A Short History of Birth Control in the United States

Human Rights March for Equality – Source Library of Congress

Overview

Our mother was born in 1916, the same year the first birth control clinic opened in New York. She was a human rights activist and voting advocate until she died at the age of 89.

We received advocacy genes from both of our caring intelligent parents who were self-educated strong individuals raised in poor loving families. They encouraged hard work, independence, and broad horizons. Being females was not a detriment in their eyes but through the years, we have found it a struggle in a man’s world and have personally faced discrimination.

A review of contraception history and factors related to women’s rights is important because so many young men and women today matured during a period when many rights were established. That time has changed. Women gained the right to vote one hundred years ago, a right more important today than ever.

Women, and men who care about them–not to control their bodies and lives but support their independence, have entered a new era of activism.

The Supreme Court actions that overturned Roe v. Wade forces all women into a negative economic and personal rights environment. Contraceptive rights have reverted to the 1800s with religious patriarchs even mandating a child-victim of incest, or victims of rape, carry a resulting conception to term.

Source Samantha-Sophia Unsplash

THEN

In 1848, a conference attracted three-hundred women and men who met to gain women the right to vote. It took seventy-two bitter years of activism, hunger strikes, arrests and fighting obstruction for women to prevail. Congress finally passed the Nineteenth Amendment to the U.S. Constitution giving women the right to vote in 1920.

While early activists fought for a woman’s right to vote, another group of feminists spent their lives helping women obtain sex education and access to birth control. One of those women, Margaret Sanger, grew up in a household of poverty with ten siblings. Her mother had eighteen pregnancies.

In 1902, Margaret began working as a nurse, and later a midwife. She cared for chronically pregnant poor women living in the tenements of New York who begged her for information to help stop unwanted pregnancies.

Sanger’s book, Motherhood in Bondage, contains hundreds of letters from hopeless women across the country imploring her to help them limit the number of children they bore. Most of them wrote of being married as teenagers and bearing a child each year. One 43-year-old woman with nineteen children had begged her doctor for contraceptive information, only to be told to be careful. Stories included child-mothers escaping poverty to marry, and having a child before their thirteenth birthday. One, married at age fourteen, had fourteen living children, many miscarriages, and failing health due to multiple pregnancies and poverty.

The women’s plight incited Margaret’s actions, but by talking about birth control she risked imprisonment under the Comstock Act of 1873. That draconian law made it illegal to discuss, produce, print or use the U.S. Postal Service to mail any literature or product pertaining to the body related to birth control and venereal disease, rampant before the age of antibiotics. Anatomy textbooks being sent to medical students were prohibited and confiscated. Doctors failed to educate women about ovulation and contraception because they could be jailed for discussing the topics.

Anthony Comstock, the influential politician and religious zealot who became a U. S. Postal Inspector, considered Sanger’s pamphlets on sex education and clinics providing contraception advice to be obscene and pornographic. His imposed religious views set medical education and U.S. public health back decades.

After her arrest for publishing and distributing contraceptive information, Margaret fled to Europe under an assumed name to avoid prosecution that could have carried up to a 45-year sentence. She studied methods of contraception in the Netherlands and returned to open the first U.S. birth control clinic in New York City in 1916. She and her sister Ethel Byre, also a nurse, provided contraceptive information and treated 486 patients in ten days, before the NYPD Comstock Vice Squad swept in to arrest the nurses and patients.

Ethel nearly died in jail during a hunger strike to raise awareness for their cause. Margaret was sentenced to the penitentiary for thirty days and upon release, reopened her clinic in protest. She founded the American Birth Control League in 1922 that eventually became Planned Parenthood of America.

Margaret Sanger’s desire to help women fueled her lifelong activism to teach contraceptive methods and advance sex education. The Catholic Church considered Margaret an enemy and opposed her work, but she had seen what continual pregnancies had done to her devout mother and others in poverty producing huge families.

Support and fortunes of philanthropic people like International Harvester heir Katherine McCormick, John D. Rockefeller, and Margaret’s second husband, oil magnate James Noah Slee, fueled her campaigns for birth control and research for an oral contraceptive. Sanger and McCormick both lived to see the success of their efforts when the FDA approved the first oral contraceptive, Enovid, in 1960.

