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Birth Control as Health Care: The Legacy of the International Workers Order #SouthOfUnionSquare

Though forms of birth control existed long before the introduction of “the pill” in 1960, most women often did not have easy access to it. In the early 20th century, public views of birth control were often negative, discussion of it was usually stifled, and in general women did not have a great deal of control over their bodies. In fact, the Comstock Act of 1876 made it illegal to advertise or share information about birth control, as it was considered “lude.” In the 1910s, as the Women’s Suffrage movement was coming to a head in this country, women also began advocating for reproductive rights. The tide was shifting; birth control was beginning to be viewed by many as a medical and public health necessity. One fraternal organization located South of Union Square in our neighborhood blazed that trail — seeing it as such a necessity that they covered it under their health insurance, becoming the first insurer to do so. 

80 Fifth Avenue, 1937

In 1936, the International Workers Order (IWO) became the first insurer to offer birth control. From their headquarters at 80 Fifth Avenue, they offered birth control and gynecological services for a flat rate. The IWO was a pioneer in the realm of pre-paid medical insurance. Though the IWO never intended to offer insurance indefinitely, they believed insurance was a vital part of life and offered it to their members and non-members as an “emergency measure” until they could realize their goal of universal health care for all Americans. The IWO rallied relentlessly for universal health care, coming close several times, including with the National Health Act (Wagner’s Bill) of 1939, which the IWO committee advised. But ultimately, universal health care in the United States did not come to fruition. 

Leaflet for the IWO benefits ca. 1930s, courtesy of the University of Pittsburgh

The IWO’s plan insured over 60,000 men, women, and children. Single members paid $2.70 a year, and families paid $4.20 a year. The IWO paid 63 physicians to be full-time staff; members could be seen at the physician’s offices or on house calls. Members also were entitled to any necessary surgeries at a cap of $50. Members also received reduced fees for labs, eyeglasses, and drugs prescribed by physicians. The IWO also offered benefits for illness, paying members $4-$10 a week when they needed to take off from work.

IWO Doctors NY District, 1940s

For an extra $4 a year, women could receive birth control and attend the clinic at 80 Fifth Avenue. According to an IWO committee member, the Birth Control clinic was regarded as one of the best of its kind in the early 20th century. Dr. Appell Cheri ran the clinic; she had long worked with Margaret Sanger of Planned Parenthood. The clinic was open late into the evening to accommodate working women who couldn’t take time off work to come during the day. 

Birth Control Review, Published by the American Birth Control League at 104 fifth Avenue

When IWO opened the clinic in 1936, the birth control debate raged. On December 31, 1936, the New York Times shared a column on the conference discussing the issue at the Hotel Roosevelt entitled “Controlled Birth Known to Ancients.” Dr. Cheri of the IWO’s clinic was in attendance. She shared the benefits of planned parenthood and dismissed the false claims that continued use of birth control would leave women sterile. Dr. Himes, a sociologist, traced birth control back to Egyptians and Romans, noting that it has always been around. He also indicated that the wealthy women of a society have long been accessing contraceptives. In contrast, less privileged people could not access birth control, which was a disadvantage. The conference seemed to end in no resolution, as doctors continued sharing negative and false information about birth control, though interestingly, the papers did not discuss those in detail. 

December 31, 1926, NYTimes

Despite the Conference on Contraceptive Research and Clinical Practice at the Hotel Roosevelt in 1936 not ending in resounding support for women’s rights to bodily autonomy, the IWO continued to provide and cover birth control, viewing it as necessary preventive medical care, until the organization was disbanded in 1954 due to Red Scare investigations and persecution. The IWO’s insurance was liquidated by New York State and investigated by the House of UnAmerican Activities. Though the idea of birth control as controversial may seem antiquated, it wasn’t until 2010 that insurance was required to cover birth control for any person needing it. After dismantling a vital resource for working women, immigrants, and less wealthy families, the United States waited 75 years to give people who needed access to this medication the right to coverage.


The neighborhood South of Union Square’s history is rich with trailblazing women we are working to ensure are remembered for their contributions to our society and city. Click here to take our Women’s History tour, and here to submit a letter in support of landmark designation for the area to the Landmark’s Preservation Commission.

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