Family planning involves decisions made by women and men concerning their reproductive lives and most importantly whether, when, and under what circumstances they have children. Couples have to make decisions about whether to engage in sexual activity that could lead to pregnancy, whether to use birth control, and whether to terminate a pregnancy.

Birth control and abortion aren’t new. Family planning has been practiced for centuries. Early methods weren’t always safe or effective. For example, centuries ago Chinese women drank lead and mercury to reduce fertility, which sometimes lead to sterility and death.

Individuals faced with family planning questions often rely on moral or religious beliefs to reach a decision. Because moral and religious beliefs vary widely in the United States, family planning laws are frequently controversial.

A review of U.S. birth control background and history is summarized below.

Birth Control History: 19th Century

During the nineteenth century in the United States, birth rates began to decline, in part due to an increase in scientific information about conception and contraception or birth control. The average white woman in 1800 gave birth 7 times. By 1900, that number dropped to an average of 3.5 births.

At the beginning of the 1800s, early stage abortions generally were legal. It wasn’t until the mid- to late- 1800s that abortion laws were passed to ban the procedure. The use of birth control and abortion, however, declined as growing public opinion considered information about birth control methods to be obscene, and abortion to be unsafe. Religious and moral beliefs then, as now, affected reproductive laws.

Birth Control History: 20th Century

In 1912, Margaret Sanger started the modern birth control movement by writing a newspaper column about the subject. Ms. Sanger was a public health nurse concerned about women affected by frequent childbirth, miscarriages, and unsafe abortions. In 1916, she opened the first birth control clinic. Ms. Sanger is a controversial figure who’s been accused of being racist.

In the early part of the 20th century, the focus was on the need for married couples to space children and limit family size. Developments in medical science also assisted in decreasing the number of children per family. In 1928, ovulation timing was established, but mistakenly included half of menstruation. From 1940 to 1957, family size increased again to 3.7 children.

In 1960, the birth control pills and IUD become available. In 1965, the Supreme Court in Griswold v. Connecticut struck down state laws prohibiting birth control use by married couples. In 1970, federal funding for family planning services was established. By 1980, these services were a part of Medicaid.

Birth Control History: 21st Century

Family planning law continues to change. People on both sides of the debate feel strongly, often for reasons related to religion or mothers’ health. The Affordable Care Act mandates that insurance pay for birth control. However, in June 2014, the Supreme Court ruled in the Hobby Lobby case that closely held corporations can object to providing birth control to employees, if it violates the corporation’s religious beliefs. The controversy over birth control and abortion laws will certainly continue.

For more history, read the FindLaw article on major reproductive rights Supreme Court cases in the 20th and 21st centuries.