Appellant's Claim: That the Comstock Act (obscenity laws) of 1873 violated both the federal and state Constitutions; therefore Sanger was not guilty of a criminal act when she opened the first birth control clinic.

Significance:This decision allowed doctors to advise their married patients about birth control for health purposes. Sanger later interpreted this ruling as grounds to start legal doctor-staffed birth control clinics in 1923, because the law had a loophole that allowed doctors to talk with their patients about such matters without it being obscene.

Margaret Sanger was born Margaret Louise Higgins in Corning, New York on 14 September 1883, one of 11 surviving children. Believing her mother's 18 pregnancies caused her death at age 50, Sanger founded the American birth control movement—and went to jail at least nine times for her efforts. She lived to see birth control become a legal practice throughout the United States in 1965.

After two years of study at Claverack College and Hudson River Institute, the Higgins' finances were exhausted, so their daughter went to work at the White Plains Hospital in New York. There she completed two years of nurse's training, and in 1902, she married William Sanger in a quick wedding that allowed her to report to her 4:30 A.M. shift the next day.

As a home nurse in New York City, Sanger ministered to maternity patients in the slums of the lower east side. However, when a truck driver's wife died painfully from a self-induced abortion, Sanger left nursing forever, turning to birth control education.

During 1910 and 1911, Sanger gave a series of lectures to Socialist Party women on female sexuality. Her popularity resulted in an invitation to become a columnist for the party paper, The Call. In one column she explicitly condemned customs that forced women to rely on men for support. In another, she warned about the dangers of syphilis—prompting the U.S. Postal Service's refusal to mail The Call under the 40-year-old federal Comstock Act that banned the topic as obscene.

After the Civil War, more rigid American attitudes had led to the passage of the Comstock Act in 1873. The law classified contraceptive literature as obscene—illegal to mail through the U.S. Post Office. It stifled the dissemination of birth control information, even in newspaper ads. It also made it a misdemeanor for a person to sell, give away, advertise, or offer for sale, any instrument, article, drug, or medicine that would prevent contraception. It was even unlawful to give someone verbal information on contraception. Until this time, the nation's birthrates had been declining and the sale of contraception devices increasing.

Sanger wanted to flout the Comstock Act, so she launched her own monthly magazine, The Woman Rebel, publishing it from her dining room table. Because the words "birth control" appeared, and with it the promise to provide women with contraceptive advice, the U.S. Post Office refused to mail the magazine. Sanger could go to jail if she continued publication.

Still Sanger continued. Predictably, police arrested her in August of 1914. Indicted on four criminal counts carrying a maximum sentence of 45 years, she fled to Europe one day before her trial. The next year, she returned. Soon after her daughter, Peggy, died of pneumonia. In February of 1916, perhaps in response to a public sympathy for Sanger, prosecutor Harold Content dropped the charges.

Sanger threw herself into promoting birth control. On 16 October 1916, using a $50 donation, she and her sister, Ethel Byrne, opened the country's first birth control clinic—an act of civil disobedience.

The clinic occupied two rooms on the ground floor at 46 Amboy Street, near Pitkin Avenue in the Brownsville section of Brooklyn, New York. Its staff consisted of Sanger, Byrne, Fania Mindell—who spoke Yiddish—and a social worker, Elizabeth Stuyvesant. During the ten days before police closed the clinic, nearly five hundred women came through its doors.

On the ninth day after the clinic's opening, a "Mrs." Whitehurst walked in to buy a ten-cent sex education pamphlet. A member of the vice squad, she returned the next day with three other officers, shouting, "I'm a police officer. You're under arrest."

According to the Brooklyn Eagle, the police "half-dragged, half-carried" the sisters to a paddy wagon. The local station freed them after they posted a $500 bail. A few weeks later, Sanger reopened the clinic, but again police shut it down, charging Sanger with creating a public nuisance. They arrested Byrne soon after.

