Eugenics by Stealth: Planned Parenthood’s Founding Ideology and Its Demographic Toll on Black America

In 2019, Justice Clarence Thomas wrote a Supreme Court concurrence that received far less attention than it deserved. In Box v. Planned Parenthood of Indiana and Kentucky, Thomas documented the direct ideological line from Margaret Sanger’s eugenics movement to modern abortion law. He showed, with primary sources, that Sanger and her contemporaries viewed abortion as a tool to reduce births among populations deemed inferior. The concurrence has not been seriously rebutted. It has been ignored.

The data that Thomas’s argument predicts are exactly what the data show. According to CDC Abortion Surveillance reports, Black women — who represent approximately 13.7 percent of the female population of childbearing age — account for 38 to 42 percent of reported abortions in states that collect race data. Applied to total abortion estimates from the Guttmacher Institute, that proportion yields approximately twenty million Black abortions since Roe v. Wade. This figure carries methodological uncertainties — the racial share was likely lower in early decades, and state reporting gaps introduce variance — but the order of magnitude is not seriously contested by researchers on either side of the abortion debate.

For scale: the entire Black population of the United States in 1970 was approximately twenty-two million. According to Pew Research Center, Black Americans today number approximately forty-nine million, or 14.4 percent of the U.S. population. The racial disparity in abortion has persisted after Dobbs v. Jackson Women’s Health Organization (2022). Black women continue to obtain abortions at rates three to four times higher than White women across jurisdictions where abortion remains broadly available.

These numbers are inseparable from the history of the organization that has dominated American abortion provision for fifty years. In her 1922 book The Pivot of Civilization, Sanger argued for reducing births among those she classified as socially unfit. In 1939, she launched the “Negro Project” targeting Southern Black communities. In a letter now in the Margaret Sanger Papers at Smith College, she wrote that she did not want “word to go out that we want to exterminate the Negro population.” Defenders argue context demonstrates innocent intent. The argument has been made and engaged; the broader institutional record — the Birth Control Review‘s framing of Black birth rates as dysgenic, the eugenic fundraising materials, the deliberate geographic targeting — does not resolve cleanly in Planned Parenthood’s favor.

The argument that this history constitutes a moral and demographic crisis for Black America is not, as its critics often claim, a white conservative talking point. Senator Tim Scott, the Senate’s leading Black Republican, has argued that the pro-life commitment must extend well beyond the moment of birth. Alveda King has called abortion “the number one killer of Black people in this country.” The National Black Pro-Life Coalition and the Radiance Foundation have built their public education work around exactly this historical lineage.

W.E.B. Du Bois — whose Birth Control Review essay in 1932 was later cited in the Negro Project’s own materials — ultimately rejected the biological determinism underlying eugenics entirely. Scholar Dorothy Roberts and others have traced that intellectual trajectory in detail. That the most sophisticated Black thinker of his era initially engaged with and ultimately repudiated the eugenics framework illustrates both the movement’s considerable reach across ideological lines and its fundamental incompatibility with Black dignity — an incompatibility that becomes clearer with each decade of demographic data. The lesson Du Bois reached late, the institutions that fund and protect Planned Parenthood have yet to reckon with at all.

The policy implications follow from the facts. Congress should redirect Title X grants and Medicaid reimbursements from Planned Parenthood to federally qualified community health centers providing comprehensive prenatal care and adoption services. More than thirteen hundred such centers, operating nearly fifteen thousand delivery sites, already serve more patients than Planned Parenthood does. Senator Scott’s proposal to extend the child tax credit to pregnant women from conception offers one legislative model for the economic support that reduces unintended pregnancies at the source.

The historical record, the CDC data, and the testimony of Black pro-life leaders converge on a single conclusion: an institution founded on eugenic ideology and sustained by public funds has produced demographic outcomes its founder would have found congenial. The Thomas concurrence documented the founding ideology. The CDC documented the outcomes. What has been missing is the political will to hold those two facts together in the same sentence and act on the implications. Directing federal Title X and Medicaid dollars to an organization with this record is a policy choice. It is not the only available policy choice, and it is not one that can be defended on grounds of equity, history, or public health. That is a policy problem. It is also a moral one.