The Birth Control Pill Is 57 Years Old, But It Never Stopped Being Radical

Still the most popular form of contraception, the pill ushered in a new era of reproductive freedom for women.

The first commercial birth control pill became available 57 years ago on Tuesday, with two women deserving much of the credit.

The pill radically changed women’s health, giving them access to reliable, safe and effective contraception. It also fundamentally changed women’s ability to control their own lives, giving them more freedom over when and how to have children, and sex.

Gloria Feldt, former president and chief executive of Planned Parenthood, told Forbes in 2010 that the pill helped women achieve economic freedom.

“If women are going to have control and power in society, they have to be able to control when they have children, and they have to be able to make money,” Feldt said. “The pill brought together the economics and the fertility timeline in a neat little package.”

Birth control pioneer Margaret Sanger, who opened the first U.S. birth control clinic in 1916 and founded the organization that became Planned Parenthood, was a fierce advocate for the pill and had a large hand in its creation. Katharine Dexter McCormick, a philanthropist with a biology degree, worked with Sanger and provided all of the funding needed to create the pill. Scientists began developing the pill in the 1950s, using a synthetic form of the hormone progesterone to suppress ovulation.

Millions of women use similar pills today, and contraception is considered an essential preventive health service. But that wasn’t the case when Sanger started her crusade ― she was loudly championing the importance of birth control at a time when it was outlawed.

Soon after Sanger opened her clinic in 1916, she was arrested and spent a few weeks in jail. Her search for a “magic pill” to prevent pregnancy, as she described it in 1939, began as early as 1912. On May 9, 1960, she finally achieved her goal when the U.S. Food and Drug Administration approved the oral contraceptive Enovid.

In the pill’s first year on the market, 400,000 women went to the doctor to get prescriptions, according to Time magazine. 

The pill’s history also has a darker side. Sanger believed in at least some of the ideas spread by the discredited and racist eugenics movement, and promoted the pill partly as a way to control the fertility of certain populations. The scientists who created the pill conducted clinical trials in Puerto Rico, which have since been condemned for exploiting poor women of color who weren’t told that the pill was experimental or about its side effects.

Still, the pill has opened doors for women, who today have access to a number of family planning options. Ninety-nine percent of women between the ages of 15 and 44 who have ever had sex report using some form of contraception in their lifetimes. The pill is still the most popular form of birth control.  

Obamacare, officially known as the Affordable Care Act, opened a new era for birth control in the U.S., requiring insurers to provide women free coverage for multiple types of contraception. Since the health care law went into effect, contraception coverage has expanded to more women and particularly helped those with low incomes. The rate of women who had any out-of-pocket costs for birth control pills dropped from 21 percent in 2012 to 3 percent in 2015. Women saved a total of $1.4 billion on birth control costs under the law.

As Congress works to repeal and replace Obamacare, however, coverage for contraception could decrease. Republicans’ Affordable Health Care Act, passed in the House last week, would cut federal funding to Planned Parenthood for Medicaid recipients ― leaving no clear alternatives for many of the 2 million low-income women who receive contraception services at the organization’s clinics.

Changes to how states receive federal funding for Medicaid could also lead them to offer reduced contraception options and family planning services, according to the Kaiser Family Foundation.

While the Republican health care plan doesn’t affect the contraception coverage requirement, women’s rights advocates are concerned that President Donald Trump’s administration could eventually allow organizations to restrict birth control coverage due to their religious beliefs.

In an executive order on religious liberty Trump signed last week, he instructed federal officials to consider changes to the contraception coverage requirement “to address conscience-based objections.”