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In 1916, Margaret Sanger established the first birth control clinic
in US history. From the mid-1920s, “Sanger clinics” spread
over the entire US These clinics advised women on contraception,
mainly by fitting diaphragms and explicitly instructing women how
to use them effectively. Combining newly digitized data on the
roll-out of these clinics, full-count Census data, and historical vital
statistics, we find that the clinics accounted for 5.4–6.5 percent
of the overall fertility decline across the US until 1940. By increasing
the spacing between births and reducing fertility, the clinics
generated important health effects and reduced stillbirths and
infant mortality.
