In the late nineteenth century, the Comstock Act of 1873 made the distribution of contraception illegal and classified contraception as an obscenity. Reflecting the predominant attitude towards contraception at the time, the Comstock Act was the first federal anti-obscenity law that targeted contraception. However, social acceptance of birth control changed at the turn of the twentieth century. In this thesis, I analyzed legislation, advocates, and literature pertinent to that social change to report on the events leading up to the decriminalization of contraception.

Mary Coffin Ware Dennett advocated for social reform in the United States in the early twentieth century, particularly regarding sex education and women's rights to access contraception. Dennett authored several publications on sex education and birth control laws. She also worked to repeal the Comstock Act, a federal law that made it illegal to distribute obscene materials through the US Postal Services. During the early 1900s, Dennett distributed a pamphlet she wrote on sex education called, The Sex Side of Life, through the post, which triggered a series of legal challenges that contributed to the dismantling of the Comstock Act. Dennett was an advocate for sex education and contraceptives, and her actions helped increase women's access to information about reproductive health.

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.

In 1901, the Arizona Territorial Legislature codified territorial law that illegalized advertising, causing, or performing abortions anywhere in Arizona. The 1901 code, in conjunction with the federal Comstock Act, regulated the advertisement and accessibility of abortion services and contraceptives in Arizona. The Federal Comstock Act of 1873 had illegalized the distribution of material on contraceptives and abortions through the US Postal Services by labeling contraceptive and abortive material as obscene. After the passage of that federal law, many states and territories, including Arizona, enacted or codified state or territory-level anti-obscenity laws to augment the federal law's effects. Those laws became called Comstock laws, and Arizona's 1901 laws was its Comstock law. The Arizona Comstock law hindered Arizona women's access to abortion services until the mid twentieth century, when state and federal court decisions dismantled Comstock laws nationwide.

In the 1930 US federal court case United States v. Dennett, Mary Coffin Ware Dennett was cleared of all charges of violating the anti-obscenity Comstock Act, a charge she had incurred by distributing her sex education pamphlet called The Sex Side of Life: An Explanation for Young People. The United States Postal Service charged Dennett under the Comstock Act, which prohibited the distribution of sex-related materials through the mail. The US Second Circuit Court of Appeals in New York City, New York, ruled that material needed to be considered in context and could not be considered obscene if it was not intended to sexually arouse an individual. The court's ruling in the appeals case of United States v. Dennett questioned the merits of the Hicklin test, used by courts to determine whether an item had an obscene component or intent, and contributed to the dissolution of the Comstock Act, thus legalizing access to materials about contraception and reproductive health.

A licensed obstetrician and gynecologist, Pearl Tang worked to improve the health of women and children in Maricopa County, Arizona, during the twentieth and twenty-first centuries. Her work with the Maricopa County Health Department ranged from immunizations to preventing cervical cancer. Tang obtained federal grants and community support to establish various child and maternal health clinics throughout Maricopa County as chief of the Maricopa County Bureau of Maternal and Child Health. Tang established mobile clinics, including a clinic she called the Maternity Care Bus, to address the lack of access to medical care among rural women in Arizona. She also focused on family planning through education and the distribution of contraception. Tang's efforts in Maricopa Country increased the delivery of maternal, child, and family planning care and helped lower Arizona's infant mortality rate.

Margaret Higgins Sanger advocated for birth control in the United States and Europe during the late nineteenth and early twentieth centuries. Although people used contraceptives prior to the twentieth century, in the US the 1873 Comstock Act made the distribution of information relating to the use of contraceptives illegal, and similar state-level Comstock laws also classified discussion and dissemination of contraceptives as illegal. Sanger helped to repeal the Comstock Act and similar laws so that women could legally use contraceptives to control their fertility and the sizes of their families. In 1916, Sanger opened the first birth control clinic in the US in New York City, New York. Later in life, Sanger formed several advocacy organizations that promoted access to contraception, including the Planned Parenthood Federation of America. Sanger's advocacy increased women's access to contraception and helped change the United States' social and legal perceptions of birth control.

Mary Coffin Ware Dennett, a supporter of sex education for children in the US in the early twentieth century, wrote The Sex Education of Children: A Book for Parents as a resource for parents teaching their children about sex. Vanguard Press in New York City, New York, published The Sex Education of Children in 1931. Dennett’s book addresses issues that Dennett argued parents should know about sex to provide their children with an accurate portrayal of the topic. In addition to expressing Dennett’s views on sex education, The Sex Education of Children was one of the few works during the early 1900s in the US to advocate for increased communication with children about reproductive health.

In the 1936 case United States v. One Package of Japanese Pessaries, the US Court of Appeals for the Second Circuit in New York City, New York, confirmed that physicians had the right to distribute contraceptives to patients for medical purposes. In January 1933, US Customs confiscated a package of contraceptives imported from Japan by US physician Hannah Stone. They claimed that the package violated section 305 of the Tariff Act of 1930, which, like the 1873 anti-obscenity Comstock Act, granted the US government authority to seize contraceptive materials imported into the country or sent through the mail. The court ruled that US Customs was not justified in confiscating the package and ordered its return to Stone. United States v. One Package exempted physicians from the restrictions surrounding the distribution of contraceptives and contributed to the subsequent dismantling of the Comstock Act in later court cases.

Anthony Comstock was a US postal inspector and politician who advocated for the suppression of obscenity and vice throughout the late nineteenth century and early twentieth century. Comstock considered any sexually explicit material like pornography and literature related to birth control and abortion as obscene. In 1873, Comstock lobbied US Congress to pass an anti-obscenity law titled An Act for the Suppression of Trade in, and Circulation of, Obscene Literature and Articles of Immoral Use, also called the Comstock Act. The law penalized individuals for sending material classified as obscene through the US postal services, which Comstock, as a special agent of the United States Post Office, could enforce. Comstock’s role in passing and enforcing the Comstock Act influenced the social and political restriction of birth control, hindering women’s access to contraceptives.