Margaret Sanger opened America’s first birth-control clinic 100 years ago this week, on October 16, 1916.

In her time, Sanger was a controversial figure, even among feminists, and she often ran afoul of the law in her quest to promote women’s health and birth control. She remains a subject of contention because anti-abortion activists and Republican candidates, including Donald Trump and his running mate, Mike Pence, have escalated their attacks on her and on Planned Parenthood, the organization she founded. But Sanger’s pioneering work has been heralded by women’s rights activists in this country and around the world.

In a speech last week at Virginia’s Liberty University, Pence—a fervent abortion foe—said: “A Trump-Pence administration will defund Planned Parenthood and redirect those dollars to women’s health care that doesn’t provide abortion services.”

Pence added that he longs “to see the day that Roe v. Wade is consigned to the ash heap of history where it belongs.”

Not surprisingly, Planned Parenthood Votes (the group’s super PAC) and Priorities USA Action, the main super PAC supporting Hillary Clinton, have teamed up to broadcast a new 30-second digital spot targeted to women voters in North Carolina, Nevada, and Pennsylvania, three key swing states. The ad shows Trump telling MSNBC’s Chris Matthews that “there has to be some form of punishment” for women who have abortions, while text on the screen proclaims: “When it comes to health, politicians shouldn’t make decisions for us."

The ad then segues to an image of Trump with the following text: “Donald Trump wants: Roe v. Wade overturned, abortion banned, Planned Parenthood defunded.”

Margaret Sanger in 1922. Underwood & Underwood – Library of Congress Prints and Photographs division/Public Domain

It concludes: “Donald Trump is too dangerous for women."

Republicans have accused Sanger and Planned Parenthood of racism. Last year, 25 House Republicans campaigned to have a bust of the pioneering family planner removed from the Smithsonian’s National Portrait Gallery. GOP senator and erstwhile presidential contender Ted Cruz, of Texas, issued a statement saying that Sanger didn’t belong there because of her “inhumane life’s work,” and because she “advocated for the extermination of African Americans.”

Another GOP presidential candidate, Ben Carson, stated during the primary that Sanger “believed that people like me should be eliminated.” He later explained that he was “talking about the black race.” This echoed the statement in 2011 by yet another Republican contender, Herman Cain, that Sanger’s original goal for Planned Parenthood was to “help kill black babies before they came into the world.” Cain also accused the group of “genocide” against African Americans.

Sanger, her sister Ethel Byrne (a registered nurse), and Fania Mindell opened their first clinic in the Brownsville section of Brooklyn. Mindell helped translate for the clinic’s clientele of primarily immigrant Jewish and Italian women. They rented a small storefront and distributed flyers written in English, Yiddish, and Italian advertising the clinic’s services. Sanger smuggled in diaphragms from the Netherlands, but she couldn’t recruit doctors to make sure they properly fit her patients. Although doctors were allowed to provide men with condoms as protection against venereal disease, providing women with contraception was illegal.

So Sanger and her sister provided the services. The first day the clinic opened, they saw 140 people. Women—some from as far away as Pennsylvania and Massachusetts—stood in long lines to avail themselves of the clinic’s services. After nine days, New York’s vice squad raided the clinic, and Sanger spent the night in jail. As soon as she was released, she returned to work. Again, the police came, and this time they forced her landlord, a Sanger sympathizer, to evict them.

Following the eviction, Sanger, her sister, and Mindell were arrested for “creating a public nuisance” and went on trial in January 1917. Sanger was convicted, but the judge offered her a suspended sentence if she agreed not to repeat the offense. She refused. Offered a choice between a fine or days in jail, Sanger chose the latter. She appealed the decision, but a year later the New York Court of Appeals upheld her conviction. Nevertheless, the judge ruled that physicians could legally prescribe contraception for general health reasons, if not exclusively for venereal disease.

Planned Parenthood grew out of Sanger’s work to promote family planning, including the original birth control clinic. Today, the organization not only runs women’s health clinics that offer birth control and abortion services, but it has also been a leading force in mobilizing opposition to national and state efforts to restrict abortion.

