50 years of the contraceptive pill
by John Illman
The contraceptive pill was acclaimed as the biggest medical advance of the 20th century. It was certainly the most controversial and the most surprising – and a milestone in social and scientific history.
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Since it was invented just over 50 years ago by Dr Carl Djerassi in a small laboratory in Mexico City, it has transformed the lives of women and the nature of human reproduction in ways which no-one could have foreseen.
Even before it was born, it packed an element of surprise. Dr Djerassi and his colleagues had been trying to develop new ways to treat menstrual disorders with the hormone progesterone. The first pill was actually launched in the 1950s as a treatment for menstrual disorders – with an unforeseen contraceptive effect that was described as a side effect.
100 million users worldwide
Today, more than 40 years after its launch as a contraceptive in Britain, the pill is as surprising and controversial as ever – even though it is used by an estimated 100 million women worldwide. Why has it been so controversial for so long? Why have its effects been so far reaching?
Almost all of today's sexually active women are too young to know what the advent of the pill really meant in 1961. Above all else, it offered women a decisive choice on the critical question of whether or not to have a child.
Before the pill, women had only the diaphragm and the condom for contraception. Abortion was illegal until the Abortion Act in 1967 and most illegitimate babies were placed for adoption. Unmarried, pregnant young women were placed in homes for unwed mothers, often far away from school, parents or friends. It was even a disgrace for a newly married mother to have a baby too soon if there was a possibility that conception had occurred 'outside wedlock'.
spearhead of the sexual revolution
The pill was the spearhead of the sexual revolution – the key to free women from what the feminist and birth control pioneer Margaret Sanger called 'biological slavery'.
In his best selling book, Sex Without Tears, in 1972, the American gynaecologist, Boyd Cooper, explained: 'Compared with any contraceptive method we've had before, the pill is incredibly simple and convenient. It asks very little of the patient: all she has to do is take one a day for 21 days, stop for a few days, have her period, and then start taking her pills again.
'Nevertheless, there are some women who insist that they can't tolerate the pill and others who have been so frightened into near panic by stories of dangers associated with it.'
Dr Cooper could have been writing in the 1990s when he added, 'It is highly discouraging to me that every time a medical scientist speculates in print as to a possible relationship between the pill and a disorder, the report is widely publicised; and women lose faith in the pill. Journalistic indiscretion on occasion almost matches sexual indiscretion as a source of unwanted pregnancies.'
The pill is a 'dangerous drug' in the sense that almost any medication is dangerous, including aspirin. Any drug that is powerful enough to help people is powerful enough to harm them, at least some of them. The pill increases the risk of circulatory problems and some women should not take it. These include those with high blood pressure; those who have suffered deep vein thrombosis and those aged 35 or over that smoke.
dangers of unprotected sex
Moreover, just as critics claim, the pill is linked with the spread of disease, albeit indirectly. Having unprotected sex (relying on the pill and not using a condom) increases the risk of sexually transmitted infection, cervical cancer and HIV.
But the overall benefits of the pill outweigh the risks, according to scientific consensus. Not only does it give women almost complete power over their fertility, it often controls menorrhagia (excessive blood loss during menstruation) and dysmenorrhoea (painful periods), protects the ovaries and stops the pain of endometriosis. This is a condition where tissue migrates from the womb to neighbouring organs.
Fifty years on, there is an intriguing, unanswered question about the pill. If it is so effective, why has abortion reached record levels when so many women are taking it? In 1998, more than three and a quarter million in Great Britain were estimated to be taking the pill, making it the most popular non-surgical contraceptive. It was used by more than a quarter (26%) of women aged between 16 and 49. The male condom (19%) was the second most popular method.
the pill: a double-edged sword
One interesting theory about 'pill failures' has been described in Contraceptive Care. Dr Merryl Roberts, then a senior medical officer in family planning and psychosexual medicine, in Canterbury, Kent, explained, 'The pill is a very powerful contraceptive. Taken correctly, the chances of pregnancy are very small.
'This is a great benefit to women, but it is also a double-edged sword. The desire to become pregnant is not always an entirely rational emotion. Many women enjoy the element of risk inherent in other, less safe methods.