Sanger immediately hired attorney Jonah J. Goldstein to represent them. During Byrne's trial, he argued that New York's Comstock Law—which permitted the distribution of birth control information only in case of medical need—denied the poor their right to chose the size of their families. Nonetheless, the court found Byrne guilty of distributing "obscene" birth control information, sentencing her to 32 days in the workhouse on Blackwell's Island.

Byrne announced she would go on a hunger strike, "to die, if need be, for my sex." Four days after she began her fast, New York City's corrections commissioner announced Byrne would be the first inmate in U.S. history to be forcibly fed through a tube inserted in her throat. The New York Times daily covered the painful details of her feedings of brandy, milk, and eggs on its front page.

As a result of all the publicity, the National Birth Control League stepped in to defend the sisters. Called the "Committee of 100," they held a rally at Carnegie Hall shortly after Byrne's sentencing. Three thousand people showed up to hear Sanger speak. Several days later, some of the group took Sanger to the office of Governor Charles Whitman to plead for her sister's release. Whitman said he would only pardon Byrne if Sanger promised not to reopen the clinic. At first, Sanger refused, but after visiting her weakened sister, she reluctantly accepted the governor's terms. Against her will, Byrne left the workhouse, carried on a stretcher.

Meanwhile, Sanger and Mindell went to trial on 29 January 1917, at the Court of Special Sessions in Brooklyn. The court fined Mindell $50 for selling copies of Sanger's article What Every Girl Should Know. Sanger was tried for trafficking in obscene materials. Policewoman Whitehurst testified she had found a box of suppositories and a rubber pessary (a contraceptive device that works something like a diaphragm) in the back room of the Brownsville clinic. Other witnesses implied Sanger had gone beyond verbal instruction to actually fit clients with the devices.

However, Sanger vowed to repeat her sister's hunger strike, so the workhouse on Blackwell's Island refused to admit her. Instead, she went to the penitentiary for women in Queens, New York.

After her release, Sanger filed an ex post facto appeal. Goldstein argued it before the Court of Appeals of the State of New York, saying: The Comstock Act "violates both the federal and state Constitutions," and by preventing the dissemination of information to all persons … it fails to make provision for cases of women who suffer from certain infirmities … endangers their lives and brings about a condition injurious to their health.

However, the court thought the Comstock Act was within the police powers of the legislature, because it benefited "the morals and health of the community." On the other hand, if the law prevented a "duly licensed physician" from taking proper care of his married patients, then the law would be unconstitutional. However, Sanger was not a doctor, and therefore the law did not apply to her. Besides, physicians were "excepted from the provisions of this act."

Nevertheless, warned Judge Frederick E. Crane, the law does not allow even doctors to advertise such matters or to give "promiscuous advice to patients irrespective of their condition." It does protect a doctor who "gives such help or advice to a married person to cure or prevent disease."

With these words, Crane upheld Sanger's conviction under the New York obscenity law — laypeople could not distribute information on birth control without violating the 1873 Comstock Act. However, by claiming that the Comstock Act provided for a medical "exception," Crane established the right of doctors to provide contraceptive advice to married women for "the cure and prevention of disease." (Formerly "disease" meant venereal disease and applied to men only. Crane broadened the interpretation of "disease" to include women's ailments.)

Sanger used Crane's decision to launch a nationwide chain of doctor-staffed birth control clinics, and lobbied for state laws allowing "doctors only" to prescribe contraceptive devices. In 1921, her emboldened American Birth Control League tried to remove all state and federal restrictions on the right of physicians to prescribe birth control devices. Not until United States v. One Package (1936), did Sanger achieve her goal of reversing the Comstock Act's classification of birth control literature as obscene. Thirty-five years later Congress rewrote the statute to remove any mention of birth control. Many states banned the use of contraceptives by married couples until Griswold v. Connecticut (1965), and not until 1972 could unmarried couples legally use birth control devices (Eisenstadt v. Baird).