A Brief History of Birth Control in the U.S. By Kirsten M.J. Thompson | December 14, 2013 Prior to modern methods of birth control, women relied on withdrawal or periodic abstinence. These methods often failed. Around 3000 B.C. Condoms made from such materials as fish bladders, linen sheaths, and animal intestines. Around 1500 First spermicides introduced which used condoms made from linen cloth sheaths and soaked in a chemical solution and dried before using. 1838 Condoms and diaphragms made from vulcanized rubber. 1873 The Comstock Act passed in the United States prohibiting advertisements, information, and distribution of birth control and allowing the postal service to confiscate birth control sold through the mail. 1916 Margaret Sanger opens first birth control clinic in the United States. The next year she was deemed guilty of maintaining a public nuisance and sentenced to jail for 30 days. Once released, she re-opened her clinic and continued to persevere through more arrests and prosecutions. 1938 In a case involving Margaret Sanger, a judge lifted the federal ban on birth control, ending the Comstock era. Diaphragms, also known as womb veils, became a popular method of birth control. 1950 While in her 80s, Sanger underwrote the research necessary to create the first human birth control pill. She raised $150,000 for the project. 1960 The first oral contraceptive, Enovid, was approved by the US Food and Drug Administration (FDA) as contraception. 1965 The Supreme Court (in Griswold v. Connecticut) gave married couples the right to use birth control, ruling that it was protected in the Constitution as a right to privacy. However, millions of unmarried women in 26 states were still denied birth control. 1968 FDA approved intrauterine devices (IUDs), bringing early versions like the Lippes Loop and Copper 7 to market. 1970 Feminists challenged the safety of oral contraceptives (the Pill) at well-publicized Congressional hearings. As a result, the formulation of the Pill was changed, and the package insert for prescription drugs came into being. 1972 The Supreme Court (in Baird v. Eisenstadt) legalized birth control for all citizens of this country, irrespective of marital status. 1974 The FDA suspended sale of the Dalkon Shield IUD due to infections and seven documented deaths among users. Although other IUD designs were not implicated, most IUDs were slowly taken off the US market due to the escalating costs of lawsuits in subsequent years. 1980s Pills with low doses of hormones were introduced, along with a new copper IUD, ParaGard (1998). (CuT380a). Growing awareness of the Yuzpe regimen for emergency contraception. 1990s Introduction of Norplant, the first contraceptive implant (1990),DepoProvera, an injectable method (1992), FC1/Reality, a female condom (1993) and Plan B, and a dedicated emergency contraceptive product (1999). 2000s Rapid expansion in method availability and improvements in safety and effectiveness, including introduction of Mirena, a new levonorgestrel-releasing IUD (2000), Ortho Evra, a hormonal patch (2001), Nuvaring, a vaginal ring (2001), Essure, a method of transcervical female sterilization (2002), Implanon, a single-rod implant (2006), and FC2, an improved female condom (2009). 2002 The first implant, Norplant, is taken off the US market. 2010s Ella, a new emergency contraceptive pill (2010) and Skyla, a new levonorgestrel-releasing IUD (2013) are introduced. Growing use of the copper IUD for emergency contraception. 2013 After protracted regulatory and legal battles, one brand of emergency contraceptive pill (Plan B One-Step) becomes available without a prescription on drug store shelves. Today More research is needed on woman-controlled methods that protect against STIs and birth control for men. Barriers to accessing reliable contraception remain for women worldwide. History of Birth Control by Kathleen London Another indication that there is need for increased education regarding birth control is suggested by a question I am constantly called upon to answer: why�when birth control is so available�why do so many adolescents continue to become pregnant? And of course the answer is not easy. Birth control failure is high for adolescents and commitment to effective use is often lacking. You may wish to consider the following points: no method is 100% effective; health care providers may not take time to fully educate clients; the commitment to use contraception effectively may be lacking because the young woman and man are not comfortable with their sexuality, are experiencing guilt or shame about being sexually active, have not fully examined their feelings about the person with whom they are having intercourse, and may not have a feeling of personal control in the relationship. In addition, birth