Ignore all the kneejerk reactions and consider that this book is primarily promoting birth control NOT abortion. Margaret Sanger was largely against abortion, except in the case of emergencies. She also had some harsh words in this book about many of the functions of modern-day Planned Parenthood.
"But there is a special type of philanthropy or benevolence, now
widely advertised and advocated, both as a federal program and as
worthy of private endowment, which strikes me as being more
insidiously injurious than any other. This concerns itself directly
with the function of maternity, and aims to supply GRATIS medical and
nursing facilities to slum mothers. "
Sanger is very much a part of the Malthusian tradition. This work begins with the simple problem of overpopulation, and more importantly overpopulation among the lower classes. This problem, she says, is driven both by ignorance and economic incentive (as children are a cheap source of labor for families, especially in rural communities). The consequences are obviously negative in the immediate sense (starvation, abuse, neglect, crime, poverty), and multiplied in future generations as misery is passed on, one dysfunctional generation to the next. She really drives home the point that this is not about class hatred, but about a liberation. Given all the knowledge and resources available, the affluent choose smaller families on their own accord, with the intent to achieve better outcomes for their children. She believes, if given the choice, this trend will take hold among women of all classes as the veil of ignorance is lifted. Birth control is just the means for Sanger's revolution to take hold. She proposes humanity reassess attitudes on sexuality and women to unlock their full human potential, freed from the tyranny of biology and uncontrolled, successive pregnancy. Sanger wants to raise the status of child rearing, from the base, unthinking, animal process, to the discrimination of humanity's finest gift, rationality.
She supports her main thesis with three angles of attack. A criticism of philanthropy and charity, an attack on Marxist economics, and a support for negative eugenics (criticizing positive eugenics and overeager enthusiasts looking to make draconian eugenic laws).
In her eyes, philanthropy and charity enable and multiply this destructive feedback-loop. It's unsustainable if the ratio of dependent-to-able grows, which is inevitable without intervention. Philanthropy gives a false security and sense of action, but does not strike at the root causes.
She then moves to Marx, who has some interesting insights, but brushes off Malthus as simple class hatred and fails to criticize his ideas thoroughly. She believes Marx is a seductive prophet, but he fails to factor the sex drive into the equation of human motivation. This is the failure of a reductive economic lens of history. She points to his failed predictions as well as the insight that uncontrolled births, without regard to quality of upbringing, actually serve the capitalist masters in providing an abundant, easily controlled, lumpenized, labor class, instead of the speculated class-conscious, empowered working class. There's an irreconcilable contradiction between raising the living standards of the proletariat and having uncontrolled births in poor conditions, especially true for the Marxist who surely emphasizes the importance of material conditions over heredity.
She wraps up with her view of eugenics. She approaches with some caution, aware that over-eager implementation could doom the movement, which has certainly been the case. There is a conservative emphasis on environment in addition to the hereditarian factors. The poor, large families, are hostile conditions for human excellence to blossom, but of course she is also worried about which genes will go on to replicate long term. She warns with great eloquence the dangers of uniformity (something we might be wise to keep in mind in the age of embryo selection).
""We want statesmen and poets and musicians and
philosophers and strong men and delicate men and brave men. The
qualities of one would be the weaknesses of the other.'' We want,
most of all, genius. Proscription on Galtonian lines would tend to
eliminate many of the great geniuses of the world who were not only
``Bohemian,'' but actually and pathologically abnormal--men like
Rousseau, Dostoevsky, Chopin, Poe, Schumann, Nietzsche, Comte,
Guy de Maupassant"
There's so many great quotes in the work, oftentimes from somebody else Sanger is quoting. Her main antagonist is the Catholic church or Christian morality more generally. She quotes the bible and some liberal church ministers to disprove the "be fruitful and multiply" as meaning raw numbers without considering the cruelty of condemning souls to near certain misery.
I'll finish by mentioning my reservations. The premise of Malthusianism is still widely debated, technology has seemed to shatter limits we thought previously impossible. Technology may yet also unlock a new emancipation from the tyranny of bad genes and may render us all jobless dependents in a world run by a handful of technocrats or computer algorithms. The problem of uncontrolled fertility seems to have been solved (at least in the developed world). If anything, the problem of under-fertility haunts the affluent. Sanger's dream of women's liberation and human sexual liberation is still playing out with mixed consequence. Man and woman are still half-committed to the roles they previously had to rigidly adhere to, to the disappointment of all parties involved. The conquest of hunger has led to obesity. The satisfaction of libido has led to a new age of simultaneous inceldom and cheapening of the sexual act. The optimist sees new frontiers to overcome, Ozempic for the fat, VR Porn for the undersexed and unsatisfied, skin cell babies for the non-traditional relationships, maybe none of these solutions are adequate. The traditionalist will continue to retreat into disgust as the world leaves them behind. Although I sympathize more with Sanger and her eugenic mission, the traditionalists are rightly disgruntled, as Civilization continues it's confusing and scary PIVOT ;^) into something new.