Abstract

This essay offers a historical overview of African American women’s efforts to gain access to contraception, from the early stirrings of the campaign to legalize birth control in the 1910s to the eve of mass movements for racial equality and women’s rights in the 1960s. The birth control struggle becomes a window on the racial, gender, and economic structures black women negotiated in pursuit of sexual and reproductive self-determination at that time. Taking us back a century, and with emphasis on resilience and resistance, their story reminds us of the deep roots and broad vision of black women’s leadership in what has become a women-of-color–led human rights movement for reproductive justice today.

Conceiving a Nation

From the colonial era to the present, African American women have resisted persistent efforts to control their sexuality and regulate their fertility. Yet the rich and complex story of their struggles for bodily self-determination has only begun to be told. This essay brings a portion of that story to the fore by focusing on the campaign for birth control as a point of entry into black women’s activism for sexual autonomy and reproductive health and, in turn, for social justice in the early twentieth century.

The full story is as long as the nation is old. African American women’s struggles for sexual and reproductive self-determination expose the deep and intertwined roots of racial oppression and sexual violence in the founding of the United States and the unfolding of the nation’s history. Over the course of the 1600s, European settlers in the southern colonies pieced together elaborate codes of gender relations that gradually consolidated their new societies around a system of racial slavery. Asserting control over women’s sexuality and reproduction was instrumental to establishing and maintaining this social order.1 (Fig. 1.)

To differentiate slaves from free persons, for example, colonists delineated distinct racial categories of white, mulatto, and Negro and passed laws punishing interracial sex and banning interracial marriage. They devised tax codes that marked black female field workers as taxable property and set them apart from white women, who were deemed fully human and free. Slave owners enacted birthright statutes that designated children as free or slave “according to the condition of the mother.” Cumulatively these measures fixed slave status as hereditary and pegged perpetuation of the socioeconomic system to the reproductive capacity of black women (Brown 1996). (Fig. 2.)

Authors of the U.S. Constitution and other founding documents incorporated these power dynamics of race and sex into the infrastructure of the new nation in the late 1700s. The framers restricted citizenship to whites, legitimized the institution of slavery, and calculated the value of slaves as part person, part property. Subsequent laws and court rulings reinforced the policies that deprived African Americans of ownership of their own bodies and denied them input in setting the terms of their existence. In the 1850s, on the eve of the Civil War, when Celia, an enslaved woman in Missouri, was convicted of murdering her owner, who had raped her repeatedly, the state supreme court denied her the legal standing to claim self-defense. From Celia’s perspective, the United States was conceived less in liberty than in violence (Freedman 2015, chap. 1; McLaurin 1991).

Sexual violence followed blacks into freedom. In the decades after emancipation, former slave owners replaced legal bondage with legal segregation, and the U.S. Supreme Court, in its landmark 1896 Plessy v. Ferguson ruling, upheld the principle of “separate but equal.” Segregationists extended this Jim Crow system into the twentieth century, invoking theories of white superiority to justify racist institutions and practices. The culture of sexualized racial terror they created entailed systematic lynching, castration, and rape to thwart African Americans’ attempts to exercise their rights. (Fig. 3.)

In every era African American women have fought sexual and reproductive oppression in its many forms. Through individual actions and collective strategies, they have defied demeaning stereotypes, defended themselves against assault, opposed coerced sterilization, pursued safe and legal contraception and abortion, sought reproductive health care, and asserted sexual autonomy. This essay offers an overview of one chapter in this centuries-long and ongoing story of resilience and resistance. We pick up the narrative in the 1910s, as black women were becoming involved in the campaign to access and legalize contraception.

Creating Community Clinics

At the turn of the twentieth century, birth control was illegal in the United States. The Comstock Act of 1873 had labeled birth control obscene and banned distribution of contraceptive devices or information. By the 1910s reformers were challenging the criminalization of birth control, and they achieved a minor victory when a New York court approved contraception for purposes of disease prevention.2

African American women routinely practiced traditional methods of preventing conception and terminating pregnancy, and in the early twentieth century they turned to pharmacies and mail-order houses for newer techniques. Some joined the movement for legalization. African American club women and male civic leaders sponsored public forums on the issue, advocated access to contraceptive knowledge, and promoted the creation of birth control services in their communities.3 (Fig. 4.)

When Margaret Sanger emerged as a champion of birth control, African Americans sought her out. In 1919 in North Carolina, where Sanger was addressing a white audience, black women invited her to speak to their groups as well, which she did (Sanger 1919). In New York City, after Sanger was arrested for publishing birth control literature and opening a birth control clinic in the Brownsville section of Brooklyn, the Harlem Women’s Political Association held lectures on the subject. Following Sanger’s opening of a second clinic, the Clinical Research Bureau in Manhattan, leaders of the Social Workers Club of Harlem and the Urban League urged her to establish a facility in their neighborhood. On February 1, 1930, the Harlem Branch of the Birth Control Clinical Research Bureau opened its doors and soon served thousands of clients a year, approximately half of them African American. (Fig. 5.)

An advisory board of prominent African American ministers, doctors, nurses, journalists, and social workers supported the Harlem Branch. The advisors cited abysmal living conditions in the black community as reason to take up the cause. Maternal and infant mortality rates in Harlem were twice those of whites in the city. Board member Dr. Louis Wright, medical secretary of the Harlem Hospital, pointed to “the appalling number of deaths” that came to his attention following illegal abortions as his motivation for ensuring that women had safe and effective means of separating sex from reproduction and regulating family size.4

Opinions on birth control varied widely among African Americans. In his 1932 essay “Negroes and Birth Control,” the noted intellectual W. E. B. Du Bois spoke to the array of considerations. Du Bois, who had written as early as 1919 that a woman should have “the right of motherhood at her own discretion,” (Du Bois 1920, 164–65) placed the issue in the historical context of slavery. He touched on the web of religious, cultural, and political concerns that surrounded matters of sex and reproduction and stood in the way of African Americans’ ready acceptance of contraception, especially if it was dispensed by white reformers, government representatives, or medical personnel. (Fig. 6.)

Although dispensing birth control remained illegal outside New York, local activists created hundreds of birth control clinics around the country in the 1920s and 1930s, especially after the 1936 Supreme Court One Package ruling, which modified the Comstock Act and allowed doctors to prescribe contraception for reasons other than disease prevention. The American Medical Association spurred the spread of clinics with its endorsement of birth control the following year. By 1939, when advocacy groups merged to form the Birth Control Federation of America (BCFA), most states had at least one clinic.5 (Figs. 7 and 8.)

Most clinics, however, did not accept black clients. Those that did typically held segregated “Negro sessions” and maintained all-white staff who often treated blacks with condescension. At the Harlem Clinic, members of the African American Advisory Board were not given a full voice in setting policy, and it was only under pressure from the Board that the clinic eventually hired black staff. One black physician who observed the clinic closely remarked, “Again and again white people, competent in every other particular, get confused in the face of interracial endeavor.” As he explained it, “Lack of deep-seated interest usually accounts for this” (quoted in McCann 1994, 135, 147–50).

