Republican presidential candidate and retired neurosurgeon Ben Carson has a selfie taken with students at the Dr. Benjamin Carson High School of Science and Medicine in Detroit on May 4, 2015. (Rebecca Cook/Reuters)

Ben Carson has made some big claims about abortion, Planned Parenthood and one of its founders, Margaret Sanger, in the last few days. If you haven't heard them, watch this video.

They boil down to this:

  1. Abortions are the leading cause of death for black Americans.
  2. That's actually in keeping with the goals of Sanger, who founded the organization that eventually became Planned Parenthood.
  3. To continue that work, Planned Parenthood clinics are concentrated in black neighborhoods.

These ideas are not new. In fact, they have been a part of a set of ideas circulated in both antiabortion and black-nationalist circles for decades. And, it is a set of claims raised by Herman Cain -- a contender for the 2012 GOP presidential nomination who, like Carson, is also black -- while contemplating his White House run.

Now, here's the part that might surprise you: They are ideas that contain at least a kernel of truth and in some cases the technical truth, along with links to an ugly-but-real history which Carson used to draw some provocative conclusions. Only one of them is baseless. Still, the Washington Post's own Fact Checker blog found that Carson's claims, when taken together, could boast an only tenuous connection to the facts and are, on balance, false.

[Fact Checker: Carson's claim that Planned Parenthood targets blacks to 'control that population']

Carson's comments, made without some critical context about race and reproduction, have been widely condemned outside of the GOP's antiabortion circles. Planned Parenthood has condemned Carson's comments and described them as a misleading attempt at race-baiting. At the same time, Republicans have lauded Carson's comments. The rather uncomfortable fact that Carson -- a candidate on record arguing that race is of no import -- has ignited a conversation that is very much about race, sex and reproduction hasn't stopped that.

A big reason for the apparent dancing around the details on the left and the right is that black women, childbearing and abortion have long served as rallying points for those who want to slash social services or mobilize Americans around the idea that their tax obligations are unnecessarily swollen. It's a sensitive set of subjects, to say the least.

With all that out of the way, let's dive into the substance of Carson's claims.

Is abortion the leading cause of death for black Americans? 

Yes -- if (and of course this is the biggest of all ifs) one considers an abortion to be a death.

Both black and Latina women, in fact, underwent more abortions in 2011 -- the most recent year for which data from the Centers for Disease Control and Prevention is available -- than the number of people who died as a result of each group's respective primary cause of death.

Now, race-related abortion data is available for only just more than half of states. Still, even without many states in the abortion data, abortions outpace the leading causes of death for both black and Latino Americans.

CarsonAbortion
Source: Centers for Disease Control and Prevention

* Abortion figures includes data for 27 states.

However, the reasons for the pattern the CDC data reveal are complex. Researchers at the CDC and the Guttmacher Institute, an abortion-rights think tank, have identified poverty, health insurance coverage rates, and inconsistent and sometimes nonexistent contraception access and use as three primary causes of elevated abortion rates among black and Latina women. They all contribute to unintended pregnancies, the leading reason women cite for having an abortion. (The Affordable Care Act has mandated that most health-insurance plans provide contraceptive coverage without a co-pay since 2012. Carson adamantly objects to Obamacare because of the control he says it attempts to exert over Americans' lives.)

[Ben Carson: Obamacare worst thing since slavery]

Was Margaret Sanger a eugenicist?

Again, there's evidence to show that Carson's assessment of Sanger is correct but incomplete. Sanger certainly said and wrote things during her lifetime (1879-1966) that support or endorse the idea that certain people should not reproduce. And she founded the organization that eventually became Planned Parenthood.

When Sanger took up the highly controversial and illegal cause of making contraceptives available in the early 1900s, she aligned herself with the one wing of the overwhelmingly male-dominated medical profession that embraced contraception and its goals, said Johanna Schoen, a Rutgers University historian who wrote the 2006 book, "Choice and Coercion." Most of these people were eugenicists, or people who believed in "improving" the human race through controlling who breeds and who doesn't.

