Henry Wilkinson, John Beckles, and Maymie L. Aiken were three Caribbean actors located in quite different positions within the colonial class, race, and gender hierarchy, but they shared a concern over reproduction and a faith in modern birth control technology. Wilkinson, a white Bermudian health reformer who served as the island's chief medical officer at the time, portrayed birth control as a means to stymie “overpopulation” of an expanding “negro” population. Beckles, a prominent middle-class black Barbadian social worker, envisioned family planning as a tool to help improve economic and social conditions for the island's most impoverished citizens. Maymie L. Aiken, a working-class activist prominent within the Universal Negro Improvement Association (UNIA) and local labor movements, viewed the issue in a somewhat more radical light.

Rose Gordon wrote a letter.

She had read the Jamaica Birth Control League's (JBCL's) advertisement in the newspaper, she explained. She was 34 years old and had given birth fourteen times, with three lost pregnancies; she had – in her own words – been “a slave to childbearing for over fourteen years.” She made her intentions for writing clear: she wanted a “full stop” so that she could be “entirely free from this terrible strain.” Conveying a sense of urgency, she called on the league to give her letter its “earliest attention” and send her a response “as quick as possible.” She wanted information – she wanted support. She wanted birth control.

She was not alone. In fact, Rose's letter was one of hundreds written to the JBCL upon its creation in 1939. These letters came from across the island, from Port Morant to Lucea, some even from women living in migrant communities abroad. Collected and preserved by the honorary secretary of the JBCL, May Farquharson, the letters document a diversity of experiences and demands. Some of the women who wrote had multiple children and were feeling the physical, financial, and emotional strain of repeated pregnancies and innumerable mouths to feed; others were at the beginning stages of their reproductive lives but were looking ahead to their futures. Some wanted an end to childbearing, others wanted a temporary break; some wanted to stop a pregnancy that had already begun. Some were single mothers, others wrote with the support of their husbands or partners, still others wrote in secret. Indeed, the stories told by the letters often appear only loosely stitched together by a common struggle for control: over one's body, one's family, one's life.

This struggle was not particularly new, but the opening of the JBCL clinic certainly was, and it was not an isolated event. From the 1930s on, a growing group of activists across Britain's Caribbean colonies had begun to mobilize to demand that birth control spread – as one commentator put it – “out of the boudoir and into the banana walk,” in other words, beyond the private bedrooms of elites and into the urban slums, rural villages, and plantations where the islands’ working-class populations lived and worked.

Trinidad's first birth control clinic held its opening session on September 20, 1956, in a building formerly occupied by the Church of Nazarene in Port Fortin. The clinic's founders (Shell Oil employee Dr. Beric Wright and his wife Joyce) and four local volunteers braced themselves for a difficult day. As noted in Chapter 2, local Roman Catholic leaders had vociferously protested the clinic on religious grounds, while others had branded it a plot by Shell Oil to control the fertility of the poor. Just a few weeks earlier, the opposition had called for a petition to the Colonial Secretary to prevent the opening of the clinic. But the day turned out to be relatively anticlimactic. As Beric Wright later recalled:

By the end of the day, the clinic had seen seven patients, providing a consultation to each and distributing birth control methods for a small fee or free for those who could not pay.

Birth control advocates on other islands in the Caribbean were similarly encouraged by the response of local women to the opening of clinics. In Bermuda, Dr. Henry Wilkinson noted that they had seen dozens of women in the first few months of birth control services in 1937 and “inquiries & interest are increasing healthily” despite little to no advertising on the part of the Medical Department. By the end of its first year, the JBCL's clinic had attended to 335 patients, as well as receiving some 521 letters from women in the countryside. As Farquharson noted, in fact, these patients and letters came “a good deal too fast, because we are not ready to deal with them.” The half-day clinic established at the Speightstown Health Centre in Barbados by the BFPA in 1955 was getting anywhere between fifty and seventy-five women per session within a few months of opening, requiring the clinic to set up additional hours, and the Beth Jacobs Clinic in St. Ann's Bay noted that women were traveling from distant villages to seek advice.

On July 5, 1955, the elected members of Barbados’ House of Representatives voted “in the affirmative without division” to provide a grant of $5,000 to the Barbados Family Planning Association (BFPA). The grant came on the recommendation of a Joint Committee appointed in 1952 “to Examine the Question of Over-Population in Barbados,” which called on the government to take action to reduce the rapid rate of population growth. Although providing grants for nonprofit organizations was standard practice (on the same day the government renewed its $2,000 annual grant to the Salvation Army) and $5,000 hardly made a dent in the island's budget, the decision was considered monumental, for it placed Barbados in the company of only a handful of other governments around the world openly committed to spreading family planning services.