Elsewhere black women’s groups were establishing services of their own. In Baltimore, Oklahoma City, Louisville, Richmond, Boston, Miami, Cincinnati, Los Angeles, San Francisco, Washington, D.C., and many other locales where their organizing was less well documented, African American women set up clinics in churches, community centers, and social workers’ homes. They also took contraceptive information to residents of housing settlements and pushed for the inclusion of birth control in maternal health and social welfare programs. (Fig. 9.)

The black press aided the effort. Major newspapers, including the Chicago Defender, the Pittsburgh Courier, the New York Amsterdam News, the San Francisco Spokesman, and the Afro-American, published editorials on birth control, carried ads for contraceptive devices, and spread news of the movement to a large national readership.

Still, advocates had barely begun to meet the need.

The Negro Project

Legal segregation, racist beliefs, and dire poverty blocked African Americans’ access to health care, and the economic depression of the 1930s made a bad situation worse. At the end of the decade, Time magazine pronounced poor health among blacks to be the nation’s most pressing health problem (“Negro Health” 1940, 43). The well-being of mothers and children was a stark measure of this inequality. With diseases such as tuberculosis and syphilis going untreated, the risks associated with pregnancy and childbirth increased. African American rates of maternal and infant mortality, which already dwarfed those of whites, rose even higher.6

National attention turned to the South, where a large majority of African Americans lived. Southern cities, counties, and states were beginning to build public health systems, and some of them dispensed birth control, but they typically served only poor whites. Passage of New Deal health and welfare reforms, notably the 1935 Social Security Act and its provision for Aid to Dependent Children, raised hopes of federal action. (Fig. 10.)

Birth control organizations dispatched field representatives to the South in the late 1930s to assess the practicality of distributing contraceptive foam powder to poor women who lacked basic services such as running water. They found black women already organizing and stirring up interest. One field worker, Hazel Moore, told of a black mother who arrived at the dispensing site with five children in tow. They had walked “a good piece” to get there, the mother reported. Asked if she could have left her children in the care of a neighbor, the mother replied, “Yes ma’m, but dis here is my evidence so I can get dat control.”

If black women’s desire to limit pregnancies was evident, so were the obstacles. In one instance, several women came back to a dispensing site, cans of foam powder in hand. As Moore recounted it, the women explained that the evangelical minister of their Sanctified Church had disapproved and directed them to return the powder and profess their faith that “de Lord will take care of me and my children.”7 (Fig. 11, Supp. 1.)

In the field projects birth control organizations were running and in the national concern for black health and poverty, Margaret Sanger saw an opportunity for a concerted effort in the South. Although Sanger was far removed from daily operations of the BCFA by this time—she had been sidelined to a position as honorary chair of the board and was living in Arizona—she continued to collaborate with Florence Rose, her longtime personal secretary, who had great enthusiasm for the venture. Rose remained at the BCFA and spearheaded the initiative that became known as the Negro Project.

In spelling out the rationale for a project that focused solely on African Americans, Rose and Sanger navigated a dense maze of political realities, bureaucratic constraints, demographic concerns, pseudo-scientific claims, cultural and religious beliefs, and racial and sexual attitudes. By and large, in the midst of economic crisis and world war, the appeal was to public health and general welfare, and these were malleable concepts.8 (Fig. 12, Supp. 2.)

Some advocates were advancing eugenic arguments for birth control to prevent overpopulation by an underclass. Sanger accepted some eugenic beliefs; in keeping with prevailing views, notably the 1927 Buck v. Bell ruling of the U.S. Supreme Court, which endorsed the sterilization of institutionalized individuals considered to be genetically flawed, she favored restricting reproduction by those with hereditary deficits. At the same time she criticized as “cradle competition” any practices intended to control population by race, class, or religion, whether by pressuring women in some groups to bear fewer children or by persuading others to bear more (Sanger 1922).

In the case of the Negro Project, Sanger gave an occasional nod to women’s rights. She frequently cited the high rate of abortion as a measure of African American women’s desire to avoid pregnancy and the risks they incurred to do so. Commenting on newspaper coverage of the project, she remarked that headlines were more than news; they were “lifelines to the mothers we are dedicated to free.”9

Sanger and Rose saw promise in birth control as a community strategy of African American survival and progress. In their proposal for funding from the philanthropist Albert Lasker, they touted the project as “a unique experiment in the field of race-building, as well as in the field of humanitarian service for a race that has been subjected to discrimination, hardship and segregation.” They made the case this way:

Birth Control, per se, cannot correct the economic conditions that result in bad housing, overcrowding, poor hygiene, malnutrition, and neglected sanitation in which Negroes are forced to live through special social and economic pressure. But Birth Control can reduce the attendant loss of life, health, and happiness that spring from these conditions in the form of excessive infant and maternal mortality among negro mothers, high morbidity rates, tuberculosis, syphilis, mental disease, epilepsy, rheumatism, heart disease, illiteracy, child-labor, ignorance and despair.10

Lasker agreed to fund the project, explaining to Sanger, “I do not see how we can have the secure democracy for which our men are fighting and dying until we find a place of security and dignity for the Negro in our national life. If one minority is degraded, we are all affected, for we all belong to some minority.”11 (Fig. 13.)

In addition to spelling out different motivations and objectives, proponents debated competing strategies for implementing the work. Sanger was mindful of lessons from the Harlem Clinic, including critiques from the advisory board about distrust among blacks. She argued strenuously for a full year of “education agitation” before clinical services would be introduced. She insisted that African Americans were best suited to do that groundwork, which would involve dispelling fears of genocidal intent and misconceptions that confused birth control with abortion. As she saw it, African American spokespersons stood the best chance of getting a hearing at the grassroots and convincing local leaders, especially ministers, to accept the benefits of contraception, or at least cease denouncing it.12 Ministers were community gatekeepers, and their backing had proved essential to popular participation in earlier health campaigns for immunization and screening. (Fig. 14, Supp. 3.)

Sanger also considered it a plus that ministers were men. After a quarter century on the front lines of the movement, she was keenly aware of male medical practitioners’ bias against women, whether health professionals or organizers. She also knew that while men opposed granting women the autonomy to prevent pregnancy, they themselves were averse to using condoms. Rather than attempt to change men’s minds about condoms—and thereby cede men the balance of power in sexual relations—Sanger preferred a contraceptive method that enhanced women’s say. A husband might be more accepting of his wife’s use of birth control, she mused, and a father might even educate his son to the practice, if the messenger was not only a minister but a male.13 (Fig. 15, Supp. 4.)

(Fig. 16, Supp. 5.)

Sanger and Rose did not succeed in winning the leaders of the new Birth Control Federation of America to their educational approach. The leaders favored a medical approach that would incorporate contraceptive services for blacks directly into existing white-run health programs. Southern officials and medical practitioners agreed, as did Lasker, who pledged $20,000 to the project. With funding secured and plans outlined, the BCFA created a Division of Negro Service to oversee the setup and operation of demonstration clinics in rural South Carolina and urban Nashville, Tennessee. The clinics ran from 1940 to 1942. (Fig. 17.)

