The pill started its life liberating women, but as technology advances and other options become available, does it still free us from our shackles?
Note: while this article explores what contraception means for women’s liberation, we of course acknowledge that not all women menstruate, and not all people who menstruate are women. Nevertheless, access to contraception was and still is, an important element of women’s liberation.
It could easily be argued that the 21st century is the best time for women’s sexual health. Contraception is readily available, trans women are able to access medical care, and abortions are becoming more accessible and acceptable than ever. But are these hard-won sexual freedoms as liberating as we think they are?
In 2019, the contraceptive pill was the most popular method of prescribed birth control for those that menstruate in the UK. According to data obtained by the Guardian, “almost nine in ten women who receive contraception from the GP or pharmacies take either the combined pill or “mini pill”. But more than fifty years after it was first widely prescribed in the UK, why is the pill still so prevalent when other (often safer) methods of contraception are available?
The combined pill was originally not available to single women
Whilst the release of the pill is associated with the swinging sixties and the emancipation of women, it was only made available on the NHS to married women in 1961. Everyone else had to wait until 1967, continuing to put careers on hold until they gained control of their fertility. Becoming pregnant was considered to be the end of economic independence for women, becoming immediately dependent on the man that impregnated them. Choices were limited for unmarried women, often resulting in adoption or a back-street abortion, and so the introduction of the pill was a godsend.
The side effects, however, were not. The first commercially available contraceptive pill, Enovid, contained many more hormones than were actually needed to prevent pregnancy. Today the pill contains between 50-150 micrograms of progestin, while Enovid contained at least 6666% more than that. Reports of health scare emerged immediately after launch in the US, with warnings of a higher risk of blood clots, strokes, and heart attacks. In the 1980s the use of the pill dipped significantly as women became more aware of the possible side effects.
Doctors knew about these side effects
In the 1950s, cumbersome US laws made trialling something as controversial as the pill very difficult, and so doctors John Rock and Gregory Pincus looked to Puerto Rico, which was overpopulated and already a supporter of birth control, with 67 birth clinics on the island. Pincus hoped to demonstrate that if the “poor, uneducated women of Puerto Rico”, could follow the pill regime then critics complaining that oral contraceptives were too “complicated” would be placated.
Conducted in 1956, women involved in the trial received little information about the safety of the product that they were being given. After a year of tests, doctors concluded that the pill was 100% efficient when taken properly. However, 17% of the women in the study reported side effects including nausea, dizziness, headaches, stomach pain, and vomiting.
At the time, Dr. Edris Rice-Wray told Rock and Pincus that the pill caused “too many side reactions to be generally acceptable.” They decided to ignore her conclusions, believing her complaints to be psychosomatic. Three women died during the trials, but no investigation was ever undertaken to determine the exact cause of death.
The introduction of the pill into the NHS was not always a popular decision
In 1974, the NHS allowed contraception to be given out free of charge to anyone regardless of age or marital status. This shift in policy wasn’t popular, leading Victoria Gillock to begin campaigning to prevent girls under the age of sixteen from being prescribed contraception in 1980. In three years she gained the support of two hundred MPS (as there were only 23 elected women at the time, it is safe to assume that this group was predominantly men).
The High Court eventually allowed contraceptives to be prescribed to under-sixteens without parental consent, under certain circumstances. Unfortunately, this case highlighted where the contraceptive discussion within British society had become so centred – not on whether under-sixteens should have access to the pill, but where the power of consent should lie.
Should men have control over something that alters women’s bodies?
It should of course be noted that the pill was originally designed with the male gaze in mind. The Catholic clergy were in an uproar over the release of the pill, arguing that it went against their ‘rhythm method’ fertility planning guidelines. This practice consists of counting backward fourteen days from the first day of menstruation to determine ovulation, planning abstinence around this to avoid pregnancy. Of course, this was an extremely unreliable method, often being referred to as ‘Vatican Roulette’, but it was actually the ‘natural’ method that the pill was based upon.
According to Professor John Guillebaud, of University College London, gynecologist John Rock introduced the seven-day break that women still follow to this day in order to make the pill more appealing to the Catholic Church. When Pope Paul VI officially outlawed all ‘artificial’ birth control in 1968, Rock denounced his Catholic faith, but the placebo week of the pill remained.
Women have unnecessarily been told to menstruate for years
It was only in 2019 that the Faculty of Sexual & Reproductive Healthcare acknowledged that the seven-day break has no health benefits. Clinicians are now suggesting that pill-takers cycle three packets back to back, and then have a four-day break instead. These less frequent breaks are sufficient to prevent “breakthrough” bleeding, which can happen if the uterine lining is not allowed to shed.
Taking a seven-day break on the pill can actually increase your chance of pregnancy, as the levels of hormones may be lowered enough during this time that if a pill is missed at the beginning of a cycle, ovulation can occur.
And of course, periods are an expensive ‘luxury’ that not everyone can afford. According to the BBC tampon tax calculator, in the 8 years that I have been menstruating, I have spent about £348.65 on products – £16.60 of which is VAT.
Although the 5% tampon tax will finally be coming to an end in December of this year, it is still a symbol of how female reproductive health has for years been controlled by men – women have always been a minority in the UK parliament, representation reaching 34% in 2020 in a record high.
Should we continue using the pill, knowing its dark history?
The pill has never been the only form of contraception, and neither is it the most reliable – typical use puts it at 91% effectiveness. But it has often been considered a symbol of women’s independence, opening the door for further education and pursuing a professional career. In a world designed for men, by men, can women be truly liberated?
I have recently stopped taking the combined pill after two and a half years of continuous use. I thought that the particular brand I took never really gave me any noticeable side effects, but I now feel more unsure about that statement. Since not taking it, I feel less prone to mood swings, slightly more like myself, and I no longer have to worry about running out and having to make an emergency dash to the doctors.
It does seem that the contraceptive pill liberates women to an extent, but it would be naive to not realise that this comes at a cost. This is valued differently for everyone, but personally, I think that I’ve had enough of blindly letting men have a say over my body. At the very least I intend to research the history of the IUD before I get one implanted. But what it boils down to is very simple. Until women are actually involved in the design of their own healthcare, it will never completely fulfill their needs.