Birth Control Movement

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BIRTH CONTROL MOVEMENT

BIRTH CONTROL MOVEMENT. A birth control movement did not exist in the United States in the nineteenth century; still, the birth rate steadily declined from 1800. Women prevented conception by a number of different methods—abstinence, breastfeeding for long periods, male withdrawal before ejaculation, douching with common ingredients, abortifacients such as penny royal, condoms made from linen or animal intestines, and homemade sponges.

Reformers advocated various forms of birth control beginning in the 1830s. The 1830s and 1840s were a period when Americans were receptive to experimental ideas. In 1831 Robert Dale Owen, son of utopian socialist Robert Owen, wrote the first major American book on birth control, Moral Physiology; or, A Brief and Plain Treatise on the Population Question. In this book he reviewed available birth control methods—the condom, the vaginal sponge, and coitus interruptus. He recommended the latter as the best choice. This work led Charles Knowlton, a physician, to write in 1832 a more thoroughgoing tract on birth control, Fruits of Philosophy; or, The Private Companion of Young Married People. Not satisfied with Owen's choice, he worked diligently to find another, more realistic method of birth control. After some thought on the subject, he advocated that women douche with a spermicidal solution after intercourse. Both books were also philosophical treatises on the benefits to society of family planning.

Birth control was revolutionized by the vulcanization of rubber in 1837. After it had been refined to a thinner more flexible product, innovations began to emerge in the 1850s and 1860s which made use of this new medium—condoms, male caps (which covered only the tip of the penis), douching devices, and womb veils or diaphragms. All were available from commercial sources. Edward Bliss Foote, a physician, advocated the womb veil in his 1864 edition of Medical Common Sense.

The ready availability of contraceptive devices on the commercial market led Anthony Comstock, a moral crusader, to try to curb the trade. In 1873, at the behest of Comstock, Congress included clauses in a postal act de-fining obscene materials barred from the mail. Included in the definition of obscenity was any drug or device that prevented conception or produced abortion, or any literature that discussed birth control or abortion. The Comstock Act provided punishment of fines from $100 to $5,000 and/or imprisonment at hard labor from one to ten years for those who put obscene materials in the mails. Commercial birth control purveyors disguised their products with words that conveyed safety and security for married men and women, enabling a healthy market in birth control to grow during the Comstock era. Because of a lack of postal agents to enforce the law, most of this trade went unpunished. Little Comstock laws—state laws such as one in New York—made it illegal to give away or sell contraceptive information or products. In this atmosphere the early birth control movement arose. The Comstock law had made birth control a criminal enterprise. Abortion was also made illegal in most states by 1870.

By the 1870s feminists such as Elizabeth Cady Stanton were espousing voluntary motherhood. They were not advocating contraception, but rather abstinence or a woman's right to refuse sexual relations with her husband. In the early 1900s radical socialists and anarchists, especially Emma Goldman, addressed the birth control issue. Goldman, an immigrant and anarchist from Russia, was the most active spokesperson for birth control during this period. She wrote about contraception in her publication, Mother Earth, as early as 1906 and gave lectures on the subject in 1910. She smuggled contraceptives into the U.S. from Europe, and printed up birth control pamphlets. Though active on the subject of birth control, she had many other interests and never devoted herself exclusively to that cause. She became the mentor of Margaret Sanger, who became the foremost leader of the birth control movement in the United States. Women and men in radical groups, which formed birth control leagues all over the country, supported Sanger.

Margaret Sanger and the Comstock Act

In 1911 Margaret Sanger, newly married and educated as a nurse, moved to New York City and joined the Socialist Party, which was then enjoying its greatest popularity in U.S. history. There she met the leading radicals of the period and began to write articles for the New York Call on sex education. One of her columns on venereal disease caused issues of the Call to be seized by the postal department in 1912. Sanger's mother had borne eleven children and had died of tuberculosis at age 49. Sanger was attracted to the birth control issue because of her mother's death, her work with poor women on the Lower East Side of New York, and her belief that women's sexual experience was diminished by the fear of unwanted pregnancy.