Even as the clinics began operations, Sanger and Rose remained convinced that “the medical way” was wrongheaded, and they went ahead with their preferred community-oriented educational approach. With Sanger’s support and ample fervor of her own, Rose solicited endorsements from major black organizations and medical groups. She also mounted a nationwide outreach campaign to put informational material in the hands of public health nurses, social workers, home demonstration agents, teachers, welfare workers, and others who might influence public opinion or come in direct contact with women who lacked access to birth control. (Fig. 18, Supp. 6.)

(Fig. 19, Supp. 7.)

In 1942, as the Negro Project was coming to an end, the Birth Control Federation of America took a new name, Planned Parenthood Federation of America (PPFA). Planned Parenthood issued Better Health for 13,000,000 as a final report on the initiative. (Fig. 20, Supp. 8.)

In the end, the Negro Project had less impact than published accounts might suggest. It proved to be neither the genocidal plot that wary observers feared nor the breakthrough for women’s autonomy and racial progress that optimistic promoters envisioned. At the demonstration clinics, the number of women seeking services fell far short of what planners had hoped, and the sites yielded no lasting model for serving poor women. Within the BCFA, Sanger and Rose failed to drum up enthusiasm for the work. They raised the start-up funds themselves, and no other donor stepped forward to match Lasker’s investment and encourage Planned Parenthood to continue the project. (Fig. 21.)

Rose and Sanger’s educational campaign may have had the greater effect. Not only did the community organizing effort spread factual information and positive arguments about birth control, but it engaged black women leaders who had the personal determination, social connections, and political vision to sustain the drive for women’s sexual and reproductive rights over the long term.

Leading Voices

In 1941 the National Council of Negro Women (NCNW) passed a resolution endorsing birth control. With this action, black women stepped to the forefront of the movement. Most major white women’s groups, such as the League of Women Voters, the U.S. Children’s Bureau, and the National Woman’s Party, still avoided the controversial issue of contraception. The Young Women’s Christian Association (YWCA) had taken a stand for legalization but conditioned its support on distribution by medical professionals.14

The National Council of Negro Women took a different approach. The NCNW was a coalition of black women’s clubs with expansive plans of action for improved education, housing, child care, employment, and health. In the 1940s the NCNW claimed to represent a million women. Its position on birth control was typical of black women reformers’ record of underscoring the prevalence of rape and integrating sexual and reproductive self-determination into agendas for racial and economic progress (Collier-Thomas 1993, 861; Gordon 1991).15 (Fig. 22.)

The civil rights leader and educator Mary McLeod Bethune was president of the NCNW and a nationally influential spokeswoman. As a member of President Franklin Roosevelt’s “Black Cabinet,” she was the highest-ranking black woman in the federal government. From her position as head of the Office of Minority Affairs of the National Youth Administration, Bethune protested sex and race discrimination in New Deal health and welfare policies and lobbied for black women’s role in setting the national agenda. Florence Rose recognized Bethune as “THE top Negro woman leader in America today.”16 (Fig. 23.)

Bethune became a staunch and valued ally of the Division of Negro Service. She publicly defended birth control against intense opposition from the Catholic Church. Within the black community, her outspoken support lent birth control respectability at a time when many preachers associated it with immorality and some political leaders equated it with genocide or “race suicide.”

The NCNW resolution in favor of birth control inserted black women’s voices into debates around the scientific merits and political implications of eugenics in controlling the size and composition of the population. Eugenics enjoyed wide acceptance in the interwar years. With the blessing of the Supreme Court’s Buck v. Bell decision, state governments were authorizing the involuntary sterilization of vulnerable individuals they defined as “unfit,” and during the economic crisis of the 1930s public officials expanded that category to include women who were poor or considered to be “feebleminded” or sexually promiscuous. Coupled with presumptions of white superiority, these policies sometimes targeted black women and intensified fears of race suicide.

Black women’s argument for birth control combined criticism of eugenics and coerced sterilization with assertion of women’s rights and racial equality. The 1941 resolution stood out for its emphasis on the right to bear as well as not to bear children, and for its focus on the socioeconomic conditions that influenced the ability to rear healthy families. Club women affirmed contraception as an empowering alternative to the threat of involuntary sterilization and the danger of illegal and self-induced abortion as a means of regulating fertility. (Fig. 24.)

Following passage of the resolution, the NCNW formed a Family Planning Committee, with Dr. Dorothy Ferebee as chair. Ferebee was among many doctors and nurses in the club movement who championed birth control. Because discrimination barred female physicians from practicing in many hospitals and because their patients often could not afford hospital care, black female doctors attended deliveries in women’s homes. Face to face with the toll frequent pregnancies took on women’s health and family life, they understood women’s struggles to control their own sexuality, regulate their fertility, and bear healthy infants as a community challenge rooted in socioeconomic inequities.

The three health providers featured here—E. Mae McCarroll, M.D., Mabel Keaton Staupers, R.N., and Dorothy Boulding Ferebee, M.D.—incorporated contraception into agendas for racial advancement. They combined professional commitment to public health with leadership in the black women’s club movement and active collaboration with Sanger and Rose and the campaign for birth control.

McCarroll, Staupers, and Ferebee all rallied to the Negro Project. They sat on the National Advisory Council of the Division of Negro Service. With other female medical providers around the country, they formed a speakers’ bureau to distribute literature, screen films, and offer medical instruction. They encouraged the memberships of African American women’s groups and other civic, religious, educational, and professional organizations—from the National Association for the Advancement of Colored People and the Elks to the African Methodist Episcopal Church and the Brotherhood of Sleeping Car Porters—to accept the Division of Negro Service as an ally. As leaders in the NCNW, they carried the backing of this large and significant constituency as they pressed others to accept birth control as a tool of race progress. (Fig. 25, Supp. 9.)

E. Mae McCarroll, M.D.

McCarroll was a clinician with the Department of Health in Newark, New Jersey. In the 1930s, she lectured audiences of women throughout the city on the subject of sexually transmitted diseases and led statewide efforts to combat them. She later earned an M.S. in public health and became the first black physician permitted to practice in the Newark City Hospital. McCarroll chaired the Health Committee of the New Jersey Federation of Colored Women’s Clubs and traveled the country on behalf of the Division of Negro Service. She spoke to many audiences, including the National Negro Business League, the National Housewives League, the Urban League, and the Purple Cross Nurses. (Fig. 26.)

In a 1942 address to the National Medical Association, the professional organization of black doctors, she touted birth control as a “great reform” and urged physicians to join “a national program of education and organization among our own people who have not yet been reached to any large extent by the benefits of Planned Parenthood.” Because it was a woman’s right to decide the number of children she would bear, McCarroll argued, it was therefore the responsibility of private physicians and public health agencies to become knowledgeable about contraceptive techniques and to make family planning information and methods available to all.17 Following her speech, the National Medical Association endorsed the work of the Division of Negro Service. Speaking to Harlem nurses on another occasion, McCarroll presented medical and social arguments for birth control. Appealing to the nurses as women, health providers, and race leaders, she urged them to disseminate contraceptive information to their patients. (Fig. 27,

Supp. 10.)

