A Brief History
On October 16, 1916, Margaret Sanger (nee Higgins), nurse, writer, and sexual educator opened the first family planning (birth control) clinic in the United States. While Sanger did not invent the idea of birth control or the methods, she was an activist for preventing unwanted pregnancy and was the first person to coin the phrase, “birth control.” Humans, unlike any other known animal, have been trying to prevent unwanted pregnancies for thousands of years and have tried a variety of methods.
Probably the most simple methods of birth control came after it was realized that sexual intercourse leads to pregnancy. With that revelation having been realized, the next assumption was that male ejaculate (sperm plus seminal fluid) when deposited into a female was the mechanism for impregnating a woman. Thus, the act of interrupting sexual intercourse (coitus interruptus) and ejaculating outside of the vagina would logically prevent unwanted pregnancy. This method, which has been used for millennia, has a major flaw, that being that a small amount of sperm bearing seminal fluid may dribble out prior to ejaculation, and this miniscule amount of sperm may well be enough to cause pregnancy. Another method of preventing sperm from entering a woman is to avoid sex altogether, a birth control method known as abstinence, a method often preached and seldom followed! Other alternatives are to have sexual relations that do not include actual sexual intercourse, such as masturbation, oral sex and anal sex. (Inventors for these methods are lost to history.) The so called “rhythm” method of timing episodes of sexual intercourse to avoid the days within a woman’s menstrual cycle most likely to result in pregnancy is another non-intrusive attempt to avoid unwanted pregnancy. The effectiveness of this particular method is marginal at best.
Blocking male ejaculate from entering a woman through mechanical means was probably the next method used by people to prevent pregnancy, using some sort of sheath over the penis, usually animal intestine, creating the first condoms. Aside from the diminished sensory experience, the rough manufacture of such condoms made them prone to leakage or breaking, a problem still experienced when condoms are used today. History is not clear on exactly when condoms were invented, whether they were used thousands of years ago or not until much more recently, such as the 15th Century as some historians insist. While animal intestine used to sheath the penis is the most common material and method of using a condom, in Asia paper and silk were also used as condom material and animal horn and tortoise shell was also adapted for such use! An alternative method of employing condoms was to manufacture a miniature condom that only covered the glans (head) of the penis, and yet another approach was to create a larger bag or sheath inserted into the vagina of the woman, with a stiff ring on the outside to prevent the female condom from being pushed inside. With the syphilis epidemic that struck Europe around 1490, the use of condoms became an important disease preventative device (prophylactic). To combat syphilis an Italian doctor invented a linen glans only condom that was soaked in chemicals and secured with a ribbon.
Rubber condoms appeared around 1855 and the common latex variety showed up in 1920. While latex is the most common material used today for condoms, the animal (sheep) intestine variety are still popular among users that claim a much better transmission of heat and sensation than latex. Such animal derived condoms are much more expensive than the latex variety, and while thicker latex condoms are less prone to breakage, they are also less comfortable and deliver reduced sensitivity. Aside from breakage and reduced sensation, condoms also have the problem of latex allergy among some people and those condoms that employ a contraceptive chemical added may also irritate some people. Condoms today are also made from polyurethane and other synthetic resins and polymers. A common spermicidal chemical added to condoms is nonoxynol-9, a substance not proven to actually enhance the pregnancy preventative properties of the condom and that may cause irritation and urinary tract infections. Other physical barriers to pregnancy include the cervical cap (diaphragm), a stretchy condom like device that covers the cervix and is used in conjunction with spermicidal formulations, and the IUD, intra-uterine devices that go inside the uterus and physically disrupt (kill) fertilized eggs that are deposited there from the Fallopian tubes.
As early as the 1600’s, debate over the morality of using condoms began, and has continued ever since with many people (notably the Catholic Church) taking the stance that sexual intercourse should be only for procreation and not for pleasure, therefore the use of birth control devices to prevent pregnancy is immoral, and using condoms to prevent disease is unnecessary among married couples that are monogamous. The debate about religious proscription against birth control continues to the current day within the United States, with arguments over whether or not an employer that does not believe in birth control should have to provide health insurance that pays for birth control drugs. Likewise, anti-birth control Americans do not want any government funds to go toward birth control.
Chemical birth control goes back to 1850 BC in ancient Egypt when crocodile dung was inserted into the vagina as a method of preventing pregnancy. We think this may have been a method of preventing sexual intercourse! Over the centuries numerous concoctions have been used to prevent pregnancy, with varying results. Such an approach was a hit and miss proposition that could be applied prior to intercourse or as a douche (rinse) afterwards. While a wide variety of chemical spermicides are available today, one of the old standbys, lemon juice, may also be quite effective. Other herbal concoctions may also be as effective as the commercial chemical products. Spermicides are often used alone or in conjunction with other birth control methods, such as Intrauterine devices and cervical caps. Spermicidal chemicals can also be employed soaked in a sponge inserted into the vagina prior to intercourse. In the form of jellies, foams, and liquids, spermicides may cause irritation and or infection. Chemists, doctors, and others have experimented for hundreds of years with formulations looking for an effective spermicide that does not hurt the users. Despite urban myths that spermicides also prevented the transmission of HIV and other STDs, research does not bear this idea out.