In 1972, the Supreme Court finally struck down the last of the oppressive Comstock law that restricted doctors from prescribing oral contraceptives to unmarried women ending nearly one hundred years of Comstock tyranny.

Source Gayati-Malhotra Unsplash

NOW

More than sixty years after the epic moment in 1960 making birth control pills available, women are fighting the same old battle, the right to self-determination and contraception.

Some legislators at the national level have vowed to defund Planned Parenthood clinics across the United States. Those who fight to defund the clinics and legislate reduced contraceptive availability and education are antiabortionists. They vehemently attack clinics that provide abortions, leading to violence, bombings, and terrorist murders of healthcare personnel.

Planned Parenthood provides healthcare to both men and women, education, contraceptives, treatment of sexually transmitted diseases, and they offer fertility consultation.

Comprehensive sex education and free contraceptives reduce unplanned pregnancies and abortions. Why would those against abortion defund Planned Parenthood clinics limiting access to education and birth control, thus increasing the need for abortions?

Abortions have been a legal right under U.S. law since the Roe v. Wade Supreme Court decision in 1973. That decision deemed abortion a fundamental right under the U.S. Constitution. Roe, (a pseudonym to protect her privacy) was a single pregnant woman who brought a class action suit against the constitutionality of Texas laws that made abortion a crime except to save the life of the mother. District Attorney Wade provided the state’s defense. The historic decision overturned the Texas law and held that a woman and her doctor could choose abortion in earlier months of pregnancy without legal restriction, and with restrictions in later months based on right to privacy.

Any adult has the right to make personal decisions based on their religious views. However, our founding principle of separation of church and state in the U.S. means no one as the right to impose their religious views on others.

Broad availability of birth control education and contraception has been shown to reduce unplanned pregnancies and reduce the need for abortions. In spite of this fact and the desire of most citizens in the United States, the U.S. Supreme Court overturned Roe v. Wade in this month. Their 2022 sweeping judgement not only removed a woman’s right to make personal healthcare choices, it broadly affects autonomy in every sphere of existence. The partisan justices also tainted the Court and destroyed the established framework of the United States of separation of church and State.

The next blog will provide an overview of Reproductive Biology for men and women, then related topics from the booklet will follow. If you are interested in following the Lipstick Logic blog, please subscribe by providing your email.

Thanks for stopping by.

Betty and Bev, The Lipstick Logic Sisters

A WOMAN’S RIGHT TO CHOOSE

LIPSTICK LOGIC BLOG

Statement of Purpose

Lipstick Logic ™ LLC was founded in 2008 to provide education and health conferences for women. This blog was developed as a way to reach a larger female audience with a wide range of science-based health topics. With woman’s rights having been set back 50 years due to Roe v. Wade being overturned, our focus on women’s issues and health seems even more important.

A new day has dawned for women in America. Freedom of choice can no longer be taken for granted. The Supreme Court ruled against a woman’s right to have an abortion. Although some states will continue to provide education and abortion services, many states are pursuing legal changes to terminate women’s rights, criminalize their actions, imprison practitioners, and even track a woman who might leave her state to obtain needed healthcare elsewhere.

Several years ago, Dr. Betty, a specialist in internal medicine, wrote a primer on contraceptive issues and related biology. Over the next several weeks, this Lipstick Logic blog will provide updated information from that primer.

CONTRACEPTION is a broad topic. Even if you have had a child and have grown up in an age where options for women’s reproductive rights were rights, you may learn new information to share with other women, your daughters, granddaughters, and the men in your life.

ORAL MEDICATION FOR ABORTION will be our first topic. It is a safe option if chosen early in pregnancy. But, if you live in a state that has banned abortions, this medication will not be available to you. Always consult with your private physician regarding your situation and any medical concerns you have.

If you are interested in reading researched, science-based information regarding women’s health and human rights, please join us by subscribing to this blog.

Everyone woman of voting age must vote to protect her rights and freedom.

Betty and Bev, The Lipstick Logic Sisters

Author Note – Betty Kuffel, MD FACP

This science-based publication is a quick reference to understanding the natural processes of reproduction and contraceptive choices available today. Information related to sexual assault and sexually transmitted disease is also included.

My desire is to provide information for informed choices and make this publication widely available to all ages. Reproductive and contraceptive education is known to reduce unplanned pregnancies and the risk of sexually transmitted disease. The need for abortions can also be minimized.