Mabel Keaton Staupers, R.N.

Staupers devoted her career to challenging race discrimination in medical training and treatment. In the 1920s she helped establish the Booker T. Washington Sanitarium, the first inpatient center in Harlem for black patients with tuberculosis. In the 1930s, as executive secretary of the National Association of Colored Graduate Nurses, she began a long and ultimately successful battle for the integration of black nurses into the American Nursing Association. She was a cofounder of the National Council of Negro Women and cochaired its Health Committee.

Staupers attended the initial meeting of the Advisory Board of the Harlem Clinic in 1931 and remained committed to its mission. She implored black nurses to accept their special responsibility to educate patients about contraception, not only because nurses had “intimate knowledge . . . of all the problems arising from ignorance of child spacing and family planning,” but also because black women would be more likely to accept birth control if it was presented “through people in whom they already have confidence.”18 (Fig. 28.)

Staupers played a leadership role in National Negro Health Week, an annual campaign of education, screenings, and services, which began at Tuskegee Institute in 1915. By the time the U.S. Public Health Service took over the program in 1932, nearly every black community in the country, rural and urban, hosted events. In 1935, some 2,200 localities organized National Negro Health Week activities. A decade later the number of sites had grown to 12,500, with millions of people participating. As one of only two women to serve on the National Negro Health Week executive committee from 1935 to 1945, Staupers undoubtedly had something to do with the fact that Planned Parenthood materials became available at the popular spring gatherings. (Fig. 29.)

In a letter to Staupers, L. Eudora Ashburne, a Chicago physician, attested to the significance of National Negro Health Week as a forum for publicizing birth control. Ashburne also noted that African American women had been organizing for birth control for some time through their own networks, independent of clinics and of Planned Parenthood. They were incorporating Division of Negro Service materials into existing campaigns.

Dorothy Boulding Ferebee, M.D.

Ferebee began teaching obstetrics at Howard University Medical School in the 1920s and was deeply involved in local and national maternal and child welfare programs. When the National Council of Negro Women endorsed birth control in 1941, Ferebee became chair of the Family Planning Committee the NCNW created to take action. (Fig. 30.)

Ferebee was also the medical director of Alpha Kappa Alpha, a sorority of black college women. Each summer from 1935 to 1941 she led teams of AKA volunteers to the Mississippi Delta, where they set up mobile clinics in cotton fields, churches, and schools to deliver basic health care to tenant farmers and sharecroppers, who may not have been examined by a doctor or nurse before. Ferebee described the project as an effort “to enlarge the range of opportunities for the masses by extending the benefit of health to those who struggle against disease and poverty and exploitation.”19 Over the several summers the volunteers provided physical examinations, medical treatments, and dietary instruction to more than 15,000 people. A majority of patients were children, many suffering from malnutrition. (Fig. 31.)

Ferebee assured Rose at the Division of Negro Service that she would attempt to introduce birth control to “plantation mothers” through the Mississippi clinics.20 Doing so meant risking the hostility of plantation owners, who were ambivalent at best toward efforts to improve workers’ lot and who had a vested interest in ensuring that black women continued to reproduce an adequate and dependent labor force. Allegations swirled around the AKA women, charging that they were communist agitators whose real motive was inciting tenant farmers to protest. Planters posted “riders” armed with guns and whips to patrol the clinics on horseback and listen in on conversations between health workers and sharecroppers (Smith 1995, chap. 6). (Fig. 32.)

In their annual reports, AKA women detailed the horrendous living conditions sharecroppers endured. They indicted the plantation economy as a “most vicious system” and noted that the power to control women’s reproductive capacity was an integral part of it. For instance, they observed that when owners inventoried their assets, they counted only those children in tenant families who were old enough to work in the fields.21 (Fig. 33, Supp. 11.)

Summing up the AKA Mississippi experience in 1941, Ferebee wrote, “The health project . . . has graphically demonstrated the interrelation of every social and economic activity as a part of a whole. Our observations and studies in the field have reinforced our conviction that the problem of health is one of many facets which link it to the entire social order; for disease is both the cause and result of many miserable social and economic conditions.”

She called the nation to account for condoning such gross injustice. Noting that the United States entered World War II under the banner of antiracism and democracy abroad, she called for an end to “discrimination against workers and citizens because of class, color, creed, or sex” at home. Speaking for the AKA sorority, Ferebee concluded, “A nation-sweeping, all-out effort is imperative . . . [in order to] remove the inconsistencies between democratic theory and existing practice—to make democracy a reality in our Nation.”22 (Fig. 34, Supp. 12.)

Like Bethune, McCarroll, and Staupers, Ferebee understood contraception as one of many determinants of reproductive self-determination, reproductive self-determination as one component of public health, and public health as one measure of genuine democracy. Oriented toward universal needs, these black women had their differences with white birth control advocates, who were less likely to embrace the kind of broad perspective that wove economic, racial, cultural, and gender factors into a structural analysis of the workings of the nation-state.

While Bethune, McCarroll, Staupers, and Ferebee worked closely with the Division of Negro Service, they were also critical of it, occasionally publicly. In a widely reported speech to the annual meeting of the Planned Parenthood Federation of America in 1942, Ferebee delivered a mild reproach. After stressing the urgency of making contraception accessible to African Americans, she remarked that white leaders were undermining the effort by failing to accept black allies as equals.23 In less scripted moments, these women were more blunt about racism in the movement. Staupers bristled at the paternalism of whites who assumed control over work intended to benefit blacks. She told Sanger pointedly, “[It’s time] you and your associates discontinue the practice of looking on us as children to be cared for and not to help decide how the caring should be done.”24

The AKA “cotton-field clinics” received considerable press and attracted the attention of First Lady Eleanor Roosevelt, who had recently acknowledged her support for birth control. With national policymakers in the early 1940s seriously contemplating proposals to guarantee health care for all Americans, Ferebee, Bethune, and other black club women lobbied Roosevelt to use her influence and encourage the federal government to look to the Mississippi project as a model for a comprehensive national health program (Smith 1995, 164–65).

In the Hands of Midwives

Plans for a national health program failed to materialize, and campaigns to extend care to underserved populations remained episodic operations. National Negro Health Week was just that: one week of activities per year. The Alpha Kappa Alpha teams operated field clinics for a few weeks over seven summers, but they discontinued with U.S. entry into World War II. The Division of Negro Service demonstration clinics distributed birth control to a relatively small number of women over two years, but the experiment did not give rise to permanent services. Projects such as these exposed the extent of need, provided a measure of treatment, and tested the efficacy of new contraceptive methods and the feasibility of various delivery systems, but they were short-lived. At the end of the day, community women looked to each other, especially to the midwives among them, for reliable information and continuity of care. (Fig. 35.)

Through most of the twentieth century, black lay midwives were the mainstays of reproductive health care in African American communities, especially among the poor. In the rural South in the 1930s, they attended 80 percent of black births and 20 percent of white births. With black physicians few and far between, at least three thousand midwives, most of them black, practiced in Alabama. More than four thousand served in North Carolina. In the Mississippi county where AKA women ran field clinics, two African American physicians practiced among 130 midwives. Even when white doctors were willing to take care of blacks, which most were not, black women usually preferred to be in the hands of midwives.

