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Copley News Service, July 17, 2005

Birth control pills helped empower women, changed the world

Author : Sandy Cohen

The year is 1959, the era of happy homemakers. Dwight D. Eisenhower is president. "Mack the Knife" is the No. 1 song. Single women aren't eligible for credit cards. Birth control is a crime in Connecticut.

The following year, Elvis will enter the Army. John F. Kennedy will be elected president.

And the Food and Drug Administration will approve a pill that will forever change the social and sexual landscape in the United States.

Forty-five years later, the impact of the oral contraceptive - known everywhere as The Pill - still resonates. More people have taken it than any other prescribed medicine in the world. "The pill arrived at such a fortuitous moment," said Roger Robins, professor of history and political science at Marymount College in Rancho Palos Verdes, Calif. "It was a product of what went before as well as a catalyst of what happened later."

Cited as a symbol of the sexual revolution and women's liberation, the pill was welcomed by a generation mired in social upheaval, from the civil rights battle and the Vietnam War. But even drug makers couldn't have predicted that this combination of estrogen and progestin that prevents ovulation and pregnancy would inspire such broad social, economic and political change.

"The whole anti-establishment movement was happening. People were willing to think outside the norm, and this was just one more way," said sociology professor Pam Brown Schachter of Marymount College. "It opened the door to a psychological mind-set of a life beyond having kids and being a housewife. It gave women a freedom they didn't have before."

No longer forced into motherhood by their biology, women could choose how they wanted to shape their lives, planning when to have children and how many to have. Meanwhile, they could pursue higher education and careers.

"Women cannot compete with men as long as they're childbearers first and employees second," said Lynne Luciano, a history professor at California State University, Dominguez Hills. "The pill allowed women to stay in their careers, and get pregnant when they feel like it, not by accident."

For the first time, preventing pregnancy was in a woman's hands. She could take the pill at her discretion, without anyone knowing and without depending on a man.

But when the drug was introduced in 1960, prescriptions were reserved for married women only. Even in 1967, with the free-love movement in full swing, single women had a hard time getting the pill.

"We had hippies, we had the Rolling Stones, we had drugs, and you still had to come in with some kind of proof that you were married to get the pill," Luciano said. "It had to do with the promiscuity factor and empowering women."

Controlling contraception meant women could embrace their sexuality like never before. Without fear of pregnancy, women had more latitude to choose partners and determine the timing and frequency of sex. That kind of female autonomy was unprecedented. "Society had a hard time coming to grips with ideas about women and women's sexuality," Luciano said.

A 1966 article in U.S. News and World Report cited fears that the popularity of the pill would lead the nation into a time of "sexual anarchy."

"With birth control so easy and effective, is the last vestige of sexual restraint to go out the window?" it read.

"It raised anxieties about moral decay and the eroding of traditional family values," Robins said. "Since then, we've seen the rise of the religious right politically."

It's not as though birth control didn't exist before the pill. Condoms and diaphragms had been widely available since the 1840s. But no method was as simple and effective as the pill, which separated contraception from sex altogether.

Besides, birth control was illegal in most of the country from 1873 to 1960. Margaret Sanger, who first envisioned a "magic pill" to control contraception in 1912, was arrested in 1916 for opening the country's first birth control clinic.

Undeterred, in 1921 she founded the American Birth Control League, which would later become the Planned Parenthood Federation. She made it her life's mission to bring safe, effective birth control to American women.

Three decades later, Sanger met scientist Gregory Pincus, who would help with the pill project. That same year, researchers extracted progestin from a yam in a Mexico City lab.

"That was the start of the oral contraceptive," said Dr. Paul Brenner, vice-chairman of obstetrics and gynecology at University of Southern California Medical Center in Los Angeles.

Katharine McCormick, a wealthy suffragist and early feminist, funded the research that led to FDA approval of the first oral contraceptive, Enovid, in 1960.

Within two years of its introduction, 1.2 million women were taking the pill every day. But the original formula caused serious side effects, from deadly blood clots to increased risk of heart attack and stroke. Still, by 1968, 12 million women were on the pill and sweeping social change was on the horizon.

"It decoupled sexual intercourse and procreation more than any other form of birth control," Robins said. "Now that it wasn't inevitable that a woman would have children every time she had sex, she could reconstruct what it meant to be a woman. It also had a profound impact on how we think about (sex), that the value of pleasure, intimacy and bonding can be separate from childbearing."

In the decades that followed, new lower-dose pills were developed. The original contained 150 micrograms of estrogen, where modern pills have 20 to 25 micrograms, said Dr. Ben Naghi, a Torrance, Calif., gynecologist.

Levels of progestin dropped from almost 10 milligrams to just one, he said.

These new formulations not only reduce negative side effects, they also offer various health benefits, Naghi said.

Today's pill helps prevent ovarian, uterine and endometrial cancer, reduces cramps and heavy bleeding and even eases acne and arthritis, doctors said. It's 99 percent effective and 100 percent reversible.

New means of delivering the medicine that is in the pill also have been developed. There's a transdermal patch worn weekly and a vaginal ring that stays in place for three weeks.

There's also a contraceptive injection that's effective for three months and a contraceptive implant that works for several years at a time.

Hormonal contraception, which started with the pill, is the most popular form of birth control in the United States, Naghi said. Eight out of 10 women have used it at some time in their lives.

In the 45 years since the pill was introduced, women have entered educational, professional and political arenas en masse. It also seriously changed relations in the bedroom.

"In psychology journals, prior to 1970, frigidity was listed as a major problem for women," Luciano said. "Today, frigidity has practically vanished from the literature. It's been replaced by erectile dysfunction and premature ejaculation, which were never considered problems before."

The whole culture shifted to accommodate the new role of women. Changing attitudes about families and sexuality have had far-reaching effects, Robins said.

"As we think about relationships differently, it's opened the door for other people to be empowered and accepted," he said. "The gay rights movement, for example, is winning success because of the changing perspective of the meaning of relationships and sexuality."

The pill's effect has been so profound that most young women today grow up knowing they're not limited by their biology. They see a broad landscape of opportunity that didn't exist two generations earlier, Schachter said.

"The changing role and empowerment of women had an impact throughout the whole societal infrastructure," she said. "For my generation, the door was opening at a prime time. Now the opportunities women have in society are just expected and taken for granted.

"It wouldn't have come without the introduction of the birth control pill."

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