Working in East Africa, I used to give an afternoon a week to a remote Catholic mission down a bumpy laterite road. It was run by a Swiss nun, aged about seventy, and, astonishingly, it was as spotlessly clean as the most expensive Helvetian clinic. The nun, who had devoted her life to work in Africa, was surrounded by an aura of inviolability: in her case, cleanliness really was next to godliness.

Among my duties was that of giving a three-month contraceptive injection to mothers who already had ten or more children as well as heart disease that would render fatal the bearing of another child. The mothers had come long distances, and their husbands knew nothing of why they had come, for they would not have approved if they had known. The nun would absent herself while I gave the injection (though it was the mission that provided it); in the room in which I gave it there was a large photographic portrait of the Pope.

No word ever passed between us about the contradiction between the official doctrine of the nun’s church, to which she owed obedience, and the practice. I had passed the age when consistency seemed to me the greatest of all virtues and hypocrisy the worst of all vices. I let the matter rest in silence.

Would Margaret Sanger have been able to do so? The subject of Jean H. Baker’s recent biography, which is admiring but not uncritical, was born into a very different world, in which birth control was a taboo and, indeed, legally censored subject, so that combativeness was necessary to bring it into the open. This quality Margaret Sanger had, perhaps to excess; there is an addictive quality to fighting what one considers to be the good fight, especially when there is a limit to what one’s opponents are prepared or able to do to silence one. I think, therefore, that she would not have been willing to pass over the contradiction in silence.

Margaret Sanger was born in 1879 in Corning, New York, to Irish immigrant parents. They were poor, but not desperately so; her mother, however, died of tuberculosis, and her father, a tombstone engraver, was a fiercely anticlerical socialist. Margaret Sanger absorbed many of his attitudes and made them her own.

Her career was a very remarkable one. She trained as a nurse, but never completed her training; she ended up, with Marie Stopes, as the most famous advocate of contraception in the world, whom writers and prime ministers courted and flattered. She was brave, intelligent, a good administrator, and determined to the point of monomania. She was also egotistical, selfish, and not always a devotee of the truth. To say that she was a mythomaniac would be going too far, but she did not hesitate to gild a good lily when she saw the opportunity to do so. For example, she claimed to have gone on hunger strike nigh unto death while in prison, when in fact it was her sister who had done so. For her, the good of the cause, and her own position within it, trumped the need for strict adherence to the truth; she could never tell the same story twice without significant alteration.

So completely has modern moral sensibility changed from that in which Sanger grew up, that we now find it almost difficult to credit the ferocious opposition those who wanted to provide birth control services once faced (in some places in the United States not all that long ago). That the mere advocacy in public of any practices—other than sexual abstinence—that limited procreation was a matter of criminal prosecution and imprisonment will seem to the young reader (if any) almost incredible. Sanger helped to change the world, and the author gives justifiably short-shrift to the argument that, even without her, that change would have come about anyway. This is like saying that if Newton hadn’t discovered his laws, someone else would have done, and therefore he wasn’t so very great after all.

Sanger repeatedly told, in differing versions, the story of Sadie Sachs, a woman whom she attended on the Lower East Side, who suffered an infection after a botched, and of course illegal, abortion. Sachs recovered, asking the doctor what she could do to prevent a further pregnancy. He replied with a flippant “You want your cake while you eat it too, do you?” Some months later, Sadie Sachs was again pregnant, and attempted a self-administered abortion. This time she died of the resultant septicaemia.

From this story, and others like them, Sanger concluded that birth control was the hope of the world; it would not merely solve some human problems, but would solve practically all of them. The author calls the story of Sadie Sachs Sanger’s “epiphany,” which suggests that, notwithstanding her fierce opposition to religion, she was in search of a substitute for it: a conclusion strengthened by the fact that when her daughter died of pneumonia aged five, possibly because of her neglect, this woman who was so fiercely rationalist in her public pronouncements turned to spiritualism for consolation, perhaps to persuade herself that her daughter was not really dead after all and that therefore she was not responsible for her death.

Sanger’s intelligence, which was undoubted, was a narrow rather than a broad beam. She was more a propagandist than an original thinker, but she could also show imaginative judgment. For example, despite a lack of rigorous scientific training, she early recognized the potential of research into reproductive hormones in the development of an oral contraceptive pill. Indeed, it was she, through the financial generosity of her friend the agricultural machine heiress Katherine Dexter McCormick, who provided support for the work of Gregory Pincus, the endocrinologist who developed the first oral contraceptive, after he and his work had been rejected both by the academy and the pharmaceutical companies. This seems to me an astonishing achievement, perhaps her greatest, and one that came towards the end of her long life.

On wider matters, however, her judgment was less sound. She swallowed the crude eugenicism of the first third of the twentieth century hook, line, and sinker. While she was very far from being alone in this—many of the most eminent literary figures of the period such as H. G. Wells and George Bernard Shaw, as well as jurists such as Oliver Wendell Holmes, also did so, G. K. Chesterton being a notable exception, writing a prescient book about its evils—it does not redound to her credit.

The hatred of Catholicism that she learned at her father’s knee, and her monomania on the subject of birth control, skewed her political judgment almost comically, when she claimed that the most dangerous enemy of the United States was not Japan, Nazism, or Communism, but the Catholic Church. And she also uncritically accepted (as, admittedly, did many others at the time) the inevitability of future famine caused by world overpopulation, to which the only answer—she said—was birth control. Instead, what we have seen is both a population explosion and the greatest increase in average wealth in human history. This might not continue into the future, but it is certainly not in concert with Sanger’s over-confident (and unduly pessimistic) predictions. It is not without reason, then, that prophets are sometimes without honor in their own country. They get things wrong.

But it was in her utopian view of what could be expected from the sexual liberation brought about by effective and cheap contraception that she showed her shallowness. This biography is subtitled A Life of Passion, but it might just as well have been subtitled A Life of Heartlessness. True, she had many passionate affairs, but there is not much evidence that she ever cared much for the passion, or even the feelings, of others. She abandoned her first husband, a draughtsman and aspiring artist called William Sanger, though he was a decent, honorable, kindly, loving man, merely because she felt like it and wanted fulfilment elsewhere. In the process she virtually abandoned her children and it was no thanks to her that two of the three did not end up too badly. Her ideal of human relationships was that everyone should do as he or she pleased, as she herself did, without considering what, in military parlance, would be called the collateral damage. In Sanger’s ideal world, everyone could have it all, all of the time; she entirely lacked the sense of the tragic, and any awareness that in order to have one desirable thing you must forgo another.

Although Sanger never campaigned for the legalization of abortion, she was a pioneer of the view that the relationship of a person with his or her own body is that of sovereignty or ownership. Irrespective of the rights and wrongs of abortion, this is a very crude attitude to human existence.

The unhappiness of her final years was a natural consequence of how she had lived. Her main battle had been won, and the struggle from which she derived most of the meaning of her life was over. There is no sadder fate for a reformer than to see his or her reforms accepted. She had sacrificed her relationships to the cause, and while she was by no means the worst of mothers, it is clear that her two sons felt no particular warmth for her, nor did they have any reason to do so. They were dutiful towards her but little more. By the time she needed their affection, it was too late for them to develop it.

Baker’s biography is clearly written, not of undue length as so many biographies these days are, and while inevitably it concentrates on the subject’s public activities, it succeeds in conveying her character. One characteristic that she lacked (if the biography is accurate) was a sense of humor. The only funny thing she ever said, however, was quite good, and worth committing to memory: “The more I have to do with Congressmen, the more I believe in birth control and sterilization.”