Court of Appeals decision in United States v. One Package

In late 1936, the United States Court of Appeals for the Second Circuit issued its decision in United States v. One Package of Japanese Pessaries, a landmark case that significantly undermined the federal Comstock Act's restrictions on contraception. The case arose when a package of pessaries (a contraceptive device) sent to Dr. Hannah Stone, a physician allied with Margaret Sanger's clinical work, was seized by customs officials as "obscene" material illegal to import under federal law.

The litigation was carefully orchestrated as part of Sanger's long-term legal strategy to dismantle the Comstock laws through the courts rather than relying solely on legislative reform, which had repeatedly failed in Congress. Judge Augustus Hand, writing for the appellate court, ruled that the 1873 Comstock Act was never intended to prevent physicians from importing or providing contraceptive materials for legitimate medical purposes affecting patients' health and well-being.

This ruling was a watershed moment because it effectively exempted physicians from federal anti-contraception restrictions, opening the door for doctors nationwide to legally prescribe and distribute birth control. The decision helped pave the way for the American Medical Association's formal recognition of birth control as legitimate medical practice the following year, in 1937. It represented the culmination of Sanger's decades-long strategy of using medical authority and legal challenges to achieve what direct activism alone could not accomplish.