In 1921 Margaret Sanger founded the national lobbying organization, American Birth Control League (ABCL) which in 1942 became Planned Parenthood Federation of America (PPFA). Between 1921 and 1942 the organization had two transformations. In 1923 Sanger opened the Birth Control Clinical Research Bureau (BCCRB) for the purposes of dispensing contraceptives under the supervision of licensed physicians and studying their effectiveness. In 1921 when she founded the American Birth Control League (ABCL) it provided institutional backing for the clinics. The BCCRB merged with the ABCL in 1939 to form the Birth Control Federation of America (BCFA). In 1942 the name of the BCFA was changed to the Planned Parenthood Federation of America.

The name change reflected a redefinition of the organization's goals from family limitation to family planning. While PPFA continued to function as the largest birth control organization in the country, it sought to position itself as a more mainstream and moderate organization committed to a broad range of programs related to reproductive health. Under the leadership of National Director D. Kenneth Rose, the PPFA expanded its programs and services through the 1940s, adding affiliate organizations throughout the country. By the end of World War II, the Federation was no longer solely a center for birth control services or a clearing house for contraceptive information but had emerged as a major national health organization. PPFA's programs included a full range of family planning services including marriage education and counseling, and infertility services. The leadership of the PPFA, largely consisting of businessmen and male physicians, endeavored to incorporate its contraceptive services unofficially into regional and national public health programs by emphasizing less politicized aspects such as child spacing. During the 1950s, the Federation further adjusted its programs and message to appeal to a family-centered, more conservative post war populace, while continuing to function, through its affiliated clinics, as the more reliable source of contraceptives in the country.

From 1942 to 1962, PPFA concentrated its efforts on strengthening its ties to affiliates, expanding public education programs, and improving its medical and research work. By 1960, visitors to PPFA centers across the nation numbered over 300,000 per year.

In the 1950s PPFA began focusing greater attention on global population issues as new concerns arose over the political, social and cultural implications of overpopulation in Asia and around the world. It became active in international birth control work through is membership in the International Planned Parenthood Federation (IPPF), which Margaret Sanger helped found in 1952. In 1961 the population crisis debate, along with funding shortages, convinced PPFA to merge with the World Population Emergency Campaign, a citizens fund-raising organization to become PPFA-World Population. (This history is excerpted from The Margaret Sanger Papers Microfilm Edition: Smith College Collection Series)