The Pill Turns 35

The desire to control female reproduction is not a 20th century phenomenon. Women first began swallowing contraceptives 4,000 years ago. Chinese women drank mercury. The Greeks consumed diluted copper ore. Africans drank gunpowder and camel foam. Canadian Indians ingested alcohol brewed with dried beaver testicles. And in America not too many years ago, many women turned their backs on their husbands' love affairs, hopeful and grateful that their mates' unfaithfulness might lessen the chance of their own unwanted pregnancies. Despite repeated opposition to birth control by the Catholic Church, studies say that the oral contraceptive known as the Pill has been used by 80 percent of American women at some point during their reproductive lives. Now that the once-revolutionary Pill is older than some of our adult children, let's take a look at how the tiny white, pink, peach or green discs have made a personal impact on some of our lives, opinions, and beliefs. Let the Revolution Begin "Our board at the time didn't think the Pill would be popular. Boy, were they wrong," exclaims Julie Easton, director of communications for Planned Parenthood of Central and Southern Indiana. She reviewed the organization's minutes from its board of directors meetings of the early '60s. "They really struggled and questioned whether women in Indianapolis would find it a viable [contraceptive] option." Their biggest concern was the cost -- at $3 to $4 a month, the board members worried it wouldn't be seen as a feasible expense. "They didn't realize the love affair that would develop between women and the Pill," says Easton. Planned Parenthood of Central Indiana provided its first client with the earliest form of the Pill, Enovid, in February, 1961. Since the mid-'50s, their sole clinic had been open just three days a week. The minutes recorded that in 1962 they had 7,057 clients; by 1964 there were more than 20,315. An expansion to eight clinics followed shortly. Looking back on that first form of the Pill, Dr. Robert Rogers, chief of gynecology at Indiana University, recalls the desperation of the first women who used the Pill. "Despite the complications, the side effects of those first high-dose pills, generally, we found women who had a number of babies, who suffered from contraceptive failure, who were willing to do anything... they were desperate," says Rogers. "They were willing to put up with weight gain, swelling of the feet and face, and vaginal discharges and infections ... they clambered to use a 100 percent effective contraceptive agent." At that point, he says, the best non-surgical contraceptive had a 15 to 20 percent failure rate. Today, he says, there is a broader spectrum person interested, from women in their earliest years of reproduction to older women. "The Pill emancipated women and raised women to a status where they were not slaves to their reproductive nature," he notes. "I can't think of anything else which has freed up reproductive-age women. The aren't slaves to chance any longer." -- Jennifer Evans The Catholic Church and the Pill Eight years after the introduction of the Pill, Pope Paul VI issued Humanae Vitae, the official Catholic response to contraception and birth control. It addresses questions of human dignity, birth control, sex, relationships, and life and defines sexual intercourse as having two purposes: expressing mutual love between two people while creating new life. Artificial contraception, according to Church teaching, not only denies the possibility of life, but devalues and undermines a love-giving dimension essential to sexual intercourse. Manipulation of the body's natural fertility process is deemed morally wrong, an act of evil against life. David Bethuram, director of Family Planning at the Archdiocese of Indianapolis, says the introduction of the pill and the sexual revolution swept people away from an already limited discussion of values and gave women a false sense of freedom. "The pill is a reaction of people feeling repressed," he says. "It gave women perceived control of their bodies, but didn't change traditional sex roles or encourage communication. It gave physical freedom, but no freedom from already damaging relationships." Today, Bethuram says he sees greater promiscuity and psychological traumas in relationships and often hears couples complain they feel like strangers, apart and distant. "We're not saying the Pill has caused this, but may have provided an easy excuse for something that should have been discussed in the first place." Today, he says, the church is making strides to help Catholics understand issues that weren't discussed as openly in the past. "We all made mistakes, not just the Church. Maybe we did make a mistake in the past, seeing sex as an end rather than an expression, " he says. "Listening to women, they've expressed bitterness living to expectations of making 'your man happy', giving him children. We weren't really dealing with real issues of emotional support and communication." Nancy Clapp, a cradle Catholic and mother of four daughters, teaches religion at Bishop Chatard High School. She has long participated in discussions about the Pill with her students and family. "There's a