'The very effectiveness of the pill can trap her, she feels taken over, becomes angry at this, and this anger is easily transferred to sex itself, causing frigidity. Sometimes there is a cogent and usually unconscious feeling that this total control is cheating nature, that nature will get its own back…
'Whatever the reasons for unease at taking the pill, the result is that the woman forgets to do so, or develops a series of problems necessitating frequent changes of pill.'
Who would have thought 50 years ago that the effectiveness of any treatment in the new millennium would be something that would turn some women against it? No other treatment in medical history retains the ability to surprise quite like the pill.
help and info
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organisations
British Pregnancy Advisory Service (BPAS)
Austy Manor
Wootton Wawen
Solihull B95 6BX
Actionline: 08457 30 40 30 (Mon-Fri 8am-9pm, Sat 8.30am-6pm, Sun 9.30am-2.30pm)
Website: www.bpas.org
Provides affordable services to those who wish to prevent an unplanned pregnancy with contraception, or end one by abortion. Offers pregnancy testing, crisis pregnancy counselling, abortion care, after abortion support, sterilisation and vasectomy and emergency contraception. Website contains information for women thinking about having an abortion, information about emergency contraception, pregnancy testing and what to do next.
Brook
421 Highgate Studios
53-79 Highgate Road
London NW5 1TL
Helpline: 0800 0185 023 (Mon-Fri 9am-5pm)
E-mail: admin@brookcentres.org.uk
Website: www.brook.org.uk
Provides free and confidential sexual health advice and contraception for anyone under 25. The website has tons of useful information including a secure on-line enquiry service and a text messaging service.
fpa
2-12 Pentonville Road
London N1 9FP
Helpline: 0845 310 1334 (Mon-Fri 9am-6pm)
fpa Scotland: 0141 576 5088 (Mon-Thurs 9am-5pm; Fri 9am-4.30pm)
fpa Northern Ireland: 028 90 325 488 (Mon-Thurs 9am-5pm; Fri 9am-4.30pm)
Website: www.fpa.org.uk
The fpa can advise on all sexual health matters, including contraception, abortion and sexual health. A range of factsheets are available to download free from the website. You can also get details of family planning clinics, sexual health clinics and other sexual health services anywhere in the UK.
Marie Stopes International
153-157 Cleveland Street
London W1T 6QW
Marie Stopes One Call: 0845 300 8090
Website: www.mariestopes.org.uk
Runs a range of reproductive health services including contraception, abortion counselling, well women screening, gynaecological consultations, vasectomy, and psychosexual and relationship counselling.
For abortion and emergency contraception advice, to book an abortion consultation, or to find about other services available near you, call the Marie Stopes One Call number. Their Abortion Help UK website www.abortion-help.co.uk is aimed at women who are considering an abortion, contains straightforward information and advice, looks at the options available, and features answers to FAQ's.
Their sexual health website www.likeitis.org.uk is aimed at young people and is a source of information and advice on puberty, pregnancy, contraception, sex and sexuality.
website
Choosing a contraceptive method
www.netdoctor.co.uk/sex_relationships/facts/contraception_which.htm
Information from netdoctor.co.uk on the different methods available.
Hormonal Contraception Methods
http://hcd2.bupa.co.uk/fact_sheets/html/hormonal_contraception.html
Useful factsheet on hormonal contraception published by Bupa's Health Information Team.
How to choose the right contraception
www.ivillage.co.uk/health/whealth/birthcontrol/articles/0,,549123_599845,00.html
Article from iVillage online women's community, comparing all the major different forms of contraception.
reading
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This Man's Pill by Carl Djrerassi (Oxford University Press, 2001) |
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The Pill and Other Forms of Hormonal Contraception by John Guillebaud (Oxford Paperbacks, 1997) |
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Margaret Sanger and the Birth Control Movement edited by Gloria Moore and Ronald Moore (Scarecrow Press, 1986) |
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Sex Without Tears by Boyd Cooper (Charles Publishing, 1972). |
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(updated December 2002, resources updated February 2005)