As a result of its health and advocacy work, Planned Parenthood has been targeted by abortion and birth control opponents. For years protesters have gathered outside Planned Parenthood clinics, hoping to embarrass and frighten its patients into not using its services. In 2011, the House of Representatives passed, by a 240 to 185 margin, an amendment sponsored by Pence, then a congressman from Indiana, to end federal funding for Planned Parenthood. During the Senate debate on the measure, Arizona Republican Jon Kyl claimed incorrectly that abortion constitutes “well over 90 percent of what Planned Parenthood does.” (In fact, according to Planned Parenthood, abortion accounts for less than 3 percent of its services.) The Senate rejected that particular measure passed by the House, but GOP pledges defund Planned Parenthood have continued.

Sanger was born Margaret Higgins in 1879, the sixth of 11 children in a working-class family in Corning, New York. Her father, Michael Higgins, a stonemason, was a freethinking atheist who gave his daughter books about strong women and encouraged her idealism. Her mother, Ann, was a devout Catholic and the strong and loving mainstay of the family. When she died of tuberculosis at age 50, young Margaret had to take care of the family. She always believed that her mother’s many pregnancies had contributed to her early death.

Gage Skidmore/Creative Commons

In a speech last week at Liberty University in Virginia, vice presidential candidate Mike Pence said he longs “to see the day that Roe v. Wade is consigned to the ash heap of history where it belongs." Here, Pence speaking at an immigration policy speech hosted by Donald Trump in Phoenix, Arizona.

Sanger longed to be a physician, but she was unable to pay for medical school. She enrolled in nursing school in White Plains, New York, and as part of her maternity training delivered many babies—unassisted—in women’s homes. She met women who had had several children and were desperate to avoid future pregnancies. Sanger had no idea what to tell them.

Soon after her 1902 marriage to architect and would-be painter William Sanger, she became pregnant, developed tuberculosis, and had a very difficult birth, followed by a lengthy illness and recovery. The young family moved from New York City to the suburbs for Margaret’s health, but two babies and eight years later, Sanger insisted that they return to the city.

In New York the Sangers were part of a progressive circle that included journalists John Reed and Lincoln Steffens, labor leader William “Big Bill” Haywood, and anarchist Emma Goldman. Goldman had been smuggling contraceptive devices into the U.S. from France since at least 1900, and greatly influenced Sanger’s thinking. Sanger joined the Socialist Party and the Industrial Workers of the World, working with other radicals to support labor strikes.

Sanger also returned to nursing, working as a visiting nurse and midwife at community nurse Lillian Wald’s Henry Street Settlement in the Lower East Side. There, again, women repeatedly asked her how to prevent future pregnancies. In those days, poor women tended to resort to dangerous methods to end pregnancies, including the use of knitting needles. After one of Sanger’s patients died from a self-induced abortion, she decided her life’s mission would be fighting for the right of low-income women to control their destinies and improve their health through family planning.

After visiting France to learn more about contraceptive use, Sanger returned to the United States and launched a newsletter, the Woman Rebel, in 1914, with backing from unions and feminists. As Sanger and her friends sat around her dining room table addressing newsletters, they brainstormed about what to call their emerging movement for reproductive freedom. From that conversation, the term “birth control” was born. Encouraging working-class women to “think for themselves and build up a fighting character,” Sanger wrote that “women cannot be on an equal footing with men until they have full and complete control over their reproductive function.”

Sanger began writing on women’s issues for the Call, a socialist newspaper. She expanded her columns into two popular books, What Every Mother Should Know (1914) and What Every Girl Should Know (1916), and later wrote an educational pamphlet called Family Limitation that would sell ten million copies in 13 languages.

In 1873, Congress had passed the Comstock Law, which made illegal the delivery or transportation of “obscene, lewd, or lascivious” material, and banned contraceptives and information about contraception from the mail. When postal officials refused to allow the Call to be mailed with the offending column, the paper responded by leaving empty the space where Sanger’s article would have appeared, except for the title: “What Every Girl Should Know—NOTHING!” Then-U.S. Postal Inspector Anthony Comstock seized the first few issues of the Woman Rebel from Sanger’s local post office, but she got around him by mailing future issues from different post offices. Thousands of women responded to the newsletter, anxious for information on contraception.