Oral contraceptives first appeared for general use in the United States in 1960, generally referred to as “the pill.” A hormone based concoction taken by women to disrupt the production of mature egg cells, this form of contraceptive has produced the most vehement debate of all. Different hormones and levels of the hormones have been used, and since 1960 other drugs have joined in the pantheon of contraceptive pills, patches and injections as well. Along with moral considerations, the use of hormone based contraceptives has also been linked to forms of cancer, a concern for many women and girls. In the US, about 16% of females from 15-44 (the main demographic of contraceptive users) report using oral contraceptives and other forms of hormone based contraception. American researcher Gregory Pincus met Margaret Sanger in 1951, and discussed the possibility of creating a hormone based contraceptive. Rebuffed by pharmaceutical company, Searle, Pincus teamed up with another researcher, John Rock to continue research. The pair benefited from the synthesis of hormones that was accomplished in the 1950’s, no longer having to rely on hormones recovered from animals. Further development of the proposed contraception, called Enovid, was done in Puerto Rico by Celso-Ramón García and Edris Rice-Wray, and by 1960 the American FDA accepted the drug for public use, starting a new chapter in birth control. In recent decades other chemical compositions have been developed as oral birth control, and the development of a male oral contraceptive that is widely accepted remains elusive.
More extreme methods of birth control include the sterilization of humans, both male and female. Castration, emasculation, or vasectomies on males prevent their ability to impregnate females, and the removal of female ovaries or uteri prevent female ability to become pregnant. Another common form of female sterilization is tying the Fallopian tubes to prevent the passage of mature egg cells to the point in which they can be fertilized. Female circumcision, a practice in Africa and the Middle East, is sometimes used to prevent young girls from having sex prior to marriage, in which the labia are cut and sewed together to prevent penile penetration, leaving only enough of an opening for urination and menstruation. This barbaric practice is under assault by activists throughout the world. Female circumcision may also include the removal of the clitoris as a method to lower the desire of females to have sexual intercourse. Abortion of unborn fetuses and infanticide are also forms of “birth control” that generate heated debate.
Sterilizing people intentionally for the purpose of preventing procreation based on nationality, race, sexual orientation, religion, physical and mental anomalies, economic class, ethnicities, criminal conviction or simply lower than the desired IQ or physical traits/appearance is called “eugenics,” a practice advocated by Margaret Sanger and Adolf Hitler, among others.
Preventing pregnancy by preventing sexual intercourse also gave rise to the so called “chastity belt,” a device often referred to in cultural references such as movies and stories, but not likely to have been widely used in Medieval times. In fact, it is unlikely such devices even existed that long ago, with the first known appearance of chastity belts around the 15th Century. Today, such devices are mainly used by role playing sexual partners and not as an actual birth control device. Another method of discouraging sexual encounters is the practice of clothing women and girls in such a way as to minimize their sexual attractiveness. Victorian efforts to hide the female body in ridiculous bathing attire is an example, and the use of the burqa (or chadri) in many Muslim cultures hide virtually the entire female when she is away from the privacy of her home, in some cases covering everything except the eyes. These “bee keeper” suits (as comedian Bill Maher is prone to call them) make all the women and girls look basically alike and are a visual cue that the woman so attired is not available for sexual pursuits.
While no single person “invented” birth control, we give Margaret Sanger (1879-1966) credit for coining the phrase and spurring development of oral contraceptives. As far as the actual researchers go, we can credit Gregory Pincus, John Rock, Celso-Ramón García and Edris Rice-Wray as being the inventors of oral contraceptives, the type we usually think of when the term “birth control” is used.
Questions for Students (and others): Do you believe that governments have a right to rule on birth control availability? What method of birth control do you believe is most acceptable? Are eugenics ever an acceptable idea? Should rapists be sterilized? Is the former 1 child law in China a reasonable approach to population control? Should severely mentally retarded people be sterilized? Is abstinence a viable form of birth control?
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For more information, please see…
Aguilar, Nona. The New No-Pill No-Risk Birth Control. Scribner, 2002.
Franks, Angela. Margaret Sanger’s Eugenic Legacy: The Control of Female Fertility. McFarland, 2005.
Grigg-Spall, Holly. Sweetening the Pill: or How We Got Hooked on Hormonal Birth Control. Zero Books, 2013.
Massa, Mark. The Structure of Theological Revolutions: How the Fight Over Birth Control Transformed American Catholicism. Oxford University Press, 2018.
The featured image in this article, a photograph by Underwood & Underwood of Margaret Sanger (* 1879) from 1922, from the Library of Congress Prints and Photographs division, reproduction number LC-USZ62-29808, is available from the United States Library of Congress‘s Prints and Photographs division under the digital ID cph.3a30477. This media file is in the public domain in the United States. This applies to U.S. works where the copyright has expired, often because its first publication occurred prior to January 1, 1923. See this page for further explanation. This file has an extracted image: File:MargaretSanger-Underwood.LOC (cropped).jpg.