Yasmin, Cilique, Cerazette, Loestrin 20, Microgynon, Dianette, and pure Progesterone: there are many contraceptive pills today but the name remains ‘The Pill’ for all. The Pill is given the definite noun—’the’—like no other drug. The Pill had a star role on the historical stage; it changed the lives of millions. In Britain today, even, 9-in-10 women in need of prescribed contraception have swallowed a variant. That amounts to 3.1 million women. Intuitively one may jump to credit its quirky definite noun-centred name to its significance. But the name ‘The Pill’ arguably lingers from 1957 because of the taboo around its inception. Lara Marks reminds us that “contraception itself was a dirty word and only mentioned in many households in hushed whispers”. Referring to chemical birth prevention by euphemism or implication therefore may have just stuck with us. The anonymous phrase The Pill, then, may be a medicalised example of what Beth Bailey calls “framing justifications in terms that avoided a language of morality”. After all, the surprising name, importance, and justifications of The Pill are contingent upon technological, social, and temporal factors. In Japan, for instance, The Pill has been barely used and only gained legal prescription status in 1999 amid a furore against men being granted access to the more recently discovered Viagra.
To speak of a single, global, history of The Pill and to universalise its importance, then, would be a big mistake. Universalised narratives of technology liberating women are vocal nonetheless, especially in British and American media from The Guardian to The New York Times. Some articles claim even that a single man invented The Pill and gifted it to women. Others suggest The Pill was synonymous with the swinging sixties’ sexual revolution whereby women demand The Pill for the control of their bodies. Some claim that The Pill is bad for women with nefarious side-effects downplayed by the medical establishment. And still others, in a pertinent example of fake news, consider ovulation-on-the-pill an example of a male conspiracy to keep women down and to court Papal approval. This messy network of narratives reveals a remarkable continuity between recent history and its contemporary manifestation; the above claims deserve exploration. The Pill had precursors antecedent to it, and was invented by groups of people; the sexual revolution was underway before The Pill; population control policies implemented The Pill; and the medicalised entrenchment of ovulation cycles makes sense from a status-quo bias rather than from a nefarious program.
Contrary to a narrative of a miracle drug developed by a few American men in 1957, it was a more piecemeal and incremental affair. Consider that seventeen years earlier, in 1930, Edouard Haberlant, a hormone research pioneer, registered a contraceptive pill named Infecundin in Hungary. An Austrian hospital, Innsbruck, then tested Infecundin by 1933. The Shoshone tribe in Nevada meanwhile had already discovered and used contraceptive plant extract—the concentrated purified form of which passes for a drug—long before the inception of The Pill. Unlike other folk medicine attempts, it consistently worked. The Shoshone’s plant extract was tested at The University of London in 1948, and the extract successfully inhibited the ovulation of four housewife test subjects. And in India circa 1949 a contraceptive pill was tested with a fifty-to-seventy per cent efficacy in a Calcutta maternity hospital; the report published in the medical press mentioned no bad side effects at all.
There were therefore three proto-pills before the usually credited inventors, Gregory Pinicus and John Rock, got to work. And their records make no mention of any rival pill. Historian Beth Bailey paints an American-centric picture of The Pill in Kansas, the uptake of which depended on social conditions and uniquely American legislative support. While Bailey’s account is flawed in leaving out the other proto pills, her logic of contingent support holds. The concerted effort in America to control births allowed for the development and diffusion of The Pill in a way that was impossible in more remote (tribe nation Nevada) or hostile (1930s Europe) environments. Although, a history where Haberlandt lived beyond 1932 may have been a different (hi)story. The Pill did not burst onto the scene all by itself, but was funded and supported into being in a culture where other forms of contraception had already gained credence. American women used more birth control, like diaphragms, than European women. And some had the financial means and gumption to advocate for a pill contraceptive.
