Katie Ripley was one of the two women who initiated the Texas birth control movement during the 1930s. One of Margaret Sanger's personal friends Ripley founded the Dallas birth control clinic on February 25, 1935, and affiliated it with Sanger's Birth Control Clinical Research Bureau. During its early years it was financed by donations from Ripley and her spouse George, a Dallas shirt manufacturer. Initially patients were referred to the clinic by city welfare agencies, and they were provided services and supplies without charge.
The U.S. Appeals Court's 1936 ruling in United States v. One Package of Japanese Pessaries that the distribution of contraceptives was legal under certain conditions removed the main legal barrier to the establishment of birth control clinics, and the number of Texas clinics increased rapidly during the following three years. Agnese Carter Nelms was the key figure in this expansion. After founding Houston's Maternal Health Center in February 1936, she assisted in the formation of at least four other clinics during the next three years: Austin (July 1937), Fort Worth (February 1938), San Antonio (July 1939), and Waco (October 1939). Clinics were also created in El Paso (April 1937) and San Angelo (November 1938). Except for the El Paso clinic these were all affiliated with the American Birth Control League. Nelms also initiated the formation of the Birth Control League of Texas in June 1936 to advance that cause statewide and became its first president. Because of her central role in the Texas birth control movement's growth, Nelms became Texas's representative on the national organization's board of directors, and national leaders referred to her as the "Margaret Sanger of Texas."
After the national organization changed its name to Planned Parenthood of America in 1942, the Texas clinics made a similar name change. This was intended to increase public acceptance by conveying that their purpose was to help plan families rather than simply restrict family size. The Catholic Church led the organized opposition to the clinics prior to the 1960s; it forced the Austin clinic to move from its original location in Brackenridge Hospital and in Houston and San Antonio attempted to prevent physicians on local clinic medical advisory boards from working at Catholic hospitals.
Although the Corpus Christi clinic was established in 1958, the second major wave of clinic expansion occurred during the 1960s; new clinics were founded in Lubbock (1963), McAllen (1963), Midland (1966), Odessa (1965), Amarillo (1968), and Permian Basin (1970) while several of the older ones established satellite clinics (San Antonio added twelve). Federal funding was a major factor in this expansion. Believing that family size often contributed to poverty, the Johnson Administration's War on Poverty included federal funds for family planning; in 1964 Planned Parenthood of Corpus Christi was the nation's first clinic to receive federal funding under this program. The 1967 Social Security Act substantially increased federal funding for family planning and required states to make it available to adult welfare recipients. In 1970 the Texas Senate Interim Committee on Welfare Reform recommended that the Texas Welfare Department include family planning as one of its services in order to reduce welfare expenditures. This proposal's implementation contributed to the continuing growth in patient load during the 1970s.
Despite family planning's widespread acceptance during the 1970s as part of the state's health and welfare services, the clinics faced serious challenges during the following decades. After the Supreme Court's 1973 Roe v. Wade ruling that abortion was legal, some of the clinics began providing abortion services. Abortion opponents responded with continuing protest demonstrations at several clinics that hampered operations. While coping with these local pressures, the clinics were also confronted with sharp reductions in federal funding during the Reagan Administration that forced them to make significant reductions in services. Despite these challenges, at the beginning of the twenty-first century the clinics continued to be important providers of women's reproductive health services (see WOMEN AND HEALTH).