Black midwives were in and of the community. They often recruited their own daughters or granddaughters as assistants and successors, and the novices learned by observing their elders. Physicians and poor mothers, white and black, all relied on midwives, and employers accommodated midwives’ comings and goings as they bowed out of fields, kitchens, and classrooms, sometimes for two or three days at a time, to see women through labor, delivery, and recovery. Births were social events, with family and friends gathering around to offer support. Neighbors commonly referred to midwives with admiration and affection as “the ones who got us here.” Knowing they would often go unpaid, many midwives undertook the work as a religious calling, and they routinely summoned divine assistance during deliveries. As conduits of spiritual strength, sources of medical knowledge, and sustainers of community, midwives took on status as respected leaders, alongside ministers and teachers. As one midwife’s daughter observed, midwives were considered “sainted women.”25 (Fig. 36.)

Midwives were vital contacts for outside health providers attempting to introduce birth control and other information to black communities. Home demonstration agents from the U.S. Extension Service relied on midwives, and Dorothy Ferebee found their involvement essential to sharecroppers’ participation in the AKA field clinics. Public health nurses also depended on midwives. When poor African American women either could not or would not go to the demonstration clinics, the Division of Negro Service hired a few black public health nurses who extended the reach of the program through thousands of home visits. (Fig. 37.)

Black public health nurses were few in number and often covered a wide territory—six served the entire state of Mississippi. During community visits, the nurses assembled midwives clubs and mothers groups for instruction on everything from sex education to the benefits of installing window screens. Local midwives and mothers then spread the new knowledge, took care of each other, did the groundwork for National Negro Health Week events, and organized around local health issues.

These local women’s networks negotiated the maze of sexual and reproductive pressures surrounding them. They shielded each others’ daughters from the advances of white men and boys who presumed entitlement to the bodies of black women. They spirited away brothers and sons who found themselves in danger of mob violence for allegedly having shown interest in white females. They sustained webs of extended kin who had migrated elsewhere and who might take in a pregnant friend and help her find a safe, though illegal, abortion. With midwives at the center, these networks mediated the interactions between poor women and expanding state-run public health and welfare systems (Valk and Brown 2010; Rogers 2006, chap. 1).

Given the prevalence and central role of midwives, African American advisors encouraged white leaders of the birth control movement to engage midwives in the campaign. As highly educated professionals, the advisors themselves were not without bias toward the poor. It was Du Bois, in his 1932 essay, who referred to “the mass of ignorant Negroes [who] breed carelessly” as representing “that part of the population least intelligent and fit.” The prominent club leader Mary Church Terrell bemoaned “irresponsible breeding” among blacks. Nonetheless these advisors advocated a public health approach that tapped the broad base of community resources, including midwives, rather than a private fee-for-service model of medical care built around individual doctor-patient relationships.26 (Fig. 38.)

Yet midwives were conspicuously absent from the circle of community groups the Division of Negro Service looked to as allies and supporters. Midwives themselves maintained an uneasy relationship with white birth control proponents and were wary of health plans that presented economic competition. For their part, white leaders tended to bypass midwives in favor of black professionals such as social workers, teachers, and nurses. The marginalization reflected mounting disregard for lay midwives. The name “granny” midwife may have been a term of endearment within the black community, but it was becoming an expression of derision from others. Although midwives boasted impressive records of safe deliveries, medical professionals and middle-class health reformers tended to disparage them as dirty and ignorant, part of the problem rather than part of the solution. Some went so far as to blame midwives for high maternal and infant mortality rates in the black community.

As states expanded public health systems, they clamped down on midwives. Boards of health began issuing licenses that required midwives to participate in educational programs, observe certain standards of dress, ensure that clients were screened by a physician, refrain from conducting internal exams or dispensing medicines, and comply with strict reporting procedures. In 1941, the Tuskegee School of Nurse-Midwifery opened for the purpose of training professional nurses who would replace lay midwives.

Lay midwives practiced for decades thereafter, but they did so under increasing scrutiny. Because only physicians could dispense birth control legally and because abortion was a crime, midwives who shared traditional contraceptive substances or assisted women with abortions put their licenses and livelihoods in jeopardy. Most professed to toe the line themselves but claimed to know others who did not.

According to an annual report from Division of Negro Service clinics in Nashville, patients reported an average of four prior pregnancies and one abortion. On the frequency of abortion, clinic staff noted, “Many patients cannot remember how many they have had.”27 Staff estimated that the actual total was four times the number given. Assuming the conjecture had some validity, it could be that abortion was common enough that women did not keep count. Maybe the distinction between abortion and miscarriage was so poorly defined that women did not fully understand the question. Or perhaps the mothers feigned poor memory in order to protect themselves and the midwives who cared for them from legal consequences.

Over time states ceased issuing licenses to lay midwives, forcing them to practice outside the law, if at all. By midcentury the number of lay midwives began a steady, steep decline. In Mississippi, where more than four thousand black and a few hundred white midwives practiced in the 1920s, only six hundred were licensed forty years later (Smith 1995, 124, 147–48). In the absence of public health systems, African Americans felt they could trust or private medical services they could afford, the marginalization of midwives left the majority of black women to fend for themselves in the search for safe, reliable, legal birth control and reproductive care.

A Strange Democracy

At midcentury reports on African American women’s reproductive health were mixed. Overall, black women’s fertility rates had dropped significantly between the late nineteenth century and World War II. To some degree the decline was a measure of success in pursuing birth control. Yet aggregate numbers glossed over deep inequities: More than a third of blacks had no access at all to health care or birth control. Similarly, although black rates of maternal and infant mortality improved over these decades, black mothers and newborns were still dying with much greater frequency than whites.

Future progress was far from certain. In plantation regions, white physicians not only continued to deny black women birth control; some routinely recommended regular sexual activity for girls as young as twelve and thirteen (Orleck 2005, 30). In the states, health officials were implementing drastic reductions in the ranks of midwives while channeling public funds into new but segregated and unequal services. (Fig. 39.)

At the federal level, policymakers in the 1940s opted against a comprehensive national health program, and they proved unwilling to pit national authority against states’ rights for the sake of racial equality. Still, with the New Deal and wartime desegregation of defense industries and the military, the government had assumed some responsibility for the general welfare, and civil rights activists were upping the pressure for federal action toward integration.

Integration proved to be a problematic path. The U.S. Public Health Service took the position that racially specific programs were out of step with the times. The Service closed its Office of Negro Health and discontinued National Negro Health Week. When the formerly all-white American Nurses Association accepted blacks as members, Mabel Staupers achieved her long-sought goal, and the National Association of Colored Graduate Nurses, which she led, disbanded in 1951. However, when racism persisted, African Americans eventually reestablished their own organization, the National Black Nurses’ Association.