Schoen said Sanger used some of their language and ideas to give her work a valuable, reputation-boosting association with medicine and "science."


On March 1, 1934, renowned birth control pioneer Margaret Sanger appeals before a Senate committee for federal birth-control legislation in Washington. Sanger's legal appeals eventually prompted federal courts to grant physicians the right to give advice about birth-control methods. (AP)

Sanger's "Negro project" -- one part of her larger contraception campaign -- aimed to bring contraceptive options to black women. But she also did similar work with white women.

At the time, a dozen or more pregnancies, deliveries, miscarriages and children were relatively common. All of that was very rough on women, deleterious to the health of mothers and children born in rapid succession and not so great for family finances.

Critics of contraception and its widespread availability claimed then (as they do today) that this would encourage promiscuity. During the early years of Sanger's work, contraception opponents also claimed it would limit the size of the nation's "desirable" white, Protestant population since other groups were too dumb to use contraception correctly, Schoen told me.

Again, eugenic ideas were, in some ways, mainstream and ultimately prompted forced sterilization laws in about half the states. These programs targeted poor and unmarried white mothers, blacks, Latinos and the disabled. Some of these programs remained active well into the 1970s.

But there's also evidence that Sanger was probably more than an opportunist who aligned with eugenicists for practical purposes. She was, in fact, an enthusiastic supporter of the idea that blacks were inferior and that their reproduction should be limited, said Nicole Rousseau, a sociologist at Kent State University who wrote the 2009 book "Black Woman's Burden: Commodifying Black Reproduction."

Once during a radio interview, Sanger said blacks, the disabled and other groups should be marooned and left to die on an island, Rousseau told me.

Why are we discussing Sanger today?

History informs the way we all think and behave. At least 100,000 black and Latina women were sterilized as a result of state sterilization programs, Rousseau told me. Some of these women were told that they needed other procedures so that doctors could sterilize them or were sterilized against their will while under anesthesia for other reasons. That happened to Fannie Lou Hamer, a  civil rights activist who advocated against the pill because of her understandable suspicions that it was a form of chemical sterilization.

What happened to Hamer was so common she reportedly gave it a name: the "Mississippi Appendectomy." Other women were coerced by social workers who threatened to discontinue welfare assistance. In Puerto Rico in the 1950s and 60s, the U.S. government took similar steps sterilizing thousands of women without their consent. And as recently as the early 2000s, at least one state operated a program that paid teens who were wards of the state to use a form of implanted (and reversible) contraception, Rousseau found in her research.


Eldridge Cleaver, third from left, and Bobby Seale, fourth from left, in a photo that became a Black Panther poster. (AP)

That history, along with other better-known medical experiments, has fueled generational suspicion about medicine, and about birth control in particular, in some families -- especially families of color -- said Jennifer L. Hochschild, a professor of government at Harvard University.

In the 1960s and '70s, black-nationalist organizations including the Black Panther Party often pushed the idea that birth control and abortions were part of an effort to minimize the black population. In more recent decades, antiabortion organizations, including those led by white Americans and those led by black Americans, have advanced the idea that abortions represent a form of attempted genocide.

So are Planned Parenthood clinics concentrated in black communities? 

This is an allegation long lodged against Planned Parenthood. But as of yet, no one -- including Carson -- has produced solid evidence to support it, and there's pretty good evidence to refute it.

The majority of the nation's abortion providers are in predominantly white neighborhoods, according to a Guttmacher Institute analysis. Guttmacher researchers compared the location of all the nation's abortion providers in 2011 with the racial and ethnic composition of the neighborhoods in which they are located.

provider-location-490

So, there you have it. There was some truth in Carson's comments. But the whole truth -- and history -- is anything but simple.

CORRECTION: This post has been altered to include Herman Cain's 2011 statements about Planned Parenthood, abortion and race. His comments predated Ben Carson's more recent statements. The post also clarifies the period of time during which Guttmacher Institute researchers examined the location of abortion clinics. The chart above was generated in 2014 but based on 2011 data.