In Motherhood in Bondage, first published in 1928, Sanger reproduced letters written to her from women and sometimes men from all over the country, in both urban and rural areas, who were seeking advice on reproductive matters and marital relations, but mostly imploring her to help them find ways to avoid more pregnancies. The letters are grouped by theme into sixteen chapters, and Sanger wrote an introduction to each chapter. With clear relevance to the current post-Roe moment, these pleas to Sanger for advice on avoiding unwanted pregnancy dramatically detail the desperation for reproductive agency when birth control was unknown, withheld, or otherwise inaccessible.

In her foreword for this edition, Margaret Marsh describes the controversies surrounding these letters and places them in their historical context.