Planned Parenthood clinic leader, Margaret Sanger, and rich heiress and MIT Biology graduate, Catherine McCormick, collaborated to solicit the project in, physiologist and obstetrician respectively, Gregory Pincus and John Rock. In cursory accounts, these four made The Pill happen but in fact the Worcester Institute they founded relied on a team effort: Anne Merrill, Mary Ellen Fitts Johnson, Min Chueh Chang included. The trials for The Pill required clinicians like Miriam Menkin, Herbert Home, Angeliki Tsacona, Luigi Mastroianni, Celso Ramno Garcia and Edris Rice-Wray. Women and ethnic minorities, then, were part and parcel of developing The Pill. The essential women who were the clinical trials’ test subjects, in countries with permissive laws like Puerto RIco and Mexico make this even clearer; no benevolent lone genius or US-only enterprise made The Pill.
Historians, including Lara Marks, take issue with the idea that The Pill caused the sexual revolution, because premartial and promiscuous sex were already upward trends amid women working, urbanisation, and the motorcar. The environments women were in, their economic freedom, and mobility fostered a more sexually liberal environment already. By one frame, The Pill didn’t allow women to have sex because, if they wanted to, they mostly already did. Instead, “it allowed them to worry less about it.” The Pill was more incremental a change than swift transformation.
Nevertheless, that The Pill didn’t cause the revolution does not exclude that it catalysed or further fueled the revolution. Sex and reproduction has always been a heated topic and The Pill exacerbated that. Some husbands poured pills down the toilet, sailors took their wives’ contraception with them to sea, and paranoias about deceitful women abounded since they had the power to say they were on The Pill when they were not and that they were not on The Pill when they were. Thus an inevitably coupled decision—whether to reproduce—prior to The Pill veered to an individualist one with choice-orientated bargaining where before the issue was deemed biologised, if not ‘God given’.
The Pill added fuel to the fire in the battle of the sexes although generalisations from extreme cases are epistemically fraught – they are nonetheless revealing, especially since what made it into the records and archives isn’t the sum of what went on around contraception. Marks quotes one wife whose husband would rip an IUD out of her “for a joke”, a trend she was familiar with as a social worker. This may be the tip of an iceberg: an example of an anecdote hinting at tacit histories which exactly because they were so taboo seldom make it into print: archives: the history books. First-person accounts of The Pill in the sixties from the sixties are surprisingly scarce; only in the 1970s did women’s liberation magazines such as Shrew, Red Rag, and Spare Rib platform first-person viewpoints, whether of lament or of accolade. Hence for my next essay I will explore sixties’ youth reminscening in the nineties and radical women’s magazines from the seventies.
Arguably, a good mark of the sexual revolution is how much the discourse about sex and debating contraception as lifestyle options became regnant rather than aberrant. Women bearing the choice to reject or to embrace The Pill as an individual is more of a liberation, arguably, than a sex-wide embrace or rejection. The Pill in that sense can be construed as a liberating tool even when it is being refused as it “messes with our bodies”, because it gives material to discourse of choice for women, and female transsexuals, informed by their exclusively female epistemies.
The retellings of the story of The Pill, today, which place choice and wild-times foremost may be a legacy of the seventies when The Pill became overt as contested matter of discussion alongside free sex. Of course there was no overnight change and second wave feminists, such as Germaine Greer, were the vocal minority, but the way the sixties are remembered may be an historical analogy of the psychological peak-end rule: events characterised by how they end and by their salient icons more than by mundane average life across those years. The Pill was not demanded into being en-masse for women to have the freedom to use their bodies; The Pill was demanded into being by a few for women to have the freedom from their pregnant bodies. More often, however, the impetus of birth control was for others to be protected from the perceived threat of resource hungry progeny. As Bailey asserts:
“Clearly, the federal government’s decisions to spend taxpayers’ money on public family planning programs were not justified by concern about women’s reproduc-tive health or sexual freedom, but rather by the confluence of alarm about the “population problem” and increased federal involvement in programs intended to alleviate the effects of poverty.”
