comstock Act. By inciting controversy during a time when the Comstock Act limited contraception access, Sanger’s pamphlet “Family Limitations” increased women’s knowledge about various methods of preventing pregnancy.

The federal Comstock Act of 1873, officially titled “Act for the Suppression of Trade in, and Circulation of Obscene Literature and Articles of Immoral Use,” made it difficult for women to access information about birth control. Anthony Comstock, a religious dry goods salesman, wrote and lobbied for the act to strengthen already existing anti-obscenity laws. The Comstock Act illegalized the distribution of material or information related to contraception or abortion through the United States Postal Service by classifying them as obscene material. After the Comstock Act was enacted, many US states created their own laws against the distribution of information about contraceptives and abortifactants, or items able to cause abortions. Several of those laws restricted physicians’ ability to provide contraception or abortion information and services to their patients. After the passage of the law, Congress appointed Comstock as a special agent in the US postal services to enforce that law.

Several individuals, including Sanger, advocated to remove contraception and abortion from the association with obscene materials in the Comstock Act. In the early 1900s, Sanger worked as a nurse in New York City, New York. She interacted with many poor, pregnant women who begged her for knowledge about limiting their pregnancies. Although Sanger tried to provide women with her limited knowledge about contraception and preventing pregnancy, she was unaware of any contraceptive methods other than a condom and the withdrawal method. However, the condom was associated with prostitution and many women did not trust their husbands to withdraw in time. The physicians Sanger worked with were unwilling to disclose information because of the laws that made it illegal to discuss contraception. According to historian Peter Engelman, Sanger decided to learn more about other contraceptive methods after watching many women attempt self-abortions, become ill with sepsis from unsterilized instruments, and die. In 1913, after futile searches for information, Sanger traveled to France to learn about contraceptive methods.

After returning from France, Sanger began publishing a newsletter, The Woman Rebel, which discussed issues related to women’s hygiene, child birth, and the negative consequences of having too many children. While the newsletter did not discuss contraceptive methods, the post office charged Sanger with violating the Comstock Act. To avoid standing trial, Sanger left the US for England. However, before leaving she quickly wrote “Family Limitations” to share all the birth control information she had learned in Europe. Sanger had 100,000 copies of “Family Limitations” printed and instructed her friends and colleagues to distribute the pamphlet upon her departure.

Sanger divides her 16-page pamphlet into seven sections. The six sections following the initial “Introduction” section describe various methods of preventing conception. In the introduction, Sanger addresses her audience as working women and men in America, with a primary focus on women. She argues that women have the responsibility of preventing unwanted pregnancies because working families cannot afford to support large families. Sanger defines preventing pregnancies as an important component of a women’s hygiene. Sanger notes that her pamphlet does not contain information about all types of preventative methods. She attributes that to either not having learned about those additional methods or to not being able to recommend the ones that she does know about. At the end of the first section, Sanger urges her readers to educate their peers about the information from the pamphlet.

In the second section titled “A Nurse’s Advice to Women,” Sanger discusses the importance of tracking one’s menstrual cycle, deciding early if abortion is preferred, and misconceptions regarding contraceptive methods. Sanger advises women who are nearing the beginning of their menstrual cycle to take laxatives and a drug called quinine to cleanse their bowels to prevent fertilization of the ovum inside the uterus. She argues that ignorance regarding one’s menstrual cycle is associated with carelessness about preventing pregnancy. Sanger cautions women to avoid abortions after one month of conception. She urges women to decide quickly about whether they wish to terminate their pregnancies or continue with them.

Finally, Sanger discusses misconceptions in contraceptive methods, including timing of intercourse, intercourse during breastfeeding, and withdrawal. Sanger states that there are myths that conception can only occur at certain times of the menstrual cycle, however, she argues that those are not reliable hypotheses and should not be used as a contraceptive method. She then discusses the myth that a woman cannot become pregnant while breastfeeding. Again, Sanger argues that contraception should still be used while a woman is breastfeeding. She also addresses the notion that conception cannot take place if a woman lies on her left side. Lastly, Sanger discusses ‘coitus interruptus’ or the withdrawal method, and argues that while effective at preventing pregnancy, it can cause women to worry during intercourse and therefore make it less enjoyable.

