1920s - Birth of the MHA

Later that year, Brush and Shepard attended the first American Birth Control Conference in New York City, where nationally known birth control advocate, Margaret Sanger, was scheduled to lecture. But city police barred Sanger from speaking and arrested her. The Clevelanders and a crowd of supporters followed Sanger to the police station in a show of solidarity.

Although police later released Sanger, this glaring violation of constitutional rights aroused new supporters for birth control in Cleveland. Brush and Shepard, however, remained careful in their efforts to counteract opposition. They knew they had to patiently win over Cleveland's civic, medical, and social service leaders to their cause. These leaders would then sway public opinion, making it possible to offer birth control in Cleveland. This "organized campaign of nagging" would take seven years.

Meanwhile, the founders worked to build a legal foundation for providing birth control. The federal Comstock Law of 1873 classified birth control information and devices with obscene material and pornography; therefore, it could not be advertised or sent through U.S. mail. Convinced that it was illegal, most doctors of the day refused to advise patients on contraception.

Cleveland attorney Jerome C. Fisher, whose wife, Katherine Bingham Fisher, helped organize the Maternal Health Association, addressed the legal confusion. In 1922, he examined Ohio obscenity laws and wrote an interpretation that would allow a doctor to give contraceptive information, providing no "secret nostrum" was used and no information was sent through the mail. Amos Burt Thompson, head of Fisher's law firm, Thompson, Hine and Flory, signed the interpretation.

With this legal basis, a committee met in 1923 at the Women's City Club. Avoiding the controversial term "birth control," the committee resolved to create a "Maternal Health Clinic." Their first mission, to set up clinics in hospital outpatient departments, failed. Hospitals of the day were afraid to venture into the disreputable arena of family planning. So the committee decided to establish an independent clinic, beginning a tradition of pioneering health services other organizations could not or would not provide.

Clinic planners sought advice from the American Birth Control League and tapped their wide circle of families, friends and colleagues. They recruited Protestant and Jewish religious leaders as well as social service managers and healthcare workers. The growing network of support represented a breadth of community leadership that crossed gender and generational lines.

On March 20, 1928, the birth control planning committee, by formal action, became the Maternal Health Association of Cleveland and opened its first clinic. The Osborn Building at Huron Road and Prospect Avenue sat just a few blocks from Public Square, the center of the city. Clients from all over the city could reach it by streetcar, and because the building already housed many doctors' offices, founders reasoned, "Patients would not feel conspicuous entering it." After "begging and borrowing" furniture and equipment for the clinic's three small rooms, committee members only had to purchase three items: a sterilizer, an examining table, and a typewriter, all second-hand.

The founders chose a Medical Advisory Board of local physicians and hired Ruth Robishaw, M.D., and Rosina Volk, R.N. as clinic staff. But American medical schools did not teach birth control techniques, and federal law restricted the transportation of birth control. So Robishaw and Volk trained at Margaret Sanger's Birth Control Research Bureau in New York City, while association members and their husbands practiced civil disobedience, toting diaphragms and other supplies home from New York in suitcases.

Initially, the clinic accepted only sick women whose lives would be jeopardized by pregnancy. Of the three women seen the first day, one was already pregnant. By June, the clinic listed only 28 clients. Though many more women asked for help, MHA turned them away because they were not ill, only poor. A year later, the Medical Advisory Board recommended the acceptance of women who needed help for "social and economic reasons." Within four months, the caseload rose to 385 clients.

The same year, Cleveland scientist and inventor Charles F. Brush endowed the Brush Foundation in memory of his son, Charles F. Brush, Jr., husband of the Maternal Health Association founder. Working closely with Cleveland's MHA, the foundation would focus on improving the health of children through research. It would also build a strong relationship with the national and international family planning movement.

Despite the association's success in establishing a clinic, it still faced the challenge of changing traditional beliefs and rhetoric, both among the public and its members. In 1929, "notorious" birth control crusader Margaret Sanger spoke at the Cleveland City Club. According to the Plain Dealer, J.J. Thomas, M.D., president of the City Club, "banged his gavel," refusing to allow a vote on a motion to endorse Sanger's effort to legalize the distribution of birth control information. Although Dr. Thomas also chaired the Maternal Health Association's Medical Advisory Board, he would not compromise the traditional, neutral stance of the City Club.

The following quote appeared in the Plain Dealer: "'Birth control,' Mrs. Sanger said, 'means that children come into the world from choice and not by chance.' She described it as "the keynote of a new social and moral awakening.""

Continue to First Decade of Service - 1930s