African Americans fared little better with the Planned Parenthood Federation of America, where professional male leaders held sway over lay women activists. The PPFA also granted state affiliates freedom to set their own priorities, and most affiliates neglected race work. Florence Rose was furious with the leadership for its indifference toward the Division of Negro Service. Before she resigned in 1943, Rose raised a small sum to extend the Negro Project, and the PPFA did hire a series of field consultants to continue organizing among blacks. But in report after report, consultants vented exasperation. As Marie Schanks, an African American field worker, complained, not only did the PPFA assign race work to blacks who were paid less and were expected to achieve more than their white coworkers; it also pressed black staff to tutor white colleagues in race relations.28

The wellspring of organizing for birth control and reproductive health lay in the needs and desires of women going about their daily lives. Elsa Mapp, a Boston area woman, read about Marie Schanks in the Pittsburgh Courier and sought her out on behalf of an organization of young black mothers in her neighborhood. Two weeks later Schanks met with the mothers at their local YWCA. She offered contraceptive information and briefed them on the uphill struggle to change state law and legalize birth control in Massachusetts.29 (Fig. 40.)

Mapp was among untold numbers of community-based women around the country who were persisting against the odds in the search for birth control and reproductive services for themselves and their daughters. Through grassroots efforts such as these, black women remained prime movers in sustaining health advocacy, and health advocacy, in turn, was seeding the broader civil rights struggle.

In the political climate of the Cold War, opponents of racial justice were quick to link health advocacy with civil rights activism and to denounce both as subversive. The powerful American Medical Association fueled the alarm by labeling proposals for a national health care system as “socialized medicine.”

The kind of suspicions Dorothy Ferebee aroused in Mississippi in the late 1930s and early 1940s—that AKA sorority women were outside agitators sowing discontent among impoverished black farm workers—grew into a national crusade against communism. Anticommunists fingered organizers like Ferebee who openly criticized health disparities as evidence of systemic race, class, and gender inequities that belied the nation’s claim to democracy. Health advocates lost jobs and more. In Congress in 1943 the House Committee on Un-American Activities branded Mary McLeod Bethune a communist, effectively indicting the entire black club movement and its comprehensive agenda. White-led women’s groups like the YWCA also came under suspicion for undertaking interracial work, favoring labor rights, promoting women’s equality, and taking progressive positions on international issues.30 (Fig. 41.)

Racist sexual anxieties reverberated through the repression of dissent and reform. As the federal government moved toward outlawing segregation, white supremacists reacted with massive resistance that relied on familiar patterns of sexual intimidation and reproductive coercion. When the Supreme Court issued its 1954 Brown v. Board of Education decision, declaring the Jim Crow system unconstitutional and mandating school desegregation, defenders of the status quo struck a raw nerve with dire warnings that integrated classrooms would effectively license interracial sex by giving predatory black boys access to innocent white girls. The resulting “mongrelization,” they claimed, would usher in social chaos and undermine the viability of the United States as they knew it. (Fig. 42, Supp. 13.)

(Fig. 43, Supp. 14.)

In 1955 the brutal lynching of Emmett Till, a fourteen-year-old African American boy, for allegedly whistling at a white woman in Mississippi, followed by the highly publicized trial and acquittal of his accused murderers, put a generation of young blacks on notice that they presumed equality at their peril. When Till’s mother insisted on an open casket, declaring that she wanted the world to see the cruelty racism inflicted, the photo of her son’s mutilated corpse confronted a worldwide audience with a gruesome image of the anguish that attended black motherhood.

Popular culture at the time elevated white middle-class motherhood to a domestic ideal, pointing up the centrality of reproduction to the perpetuation of white supremacy. In its 1956 special issue, “The American Woman,” Life magazine featured a thirty-two-year-old mother of four. The “baby boom” she embodied reflected the nation’s reliance on affluent consumer households to ease the transition from defense to peacetime production and prevent the economy from relapsing into depression. She had dropped out of high school to marry at the age of sixteen and considered being a housewife her career, which included hosting frequent parties and serving as a community volunteer—all with the aid of a full-time maid.

Behind this celebration of private life was not only a domestic servant but a host of incentives and disincentives steering a generation of white women toward marriage and motherhood. For the housewife who embodied the ideal, alternatives were foreclosed by educational and occupational discrimination; by the illegality of contraception, abortion, and biracial marriage; and by psychological warnings against lesbianism and careers as symptoms of mental illness.

While pronatalist pressures expanded the white middle class, other policies cordoned off that family model to African Americans. Race discrimination denied most black men jobs that would support a dependent wife and children and consigned a large percentage of black women to either agricultural work or domestic service, where they cared for white women’s children. Often heads of household themselves, black mothers negotiated welfare policies that stigmatized them as sexually promiscuous and their children as unworthy of support. Welfare agents were known to grant poor white mothers public assistance on the grounds that their children needed them at home, but to reject black mothers’ claims for child support, reasoning that these women’s labor was needed in the fields. Many agents wielded their power over the public purse to police poor women’s behavior, withholding payments as a means of punishing challenges to segregation and enforcing compliance with its gendered regulations, such as the “man-in-the-house rule” that denied a mother benefits if she was in a sexual relationship with a man. Legislators in some southern states drafted laws to imprison or sterilize mothers on public assistance who gave birth to additional children, and in some places black mothers were more likely than whites to be subjected to sterilization as a condition of benefits (Solinger 2005, 131–49; Beardsley 1987, 296; Schoen).

Although anticommunism had chilling effects on progressive movements, black women continued to mobilize in ways large and small in the 1940s and 1950s. Hundreds of thousands fled the plantation region, migrating to safer settings where they formed supportive communities for themselves (Orleck 2005). Others kept up the fight through the National Council of Negro Women and interracial organizations such as the Congress of American Women or the YWCA. Dorothy Ferebee, in addition to holding leadership positions in both the NCNW and the YWCA, carried her concerns with her as she led the AKA into the newly formed American Council on Human Rights, a coalition of black sororities and fraternities committed to a multi-issue reform agenda. (Fig. 44.)

For their part, radical black women took direct aim at the differential treatment of black and white mothers. Through their art, activism, and analysis, the playwright Lorraine Hansberry, the journalist Claudia Jones, the poet and actress Beulah Richardson (aka Beah Richards), and others involved in black left groups such as the Civil Rights Congress and Freedom newspaper, protested the caricature of “mammy” as a loyal and long-suffering servant content with caring for white women’s children while being unavailable to her own. The stereotype wished away tensions inherent in the inequities that bound black and white women together in the close quarters of households where servants were “like family” but emphatically not family at all. (Fig. 45.)

Domestic workers poured those tensions into the streets of Montgomery, Alabama, in 1955. Thousands of domestic servants walked to work every day for a year rather than ride city buses. A demonstration against racial and economic discrimination, the bus boycott was also a mass protest against the sexual indignities they confronted on public streets and buses and in private homes. Rosa Parks, who is often credited with sparking the boycott and portrayed as acting alone and spontaneously when she refused to give up her seat on the bus, was actually a seasoned organizer around sexual assault cases, and evidence suggests she may have had her own brush with harassment as a domestic worker (Garrow 1987; McGuire 2017).

