First American Birth Control Clinic (The Brownsville Clinic), 1916

On 16 October 1916, Margaret Sanger opened one of the first birth control clinics in the United States in Brooklyn, New York, which some have called the Brownsville Clinic. Located at 46 Amboy Street, the clinic was a place where Sanger and her staff verbally communicated with women seeking information about birth control. During the early 1900s, both birth control and abortion were illegal in the US, and publication or circulation of information on both topics was deemed obscene and illegal by the federal Comstock Act. However, women still sought means to control unwanted pregnancies and visited the clinic to learn about birth control. The clinic was open for only ten days. It shut down after being found guilty of violation of the Comstock Act. The Brownsville Clinic represented a step toward the eventual founding of Planned Parenthood Federation of America, which Sanger led. Despite being short-lived, America’s first birth control clinic provided educational resources to women in New York and raised awareness of the birth control movement in the US through media exposure.

During the early twentieth century, Sanger was a writer, nurse, sex educator, and contraceptive advocate in New York City, New York. She coined the term birth control and, prior to opening her clinic, Sanger published various informational pamphlets on reproductive health and birth control topics. In 1911, Sanger gained popularity after writing a column for the New York Call newspaper on female sexuality. She also published eight issues of a monthly newsletter called Woman Rebel that ended after Sanger got charged with violating the federal Comstock Act for publishing information that was considered obscene.

In the late 1800s, Anthony Comstock was a US Postal Inspector and politician who campaigned for the elimination of what he considered obscene and indecent content from the US postal system. His activism resulted in the passing of the Comstock Act of 1873. That act prohibited trade and circulation of documents containing what was then considered obscene information, including pornography, birth control, abortion, and other female health-related literature.

Under the Comstock Act, five of the eight issues of Sanger’s magazine Woman Rebel published during 1914 were banned from postal circulation and Sanger faced obscenity charges. The court eventually dropped the charges against her in 1916. The goal of that was to prevent Sanger and the birth control movement from gaining any more public attention after she had already founded one of the first birth control clinics in the US in October. According to a historian Vern Bullough, the public's affinity and compassion towards Sanger impacted the court's decision.

Before deciding to open one of the first birth control clinics, Sanger wrote and spoke openly about her desire to normalize birth control and promote family limitation. After working as a nurse in low income neighborhoods for several years, Sanger claimed that the presence of criminals, those with mental disabilities, and those involved in prostitution was the product of families with too many children. According to her writings, Sanger believed that family limitation could improve the lives of lower income families by preventing the births of children that those families could not afford to raise. Sanger stated that she believed that every man and woman in America should be able to calculate how many children they could afford to support. Sanger also stated that the presence of birth control clinics would provide information and healthcare to reduce the number of people living in poverty, living with mental deficiencies, and living in asylums. According to her, the presence of birth control clinicals would also reduce the number of children involved in prostitution. With contraception and abortion still illegal, women resorted to back alley abortions and other unsafe, unsanitary, and often expensive and ineffective tactics for managing reproduction.

Sanger’s clinic opened on 16 October 1916 at 46 Amboy Street in Brooklyn. The clinic operated secretly in an old, run-down building during World War I in an area called Brownsville, a subsection of Brooklyn, which was home to many working-class immigrants. Sanger opened the clinic with her sister and fellow nurse, Ethel Byrne, and with the help of friend and bilingual Russian-English translator Fania Mindell. The area in which Sanger decided to open her clinic was home to many European immigrants, including many of eastern European and Russian descent. At the clinic, Sanger and her colleagues provided sexual education and birth control information to their clients. To avoid violating the Comstock Act, Sanger and her co-workers did not write anything down or hand out any informational pamphlets.

When a woman walked into the clinic, she could ask Sanger and her colleagues questions about birth control and learn about birth control options. All communication was done verbally, and the clinic did not provide actual contraception to its clients, as that was also illegal. Sanger had attempted to recruit a doctor to work at the clinic but was unsuccessful in finding a volunteer since birth control was such a controversial subject at the time. The clinic advertised subtly to women in local newspapers and on posters throughout Brooklyn in English, Hebrew, Russian, and Italian without the explicit mention of birth control. During its first day of operation, the clinic served 150 patients and by the tenth day had served around 450. Sanger also received letters from nurses and women across the country requesting educational birth control information that they could provide to women in their local towns.