control services have not been consistently and appropriately available to teenagers. Many factors contribute to the lack of birth control use and contraceptive failure. And, indeed, education about the history of birth control in this country is useful only as one contribution to a more comprehensive family-life and human-sexuality education program. An examination of the folklore and politics of birth control�and of how the issues, pro and con, have been politically negotiated over the years�may lead students to reflect on their own attitudes and the origins of them and thereby to re-evaluate them. I hope the information in this unit will: -offer pertinent information to promote more thorough intellectual and psychological introspection about family planning; -enhance students� sense of identification with women of past, present, and future generations; -encourage students to examine �unseen� forces which affect prevailing morality and legislation, to reevaluate their thinking and to develop a sense of personal control over their bodies and their destinies; -promote more effective use of available contraceptive methods; -motivate students to become and remain informed of health and social services which will affect the quality of their personal and family life. Infanticide, Abortion, Contraception Infanticide, the killing of newborn babies, was the most universal solution to periodic overpopulation in pre-industrial societies. It was used to control population and, at times, the sex ratio where the sexual division of labor dictated. Some groups practiced infanticide because, in the absence of medical techniques, it was less risky and painful than abortion. Among some Australian tribes and among the Cheyenne and other Northern Plain Indians, infanticide was practiced so the tribe could maintain its mobility. The Pima of Arizona practiced infanticide when a child was born after the death of its father�thereby relieving the mother of the added economic burden (Woman�s Body, Woman�s Right, Linda Gordon, p.33). When practiced, the decision was almost always made by men, and there is little evidence of male infanticide in any society whereas female infanticide was practiced in Tahiti, Formosa, India, and North Africa. It is significant to note that infanticide was not just a �primitive� practice; Aristotle and Plato recommended it for eugenic reasons. And if infanticide is not acceptable today, it may be (as Gordon suggests) because we have better birth control methods, not because we are morally superior. Infanticide and abortion were considered criminal practices during the 18th and 19th centuries and their practice is documented in the transcripts of trials and in newspapers. This evidence suggests that both practices were widespread. Three cases of infanticide have been found reported in the Maryland Gazette on one day in 1761. In 1806, the transcript of the trial of Elizabeth Valpy in Boston was published. Elizabeth was an immigrant girl working as a maid for a Dr. Jarvis; she became pregnant by a Black indentured servant, William Hardy. She attempted to abort the pregnancy, but the medicine failed and she later gave birth to a completely white girl; the infant was discovered drowned twenty-three days later. Elizabeth claimed Hardy had killed it; he had taken the infant ostensibly to a wet nurse so Elizabeth could return to work. He was acquitted for lack of evidence and Elizabeth was not brought to trial also for lack of evidence; this case generated great public interest, perhaps because of the race question and because it remained unsolved. Women found guilty of infanticide were usually hung. Infanticide is clearly a desperate method of birth control and was most likely used by unmarried women frightened by the stigma of bearing an illegitimate child or by women forced by poverty. Women, alone or with the help of older women (though there were male abortionists) have attempted to abort unwanted pregnancies since ancient times. A standard method of inducing abortion (ancient and modern) is the abortifacient or potion. Abortifacients are part of a folk culture of herbal medicine handed down among women for thousands of years. In German folk medicine marjoram, thyme, parsely and lavender in tea form were used. The root of worm fern was used by German and French women and was also prescribed by a Greek physician in the time of Nero; in French it was called the �prostitute root�. Other ancient recipes called for a paste of mashed ants, foam from camels� mouths, tail hairs of blacktail deer dissolved in bear fat. In modern times, women have been reported to use turpentine, castor oil, tansy tea, quinine water in which a rusty nail has been soaked, horseradish, ginger, epsom salts, ammonia, mustard, gin with iron