Before contraception was legal women often had a child every two or three years until their luck ran out and they died in childbirth or they went through menopause. C-sections, which didn't kill the mother, and more sanitary conditions were also factors. Dr. Jesse Bennett performed the first successful caesarean section in the US in 1794 on his own wife, removing her ovaries at the same time, saying he would not be subjected to such an ordeal again. She was afraid she was dying and asked for one. Her attending physician refused. Her husband put her out using laudanum and saved her and their daughter.
"Margaret Higgins Sanger Slee (September 14, 1879 – September 6, 1966) was an American birth control activist and the founder of the American Birth Control League (which eventually became Planned Parenthood). Although she initially met with opposition, Sanger gradually won some support for getting women access to contraception.
Distributing a pamphlet, Family Limitation, to women, Sanger repeatedly caused scandal and risked imprisonment by acting in defiance of the Comstock Law of 1873, which outlawed as obscene the dissemination of contraceptive information and devices."