The birth control pill is a form of contraceptive taken orally to prevent pregnancy. First introduced in the mid-twentieth century, the pill is composed of a combination of estrogen and progesterone, two female sex hormones. When combined, these hormones effectively react within the female body to block fertility by inhibiting ovulation. To remain effective, the birth control pill must be ingested on a daily basis at the same time every day for a set number of weeks. The duration of each pill cycle varies by brand. A number of side effects have been reported by birth control users since the pill was first legalized in the early 1960s. The pill has also been the subject of ideological debate over the years. Many conservative politicians oppose its use based on religious values. Lawmakers who are more liberal defend a woman's right to avoid unwanted pregnancies, however.
Overview: History
The birth control pill was first approved in the 1960s. The fight to legalize birth control began long before this, however. American women's rights activist Margaret Sanger first coined the phrase "birth control" in an article she wrote for her radical journal The Woman Rebel in June of 1914. Sanger touted the benefits of birth control in a predominately anti-birth control environment and consistently challenged birth control laws, launching the publication Birth Control Review and opening the first birth control clinic in Brooklyn, New York, in 1916.
Sanger's cause caught the attention of socialite Katharine McCormick in 1917. After hearing one of Sanger's lectures on birth control in Boston, McCormick became Sanger's main benefactor. As Sanger fought to educate women about birth control over the next several decades, scientists were making groundbreaking discoveries in the field of reproductive biology. In 1928 and 1929, scientists managed to identify two important female sex hormones critical to the reproduction process: progesterone and estrogen. Over the next twenty years, scientists discovered that high doses of these hormones were capable of inhibiting pregnancies.
By the 1950s, birth control by diaphragm or condom was widely accepted in the United States. Despite her achievements, Sanger still longed for a better method of birth control. Sanger met fertility doctor Gregory Pincus at a dinner party in 1951. The two began discussing the possibility of birth control in pill form. To Sanger's surprise, Pincus believed a birth control pill made of ovulation-inhibiting hormones was possible. Sanger recruited longtime friend McCormick to provide funding for Pincus's research. Pincus later collaborated with Harvard scientist Dr. John Rock to test progesterone pills on female human subjects. The two doctors also established an effective birth control pill regime based on a woman's twenty-eight-day menstruation period, with participants taking the pill for twenty-one days, followed by seven days of no pills. Results from the trials were irrefutable. None of the test subjects became pregnant while on the pill.
Rock chose the drug company Searle to issue the first mass-produced birth control pill. Searle mistakenly contaminated its shipments with a small dose of synthetic estrogen. The mistake proved advantageous, however. Pincus and Rock discovered that the combination of the two hormones worked better than using pure progesterone. The company added estrogen to the pill from then on. The Food and Drug Administration (FDA) approved the Searle-made pill, called Enovid, for sale in May of 1960. Realizing the huge profit potential, many drug companies began developing their own version of the birth control pill. Birth control pill usage spiked in the years following its approval. By the early 1980s, more than ten million American women were on the pill and an estimated fifty to eighty million women used it worldwide.
Reports of Side Effects
During the early years of birth control pills, users reported severe side effects including blood clotting and heart attacks. Drug companies denied the pill's link to these effects, however. Women continued to report side effects over the next few decades such as blurred vision and depression. Many women also suffered strokes. The association was not seriously investigated until after the publication of the book A Doctor's Case Against the Pill by Barbara Seaman in 1969. The book highlighted the dangers of taking the birth control pill. It received major publicity and eventually sparked a Senate investigation in the winter of 1970. Drug companies eventually lowered the hormone dosage of each pill. Shortly after the hearings ended, the FDA mandated that all prescription drugs come with an information insert to inform patients of potential side effects.
The new low-dose birth control pills were still effective preventers of pregnancy and were later shown to decrease the risk of ovarian cancer, iron deficiency anemia, and pelvic inflammatory disease in women. This new data boosted pill sales, but concerns about side effects persisted in the decades that followed. In 2010, more than one thousand lawsuits alleging severe side effects caused by birth control pills remained unresolved.
Ethics of Birth Control
Opposition to the birth control pill was mainly religious in nature. The Roman Catholic Church staunchly opposed the pill's use since its introduction. Pope Paul VI included anti-birth control language in the 1968 Humanae Vitae document, which outlines acceptable sexual practices within marriage. This religious doctrine held that sexual intercourse was meant solely for procreation, or the reproduction of children, and birth control violated the natural law of God. Despite the church's clear disapproval, many Catholic women still used the pill to regulate pregnancy.
The pill's evident popularity did not prevent conservative politicians from trying to stifle its use, however. Conservatives voted against the inclusion of birth control in health insurance plans for many years. The Equal Employment Opportunity Commission ruled that birth control pill prescriptions should be covered by employee insurance in 2000. Owners of a chain of craft stores challenged the ruling in early 2014. The company did not want to provide employees with access to birth control due to personal beliefs. The Supreme Court later ruled that the company could choose not to cover birth control in employee insurance plans, a move that outraged birth control proponents, who argued that birth control was an essential form of preventive health care for all women.
Bibliography
Conry, Dr. Jeanne A. and Nancy L. Stanwood. "In 2014, Why Are We Still Arguing About Birth Control?" CNN. Cable News Network. Web. 9 Oct. 2014. http://edition.cnn.com/2014/03/25/opinion/conry-stanwood-contraception-hobby-lobby/
PBS. "A Brief History of the Birth Control Pill." PBS. PBS. Web. 9 Oct. 2014. http://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-pill/480/
PBS. "The Pill and Informed Consent." PBS. PBS. Web. 9 Oct. 2014. http://www.pbs.org/wgbh/amex/pill/peopleevents/e_informed.html
PBS. "The Senate Holds Hearings on the Pill (1970)." PBS. PBS. Web. 9 Oct. 2014. http://www.pbs.org/wgbh/amex/pill/peopleevents/e_hearings.html
PBS. "Timeline: The Pill." PBS. PBS. Web. 9 Oct. 2014. http://www.pbs.org/wgbh/amex/pill/timeline/index.html
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