Sanger’s next project was an educational pamphlet, Family Limitation, that described clearly and simply what she had learned in France about such not always effective birth-control methods as the condom, suppositories, and douches. She had planned to print 10,000 copies, but demand from labor unions representing copper and cotton mills was so great that she scraped up enough money together to print 100,000 copies. Over the years, the pamphlet’s distribution reached ten million, and it was translated into 13 languages. In the 1920s in YucatÃ¡n, Mexico, feminists distributed the pamphlet to every couple requesting a marriage license.

The first issue of Woman Rebel, published in March 1914. New York University/Public Domain

But before she could distribute Family Limitation in the United States, Sanger had to go to court for the “crime” of distributing Woman Rebel. With very little time to prepare her defense and faced with a seemingly hostile judge, she jumped bail and ï¬‚ed alone to England. While in Europe, she visited a birth-control clinic in Holland run by midwives, where she learned about a more effective method of contraception, the diaphragm, or “pessary.”

After a year in exile, Sanger returned to the United States in 1916. By then, Comstock had died, and Sanger had hopes that enforcement might wane and she might not have to stand trial. A well-publicized open letter to President Woodrow Wilson, signed by nine prominent British writers, including H. G. Wells, praised Sanger and her work. She gained more sympathy when newspapers reported that her five-year-old daughter, Peggy, had died suddenly of pneumonia. In the face of public pressure, the government dropped the case, though the Comstock laws remained on the books.

It was those laws that got Sanger in trouble after she opened the Brooklyn birth-control clinic in 1916. While running the clinic, she continued writing and advocating for reproductive health rights. In 1921, she founded the American Birth Control League, the precursor to Planned Parenthood. In 1923, Sanger founded the Birth Control Clinic Research Bureau, the first legal clinic to distribute contraceptive information and to fit diaphragms under the direction of women doctors.

It wasn’t until 1936 that a federal district court in New York City ruled that the U.S. government could not interfere with the importation of diaphragms for medical use. In 1952, Sanger would help found the International Planned Parenthood Federation. She spent the end of her career raising money for research, in efforts that contributed to the development of the birth control pill.

Feminist and progressive reformers were divided over Sanger’s crusade for birth control. Alice Hamilton, Crystal Eastman, and Katharine Houghton Hepburn (mother of actress Katharine Hepburn) supported Sanger, but others, such as Charlotte Perkins Gilman and Carrie Chapman Catt, argued that birth control would increase men’s power over women as sex objects.

In 1930, with the support of the prominent black activist and intellectual W.E.B. Du Bois, the Urban League, and the Amsterdam News (New York’s leading black newspaper), Sanger opened a family planning clinic in Harlem, staffed by a black doctor and black social worker. Then, in 1939, key leaders in the black community encouraged Sanger to expand her efforts to the rural South, where most African Americans then lived. Thus began the “Negro Project,” with Du Bois, Rev. Adam Clayton Powell, Jr., and other black leaders lending support.

Sanger explained that the project was designed to help “a group notoriously underprivileged and handicapped … to get a fair share of the better things in life. To give them the means of helping themselves is perhaps the richest gift of all. We believe birth-control knowledge brought to this group is the most direct, constructive aid that can be given them to improve their immediate situation.”

Sanger viewed birth control as a way to empower black women, not as a means to reduce the black population. And according to Hazel Moore, who ran a birth-control project in Virginia in the 1930s under Sanger’s direction, black women were very responsive to the birth control education offered by the “Negro Project.” At the same time, a number of Southern states began incorporating birth-control services unevenly into their public health programs, which were rigidly segregated, providing poorly funded health services to African Americans.

To the detriment of her reputation and to the cause of reproductive freedom, Sanger was also drawn to aspects of the eugenics movement. In the 1920s, some scientists viewed eugenics as a way to identify the hereditary bases of both physical and mental diseases; others, however, viewed it as a means to create a “superior” human race. But eugenics and contraception did not go hand in hand. The Nazis opposed birth control or abortion for healthy and “fit” women in their effort to promote a white master race. In fact, Nazi Germany banned and burned Sanger’s books on family planning.