filings, rosemary, lavender, and opium (Gordon, p.36; Norman Himes, Medical History of Contraception; George Devereux, �A Typological Study of Abortion in 350 Primitive, Ancient, and Pre-Industrial Societies�Please Register or Log in to view the hidden image! Aside from internal abortifacients, women have attempted external methods such as severe exercise, heavy lifting, climbing trees, hot baths, jumping and shaking. As late as the 20th Century, Jewish women of the Manhattan Lower East Side attempted to abort by sitting over a pot of steam (or hot stewed onions), a technique described in an 8th Century Sanskrit source. Women�s diaries and correspondence indicate that abortion was commonplace and accepted in the United States during the 19th century. The majority of women before the 19th century and many in the 19th century did not consider abortion a sin. Until the early part of the century, there were no laws against abortions done in the first few months of pregnancy. Prior to the 19th century, Protestants and Catholics held abortion permissible until �quickening��the moment the fetus was believed to gain life. In the 1870�s, the New York Times estimated there were 200 full time abortionists in New York City and abortion safety was generally quite high. Today, as likely then, more women die in childbirth than during abortions. The most dangerous abortions were not those done mechanically by abortionists but those attempted with internal medicines which caused abortion by a general harsh treatment of the entire body (Gordon, p.53). During the 1800�s, newspaper ads were plentiful: �Portuguese Female Pills, not to be used during pregnancy for they will cause miscarriage.� Folk remedies for unwanted pregnancies were common and stories come from all periods of American history. In Maryland in 1652, Susanna Warren, a single woman made pregnant by �prominent citizen�, Captain Mitchell, said that he prepared for her a �potion of Phisick�, put it in an egg and forced her to take it. It didn�t work and she brought charges against him. In 1862, when the wife of Confederate General William Dorsey Pender wrote him that unfortunately she was pregnant, he wrote her pious phrases about �God�s will� but also sent her pills which his company surgeon had thought might �relieve� her. (Gordon, p.55) By the first half of the 19th Century, many states had already made abortion a crime at any stage of fetal development. Yet criminal abortionists continued to practice and in fact were often acquitted by juries. During the 1860�s and 1870�s, abortions continued to be available and doctors admitted to being asked frequently to perform abortions. Increasingly during the second half of the 19th century, medical attacks on abortion grew and moral condemnation intensified. The evidence of ancient contraceptive knowledge, methods of birth control which (unlike infanticide and abortion) are used before conception, is impressive. A list of contraceptive methods would include: withdrawal by the male; melting suppositories designed to form an impenetrable coating over the cervix; diaphragms, caps, or other devices which are inserted into the vagina over the cervix and withdrawn after intercourse; intrauterine devices; douching after intercourse designed to kill or drive out the sperm; condoms; and varieties of the rhythm methods. None of these methods are new. Except for the addition of the modern birth control pill introduced in 1960, there are no new methods. All of these techniques were practiced in the ancient world and in modern pre-industrial societies. Coitus interruptus, withdrawal, was practiced in Africa, Australasia, the Middle East, and in Europe. Though condemned by Judaism and Roman Catholicism, its practice was common enough in Medieval Europe and later to be frequently attacked in canonical writings as a �vice against nature� (Gordon, p.41). Studies in the 1920�s and 30�s in New York and New Jersey found that coitus interruptus was the most common pre-medical form of birth control. Further evidence of its practice comes from documentation of doctors� remonstrances against it�arguing that it was dangerous, caused nervousness, ultimately impotence, and one who said it might lead to hardening of the uterus in women. Coitus obstructus was a method recommended in several Sanskrit texts which required pressing on the forepart of the testicle; the pressure of the finger there may block the urethra forcing semen into the bladder. Coitus reservatus is a method whereby the male avoids ejaculation entirely. This method was used by the Hindus and reappeared among some American Utopian societies in the 19th Century. Douching was used in ancient times but was not very effective. The Greek physician A�tious know the properties of vinegar but recommended it be applied to the penis rather than used as a douche. 