The Combined Oral contraceptive pill, or just simply known as “The Pill”, is a birth control method which regulates the release of hormones within the body and supresses female fertility. Seen as revolutionary and a medical triumph, it was first approved for use in the 1960s in America by the Food and Drug Administration. 50 years later it is one of the most popular forms of birth control with over 100 million women worldwide who are users (Skuy, 2012). The Pill, although small in size, created a lasting impact that revolutionised the behaviour of women, contributing to the sexual revolution and the women’s rights movement. Its release into the market also brought along with it a wave of new thinking for women and society, changing the context of what it meant to be a female during the 60s, already a period of radical change brought upon by the end of World War II.
To truly appreciate and understand the contraceptive pill, one must comprehend the science and technology behind it. The appearance of the Pill is very ordinary – small pills, each only half a centimetre in diameter, often tinted different colours depending on the brand. They come in a variety of different packets depending on the individual’s needs. There are two main types of the Pill that are available – the combined method, which contained the hormones estrogen and progestogen, and a progestogen-only method which contains only the progestogen hormone. The combined method works by suppressing the ovulation cycle by as well as thicken the cervical mucus, compared with the progestogen-only method, which simply reduces the frequency of ovulation. Most women still will experience the monthly bleeding, as early research believed that some would need reassurance that menstruation brought to reduce their anxiety of being pregnant (Skuy, 2012).
Contraception however, is not the only reason that women take the Pill. There are other benefits to the hormones inside the Pill, which includes treatment for problems such as polycystic ovary syndrome, menstrual cramps, menorrhagia (extreme menstrual bleeding) and dysmenorrhea, which means painful menstruation (CYWH Staff, 2011). It can also be prescribed to treat acne as well. Other benefits include reduced mortality rates; overall reduction in death rates caused by cancer, as well as reduces the chance of ovarian cancer by almost 50%, as suppression of ovulation means less cell division, thus decreasing chance of cancer.
The history of the Pill can be traced back to 1919, where a physiologist named Ludwig Haberlandt was the first to understand the connection between pregnancy and ovulation (Weintraub, 2005). The first prototype creation of the Pill however, was said to have begun in the 1930s, where scientists had discovered through isolation and determining the structure of steroid hormones that high doses of estrogen, progestogen and androgens inhibited ovulation. However, obtaining the hormones derives from animals were too expensive, and the research was pushed aside. In 1950s, a woman named Margaret Sanger, the founder for the birth control movement in America, and Gregory Pincus, a reproductive physiologist¬¬¬, began further research into this area. Sanger introduced Pincus to suffragist Katherine McCormick, who provided the financial support for continued research into this area. Pincus, along with John Rock, a gynaecologist from Harvard University, then both became a major developer of the Pill. The first large scale trials of the modern Pill however had to be conducted in Puerto Rico, due to Massachusetts law banning the use of contraceptives. By 1957 the Pill had been tested on 830 women, mostly in Puerto Rico, and by 1958 The Pill was released as a treatment for gynecological disorders, stating that “side effects included inhibited female fertility”(Skuy, 2012).
The creation of the Pill is a significant turning point, not only in the history of medicine, but especially in the history of women's health, reproduction, and contraception and society in general. "I don't think people thought [the Pill] would be as revolutionary as it was," says Valerie Beral, a professor of epidemiology at Oxford University, who has spent the last 40 years researching the pill. She went on to state that for women's health, “it was the most important thing in the latter half of the century - no question about it" (Cafe 2011).
To understand the significance of the Pill, one has to understand the context of the 1960s, especially in America. During the 50s and even to an extent, the 60s, the average woman was limited in almost every respect from the workforce to her family life. She would’ve been expected to follow a certain path of marriage, starting a family quickly, and devoting the rest of her life to homemaking, all during her early 20s. The 1960s was the post-war period, a decade marked by extremes and transformational change. It was during this decade that the role of women in society were altering through many different ways – the increase in females entering the paid workforce led to an increased dissatisfaction among women in regards to the gender disparities between pay and work advancements, and the problem of sexual harassment within the work place. Many women also began to question the typical gender role of a woman – staying at home and raising the children – as well as being confined to the traditionally female occupations such as teaching and secretarial work (Skwirk, 2011).