Margaret Sanger celebrated the control women have of their bodies, true, but predicated on the needs of population control and even eugenics; the implementation of The Pill uniquely in America (whereas its prototypes hadn’t taken off elsewhere) similarly relied on a government receptive-enough to population control amid a perceived Malthusian threat to world peace. Hence, as Marks outlines, some saw The (Contraceptive) Pill as more momentous than The (Atomic) Bomb. Protecting women from want was to protect poorer peoples from the scarlet allure of socialism. Or more bluntly than Marks implies—to protect red-scared Americans from the thought. The Pill therefore may have come to be identified with individual choice but came about through the narrative of collective necessity, which given the exponent agriculture advancements had in feeding the masses, proved illusory. Curiously the originator of big population modelling—Nicolas de Condorcet—did factor in scientific advancement allowing economic growth to cater to the population; it was Malthus’s outsize influence which led both policy-wonks and public-participants astray.
Second-wave feminists in the 1970s and some third-wave feminists in the 2010s are suspicious of The Pill. Indeed thrombosis, cancer, and mood altering effects are good reasons for women to be suspicious. As with most technology The Pill has better and worse consequences depending on the context. Some accounts have women celebrating The Pill even amidst cancer scares and moral panics: one says she would choose The Pill and cancer over a baby without The Pill. Other women rejected The Pill from the start because it made sex less intimate, made them sick, or altered moods terribly. Women today lament side-effects still, with fewer women (accounting for population inflation especially) taking The Pill; some narratives claim malfeasance behind The Pill and a concerted effort to keep women bound to a monthly clock. In 2019, the NHS updated its guidelines to say there is no medical benefit to a monthly bleed whilst on The Pill; the outcry as to why The Pill continued to be prescribed with instructions which deemed periods necessary for sixty years before then, was palpable. Family Planning and Reproductive Health Professor John Guiellard claimed that “The gynaecologist John Rock devised [the ovulatory break] because he hoped that the pope would accept The Pill and make it acceptable for Catholics to use. Rock thought if it did imitate the natural cycle then the pope would accept it.” Catholics indeed were key actors in The Pill development, both in creating and stifling, as both Rock and The Pope were Catholic adherents.
The ability of historical actors to foresee entirely new arrangements like fertile ovulation-less women, however, is inevitably limited. To guess at malesfance is to read into the past, then, rather than from the past; no mention of intent to limit women to ovulation exists in either figureheads’ correspondence, quite the contrary. Marks clarifies that its promoters did appeal to nature, but on the grounds that the hormone interventions were just as ‘natural’ because they extended the infertile part of the ovulatory cycle, complementing nature. The Pill, moreover, became patterned into having breaks to please women, who were subjects in the incipient clinical trials, and who worried that they were pregnant without period evidence they were not.
Haworth, however, claims the medical establishment committed neglect by omitting to reduce the pain of women who ovulate. Plentiful evidence indeed shows bias against women and their bodies. There may be something to Howarth’s neglect claim then—early doctors may have brought intuitive and often tacit definitions, understandings, and assumptions of identity and nature to bear on ovulation which limited their visions of interest in mitigating pain. Just as funding bodies were reluctant to change ‘part of life’ by investing in the taboo pill, changing the social practice of taking The Pill and investing money in how it could be taken permanently are likely more taboo and counterintuitive to those trained to treat obvious maladies, rather than sex-specific reproductive pains. Nonetheless, to ascribe agency here is too grand a narrative. Instead I propose that The Pill is an example of technological lock-in or entrenchment. Even though taking more pills through the month would be more profitable for companies—and ergo different drug companies had vested interest in labelling theirs safe for constant use—the idea of lobbying for that may simply have never emerged. At least, not enough to make a mark on historical records. Meanwhile placebo contraceptive pills, for the bleed part of the cycle, became ordinary practice.
Other sexual health priorities and research programs arguably took the priority over mitigating periods: deaths and disabilities from cancer and thrombosis rendered by high-dose pills; sexually transmitted diseases, especially during the AIDS crisis, eliciting support for other contraceptive methods; amenable studies of positive pill effects on ovarian cancer. Given these, projects into taking The Pill to prevent ovulation were far-fetched and thereby never garnered credence nor normalisation—until now when the women taking The Pill, remember, are different to their predecessors. The NHS guidelines, also, while authoritative are revisable by the medical authorities. Elsewhere in the world national authorities offer differing advice from near-identical evidence.
