This essay offers a historical overview of African American women's efforts to gain access to contraception, from the early stirrings of the campaign to legalize birth control in the 1910s to the eve of mass movements for racial equality and women's rights in the 1960s. The birth control struggle becomes a window on the racial, gender, and economic structures black women negotiated in pursuit of sexual and reproductive self-determination at that time. Taking us back a century, and with emphasis on resilience and resistance, their story reminds us of the deep roots and broad vision of black women's leadership in what has become a women-of-color–led human rights movement for reproductive justice today.