Sanger went to Europe in 1913 and began investigating birth control methods. She found that in France birth control was perfectly acceptable. Upon her return to the United States, Sanger published a periodical called The Woman Rebel, in which she first used the term birth control. The postal authorities subsequently suppressed the publication. Indicted for violation of the postal code, Sanger left for Europe. She left 100,000 copies of a pamphlet called Family Limitation, which described condoms, douches, and cervical caps, to be distributed when she signaled. The news of her indictment caused local birth control groups to form all over the country during 1914 and 1915.

While she was in Europe, she visited the Netherlands; there she found birth control centers where doctors individually fitted women with advanced spring-type diaphragms, which were more reliable and better-fitting than the womb veil. This provided her with a model for her work in the United States when she returned in 1915.

The government dropped the charges against Sanger in 1916 because of extensive publicity surrounding the case. This development allowed her to open a birth control clinic in Brooklyn on 16 October 1916. She and her sister, Ethel Byrne, ran the clinic and dispensed birth control information and devices. The police closed down the clinic under the New York law after only ten days. Her trial and imprisonment for this act made her renowned. The appeal of her case led to a breakthrough for the birth control movement. In 1918 Judge Frederick Crane of the Court of Appeals of New York stated in his decision that doctors could prescribe birth control to women for the cure and prevention of disease. Sanger took this as a mandate to open birth control clinics staffed by physicians. Condom manufacturers saw it as the chance to sell condoms. Their business thrived to the dismay of Sanger, who wanted woman-controlled birth control.

Sanger forged ahead with the loophole granted her by the judge's decision, but she was opposed by Mary Ware Dennett, a birth control reformer in her own right and founder of the National Birth Control League, later the Voluntary Parenthood League. Dennett was striving for complete abolition of the laws against the dispensing of birth control devices and information. She considered Sanger's strategy a capitulation to the moral crusaders; birth control should be freely dispensed, not controlled exclusively by the medical establishment.

The American Birth Control League and the growth of clinics. In 1921 Sanger organized the American Birth Control League (ABCL). Soon she began to cultivate wealthy people to back birth control clinics. Her second marriage to J. Noah Slee, president of the Three-in-One Oil Company, took place in 1922. He became the major contributor to the ABCL. In 1923 Sanger opened the Clinical Research Bureau in New York City, later the Birth Control Clinical Research Bureau (BCCRB), the first legal clinic in the United States to be staffed by a physician. Slee funded a manufacturer, Holland-Rantos Company, to make diaphragms to Sanger's specifications for dispensing by private physicians and by those at ABCL clinics.

Other events indicated that there was a major shift in the country's attitude toward birth control. The courts finally reversed the Comstock Act's definition of birth control as obscenity in United States v. One Package (1936). This opened the way for contraceptive materials to be mailed to physicians. In 1937 the American Medical Association agreed that birth control should be taught in medical schools, and by 1938 ABCL had opened three hundred birth control clinics across the nation. In 1942 Sanger founded Planned Parenthood, the successor to the ABCL, and she had a role in the 1952 founding of International Planned Parenthood.

Development of the Pill

Still Sanger was not satisfied. Clinics were reaching only a small percentage of the population and most people re-lied on commercial products for birth control. In 1946 she began to think about the development of a pill that, unlike the diaphragm, would separate sex from birth control. In 1917 Sanger had befriended Katharine Dexter McCormick, one of the first two women to graduate from the Massachusetts Institute of Technology with science degrees. She was the widow of Stanley McCormick, heir to the International Harvester Company fortune. Katharine McCormick had smuggled contraceptives into the United States from Europe for Sanger's clinics for many years. She had written to Sanger in 1950 asking where she could best put her fortune to use. Her interest in biology and birth control motivated her to donate $2 million to the effort to develop the pill.