Inside the context of the Women’s Rights Movement, the prescription of the pill was exactly what women needed to fulfil their needs. With the introduction of the Pill in America came the revelation that for the first time, women had almost complete control over their own bodies, and consequently, more freedom of choice on deciding on when and whether or not to have children. This of course, impacted on society in many different forms. In her discussion of the pill and social reform, Leah Lawrence, an author, notes that “with more choices about the timing of starting a family, women could complete or extend their education and then remain in the work force longer before having children.”(Asbell, 1995)
However, when the drug was introduced in 1960, prescriptions were reserved for married women only. Even towards the end of the 60s, despite radical changes happening already, single women still had a hard time acquiring the pill. It wasn’t until the mid-60s where doctors began prescribing to single women.
"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.” said Lynne Luciano, a history professor at California State University. “Clearly something was wrong here.”
Yet the availability of the Pill and its effectiveness caused anxiety within the public sector, with the fear that the popularity of the contraception will lead to a time of “sexual anarchy” Cohen, 2005). Birth control of course, has been around since the early 1550BC. Ancient Egyptians employed the use of crocodile dung as a barrier to prevent contraception, while early examples of condoms made out of intestines were also in use during the medieval period. Condoms and diaphragms had been widely available as well since 1840s. However, no method ever produced before was as simple and effective, and also separated contraception from the act of sex altogether as the Pill did.
The Pill also became the symbol of the "sexual revolution" which began at the start of the 1960s, and carried into the 70s. The control it also gave women over their bodies meant that women could finally embrace their sexuality. This gave women the choice of being able to choose partners, determine the time and frequency of sex without the fear of unwanted pregnancies. The sort of autonomy which females were granted through the Pill was unprecedented and marked transformation in the way that society functioned.
The Pill changed the discourse and the mindset of the American public as it blurred the lines between what was acceptable to talk about and what was not, which can be traced through the rise of new social and legal standards. The contraceptive could be used every day, and it cleared a distinct line between discussing the Pill and discussing intercourse. Laws began to emerge, reflecting the attitudes that people had regarding sex and birth control. In 1965, a law was passed stating that the prohibition of birth control information was unconstitutional. It was also no longer illegal for states to hand out information to married women, and by 1972 the law was extended to cover the rights of unmarried women as well. This meant that for females who grew up during the 1960s did so in an age where oral contraception was acceptable. As Ladies Home Journal proclaims, it “transformed our lives like nothing before or since…It’s easy to forget how truly liberating the pill seemed to be in 1960. Nothing else in this century – perhaps not even winning the right to vote – made such an immediate difference in women’s lives.” (Asbell, 1995)
The Pill also caused controversy especially in the face of the Catholic Church. Despite the approval by FDA in America, the church continued to warn against the use of contraceptives, especially the Pill. In the view of the Church, any artificial means that killed or prevented the egg from being fertilised was equivalent to the act of homicide. The idea of the Pill went against religious principles, despite the growing changes and radical movements away from religious thinking towards science during this decade and the latter decades.
The effect so the Pill is not restricted to the 60s only. Another area in which the Pill had a significant impact on was the number of abortions worldwide. The amount of women who die or suffer intense injuries from the effects of unsafe abortion in this past decade surpasses 70, 000. Due to the Pill, there were fewer cases of unwanted pregnancies and induced abortions. Between 1995 and 2003, the number of induced abortions worldwide declined from nearly 46 million to under 42 million; from almost 27 million to 26 million in Asia.
50 years on, the Pill was a significant milestone not only in women’s right and health, but it also opened the door for other hormonal birth control options. In this regard, the Pill itself has come a long way since its first release in the 60s. The previous doses of estrogen have declined steadily from their initial 150 micrograms in 1960 to 20 or 30 grams in products today. The drop is significant in alleviating many of the side effects such as nausea, headaches and vomiting, which made the early Pill harder for women to tolerate. The option also arises for women who do not like taking the daily Pill, Instead, other hormonal options are available, including methods such as vaginal ring, or the implant, a small device inserted under the skin which releases hormones over a steady period of time and can be effective in preventing pregnancy for up to three years. A progesterone shot, Depo Provera, is also an option. The future of oral contraception seems hopeful, and further development will also potentially lead to the eradication of all negative side effects.
The Combined Oral Contraceptive Pill, otherwise known simply as “The Pill”, is a significant milestone in both scientific advancement and the Women’s Rights movement, challenging society’s perceptions of gender and sex. As Don Ihde states, “I have suggested that all technologies are embedded in culture… insofar as technologies entail "ways of seeing" – whether or not Technology (with the capital) equals the metaphysical way of seeing (Heidegger) – that, too, implicates the particularities of culture.” (Ihde, 1993). I believe that the Pill is a technology that can clearly be seen as being firmly embedded within the culture and the context of the time – the rise of women’s rights and freedom in the 60s seemed inevitable, and the Pill was a product of its time, just as the decade was shaped by the product itself.
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