The histories of The Pill shadow health, reproduction, sex, mental life, and family planning as conceived today. As with all eras, ours contains fake news and contested narratives. Here I have gone some way to tell counter-narratives so as to remedy fake news: an international group fostered The Pill, The Pill was facilitated from permissive top-down policies, The Pill was synonymous more with modest life regulation than a swinging-sixties liberation, side-effects are inevitable, progressive, and mixed, and per-month ovulation endured due to status-quo bias and drug-use entrenchment rather than incipient malefesance. I have also explained why the Histories of The Pill are interesting and relevant to ongoing narratives about contraception and sex, and exemplified how the adaptive social, cultural, and political landscape affects the reception and diffusion of technologies, radical foetus-preventing drugs included, and those technologies affect the social, cultural, and political landscape in return. The Pill in the right context, at the right time, in the right body, has been, and can be, positive for feminist social change.
PART TWO, PRIMARY SOURCE ANALYSIS AND WOMEN’S MAGAZINES AND MOVEMENTS AROUND CONTRACEPTION
I just concluded that the pill in the right body, time, and context has been a boon to feminist social change based on a review of secondary work by Beth Bailey and Lara Marks. However, a review of Women’s liberation course Women and Their Bodies and British magazine Spare Rib, render my conclusions of positive feminist change problematic. Because the pill has been good for some women does not mean that women or feminists of the day embraced the pill wholesale. The uptake of the pill, in prescription numbers, may be misconstrued as enthusiasm for the pill. Both Women and Their Bodies and Spare Rib articles in editions 104 and 105 are unenthusiastic about the pill: both consider the pill as an instrument of oppression. Granted, the persistent opposition to the pill and the medical establishment still attests to its influence. But use and interpretation of it are more complicated in the primary sources’ account. Here I will explore how interpretations and pill use were affected by a. Feminist sexuality re-claiming sex with celibacy and clitcentric sex and b. Queer sexuality decoupling intimacy from pill-required penetrative sex c. Collectivist womens’ movements’ antagonism against the medical establishment and patriarchal state deciding birth control methods for women. These strands provide a more complete narrative to the prevailing rhetoric surrounding womens’ uptake of the pill. And challenges the 2010s journalistic picture of the pill as a positive disruptor; instead the uptake of the pill was mixed, diffuse, and its impact(s) alongside nonuse, other contraceptive alternatives, always dependent on local milieu customs.
A Feminist Sexuality
A trend in Hamblin’s magazine contributors is a redefining of sex away from a male-centric defined sex, by penetration and its precusors. “For many of us the first step in breaking out of these conditioned patterns and responses was to refuse penetration.” Hamblin claims “We found it took considerable time and struggle to reform our sexuality from sex-as-penetration to a more female-centred sexuality”. With sex redefined as non-penetrative comes a reduction in the need for contraception. Many meanwhile took up celibacy. As one woman explains, “I see celibacy in a very positive light. It’s about finding out who I am and where I’m at — and it’s very important to me”. Hamblin generalises that irrespective of genders, “periods of celibacy were necessary”. Thus celibacy was practiced for psychological reasons. And the initiative for sex predicated more on the choice to not have sex or to not masturbate at all. Penetrative intercourse became in their practice but “one option”. Women and Their Bodies, too, attests “that celibacy has helped a lot of women we know get closer in touch with themselves because it cleared away the sexual distraction.” By this feminist light, the pill as a positive disruptor is questionable, and it’s nonuse is as much part of the story as its prescription.
