When Margaret Sanger opened her birth control clinic in 1916, she knew she was breaking the law. Distributing contraceptives, or even literature about birth control, was a jailable offense. But she didn’t care. As a nurse, Sanger had sworn to devote herself to the welfare of those in her community. And in the early 1900s, that meant doing something about the public health crisis caused by unplanned pregnancies.

At the turn of the century, many women were having babies with no break in between pregnancies. It put them at risk for anemia, and uterine ruptures. Miscarriages were common. Of the children that were born, one in five died during the first five years of life.

To Sanger, the solution was clear: a safe, effective, discrete contraceptive for women—a pill, no bigger than an aspirin. At the time, the idea seemed more radical than putting a man on the moon. And in some ways, developing it would be even more difficult.

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