The information is current at the time of publication. Individualized guidance must be obtained from your health practitioner or pharmacist.

Make informed choices. The effects of what you do today will be with you the rest of your life.

If men got pregnant, there would be safe, reliable methods of birth control.

They’d be inexpensive, too.

Anna Quindlen, Pulitzer Prize-winning columnist

 and bestselling novelist

ORAL MEDICATION

ABORTION OVERVIEW

The 1973 Supreme Court decision on Roe v. Wade legalized ending a pregnancy during the first twelve weeks following conception. Prior to the legalization, women were forced to go to untrained abortionists, or aborted themselves using all sorts of objects including knitting needles and rug hooks. Often, they died of hemorrhage and sepsis from infection.

In 2000, the Federal Drug Administration (FDA) approved the first oral medication to induce abortion, (RU-486).  A newer, lower dose drug, Mifeprex (mifepristone), is also available. The FDA lengthened the duration of time it can be used to 70 days (10 weeks) of gestation. The time is calculated from the first day of the woman’s last menstrual period.

  • Mifepristone blocks progesterone cell receptors, a hormone important in maintaining pregnancy. It is used in combination with misoprostol to complete the abortion.
  • Misoprostol softens and dilates the cervix and induces uterine contractions to expel the products of conception. There will be significant cramping and some bleeding when the abortion occurs. A follow-up visit with a practitioner is recommended.

Following the advent of birth control pills, improved education and more options for contraception, pregnancy rates fell, as did the number of abortions. There are still times when women decide to end a pregnancy, however, the current Supreme Court ruling makes it illegal to end any pregnancy even those resulting from violent rape or incest.

Procedure:

* Patient receives counseling, signs an agreement form, and is given a copy of the FDA Mifeprex (GENERIC- mefepristone) Medication Guide.

Note: Cost is markedly reduced from the approximate cost of $100/pill, to $14.00 using WebMDRx.

* A certified healthcare provider dispenses the medications.

* Mifepristone, 200 mg, is taken by mouth.

* 24-48 hours later, misoprostol, 800 mcg, is taken as directed.

This method is 98% effective. If the abortion is incomplete and some tissue is retained, such as remnants of the placenta, a procedure may be necessary to remove the tissue to stop bleeding and infection. See www.fda.gov/drugs/ for detailed information.

EMERGENCY CONTRACEPTION

THE MORNING AFTER PILL

Emergency Contraception (EC) can be used to reduce pregnancy risk following unprotected intercourse. When taken early and correctly, the medication is usually effective following a rape or unexpected situations such as a broken condom. EC must be used soon after intercourse and will not be effective if pregnancy has already occurred.

Rape

If you are raped, Emergency Contraception is recommended to prevent pregnancy. This medication is usually provided in the Emergency Room if the victim seeks medical assistance and a rape exam to collect forensic specimens. Medication to prevent sexually transmitted diseases is also given to victims.

Note: An emergency contraceptive prevents pregnancy. It does not cause an abortion. This treatment will be unavailable in many states under the new Supreme Court ruling that overturned the Roe v. Wade right to privacy and abortion.

Progestin

The “Morning After Pill” has many forms: Plan B, One-Step, My Way, and others. They are available over the counter, without a prescription. There were no point-of-sale restrictions prior to overturning Roe v. Wade. Many states still allow use of this medication.

Progestin is a hormone that stops or delays ovulation and is best taken within three days of unprotected intercourse. It will not end a pregnancy. Talk with a pharmacist for information and side effects. Cost: ~$40.

Ulipristal (Ella)

This prescription medication delays or prevents ovulation. It can be taken up to 5 days after unprotected intercourse. (It is thought to be more effective than either progestin-only or a combination hormone pill containing both estrogen and progestin.) Cost: ~$40-$60.

Combination pills

These pills contain both estrogen + progestin., taken in two doses and result in delayed ovulation. For dosage, consult with a physician or pharmacist. More information may be found at: https://www.mayoclinic.org/tests-procedures/morning-after-pill/about/pac-20394730 Cost ~$30

Copper Intrauterine Device (IUD)

If you are overweight or obese, effectiveness of EC pills is reduced. Insertion of a Copper IUD is effective and provides contraception for ten years. IUDs must be inserted by a health practitioner. More information will be provided later on IUDs. Cost is variable. Placement may be free at Planned Parenthood clinics.