19th Century recipes in women�s books show that douching was known and tried in the United States. A pessary is a vaginal suppository used to kill sperm and/or block their passage through the cervix. The pessary was the most effective contraceptive device used in ancient times and numerous recipes for pessaries from ancient times are known. Ingredients for pessaries included: a base of crocodile dung (dung was frequently a base), a mixture of honey and natural sodium carbonate forming a kind of gum. All were of a consistency which would melt at body temperature and form an impenetrable covering of the cervix. The use of oil was also suggested by Aristotle and advocated as late as 1931 by birth control advocate Marie Stopes. Another kind of pessary was a solid object to block the cervix. This method was popular in pre-industrial societies, especially Africa; here women used plugs of chopped grass or cloth. Balls of bamboo tissue paper were used by Japanese prostitutes, wool by Islamic and Greek women, linen rags by Slavic women (Gordon, p. 43). The sponge used by Ancient Jews was considered the most effective contraceptive in use until the development of the diaphragm. The sea sponge was wrapped in silk with a string attached. The rhythm methods (based on calculating the woman�s fertile period and abstaining from intercourse during it) were widely discussed during the 19th century. Unfortunately it was very ineffective during the 19th and early 20th century, since the female fertility cycle was not understood until 1920. Until that time, observing other mammals lead most to believe ovulation occurred either during menstruation or just before it. The condom has been produced in this country since 1840. It was second in popularity to male withdrawal according to the 1920�s and 30�s studies. In fact, though, the condom was fully advocated not to prevent pregnancy but in campaigns against venereal disease. The widespread use of the condom to prevent V.D. following World War I contributed to the acceptance of contraception because even people of fundamentalist persuasion were forced to encourage its use. Since ancient times, people have been attempting to control the sizes of their families. Clearly, men and women have wanted to control the number of their offspring for physical, emotional, social, and economic reasons and they have taken responsibility for attempting to use various methods of contraception. Yet, periodically throughout history, some people have attempted to deny women the right to birth control. Their reasons have had social, moral and religious, economic and political foundations. In 1873 Anthony Comstock pushed a bill through Congress which defined contraceptive information as obscene. What was the social, economic and political climate in the United States that fostered the passage of the Comstock Law and continued adherence to it at the turn of the century? Why was it not until 1965 before the U.S. Supreme Court struck down as unconstitutional the 1879 birth control law of Connecticut? By the 1860�s in this country, new legislation had outlawed all abortions except those �necessary to save the life of a woman�. In 1869, Pope Pius IX declared that all abortion is murder. While there were many reasons why abortion was suddenly a crime, one reason is quite sensible: abortion was a potentially dangerous operation and a new wave of humanitarianism in the mid 19th century brought laws to protect women. The other reasons for making abortion a crime related to changing views on birth control. Medical care for women passed out of the hands of mid-wives and into the hands of male doctors, most of whom did not respect a woman�s right to terminate (or prevent) a pregnancy. Dr. Edmund Bliss Foote was an exception. An ardent feminist, his writings during the 1860�s and 70�s on birth control and sex emphasized women�s rights and he publicly advocated the use of the condom and the �womb veil�, an early diaphragm. Attitudes towards abortion changed with a new understanding of the biology of conception and pregnancy which made it clear that the fetus is �alive� sooner than previously thought. Even the Catholic Church had previously considered 40 days after conception for a boy and 80 days for a girl as the moment of �quickening� or the beginning of life. Governments and religious groups desired population growth to fill factories and industries and new farming territories. Just as women were beginning to understand conception well enough to attempt to avoid it, President Theodore Roosevelt in March, 1905, attacked birth control and condemned the tendency towards smaller families as decadent, a sign of moral disease. Social and moral reformers campaigned to ban �sex for pleasure� and