As this collective resistance illustrated, each household in which a black woman labored to prop up a white woman’s status was a microcosm of a gender system that propped up race and class power. In her 1949 essay, “An End to the Neglect of the Problems of the Negro Woman,” Communist Party leader Claudia Jones maintained that white men “have historically hidden behind the skirts of white women” by claiming they lynched black men as an act of chivalry, to protect the sexual purity and reproductive integrity of their wives and daughters. To the extent that white women embraced the homemaker role uncritically, Jones argued, they became standard-bearers of white supremacy, reinforcing the lies that underpinned it and excusing the violence white men committed in their name, including the “super exploitation” of black females as women, African Americans, and workers (Jones 1949; Weigand 2001, chap. 5). (Fig. 46.)

Radical black women dissected the trope of white womanhood as a protection racket. What white women protected by providing cover to their fathers, husbands, and sons was a social order held together in a web of male dominance, white supremacy, and capitalist rule. In the bargain, white women traded away their own economic independence and sexual freedom, including the option of consensual relations with non-white men. Therefore white women too had a stake in unraveling the web and promoting social justice.

The U.S. government deported Jones for her ideas. Nonetheless the importance of black women’s control of their bodies was gradually taking hold within black movement culture, which had previously emphasized violence against men. Around the country local leaders formed committees not only to rally around black men falsely accused of raping white women but also to support black female victims of sexual assault who mustered the courage to file charges against white assailants. Black press coverage of individual incidents grew into a compelling body of evidence, and national civil rights organizations began categorizing these as “sex crimes” (McGuire 2010).

The case of Rosa Lee Ingram came to symbolize the plight of black mothers entangled in the web of sexism, poverty, and racism. A sharecropper and recently widowed mother of fourteen children, Ingram and two sons were sentenced to execution in the 1947 death of a white male neighbor with whom they had run-ins and who, Ingram said, sexually harassed her repeatedly. In a decade-long national campaign to free the three, activists stressed Ingram’s family role, sending thousands of appeals to President Truman on Mother’s Day. (Fig. 47.)

They also championed her right to self-defense. In Beulah Richardson’s poem “The Revolt of Rosa Lee Ingram,” Ingram voiced the bold, disruptive claim that drove black women’s activism: “My body belongs to me.” Radicals elaborated that claim into a critique of the nation itself: it was at best “a strange democracy” that could abide unchecked killings of black men on trumped-up charges of threatening white women and families while turning a blind eye to white men’s actual violation of black women, yet condemn a black woman to death for defending her dignity and her children.

Radicals laid those hypocrisies on the nation’s doorstep. Inspired by another of Richardson’s poems, “A Black Woman Speaks . . . of White Womanhood, of White Supremacy, of Peace,” they mobilized as Sojourners for Truth and Justice. Summoning women to “dry your tears and speak your mind” and “demand the death of Jim Crow,” Sojourners staged a 1951 protest at the U.S. Justice Department. Citing the Ingrams and a spate of recent lynchings, they presented their personal testimonies as wives, mothers, and victims as proof of the government’s complicity in “legal lynching” and other forms of racial hatred. (Fig. 48, Supp. 15.)

African American women took their grievances into the international arena. Just as world tensions were shifting from Europe to Asia, Africa, and Latin America, making cold war politics increasingly racialized, black women pushed sexual and reproductive oppression to the center of the struggle against white supremacy. Further, they likened the struggle in the United States to anticolonial movements of peoples in the Global South who were claiming independence after centuries of subordination to white European imperial powers. Invoking criteria newly established by the United Nations, they charged the U.S. government with “domestic genocide” for condoning habitual assaults against African Americans. By soliciting international support for the Ingrams and others, African American women invited the community of nations to hold this “strange democracy” to the standards of the 1948 Universal Declaration of Human Rights.31 The pressure they generated contributed to the eventual release of the Ingrams on parole in 1959.

Whose Great Society?

Over the early decades of the twentieth century, black women set the contours of a distinctive reproductive politics that encompassed the rights not to bear children, to bear children, and to rear children in safe, healthy conditions, as well as the right to sexual activity without sacrificing personal dignity or children’s needs. At a minimum, realizing those goals required freedom from racist stereotypes, sexual assault, and coerced sterilization, along with access to contraception and abortion, medical care, and economic security.

This agenda called for nothing less than social justice and begged questions that went to the heart of the United States as a nation-state. Was the United States a young nation evolving in fits and starts toward a more perfect union? Were the country’s institutions capable of reform sufficient to ensure actual liberty and equality for all, given political will and time enough? Or was the infrastructure so compromised by founding assumptions of race and sex hierarchy and the primacy of property—notions ingrained through centuries of ideology and practice—that only transformation to a new form of governance would suffice? Was the vision of justice a dream deferred or a delusion? (Fig. 49.)

By 1960, with formation of the Student Nonviolent Coordinating Committee, a new generation of black leaders was emerging to take up these questions (Holsaert et al. 2010). The terrain of reproductive politics was shifting rapidly. The birth control pill was about to go on the market, the Supreme Court was on the verge of decriminalizing contraception and declaring antimiscegenation laws unconstitutional, and movements for lesbian and gay rights and legal abortion were gaining strength. Passage of the Civil Rights Act and the Voting Rights Act signaled changes in the race and gender balance of economic and political power, and contraception figured prominently in these realignments, which coincided with the federal government’s launch of a reform agenda of “Great Society” programs. One initiative was a “war on poverty,” which turned policymakers’ attention to the fertility of poor women and made family planning a national priority. (Fig. 50.)

In this high-stakes moment, young black women built on the lessons of their mothers and grandmothers as they organized to place their own experiences of sexuality and reproduction on the agendas of expanding black freedom and women’s liberation movements. At times the older women stood by young activists on the front lines. Dorothy Ferebee, Dorothy Height, and others traveled to conflict sites in the South to bear witness and ensure that protesters detained for civil rights activism were not sexually molested by jail attendants or other hostile officials, as often happened. They also issued warnings born of long experience. They advocated that legalized birth control and abortion be available to black and white women on equal terms. At the same time, they cautioned that birth control and abortion, combined with sterilization, could be abused for purposes of population control if the government, in its attempt to reduce poverty, directed its force and funds toward reducing childbearing among poor women, thus limiting the growth and influence of communities of color, rather than toward unraveling the web of racial, economic, and gender pressures that rendered certain women poor.

With ever greater clarity, resolve, and impact in the years ahead, and soon in alliance with other women of color, the young African American activists would continue to refine political analyses and devise organizing strategies that flow from the sure, embodied knowledge that their struggle for sexual and reproductive self-determination must be integral to any movement aspiring to make democracy real.32

Online Supplementary Materials

Supplementary material is available online for many of the documents in this article. When a document contains additional pages, it is noted in its caption.

