In another passage, she decries the burden of "human waste" on society:

It [charity] encourages the healthier and more normal sections of the world to shoulder the burden of unthinking and indiscriminate fecundity of others; which brings with it, as I think the reader must agree, a dead weight of human waste. Instead of decreasing and aiming to eliminate the stocks that are most detrimental to the future of the race and the world, it tends to render them to a menacing degree dominant [emphasis added].

She concluded,

The most serious charge that can be brought against modern "benevolence" is that it encourages the perpetuation of defectives, delinquents and dependents. These are the most dangerous elements in the world community, the most devastating curse on human progress and expression.

The Review printed an excerpt of an address Sanger gave in 1926. In it she said:

It now remains for the U.S. government to set a sensible example to the world by offering a bonus or yearly pension to all obviously unfit parents who allow themselves to be sterilized by harmless and scientific means. In this way the moron and the diseased would have no posterity to inherit their unhappy condition. The number of the feeble-minded would decrease and a heavy burden would be lifted from the shoulders of the fit.

Sanger said a "bonus" would be "wise and profitable" and "the salvation of American civilization." She presented her ideas to Mr. C. Harold Smith (of the New York Evening World) on "the welfare committee" in New York City. She said, "people must be helped to help themselves. Any plan or program that would make them "dependent upon doles and charities" is "paternalistic" and would not be " of any permanent value." She included an essay (what she called a "program of public welfare,") entitled "We Must Breed a Race of Thoroughbreds."

In it she argued that birth control clinics, or bureaus, should be established "in which men and women will be taught the science of parenthood and the science of breeding." For this was the way "to breed out of the race the scourges of transmissible disease, mental defect, poverty, lawlessness, crime … since these classes would be decreasing in number instead of breeding like weeds."

Her program called for women to receive birth control advice in various situations, including where:

the woman or man had a "transmissible" disease such as insanity, feeble-mindedness, epilepsy, syphilis, etc.;

the children already born were "subnormal or feeble-minded";

the father’s wages were "inadequate … to provide for more children."

Sanger said "such a plan would … reduce the birthrate among the diseased, the sickly, the poverty stricken and anti-social classes, elements unable to provide for themselves, and the burden of which we are all forced to carry."

Sanger had openly embraced Malthusian eugenics, and it shaped her actions in the ensuing years.

The Harlem Clinic

In 1929, 10 years before Sanger created the Negro Project, the ABCL laid the groundwork for a clinic in Harlem, a largely black section of New York City. It was the dawn of the Great Depression, and for blacks that meant double the misery. Blacks faced harsher conditions of desperation and privation because of widespread racial prejudice and discrimination. From the ABCL’s perspective, Harlem was the ideal place for this "experimental clinic," which officially opened on November 21, 1930. Many blacks looked to escape their adverse circumstances and therefore did not recognize the eugenic undercurrent of the clinic. The clinic relied on the generosity of private foundations to remain in business. In addition to being thought of as "inferior" and disproportionately represented in the underclass, according to the clinic’s own files used to justify its "work," blacks in Harlem:

were segregated in an over-populated area (224,760 of 330,000 of greater New York’s         population lived in Harlem during the late 1920s and 1930s);

comprised 12 percent of New York City’s population, but accounted for 18.4 percent of New York City’s unemployment;

had an infant mortality rate of 101 per 1000 births, compared to 56 among whites;

had a death rate from tuberculosis–237 per 100,000–that was highest in central Harlem, out of all of New York City.

Although the clinic served whites as well as blacks, it "was established for the benefit of the colored people." Sanger wrote this in a letter to Dr. W. E. Burghardt DuBois, one of the day’s most influential blacks. A sociologist and author, he helped found the National Association for the Advancement of Colored People (NAACP) in 1909 to improve the living conditions of black Americans.

That blacks endured extreme prejudice and discrimination, which contributed greatly to their plight, seemed to further justify restricting their numbers. Many believed the solution lay in reducing reproduction. Sanger suggested the answer to poverty and degradation lay in smaller numbers of blacks. She convinced black civic groups in Harlem of the "benefits" of birth control, under the cloak of "better health" (i.e., reduction of maternal and infant death; child spacing) and "family planning." So with their cooperation, and the endorsement of The Amsterdam News (a prominent black newspaper), Sanger established the Harlem branch of the Birth Control Clinical Research Bureau. The ABCL told the community birth control was the answer to their predicament.

Sanger shrewdly used the influence of prominent blacks to reach the masses with this message. She invited DuBois and a host of Harlem’s leading blacks, including physicians, social workers, ministers and journalists, to form an advisory council to help direct the clinic "so that our work in birth control will be a constructive force in the community." She knew the importance of having black professionals on the advisory board and in the clinic; she knew blacks would instinctively suspect whites of wanting to decrease their numbers. She would later use this knowledge to implement the Negro Project.

Sanger convinced the community so well that Harlem’s largest black church, the Abyssinian Baptist Church, held a mass meeting featuring Sanger as the speaker. But that event received criticism. At least one "very prominent minister of a denomination other than Baptist" spoke out against Sanger. Dr. Adam Clayton Powell Sr., pastor of Abyssinian Baptist, "received adverse criticism" from the (unnamed) minister who was "surprised that he’d allow that awful woman in his church."

Grace Congregational Church hosted a debate on birth control. Proponents argued birth control was necessary to regulate births in proportion to the family’s income; spacing births would help mothers recover physically and fathers financially; physically strong and mentally sound babies would result; and incidences of communicable diseases would decrease.

Opponents contended that as a minority group blacks needed to increase rather than decrease and that they needed an equal distribution of wealth to improve their status. In the end, the debate judges decided the proponents were more persuasive: Birth control would improve the status of blacks. Still, there were others who equated birth control with abortion and therefore considered it immoral.

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