against abortion and birth control. Early suffragists had campaigned for voluntary motherhood during the 1870�s, but they advocated celibacy and abstinence for birth control. But as social moralists began to preach�sex outside of marriage was immoral and, indeed, sex within marriage was immoral if not for making babies�cautious suffragists became ardent feminists. And conservative suffragists began to speak out publicly for birth control in response to President Roosevelt and the social moralists. Those who saw fit to define contraceptive information as obscene opposed birth control, citing the following objections: birth control practice is sinful; the nation needs a growing population of large, stable families (and indeed some of them feared that �Yankee� stock would be overcome by immigrants, non-whites and the poor); and birth control represented a rebellion of women against their primary social duty�motherhood. A. Comstock, who was born in New Canaan, Connecticut, was responsible for the federal law banning birth control and for the passage of similar laws in twenty two states. The strictest laws were passed in Connecticut and Massachusetts. 1879 General Statutes of Connecticut, Section 6246: Use of drugs or instruments to prevent conception. Any person who will use any drug, medicinal article or instrument for the purpose of preventing conception shall be fined not less than fifty dollars or imprisoned not less than sixty days nor more than one year or be both fined and imprisoned. Accessories. Section 54-196: Any person who assists, abets, councils, causes, hires or commands another to commit any offense may be prosecuted and punished as if he were the principal offender. Comstock worked as a special federal agent charged with the responsibility of enforcing laws aimed at stopping proliferation, distribution and use of �obscene� articles. Margaret Sanger (1879-1966) campaigned from 1914 until 1937 to remove the stigma of obscenity from contraception. Working with a doctor to save the life of tenement dweller, Sadie Sachs, from the affects of a self-induced abortion, she made her decision to fight the Comstock Law and to insure that women received contraceptive education, counseling and service. She is credited with coining the phrase, birth control. In 1914, Sanger published and mailed a magazine, Women Rebel, advocating the use of birth control techniques she had learned about in France. In 1916, she opened the first birth control clinic in the Brownsville section of Brooklyn. Hundreds of women attended the clinic; but within one month police arrested Sanger, her sister, and her friend and closed the clinic. Sanger then turned her energy toward the legislative process; the Suffragette Movement contributed to her feeling that legal reform was possible if newly won political power was used. Sanger�s ultimate goal was to make medically prescribed birth control legal and available to anyone for any reason�personal, social, economic or medical. Between 1912 and 1930, House Bills to repeal the Comstock Laws in Connecticut were repeatedly rejected. In 1931 doctors began to support the bills. Between 1941 and 1959, seventeen bills were entered; some passed in the House but were defeated in the Senate. Arguments continued to center on religious views and questions of public morality. In 1961, Dr. C. Lee Buxton and Estelle Griswald opened a birth control clinic in New Haven, Connecticut. They were arrested and fined. The Planned Parenthood League appealed the Griswald vs. Ct. case and, in 1965, the U.S. Supreme Court struck down as unconstitutional the 1879 birth control law. After 86 years, birth control could be used legally in Connecticut, and contraceptive services have become increasingly available to teenagers, including minors. During 1980 and 1981, a number of bills and amendments were entered which attempted to limit the availability of these services to adolescents. Boston Women�s Health Book Collective, Our Bodies, Ourselves. N.Y.: Simon and Schuster. 1975. Gordon, Linda. Woman�s Body, Woman�s Right: A Social History of Birth Control in America. New York: Penguin Books. 1976. Guttmacher Report. Teenage Pregnancy: The Problem That Hasn�t Gone Away. New York: The Alan Guttmacher Institute/Policy Analysis and Public Education. 1980. Hatcher, Robert A., MD., et al. Contraceptive Technology 1980-81. Atlanta: Emory University/Grady Memorial Hospital, Family Planning Program. 1981. History of the Birth Control Movement�Tape of Connecticut Public Radio broadcast�Planned Parenthood Federation of America. London, K. �Mainstreaming the Adolescent Mother.� Issues in Health Care of Women Vol. 3, No. 1 Jan.-Feb. 1981. Reed, James. From Private Vice to Public Virtue: Birth Control in America Since 1830. New York: Basic Books. 1978.