Questioning Bias In Liberation Texts
Women’s liberation literature is informed yet biased since it’s reasonable to assume non feminists negotiated less vociferously with men. Nonetheless Womens’ Liberation is representative and informative exactly because it’s biased towards the progressive perspectives of women. To assess how the times are changing, the cutting edge is a good place to look; especially where the debates are less progressive than secondary sources’ retrospect may lead one to believe. One Spare Rib founder, Marsha Rowe, claims in 2013, “When we founded Spare Rib in 1972, the women’s liberation movement was still very small – a couple of hundred women, at most”, let alone many queer or transex women; although the movement grew by leaps and bounds. Hamblin speaks for ‘we’ that non-penetration became preferable but that might be coloured by her perspective. The proportion of women who took up non-penetrative sex also remains vague. The fact most women derive ultimate pleasure from clitoral stimulation does not mean all women do either. Consider how a 2018 anonymous survey of 2000 women found that eighteen per cent—360—orgasm from penetration alone. For whom therefore non-penetrative sex would have less appeal than Hamblin’s narrative asserts about casually universal ‘female centered sexuality’. A low percentage, however, actually supports her overall argument against penetrative sex being the norm, since the majority of women never derive ultimate pleasure from penetration alone. This begs the question of the influence of gay relationships on heterodox sex.
Angela Hamblin details how many liberation movement women had moved from heterosexual relationships to lesbian and bisexual ones where contraception is seldom requiste. For transgender women and for bisexuals, of course, contraception might remain pertinent. The focus of the article is predicated not on the anxiety of birth or approaches to preventing conception however, but rather on sex itself. Arguably a mark of changing times: that women could focus happily on how best to have sex or to not, rather than on avoiding sex or experiencing displeasure for fear of pregnancy. These feminist publications in 1970 and 1981, consider birth control more diffuse and contextual than in mainstream accounts from 2010s journalism or even a preeminent 1969 debate.
Nevertheless outside of this queer and feminist commentary, reproductive-risk sex would have continued perhaps more in alignment with the expectations of nonfeminist and non queer women magazines. We can however only estimate; extrapolating numbers from a survey is imprecise. Queer sexuality is perhaps overplayed in liberation documents: lesbians and bisexuals who identify as lesbian in 2017 count as 2 per cent of the UK population, and a 4.5 per cent who are unsure or refuse to identity with a given category. The extent to which queer sexuality and femenist sexuality therefore problematises the importance of the pill from the sixties to eighties may be tenuous, a too trusting generalisation from prominent, rather than population representative, primary sources. The implication of queer and feminist sexuality, however, does bear representative merit since sparse credence is given in the secondary literature to the impact of queer and feminist sexuality not to numbers but to discourse, relationship bonds, and sexual practices; especially given how heterosexuality is defined comparably by non-heternormative sex. As Sue O’Sullivan, claims in 1981 “As more women became lesbians I think it brought it home even more sharply to heterosexual women that they were taking risks with their bodies for the men they related to, and they felt angry at the casual assumption that it was OK for women to pump themselves with pills for years on end”. The decoupling of reproduction and sex with the movement away from phallocentric or malecentric sex, could evidently be influenced by the interactions among womens’ groups of lesbian, bisexual, or other queer identities for whom contraception is seldom a precondition to sex. The sepratist lesbians The DC Furies, for example, were ambitious and influential in their message to create rival societies without heteronormative and patriarchial assumptions. These liberation texts are remarkable for their decentralised and anarchic sympathies towards clinics, yet in partisanship tend to overgeneralise what individual women or sisters really want—and even have wanted.
Decentralised Contraception and What Different Women Want
O’Sullivan’s assumption that women took pills ‘for’ the men in their life, and with displeasure, is a crude interpretation which might espouse higher standards in author’s retrospect than women expected back then. Many interviewees expressed sheer gratitude for a contraception that was so reliable. Remember the interviewee who said she would choose the pill and cancer over no pill and a baby. Or recall begging letters sent to John Pinicus asking for the pill regardless of risks. Cancer and thrombosis scares did, however, proliferate alongside prescriptions for the pill, which makes sense of these liberation sources’ suspicion of the pill and the system distributing it. Instead of a prescribed pill, Spare Rib sympathised with decentralised contraception clinics and older methods. O’Sullivan argues for the cervical cap. On the one hand she presents a view of barrier contraception as risk-free, “without side-effects”, and on the other presents a good case that women administering contraception for themselves provides a more feminist arrangement for communities to own and solve their problems. In that respect the ongoing enthusiasm for barrier methods shows the distrust for the medical establishment as women movements claimed management of their bodies, including their chosen contraception even in 1981. Contrary to the sympathetic doctor and statist narratives of Lara Marks and Beth Bailey, primary sources consider the state and doctors oppressive.