With this financial backing, Sanger commissioned Dr. Gregory Pincus to develop the pill in 1951. Pincus had developed the first test-tube rabbit embryo, which so scandalized Harvard University that they denied him tenure. He founded his own independent biological laboratory in 1944 and sought grants to keep it funded. For this reason, one of the most brilliant scientists of sexual physiology was available for Sanger's project. His team included John Rock and Min-Chueh Chang. They were aided in their quest by chemists Carl Djerassi and Frank Colton, who synthesized progesterone potent enough to be effective in a pill.

In May 1960 the Food and Drug Administration approved the pill, called Enovid, for use as a contraceptive. The pill quickly became the most popular form of birth control in the United States because of its ease of use, its reliability, and its control by women. Sanger's dream of a woman-controlled pill prescribed by a doctor had come true.

Still there were barriers to its use. Some state laws modeled on the Comstock law were still in force. In Connecticut a state law outlawed the prescription of contraception by a doctor. Planned Parenthood opened a clinic, distributed the pill and challenged the law. The Supreme Court case Griswold v. Connecticut (1965) held that married people had a constitutional right to privacy in the bedroom—and therefore the right to use birth control. Not until 1972 were unmarried people allowed the same privacy rights by Eisenstadt v. Baird. Comstockery was finally dead.

Advancement of Birth Control

The pill had been tested on a relatively small sample. When it became widely used, problems emerged, such as blood-clotting disorders that could lead to death. By 1970 when Senator Gaylord Nelson was holding hearings on the safety of the pill, the new women's health movement was advancing. Feminists wanted birth control, but they wanted it to be safe. Two women's health groups had been formed in 1969, the Boston Women's Health Collective and the National Abortion and Reproductive Rights Action League. The hearings were well attended. Women resented the fact that birth control decisions were being made by an all-male group of politicians. Manufacturers lowered the dosage of the pill and, because of the protest and subsequent regulations, included inserts in the pill's package describing its side effects.

Meanwhile a new doctor-prescribed birth control product was being developed; the IUD (Intrauterine Device) came in a number of different forms such as the Lippes Loop and the Dalkon Shield. Problems began to arise with these devices as well—especially the Dalkon Shield. Because the FDA only tested drugs, there was no government testing of IUDs. Some of the data presented to the FDA before the Dalkon Shield was marketed was untrue. Eventually it was withdrawn from the market after it had caused hundreds of thousands of injuries and millions of dollars had been awarded in court cases. Other IUDs lost their sheen in the face of the Dalkon Shield publicity.

New birth control methods were developed in the 1980s and 1990s, which separated birth control from sex even more completely than did the pill. Depo-Provera is a hormonal contraceptive injected every three months, while Norplant silicone implants periodically emitted hormones into a woman's system for five years. Norplant was controversial, because silicone was suspected of causing breast cancer in women with silicone breast implants. Though these products were effective, their semipermanency caused concern that they would be used to suppress pregnancy in poor women, just as sterilization laws had once been used. Starting in 1907 states had passed involuntary eugenic sterilization laws, which were not repealed until the 1960s. Under these laws many disabled and poor women had been sterilized.

In the 1990s new hormone regimens were developed—the morning-after pill and Mifepristone, or RU-486. The morning-after pill delivered a high dosage of hormones to delay ovulation and act on cervical mucous to prevent conception. In the early 2000s feminists were working to make this pill available at pharmacies without a prescription so that women could take it within 72 hours of unprotected intercourse, the only time it could be effective.

Mifepristone, an orally ingested hormone for use by prescription in the first three months of pregnancy, caused the lining of the uterus to be shed. Feminists saw these two new drugs as a means of avoiding surgical abortion, which antiabortion groups have made harder to obtain.

The birth control movement made great headway in the twentieth century. From the complete ban on birth control devices at the beginning of the century to the availability of a wide array of products by the end of the century, birth control had revolutionized sexual relations and marriage. In 2000, 80 percent of women had used the pill at some time in their lives. Still, the United States had a greater unwanted pregnancy rate than most industrialized countries and many were still dissatisfied with the methods at their disposal. Many women were tired of birth control responsibility and wanted reliable birth control for men to become a reality.