terrible number of unwed women having kids, and a terrible number of people preaching chastity without giving good reasons," she says. "I think there's a beginning of people coming back to the middle where there's some sanity." Clapp believes the introduction of the Pill doesn't emotionally and spiritually support relationships, and still leaves women bearing more responsibility than men. "To a man, sex may mean, 'I'm excited.' To a woman it may mean her heart's involved. Until there's a dialogue for women to express what it means and him to discuss its importance, the responsibility is not mutually shared." Clapp emphasizes the importance of understanding the Church's position on life. "The church is saying respect life, and sexuality is just a gift continuing that respect. If you don't have respect for each other by communicating and discussing these issues, you're degrading yourself, saying your own life isn't really worth it." -- Genene Johnson The Choices That Insured Change Several weeks ago my sister and I were looking at family photographs when we came across a large photograph of my great-grandparents and their 13 children. Raising and feeding 13 children on a farm 80 years ago is something I am unable to imagine. How long those days must have been and how tired she must have felt when she dropped into bed at night. How little time she must have spent considering her future beyond nature's next season, and her next pregnancy. By the time she died in 1976, Great-grandma Brower had a $500 life insurance policy, enough to pay for her burial. It was Grandma and Grandpa Brower who moved close to the city. Grandma Brower had worked at a department store, but most of her life she was a full-time mom and grandmother. I recall her talking about working until she was eligible for Social Security benefits. My grandma had a life insurance policy which my grandpa paid at a rate of 10 cents a week to an insurance man who stopped by the house. By the time she died, Grandma Brower had a $5,000 insurance policy -- as with my great-grandmother, enough to pay funeral expenses. My mother was the first female of her family to achieve education after high school -- secretarial school. By the time she was 21, I was born and then three more after me. Like the others in our neighborhood, she was a stay-at-home mom most of our growing-up years. When I went to college, she began working as a cashier in the nearby school cafeteria. I believe she enjoyed this job and the life beyond home that it provided her. With four children who were certainly going to college, the extra income was welcome as well. While we were growing up, my father made payments on a family life insurance policy that would have paid enough for my mother's burial expenses. My mother recently offered that her current life insurance exceeds the expenses associated with death. At the beginning of my marriage, I was working full-time as an obstetrics nurse. My income was important since my husband was in school. We began our family soon and it was about this time that my husband took out a sizable insurance policy on me. It wasn't the loss of an income that concerned him the most; it was the realization that the job I did as mother and homemaker had a "market value." In other words, if I wasn't there to run the house and care for our two children, he would have to hire someone to do those jobs. In the generations preceding mine, birth control was one of those subjects, such as the contents of your purse and who you voted for, that was never broached. A friend who is about a decade younger than my grandmother told me that when she was a young wife, many women knowingly turned their backs when their husbands were having affairs. There was an unspoken gratitude that their husband's unfaithfulness might lessen the chance of an unwanted pregnancy. Several of my friends recall their parents actually inventing illnesses to cover up their father's hospitalization for a vasectomy. In the '50s the choices were limited and messy and often unsuccessful. My generation was the first to be affected by the birth-control pill -- positively and negatively. Certainly it played a major role in the sexual freedom and experimentation of the late '60s and early '70s, the remembrance of which is frightening in the AIDS age. It allowed us to consider that we could pursue a career and be able to time when, and if, we desired children. We attached new values to our lives and expected more of ourselves than ever before. My generation was raised with the domestic messages of pre-Pill mothers and offered reproductive freedoms just as we were becoming sexually active. We expect ourselves to juggle both worlds. This freedom came at a price, however. My life insurance policy guarantees that my husband can pay someone to do all of those big and little jobs I perform. My Great-grandfather Brower and his 13 children didn't have the same monetary recognition of great grandma's worth -- they had something much better. Back then, a family was its own insurance policy. If my great-grandmother had suffered an early death, her family -- who were all in the area -- would have taken care of their needs. A couple of my widowed great aunts married their