The definition ‘oppression’ is relative to time and whom is asked: these second-wave Feminist groups considered default contraceptive methods like the pill an imposed means of individual control because of their manufacturer, production, distribution, and biological risks. In a way that present-day minds can struggle to apprehend without adopting the grassroots Feminist perspective of these, unique, sources. For example, in outright banning and restricting shipments of barrier method contraception from Britain to the USA. And in continuing to prescribe the pill with its reported cancerous and thrombotic side effects, and the risk of sexually transmitted disease, rather than prescribe condoms. Any contraceptive alternatives met with top-down crackdowns, against bottom-up enthusiastic choices by 30-40,000 women fitted with cervical caps by 1981.
In O’Sullivan’s account, too, men engineered the pill and clinical trials, for The State, against communism, out of Malthusian anxiety. Exposés indeed showed victimised “black”, “poor”, “third world” and “United States” women. The development and instrumentation was fostered by these factors but victimisation of women is exaggerated. Women and minorities helped make the pill; most participants were eager volunteers. That such misrepresentation remained credible in 1981 though is revealing. Because it demonstrates how antagonistic the relationships between womens’ movements and the medical profession and The State remained.
Indeed, comparing the emblematic televised debate of three doctors, Celso-Ramon Garcia, Sheldon Segal, Louis Lasagna, in 1969—to Women and Their Bodies “written for women by women” in 1970 makes mistreatment and misinformation pertinent for social reasons beyond biological effects. The Boston Womens’ Liberation authors blamed doctors’ “MD priesthood mystique” for leaving out side effects (omission), and ignoring patients’ requests (commission). As the text claims, taking the sequential pill is “Russian roulette” and doctors “treat us as patients, not people”. Instead of prioritising the optimal choice the onus in Women and Their Bodies is on individual choice of contraceptive, as a woman, rather than take the method proffered by doctor and authorities. The statistical efficacy of contraception is seconded to a woman deciding her method.
We don’t want contraception to become one more area in which we are intimidated and frightened into doing things we’re not sure of or don’t want to do. Each of us has the right to choose a method which is best for us and to understand that method in terms of application, effectiveness, safety, etc. For we alone best know what our needs are.
The pill in 2010s journalism meanwhile is celebrated for its use in mitigating periods and freeing women. Alice Howarth accuses doctors of negligence in never eliminating pill menstruation. Yet ‘fixing’ menstruation never made the agenda nor the pages of these sources. Given the onus of reclaiming menstruation as a shameless natural process, a medical movement to eliminate it would be anathema. Improving the basic health standards and assuring women, took priority over any venture to cure ‘menstruation’. Seeking a male pill similarly flew against “social convention”. Whilst many today consider the pill liberating, back then, liberation groups thought the opposite.
I have examined how complicated the reception and practise of contraception was in the eyes of womens’ movement members in Spare Rib and Women and Their Bodies. In doing so, I have argued for the contributions of hetero-disrupting queer sexuality, feminist clitcentric sexuality, and collectivist womens’ movements in antangonisim with men doctors and The State in sources as late as 1981. These sources are politically radical enough to make generalising about contraception and the pill dubious. But that difficulty is actually representative of how mixed its uptake and the discourse around it was from 1969-1981. My previous essay demonstrated how the right pill in the right time and body has offered a mechanism for female empowerment. That remains true. This essay however demonstrates the circumstances and attitudes whereby women experienced the instrumentation of the pill to be oppressive. Contrary to my first essay sources, the medical establishment and state played a more aggressive role than hitherto interpreted. The effects of womens’ movements, queer sexuality, and clitcentric sex, are also worthy of further histories about contraception.