During its ten days of operation, the clinic impacted the community members and was well-received. One woman stated that visiting the clinic and getting advice from Sanger and the other female employees was significantly easier and more comfortable than discussing the same topics with a man. She also stated that she would not discuss those reproductive and sexual issues with her male physician. Sanger claimed that, if she could help prevent a woman from having her eighth child by providing birth control information that women could not access elsewhere, she would be giving the seven existing children a better chance to grow into productive citizens. Sanger stated that her goal was to help tired and overworked women who came to the clinic by eliminating their fear of having to care for another child they could not afford to raise. A reporter also noted that many immigrant and native women visited the clinic, leaving their baby strollers parked outside with multiple children in each stroller.

Sanger spoke optimistically about the future of her first clinic and her strategies for spreading birth control throughout the US and beyond. Two days after opening her clinic, Sanger stated in an interview that no legal harm could come to her clinic as she was not breaking any laws. Sanger said that she was not violating obscenity laws by only spreading information about birth control orally, as the Comstock Act applied to written communication only. Sanger also discussed her plans for four more secret clinics that she would open in the near future and mentioned opening clinics in Washington, DC, Cleveland, Ohio, Detroit, Michigan, St. Paul, Minnesota, Minneapolis, Minnesota, Milwaukee, Wisconsin, Denver, Colorado, St. Louis, Missouri, Los Angeles, California, San Francisco, California, San Diego, California, Portland, Oregon, Seattle, Washington, Spokane, Washington, and Butte, California, in the next year.

After only being open for ten days, the authorities shut down the clinic and arrested Sanger for violating the Comstock Act. On 26 October 1916, an undercover policewoman and fellow officers raided Sanger’s clinic, which led to the shut down and the arrest. Sanger was released from jail the following morning and reopened the clinic on 14 November 1916. The police arrested Sanger again for maintaining a public nuisance by keeping her clinic open after being ordered to close it permanently. After the third attempt to open the birth control clinic on 16 November 1916, the police forced the landlord to evict Sanger and her coworkers and the clinic permanently closed.

Despite her efforts to avoid legal intervention, Sanger participated in a trial on 29 January 1917. The court gave Sanger the choice to promise that she would not attempt to reopen the clinic in return for not serving jail time. Sanger declined the offer. As a result, she served thirty days in Queens County Penitentiary in New York City, New York. Sanger’s sister, Byrne, was also sentenced to thirty days imprisonment and began a hunger strike that garnered media attention. Prison staff eventually force fed Byrne through a tube. Sanger appealed her own conviction. During her trial, Sanger called upon several Brownsville clients as witnesses who expressed their support for Sanger. They shared emotional stories of dangerous failed abortions and miscarriages, as well as the burden they faced having to care for so many children. The New York Court of Appeals did not grant her appeal in January of 1918.

Although the court upheld Sanger’s conviction, judge Frederick Crane’s decision included a more liberal interpretation of the Comstock Act that created a precedent. The new guidelines allowed doctors to legally prescribe birth control in the state of New York for reasons other than venereal diseases for the first time in US history. Although Sanger herself could not appeal her conviction for circulating birth control information, the Court’s decision increased women’s access to birth control through a doctor.

During its ten days of operation, the Brownsville Clinic drew national attention as legal authorities, the Catholic Church, and other anti-birth control organizations made attempts to shut the clinic down. Consequently, the clinic’s publicity grew and helped raise awareness of birth control and family planning movements in the US. According to a historian Taylor Sullivan, opening Sanger’s clinic was a strategic decision to capture the attention of the public and force birth control into public discourse and debate. Despite losing the clinic so soon after it opened, Sanger continued to promote birth control accessibility. In 1921, Sanger founded the American Birth Control League to continue growing the birth control movement in the US and internationally by publishing books, pamphlets, and articles on the subject. By 1953, the American Birth Control League had evolved into Planned Parenthood Federation of America, and Sanger served as the first president of that organization. After Sanger’s death in 1966, the Federation continued to grow and as of 2018 it operated over 600 health centers throughout the US.