In the third section titled “Douches and Their Importance,” Sanger introduces a method to clean the vaginal canal to prevent conception. She defines the douche as a bag of chemical solutions that can be poured into the vagina with a rubber tube to kill sperm or remove them from the vaginal canal. Sanger lists a variety of solutions that can cleanse the vaginal canal following intercourse including lysol, bichloride, potassium permanganate, carbolic acid, chinosol, a salt solution, a vinegar solution, or cold water. In addition, she lists the chemicals boric acid, citric acid, and hydrochlorate of quinine as solution options for women who would like to use a preventative douche prior to intercourse.

In the fourth section titled “The Use of the Condom or ‘Cots,’” Sanger states that using a condom, which she also refers to as a rubber cot, can prevent the sperm from entering the vagina. Sanger discusses the possibility that the condom, which was either made from the lining of animal intestines or rubber in 1914, can break. To avoid sperm from entering the vagina, she advises individuals to make sure that the sheath is worn properly and discarded quickly if the condom is not reusable. Sanger labels the condom as one of the best and most known methods of preventing pregnancy and venereal diseases. Sanger also argues that the condom can help both men and women enjoy their sexual relations.

In the following section “The Pessary and the Sponge,” Sanger describes the pessary as being the most effective, convenient, and cheapest technique to avoid conception. Sanger defines the pessary as being a small device that fits into the vaginal canal and covers the opening to the uterus. Pessaries are known in the twenty-first century as diaphragms. Sanger includes a diagram of a pessary from France and two diagrams of the womb to explain how women should insert the pessary. Sanger reassures women that if inserted correctly, the pessary will not cause pain and will be unnoticeable. She suggests women see a doctor or nurse for assistance with adjusting the device.

Although Sanger listed sponges in the title for the previous section, she does not discuss them until the sixth section, “Sponges.” In that section, she instructs women to first soak the sponge in an antiseptic solution and then place it inside the vagina prior to intercourse. Sanger suggests carbolic acid, boric acid, or vinegar as antiseptic solutions to kill sperm. She states that some physicians recommend women use cotton instead of sponges.

In the final section “Vaginal Suppositories,” Sanger includes four separate lists of ingredients to create a mixture that kills sperm and prevents conception when spread inside the vagina. Sanger states that women can purchase those ingredients from pharmacists. All four recipes contain a varying amount of boric acid. Sanger also includes a fifth recipe that she learned from women living in rural areas in France. She concludes the final section with the claim that women should seek personalized advice prior to utilizing that method of contraception.

In January 1915, Comstock arrested Sanger’s husband, William Sanger, for providing “Family Limitations” to a man who claimed to need a copy of the pamphlet for his wife. The man, however, worked as an undercover agent for Comstock. During Sanger’s husband’s trial, many US birth control activists formed groups that lobbied for the repeal of the Comstock Act. In September 1915, Sanger’s husband was sentenced to thirty days in jail for violating the Comstock Act.

At least 18 subsequent editions of “Family Limitations” were published after Sanger’s initial publication of 100,000 copies. The pamphlet was also translated into other languages and used as a resource for other contraceptive guides. According to historian Engelman, “Family Limitations” covered more types of contraceptive methods than any other publication until the 1920s. Individuals distributed the pamphlet widely, even copying sections by hand before passing it on to friends.

“Family Limitations” summarized various birth control methods that Sanger endorsed as being safe and effective for women. The wide distribution of the pamphlet allowed many women to have access to information otherwise restricted by the federal Comstock Act. Sanger advocated for women being responsible for their own reproduction and “Family Limitations” provided them with a resource to do so.