“Making Democracy Real,” which appears in three formats—print, online with documents, and in full-text HTML (https://sophia.smith.edu/making-democracy-real/), represents the contributions of many talented individuals and innovative spirits. My thanks go to colleagues at the Sophia Smith Collection—Nicole Colero, Maida Goodwin, Amy Hague, Lori Harris, Margie Jessup, Kathleen Banks Nutter, and Sherrill Redmon—for their research assistance and steady support. I am grateful to movement scholars and activists Joyce Berkman, Jasmine Burnett, Cynthia Greenlee, and Loretta Ross for critiquing early drafts, and to Peter Engelman, editor of the Margaret Sanger Papers, for sharing his vast knowledge of archival sources. Without Miriam Neptune’s determination and Joe Bacal’s skills, the digital version that embeds full-length primary documents would not be a reality, and Ginetta E. B. Candelario, Leslie Marie Aguilar, and the editorial team of Meridians have gone the extra mile to ensure that these resources are accessible to current organizers who continue to build on the activism of foremothers recalled here. Finally, I am indebted to Gloria Steinem for the hope and hard work she has invested in our efforts to bridge the worlds of academia and activism, and to the generous funders of the Steinem Initiative who made it possible to undertake this and other experiments in developing women’s history as an organizing tool for movement building today. The errors and shortcomings of the essay are my own.

Notes

1

For overviews of the history of reproductive politics in the United States, see Gordon 2007; Solinger 2005; Ross and Solinger 2017. See also Berkman 2011a.

2

Overviews of the early twentieth-century birth control movement include McCann 1994; Hajo 2010; Engelman 2011. See also Schoen 2005.

3

For overviews of African American women’s organizing for birth control and reproductive rights, see Rodrique 1989; Roberts 1997.

4

Minutes of the Organization Meeting of the Board of Managers of the Harlem Branch of the Birth Control Clinical Research Bureau, May 20, 1931, Margaret Sanger Papers, Sophia Smith Collection, Smith College (hereafter SSC); Muigai 2010.

5

Birth Control Federation of America, Distribution of Birth Control Clinics and Clinical Services, June 1939, Planned Parenthood Federation of America Records I (hereafter PPFA-I), SSC.

6

For an overview of health care among African Americans, see Beardsley 1987.

7

Hazel Moore, “Birth Control for the Negro,” Field Report, 1937, Florence Rose Papers, SSC.

8

For a review of scholarship on Margaret Sanger, see Berkman 2011b. See also Margaret Sanger Papers Project 2001.

9

Margaret Sanger, “To Members and Friends of the Birth Control Federation of America, Inc.,” n.d., Rose Papers.

10

Mary Rinehardt [sic] and Margaret Sanger for Birth Control Federation of America, Inc., “Birth Control and the Negro,” draft proposal, July 1939, 9–10, Rose Papers. The final version of the proposal for the Negro Project is in the Mary [Reinhardt] Lasker Papers, Rare Book and Manuscript Library, Columbia University.

11

Albert D. Lasker to “my dear Margaret [Sanger],” July 14, 1942, Rose Papers.

12

Margaret Sanger to Dr. Clarence J. Gamble, November 26, 1939, Sanger Papers; Margaret Sanger to Robert E. Seibels, M.D., February 12, 1940, Sanger Papers.

13

Margaret Sanger [to Florence Rose] (“I like the Lasker letter”), n.d., Rose Papers.

14

Janet Fowler Nelson, “Convention Action on Birth Control Laws,” Woman’s Press, July–August 1934, 367–68, Records of the YWCA of the USA, SSC.

15

For a history of the black women’s club movement, see Tuuri 2018. On black women’s health activism, see Smith 1995; Gordon 1991.

16

Florence Rose, Summary Report [of] Field Trips, January 22, 1940, Rose Papers.

17

E. Mae McCarroll, M.D., “A Report on the Two-Year Negro Demonstration Health Program of the Planned Parenthood Federation of America, Inc.,” paper presented at the Annual Convention of the National Medical Association, August 17, 1942, Rose Papers.

18

Minutes of the Organization Meeting of the Board of Managers of the Harlem Branch of the Birth Control Clinical Research Bureau, May 20, 1931, Sanger Papers; Mabel K. Staupers, R.N., Birth Control Federation of America form letter, April 5, 1941, Rose Papers; Minutes of National Advisory Council Meeting, Division of Negro Service, Planned Parenthood Federation of America, December 11, 1942, Rose Papers.

19

Dorothy Boulding Ferebee to Mary R. Beard, April 23, 1940, Mary Beard Papers, SSC.

20

Dorothy Boulding Ferebee to Florence Rose, [1940], Rose Papers; “Mississippi Cotton Field Volunteer Clinic,” Summary of Highlights since May 9 meeting of National Advisory Council, December 2, 1940, Rose Papers.

21

Alpha Kappa Alpha Sorority, The 1938 Mississippi Health Project, December 1938, Records of Miscellaneous Organizations, U.S., SSC.

22

Alpha Kappa Alpha Sorority, The 1941 Mississippi Health Project, December 1941, Dorothy Ferebee Papers, Moorland-Spingarn Research Center, Howard University.

23

Dorothy Boulding Ferebee, M.D., “Planned Parenthood as a Public Health Measure for the Negro Race,” paper presented at Annual Meeting of the Birth Control Federation of America, New York City, January 29, 1942, Rose Papers.

24

Mabel Staupers to Margaret Sanger, April 2, 1935, Sanger Papers, Library of Congress, quoted in McCann 1994, 158.

25

On African American midwifery, see Fraser 1998; Smith and Holmes 1996; Smith 1995, chap. 5; Holland 1997, 51. See also Litoff 1978.

26

Minutes of National Advisory Council Meeting, Division of Negro Service, December 11, 1942, Rose Papers; Marie B. Schanks, “Progress and Program on Work with Negroes,” January 1945, Rose Papers; Marie B. Schanks to D. K. Rose, “Summary of Recommendations made by the Planning Committee, 21 Apr 1944: Negro Program,” Rose Papers.

27

Division of Negro Service, “Patients Registered during first 12 months at Bethlehem Center and Fisk Social Center clinic, Summary Report (appendix C),” June 1942, Rose Papers.

28

Marie S[chanks] Key, Summary Report on Work with Minority Groups, 1944–1947, December 19, 1947, Planned Parenthood League of Massachusetts Records, SSC.

29

M. B. Schanks, “Field trip to Boston, Mass, Brockton, Mass, Washington, D.C., February 18–28, 1945,” March 1, 1945, Planned Parenthood League of Massachusetts Records.

30

On accusations against the YWCA, see the widely distributed 1948 pamphlet Joseph Kamp, “Behind the Lace Curtains of the YWCA: A Report on the Extent and Nature of the Infiltration by Communist, Socialist and Other Left-Wing Elements, and the Resultant Red Complexion of Propaganda Disseminated in, by, and through the Young Women’s Christian Association,” Records of the YWCA of the USA. For a history of the YWCA, see Robertson 2007.

31

For the Ingram campaign and Sojourners for Truth and Justice, see Gore 2005, 2015; Martin 1985; McDuffie 2008. For studies of Rosa Parks and other women on the black left from the 1930s to 1970s, see Gore et al. 2009.

32

For introductions to women of color organizing in the late twentieth century for what comes to be known as “reproductive justice,” see Silliman et al., 2016; Ross and Solinger, 2017; Ross et al. 2017.

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