The Pill at 50: Sex, Freedom and Paradox

In May 1960, the FDA approved a new oral contraceptive. Somehow we are still fighting about it half a century later — whom it helped, whom it hurt, what it meant and why it mattered

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Combined monophasic early contraception pill, 1960. Pink contraceptive pills (marked 'PD') in a circular blue plastic dispenser.

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Steinem disputes this whole framework, noting that sex and procreation have never been as tightly connected as Mohler suggests. "Most animals seem to have periods of heat, in which sexual activity is most concentrated and they are most likely to conceive," she says. "Human beings uniquely don't. So for us, sexuality is a mark of our humanity, like our ability to reason or remember or think about thinking. Sexuality is not only a way we procreate but also a way we communicate and express love and caring and community."

Women's-rights leaders see multiple agendas at work in the counterrevolution: an attempt not just to roll back access to contraception but also to return women to more traditional roles. "The cynic in me says, Hmm, they are winning the abortion fight, so they need to raise money some other way, which means go somewhere else. They go to contraception," says NOW president O'Neill of social conservatives. "If the project is to re-establish patriarchal structures, where women are subordinate to male family members, they have to end women's access to contraception."

Mohler does not dispute every charge. That would be intellectually dishonest, he says. The Pill "changed the woman's moral horizon from a likelihood of becoming pregnant to a total lack of likelihood. I'm certain feminists champion that as a tremendous gain necessary for their liberation in the workforce and elsewhere — I think it's fair to say social conservatives have great concerns about that entire package."

The reconsideration of contraception has had concrete implications for public policy. "When I was growing up, Rob and Laura Petrie didn't sleep in the same bed, but we were taught about birth control in health class," recalls Cecile Richards, president of Planned Parenthood. "And I grew up in Texas! Not exactly the cutting edge. My kids grow up with sex everywhere, but birth control is not talked about in school." When the GOP controlled both Congress and the White House after 2000, funding shifted away from family-planning programs and into abstinence education. The Deficit Reduction Act of 2005 increased the cost of birth control at campus health clinics four- to fivefold. The promotion of "conscience clauses" allowed hospital workers and pharmacists who have moral qualms about contraception to refuse to fill prescriptions. "We're still fighting those battles in Congress," says Katherine Spillar, executive editor of Ms. magazine and executive vice president of the Feminist Majority Foundation. "To think that in 2010, 50 years after the birth control pill, we still have to fight for access and effective family planning — it's painful."

If conflict abides around the politics and morality of the Pill, it may help explain why young people are so confused about using it. A study by the National Campaign to Prevent Teen and Unplanned Pregnancy found that 86% of young men and 88% of young women say it is important to avoid pregnancy in their lives right now. Yet 63% say they know little or nothing about birth control pills, and much of what they think they know is wrong. More than 40% think that even when using the Pill, a woman has a 50% or higher chance of getting pregnant in any given year; actually, the Pill is 92% effective. Four in 10 blacks and Hispanics think the government uses minorities as guinea pigs to try out new birth control methods, and even more think the government is pushing birth control in order to reduce the minority population. Some of the women who were on the family-planning front lines 50 years ago get a little impatient when they hear young women talking ungratefully about the freedoms they take for granted. But Steinem, for one, takes the longer view. "I don't walk around saying, 'Thank you for the vote,' " she says of a battle even longer past. "I might add, as Susan B. Anthony said, Our job is not to make young women grateful. It's to make them ungrateful so they keep going. Gratitude never radicalized anybody."

It is possible that somewhere in some lab, the next big thing is being invented that will twist the whole debate another 90 degrees. Maybe it will be an artificial womb, which would allow unwanted pregnancies to be carried to term, just not by the reluctant mother. There was a time when researchers imagined that Plan B, or the morning-after pill, might become not an emergency form of contraception but a routine one; women would take it once a month to induce a period and never even know whether they had gotten pregnant. Would just enough ignorance appease the twitching conscience while solving the cost and convenience challenges as well? Traditionalists, meanwhile, press for progress not in medicine but in marriage, to restore it as the central social institution shaping people's sexuality. As the conversation of the past half-century makes plain, science alone will not resolve questions that reach this deep into our relations with one another.

— With reporting by Deirdre van Dyk and Kathleen Adams / New York

An unabridged version of this riveting story is now available as an e-book. Love, Sex, Freedom and the Paradox of the Pill: A Brief History of Birth Control is available exclusively in Amazon's Kindle Store by searching "the Pill on Kindle" and can be read on the Kindle and Kindle reading apps [on the iPhone, the iPod touch and the iPad, plus the BlackBerry, PC and Mac.]

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