Oral Contraception: a History of Social Reform, Empowerment and Health Concern

The article below was written by Matt Phillips and submitted to Women of History.  Issues concerning fertility and childbirth are important to all women, and the advances made over time should not be taken lightly.

Many thanks to Matt for his most welcome contribution.

Despite its relatively short history, oral contraception has had a tremendous impact on numerous aspects of modern society. However, its role in recent movements that won women legal equality stands out more than any other outcome. Nevertheless, this modern method of birth control, which is the most popular today, represents just one in a long succession of contraceptive devices that enable women to enjoy physical intimacy while decreasing the risk of pregnancy.

One of the most striking aspects of birth control is the history it has. Although many tend to view contraception as a fairly modern development, historians point out that individuals attempted to control family size in Mesopotamian and early Egyptian times. However, these methods were generally lacking in safety and sophistication, involving infanticide or the use of questionable barrier mixtures that sometimes contained materials like honey or animal excrement. Prolonged lactation and spermicidal chemicals were also used in ancient societies to prevent pregnancy. The ancient Chinese even produced a chemical women could ingest to produce sterility.

However, historically recent developments show social motives behind the use of contraception, while past fertility control generally centered on practical issues like the economic strain another child would bring. During the 19th century in the United States, women’s medical care was passed from midwives to male doctors. At that time, because of the social, economic and religious climate, few male doctors were willing to sanction the use of contraception and give them that power, an illustration of the general opinion regarding women’s rights at the time. Although the use of condoms gained acceptance and popularity after WWI, it wasn’t until February 15, 1961 that women gained full control over their fertility, with the FDA approval of Enovid, an oral contraceptive, for public contraceptive use.

The popularity of this drug increased rapidly after its introduction as it gave women more control of their fertility than they ever had before. Its introduction also coincided with the great social restructuring that was occurring at the time. Many women looked to these pills as a way to advance both socially and economically. Indeed, after the introduction of oral contraception, female college attendance and graduation saw a sharp rise. Its use signified more than just a fertility tool, but a complete reevaluation of women’s role in the workplace as well. Now that women could delay pregnancy indefinitely, long-term career goals became the focus of individuals that might have previously settled for early marriage and economic reliance on their spouse.

However, social and economic changes were not the only trends seen with these drugs. Since their introduction, cancer cases among U.S. women have also seen a jump. Although doctors now generally agree today’s forms of oral contraception, which contain far lower hormone doses, do not significantly increase the risk of cancer, other serious side effects have been seen. Specifically, the hormonal ingredient, estrogen, acts as a blood coagulator, leading to an increased risk of cardiovascular complications, among other dangers. One recent Yaz lawsuit even involves a woman who developed blood clots in her lungs after correctly using this particular product.

While modern oral contraception has empowered women with independent, discretionary control over their fertility, it has also been blamed for several direct health impacts, as well as indirect social consequences. Some opponents of the medication fear that this drug has led to a rise in sexually transmitted disease spread by encouraging physical intimacy and removing the fear of pregnancy. Despite the social strides women have made since using this contraceptive tool, critics continue to voice their opposition loudly, much like past opponents of female fertility control who denounced these practices on moral, economic and social grounds.