Race-based eugenics was practiced in the United States as well. Blacks were used as unwitting subjects for medical experiments, such as the infamous Tuskegee syphilis experiment conducted by the U.S. Public Health Service from 1932 to 1972. Poor and especially black women were frequently sterilized in hospitals, often without their knowledge. Many of the eugenics movement’s leaders were racists and anti-Semites who promoted involuntary sterilization in order to help breed a “superior” race.

But Sanger was not among them. Her primary focus was on freeing women who lived in poverty from the burden of unwanted pregnancies. She embraced eugenics as a means of blocking individuals from passing down mental and physical diseases to their descendants, whatever we may think of that practice today. In a 1921 article, she argued that “the most urgent problem today is how to limit and discourage the over-fertility of the mentally and physically defective.”

Public Domain/Sanger and her sister Ethyl Byrne, on the steps of a courthouse in Brooklyn, New York, during a trial accusing Sanger and others for opening a birth control clinic on January 8, 1917.

These words are certainly troublesome, but Sanger always repudiated the use of eugenics on specific racial or ethnic groups. She believed that reproductive choices should be made by individual women. Neither Sanger nor Planned Parenthood sought to coerce black women into using birth control or getting sterilized. In the 1920s, when anti-immigrant sentiment reached a peak and some scientists justified restricting immigration on the grounds that some ethnic groups were mentally and physically inferior, Sanger denounced such stereotyping.

Even so, over the years Sanger’s flirtation with eugenics has provided fodder for attacks from across the political spectrum. As several of her biographers have documented, a number of racist statements have been falsely attributed to Sanger. Anti-abortion activists and politicians continue to repeat the bogus accusations against Sanger and Planned Parenthood, to score political points with conservatives.

According to the Guttmacher Institute, less than one in ten of all 1,800 clinics that perform abortions are located in predominantly African American neighborhoods, and only about 110 of Planned Parenthood’s 800 clinics are in areas where blacks make up more than 25 percent of the overall population. Planned Parenthood establishes clinics based on where medical needs, health-care shortages and poverty rates are highest. They offer birth control, STD screenings, antibiotics, paps smears and education in breast self-examinations. They also safely terminate pregnancies, protecting women from the hazards of self-induced abortion.

In 1961, Estelle Griswold, executive director of Planned Parenthood of Connecticut, opened a clinic in New Haven with Dr. C. Lee Buxton, a physician and professor at Yale’s medical school. They were arrested in November 1961 for violating a state law prohibiting the use of birth control. Their case made it to the U.S. Supreme Court, which in 1965 ruled in Griswold v Connecticut that the law violated the right to marital privacy. The case established couples’ right to birth control and women’s right to privacy in medical decisions, which paved the way for Roe v Wade, the landmark 1973 Supreme Court ruling that recognized a woman’s right to choose abortion.

Throughout the 1960s and early 1970s, the Republican Party embraced family planning and abortion. Prescott Bush, a Republican Senator from Connecticut and father and grandfather to the two Bush presidents, was Planned Parenthood’s treasurer in the late 1940s. Senator Barry Goldwater, the GOP’s 1964 presidential candidate, supported Planned Parenthood; his wife was a board member of its Phoenix affiliate. In 1968, while President Richard Nixon advocated federal funds for family planning, then-Congressman George H. W. Bush, of Texas, argued that “we need to make family planning a household word.”

After Roe v. Wade, however, Republican operatives and religious conservatives joined forces to promote a “family values” agenda that challenged the political and cultural victories of the women’s and civil rights movements. Since then, conservatives have consistently sought to restrict abortion rights. In recent years, that effort has escalated into a fervent crusade, including state-level ballot measures that limit abortion access and daily vigils outside clinics. The movement’s most extreme wing has engaged in clinic bombing and even encouraged (and in some cases carried out) the assassination of those who work at abortion clinics.

In 1966, Martin Luther King Jr. received Planned Parenthood’s Margaret Sanger Award in Human Rights. Accepting the award, he wrote: “There is a striking kinship between our movement and Margaret Sanger’s early efforts. … Margaret Sanger had to commit what was then called a crime in order to enrich humanity, and today we honor her courage and vision.”