Legislation against contraceptive methods began in the United States in the 1800s. These legal prohibitions against the sale of contraceptive devices in the nineteenth century were not promoted by deeply felt and widely held moral standards—in fact, the majority of women continued to practice contraception and considered this a right. Rather, these prohibitions reflected the interests of government in promoting population growth in maintaining their control over health care. These laws and prohibitions were challenged by the birth control movement at the turn of the century. The rubber and chemical industries had made the mass production of contraceptive devices possible; the problem was their distribution. This was, and is, predominantly a political issue. Margaret Sanger, the founder of the American Birth Control League, saw that although contraceptives were available to rich women who had access to private physicians, legal prohibitions restricted the access of poor people.
Sanger, a public-health nurse, saw the desperation caused among her patients by ignorance of contraception. After viewing the ignorance about birth control in America, Margaret Sanger traveled to Europe, learned about the latest birth control technology in clinics in Holland, and returned to the United States determined to make birth control available to poor women. Because she could not enlist the support of the medical profession, Sanger broke the law by opening a clinic in Brownsville in 1916, where the staff included only Sanger and two other nurses. On the first day the clinic opened, the lines stretched around the block, and on the second day, one of the patients turned out to be a policewoman who received her own diaphragm and then turned in Sanger and her colleagues to the authorities. Sanger went to trial and accepted jail term rather than promise to give up her activity.
By this time, the birth control movement had won many supporters, and Sanger founded the American Birth Control League in 1916 to organize this support. The chief obstacle to the distribution of birth control in the 1920s was the opposition of physicians. Increasingly, however, this opposition focused not on birth control itself, which became increasingly socially acceptable, but on the prescription of devices by non-physicians such as Sanger and her co-workers. The American Birth Control League responded by sponsoring “doctors-only” bills – that is, laws legalizing Birth Control but only if prescribed by physicians. Among the political consequences of this strategy was that access to birth control for poor women, who seldom had access to physicians or private clinics, remained very limited. The ABCL and its state affiliates were set up to fill this need by providing free or low-cost contraceptive services to poor women.
The Kentucky Birth Control League
The Kentucky Birth Control League was founded in 1933 and became the fifteenth state affiliate of the American Birth Control League. Jean Brandeis Tachau, who had previously worked for the children’s agency, was its first president and worked as a full-time volunteer as its executive director until the first paid director took over in 1962. The organization opened its first clinic in Louisville in 1933 at Norton’s Infirmary, with a clinic in Lexington opening in 1936. That same year, Lena Gilliam became the first nurse for Mountain Maternal Health League, then known as Kentucky Maternal Health League, located in Berea. She visited approximately 500 families between July 1936 and November 1937 in Madison, Jackson and Rockcastle Counties, making follow-up visits every six months and answering questions by mail.
In 1937, a clinic for black patients was opened in a church with the support of a gift from Mary Helen Byck. Fees were on a sliding scale; according to a report on Kentucky clinics in 1939, and almost half of the patients paid nothing, and the rest paid an average fee of one dollar. The typical patient was a woman of 29 with three living children although many patients were younger.
Of course, the spread of birth control information provoked a great deal of opposition in Kentucky and elsewhere. Jean Tachau, in addition to her work in the Louisville clinics, traveled throughout the state in order to spread birth control information to physicians and to the general public. On the state and national level, obscenity laws were used to prohibit the spread of birth control information. In Breathitt County, Jean Tachau was arrested as a “lewd woman” because a nurse overhead her discussing birth control methods with a male physician and reported her to the local police. Tachau spent a night in the Breathitt County jail. The case gained national prominence, and Margaret Sanger traveled to Kentucky to show support for Tachau and the Kentucky Birth Control League.
Although the Kentucky Birth Control League faced opposition, considerable support grew in influential circles for the organization’s efforts. During the Depression, socially prominent supporters were motivated by concern for poor families. In the 1930s, some people still believed that widespread use of birth control would lead to a decline in population and thus in national strength. Spokespersons for the KBCL tried to assuage these fears by emphasizing the decrease in infant mortality in families where birth control was practiced. In the period from 1939-1941, several conferences on “Tomorrow’s Children” were held in Louisville with the financial support of Barry Bingham, Sr. The purpose of these conferences was to incorporate birth control provision in to public health services.
