In August 1939, the newly formed Jamaica Birth Control League opened the island’s first birth control clinic in Kingston to distribute diaphragms at cost or free to working-class women. To advertise their services, the League published a small, discreet notice in the “Wanted” section of the Daily Gleaner, the island’s main newspaper. Within a year, some 500 women had written passionate letters to the League from across the island; thousands more would show up at the clinic’s doorstep, eager to seize on new methods for controlling reproduction.

Doctors, nurses, and activists who opened clinics in other areas of the world from the 1920s to the 1940s faced a similar outpouring of interest from local women and men, suggesting an unfulfilled thirst for knowledge about contraception in the early twentieth century. These shared experiences helped bind together a growing transnational family-planning movement that became increasingly organized and well-funded over the following decades, particularly as it became tied to Cold War–era concerns surrounding population growth in the Global South. Groups like the Pathfinder Fund and Population Council coordinated activities across countries and sent fieldworkers to advise on the state family-planning programs spreading across Asia, Africa, Latin America, and the Caribbean. By the mid–1960s, the cause had the support of key political leaders and international aid organizations like the U.S. Agency for International Development, creating a multi-million dollar global family-planning industry armed with new methods like the pill and IUD.

As Manon Perry details in Broadcasting Birth Control, the growth of this movement also intersected with new developments in communications technology and methods that took family-planning promotion to a whole new level. Population organizations teamed up with communications specialists and producers to craft a new genre of family-planning posters, radio spots, and films. Even Donald Duck got involved, featured in a Walt Disney–Population Council production from the late 1960s that was translated into twenty-three languages and distributed widely throughout Asia and Latin America.

As critical histories have pointed out, these informative materials also frequently conveyed apocalyptic narratives of impending “over-population” inflected with eugenic and neo-Malthusian ideologies. In Fatal Misconception, Matthew Connelly argues that this tendency to blame complex problems like poverty and conflict on “reckless” reproduction among “Third World” women paved the way for aggressive practices to contain the fertility of poor and marginalized communities. Critics have also accused the family-planning movement of being a form of cultural imperialism, an attempt to force a certain vision of the family—usually a small, modern, Westernized nuclear family—onto the entire world, while demonizing other family forms and socio-cultural practices.

This narrow vision of the “appropriate” family comes across quite clearly in much family-planning propaganda. The historical record is also rife with examples of ethical abuses and coercive practices, from the testing of methods without patients’ knowledge to the sterilization of women without their consent. But reducing all family-planning promotion to a form of imperialism makes it difficult to contend with the very real demand for information and services and the wide diversity of experiences captured in the records of local and international fieldworkers. It also masks the grassroots organization and organic information networks that, in many places, formed the foundation of—and set limits to—twentieth-century family-planning activism.

In the archives of Caribbean birth control organizations, for example, I found petitions from local communities requesting birth control lectures; reports from public health nurses who started to give sex education classes to parents asking for help; and letters from working-class women discussing their own efforts to convert friends and family to the cause. Fieldworkers sent out to spread the word internationally also frequently arrived in a given country to find local doctors and nurses already providing services, along with pre-existing contraceptive information networks that mobilized quickly to funnel women to new projects. Population Council consultants in Thailand, for example, were shocked to find that their 1965 research project on the acceptability of the Lippes Loop IUD had attracted ten times the number of women who had been directly informed of the project despite a lack of advertising, a result they traced to word of mouth.

But these information networks could also work the other way. The same project in Thailand, for example, saw a sharp decline in insertions after women started experiencing side effects and warned others that the IUD was not the miracle solution they’d been touting. Activists also shared stories and mobilized transnationally and locally against coercive state proposals. They could be remarkably successful even in situations of considerable inequality, as when mass action prevented the passing of compulsory sterilization measures in Bermuda in 1935.

Communities also pushed back against the agendas of family-planning workers in more subtle ways—sometimes by closing the door to outreach visitors going house to house to spread “the good news” of birth control, sometimes by driving state agents out of town, and sometimes through sheer wit. As one social worker in Bermuda recalled:

Whilst doing tour of duty as a social worker in the garrison town of Dover, I attended a lecture given to a group of unwed mothers (camp followers). The lecturer ended her talk by telling these girls that just for an hour’s pleasure each now had the responsibility of bringing up a fatherless child. “Now girls. Any questions?” she asked. “Yes miss, how do you make the pleasure last that long.”

Such interactions frustrated some family-planning activists and doctors, who dismissed reports of side effects as mere “rumour” and attributed all resistance to “superstition.” But others were sensitive to women’s concerns and recognized that the communities targeted by such programs were not empty vectors that could be easily convinced to change the entire course of their family life after viewing a single poster. Indeed, if the discourses represented by propaganda materials appear clear and powerful to us, family-planning workers often saw them more modestly as conversation starters. As one Bermudian health worker noted, whatever the content of a family-planning presentation, “it is the question period afterwards that is of most value.”

These experiences raise an important question: under what conditions might people have been more or less vulnerable to state and social coercion, more or less empowered to seize on the contraceptive information made available by family-planning movements while questioning or rejecting the simplistic ideologies that often underlay them? And what role did fieldworkers play in mediating this process?

Theorists of reproductive rights and reproductive justice provide us with a framework through which to approach these questions, outlining the optimal social, economic, and political conditions required for men and women to exercise full reproductive freedom. As a historian, I’m interested to see how people around the world struggled and negotiated spaces of control under much less than ideal circumstances. Although this effort is very much a work in progress, the importance of grassroots knowledge sharing seems to be a recurring and critical theme. At the risk of over-simplifying: the more people talked—sharing good and bad experiences with each other, expressing their concerns to nurses and doctors, and calling out the flawed logic and abuses they saw in some state and international programs—the more power they had to shape the twentieth-century family-planning agenda.

Nicole Bourbonnais is Assistant Professor of International History at the Graduate Institute of International and Development Studies, Geneva, Switzerland.