This study traces the history of birth control and reproductive politics in the West Indies from the 1930s to the 1970s, focusing on Jamaica, Trinidad, Barbados, and Bermuda. During this period, a diverse group of activists began to organize in order to spread modern contraceptives to the working classes. These efforts provoked widespread debate over reproduction and led to the opening of the region’s first birth control clinics from the 1930s to 1950s. Birth control advocates also pressured politicians to support the cause, and by the late 1960s/early 1970s nearly every newly-independent government in the region had committed itself to state-funded family planning services. Utilizing papers of family planning advocates and associations, government records, newspapers, pamphlets, and reports, this study places these birth control campaigns and debates within the context of Caribbean political and social movements, the rise of the international birth control campaign, working class family life and gender relations, the decline of British rule, and the expansion of political independence across the region. It demonstrates that — as argued by much of the scholarly literature on the international birth control movement — early campaigns in the West Indies were initiated and funded largely by local and foreign (white) elites, and were pushed by many conservative actors who blamed political and economic instability on working class (black) fertility as a means to stave off wider reforms. However, this study also shows that the birth control cause found support among a much wider demographic on these islands, including anti-imperial politicians who incorporated birth control into broader development plans, doctors, nurses, and social workers who saw it as a critical measure to aid working class families, black nationalist feminists who argued that it was a woman’s right, and working class women and men who seized the opportunity to exercise a measure of control over their reproductive lives. These actors shaped both reproductive politics and the delivery of birth control services on the ground over the course of the twentieth century, producing campaigns that were more diverse, decentralized, and dynamic than they appear on the surface.