In 1942, the American Birth Control League changed its name to PPFA, and the Louisville organization became an affiliate. The decade of the 1950s was marred by the postwar baby boom and the accompanying glorification of family togetherness and women’s domestic roles that has since been called “the feminist mystique.” Planned Parenthood, which even temporarily changed the clinic’s name to “Family Relations Center,” expanded its services to include marriage, family living and infertility counseling. In the 1960s, however, contraception again became the main agenda with the introduction of the birth-control pill. In 1959, Louisville Planned Parenthood received a grant from Lilly pharmaceuticals to evaluate Enovid, the first birth control pill. Patients reported that, although the pill made them sick, so did pregnancy. With the approval of the birth control pill, the patient load increased dramatically. The typical patient was still a married woman in her 20s or 30s who had one or more children
In the 1960s, awareness of the persistence of poverty in the affluent society prompted the involvement of state and local governments in the distribution of contraceptives. This decade saw the first incorporation of birth control into publicly-supported health services. In 1961, Lexington Planned Parenthood becomes the first clinic to provide services in a county health department in the state. In 1963, social workers were permitted to initiate discussion of contraception with their clients and nursing training programs included birth control information. Planned Parenthood played an important role in training these professionals. In 1963, Viola Keys, who became Executive Director of Planned Parenthood in the following year, overcame the resistance of the directors of General Hospital and began counseling patients in the obstetrical ward. In 1966, Kentucky issued guidelines for the distribution of contraceptive by state agencies with no restrictions on age and marital status. Planned Parenthood became the agency that provided these services. Also, in 1966, Lexington Planned Parenthood became a not-for-profit corporation. The name was officially changed from “The Birth Control League” to “Lexington Planned Parenthood Center.” Federal funds were approved in April for state health departments to use for family planning. Of the 37 Kentucky counties that qualified, most had received attention from the Kentucky Birth Control League and/or Mountain Maternal Health League.
In 1969, the Office of Economic Opportunity financed six public clinics in Louisville and in 1971, the public health services and counseling. In September of 1970, the Lexington Planned Parenthood Center was able to hire its first full-time director and moved to a more central location on Second Street. In 1972, a state law permitted minors to receive contraceptives counseling without parental consent. The clientele of Planned Parenthood, which at first composed of married women who had borne several children, now began to include many more unmarried teenagers and young women. In the 1970s, such policies were justified now only by concern for individuals and families, but also for the problem of world overpopulation. During the debates in the 1930s, pessimists feared a catastrophic decline of the American population if birth control became widespread; in the 1970s however, birth control was viewed more positively as a public-spirited measure against the "population explosion." Planned Parenthood of Louisville began accepting Title X funding in 1974 to subsidize the cost of providing family planning to low-income women.
In 2000, Planned Parenthood of Louisville instituted services for males, and pill pick-up became available at the front desk. Dr. Shirley Jones began as the new Chief Executive Officer in 2005, and Planned Parenthood of Louisville recieved full four-year accredidation from PPFA. Several task forces - the Strategic Planning and Vision Task Force and the Communications Task Force - were formed in 2006 to revisit Planned Parenthood's mission, vision, and branding. The Men's Engagement Task Force was also formed to understand how Planned Parenthood can better service men in the community.
2008 and Beyond
2008 brings exciting changes to Planned Parenthood in Kentucky (PPKY). Planned Parenthood of Louisville and Planned Parenthood of the Bluegrass merged to form one state-wide affiliate to provide more comprehensive and consistent services to individuals throughout the state. The future of PPKY is bright as we look forward to expanded healthcare services, advocacy, education,and community outreach.
(Adapted from Planned Parenthood: A Seventy-Five Year History by Ann Taylor Allen, PhD)