brother-in-laws. The family provided food, healthcare, childcare, and all of the necessities that could not otherwise be met. My mother and my sister both live three hours away, in different directions. My daughter lives over an hour away. Even though we all care for and about one another, we each take pleasure in our full and independent lives. If we are in need we most likely rely on our own resources to provide for our own care. -- Sharon Calhoon The Real Revolution Has Just Begun The Pill is often credited with the onset of the sexual revolution of the '60s -- no doubt correctly. But looking at its invention from the long view suggests a revolution we've only just begun. For the first time in the history of the human species, man can control his reproduction. Biology is no longer necessarily destiny. From this perspective, the 35th anniversary of the Pill changes from a "remember when..." occasion to an opportunity to speculate on the future. In the past, population control was an effect of famine, plague, war and natural disaster. Now we have the technology to choose to maintain population at optimum numbers in relation to food, resources, the environment and the community. How we choose to use the technology depends on our awareness of its implications for good or evil. To bring the issue a little closer to our everyday lives, we might consider the impact of effective birth control on the family and the workplace. In the past, large families were economically desirable, and the division of labor was biologically determined. Now, large families are expensive to feed and educate, and the division of labor is a bone of contention not only in the workplace but in homes everywhere. Even closer and more personal is the impact of this new technology on the most basic human relationship -- that between a man and a woman. A woman's power over her own reproduction throws off the balance in traditional customs and roles. The reciprocity between man and woman is changed forever. The shift in power and economics is scary, but it provides a better chance for men and women to enjoy relations of equality, by choice. Mankind's growing power over human reproduction has the potential to be used creatively, to improve human conditions and the prospects of the planet. Or it can be misused or ignored. Anyway, it stands to upset the evolutionary equation. From the global village to the bedroom, the influence of the Pill -- and devices like it -- is only beginning to be appreciated. In the overall scheme of things, 35 years is a pretty short time. Whether this new technology is used for genetic engineering to program reproduction, or to create more humane conditions in Rwanda, the workplace, and the family, will depend on our recognition of it as a factor in our rapidly changing world. As the first generation to face this challenge, we don't have many answers; we're on land where, literally, no man has gone before. But to find the right answers, we'd better be sure we're asking the right questions. The questions are bigger than Whatever happened to family values? They ask What is a family? Is it still wise to be fruitful and multiply? What is the greater good -- in ethics, politics, economics, religion, justice and education?The questions we come up with, and the answers, will be worked out among people like us, coping day to day, and speculating on the future. -- Susan Gilmer Sidebar 1: The Pill's Side Effects -- On Health Care The availability of the Pill had a very positive effect on the way health care became provided to women, according to Julie Easton, director of communications for Planned Parenthood of Central and Southern Indiana. Because women had to see a doctor to receive a prescription for the Pill, more women had routine gynecological exams, and diseases of the female organs became more easily diagnosed. Also, nurse practitioners became a new tier of health care providers, in part due to the increased call for these types of services. "When you look at the amount research done on Norplant [the long-term birth control injection] it was studied for almost twenty years before it was okayed," recalls Dr. Robert Rogers, chief of gynecology at IU. "The Pill had been studied for a short period of time, three years or so, in Puerto Rico before it was available," explains Rogers, contrasting the amount of information patients today can receive about a contraceptive versus 35 years ago. "There were no printed patient materials and no long term studies," he says, compared to the videos and handouts which are available on Norplant. "Women just knew that if they could control when they had children, and how many children they had, it would mean they could make career and educational decisions they'd never had the luxury of making prior to the '60s. It was a different day back then," Rogers recalls. -- Jennifer Evans Sidebar 2: Pill Facts * The first Pill was introduced in the U.S. on May 9, 1960. * The Pill is the most popular method of reversible birth control in the U.S. * One-fourth of all women between the ages of 15 and 50 take the Pill. * More than one-third of all Pill users are over the age of 30. Nine percent are 40 or older.

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