Barbados’ premier at the time, Sir Grantley Adams, had spoken out in favor of birth control as far back as 1938 and quickly embraced the island's new role as a world leader in family planning. In 1957, Adams spoke at the annual luncheon of the Planned Parenthood Federation of America (PPFA) in New York, calling on the pope and the United Nations to amend their policies to support birth control in underdeveloped countries. Adams's trip was praised by the PPFA, as well as by African American news organizations like the Cleveland Call and Post, which commended the steps taken by this “distinguished Negro leader.” It also attracted the attention of American Hugh Moore, founder of the Dixie Cup Corporation and author of The Population Bomb, a widely distributed pamphlet that warned in apocalyptic terms about population growth in the developing world. In April 1958, Adams was presented with the Hugh Moore Award for his “fearless advocacy of family planning to arrest the current population explosion which is retarding economic progress in underdeveloped countries.” The newly independent islands of Jamaica and Trinidad would also join Barbados in this “fearless advocacy,” announcing their support and committing state funding to family planning in 1964 and 1967, respectively. By 1974, nearly every island in the English-speaking Caribbean had followed suit, leading to a rapid expansion of birth control clinics armed with new methods like the pill and IUD.

The enthusiasm in the air was palpable on March 20, 1939, when over 100 men and women gathered at the Esquire Restaurant in Kingston. A veritable who's who of politically active middle-class Jamaicans spoke of their pride in Jamaica, their commitment to social and political advance, and the spirited climate prevailing since the 1938 labor rebellion; as Honorable E.E.A. Campbell claimed, Jamaica “had made more progress in ten months than she had during the first century of emancipation.” The dinner focused on honoring Mary Morris Knibb for making history as the first woman to be elected to the Kingston and St Andrew Corporate Council. But activists also used the opportunity to say farewell to British feminist Edith How-Martyn, who had just completed an eleven-week long birth control lecture tour of the island. Social worker Amy Bailey recalled her efforts to recruit How-Martyn during a trip to London the year before and praised How-Martyn for standing beside her “sisters” and for showing “no narrow-mindedness or pettiness of race, colour or creed.” The mayor of Kingston Dr. Oswald Anderson called How-Martyn

After a presentation from Alma LaBadie on behalf of the Women's Liberal Club, How-Martyn closed the dinner by giving her thanks and announcing the formation of the first ever Jamaica Birth Control League, encouraging the audience to contact Honorary Secretary May Farquharson for more information.

The nationalist fervor present at the Esquire restaurant that day joined a larger chorus spreading across the British Empire in the early twentieth century. Activists from Asia to Africa to the Caribbean called out the fundamental injustices of the colonial system and demanded self-determination. This pressure from the colonies prompted a number of reforms in the Caribbean in the 1940s and 1950s, including the implementation of universal suffrage and the creation of a locally elected prime minister with expanded powers, paving the way for the creation of modern political parties. But the British did not resign from the colonial project so easily; on the contrary, the Colonial Office committed itself to a series of “social welfare” and “development” initiatives in the post–World War II period meant to defend and revitalize the empire.

The shifting politics and practices of reproduction in the Caribbean that began in the 1930s and accelerated in the 1960s took off in the 1970s and 1980s, attracting the attention of both local and international commentators. While conducting research in a small town in Trinidad in the 1980s, for example, anthropologist Joseph Nevadomsky highlighted the way villagers would openly discuss birth control in mixed company, relating experiences and sharing complaints about side effects and preferences. As one man reported to him,

Sociologists also noted the high rates of birth control literacy in several Caribbean countries; a 1986 study, for example, showed that some 75 percent of Barbadian women were able to name six or more types of contraceptives. This increased birth control literacy also seems to have corresponded with an increase in birth control practice. Indeed, over the course of the 1960s–1980s, Caribbean countries experienced rapid declines in their birthrates, and by 1990, the Anglophone Caribbean as a whole was recognized as having had some of the most dramatic declines in total fertility in the world. As Patricia Mohammed argues, by the thirtieth anniversary of the Family Planning Association of Trinidad and Tobago in 1986, birth control had moved fairly concretely from something “not mentioned in polite circles and unheard of in others” to “an accepted institution.”

Family planning campaigns and state programs cannot claim sole responsibility for these shifts. On some islands, such as Trinidad, birth-rates began to decline before the expansion of state clinics, suggesting that some of those motivated to limit their families were able to find ways to do so without the support of the state.