The Pill turns 50

Even fifty years after the oral contraceptive’s approval by the US Food and Drug Administration (FDA), the Pill is one of the most debated pharmaceuticals of the last five decades. While oral contraception is often blamed for changing the dynamics of human relationships, the worst allegation levelled against it is that it encourages promiscuity.

From 1960, however, when it was approved by the FDA as a safe method of birth control, the Pill has played a major role in bringing the average number of children in US families down to two from 3.6, by the 1980s.

“There is a straight line between the Pill and the changes in family structure we now see,” Terry O’Neil, president, National Organisation for Women, told Time. He added, “In 1970, 70% of women with children under six were at home; 30% worked. Now that’s roughly reversed.”

Today, it is believed, more than 100 million women around the world start or end their day with the tablet.

The 50-year journey of the Pill has not been easy, say experts. “Most women are averse to the use of regular contraception fearing that the side-effects might outweigh the benefits,” says Dr Jyothi Shenoy, consultant gynaecologist at Columbia Asia Hospital, Bangalore. “They fear they will put on weight and have excessive growth of facial hair, and so on, because of the pill.

"[But] with so many varieties available today, one hardly needs to worry about such things; there are many low-dose oral contraceptives too.”

Dr Pallavi VR, consultant gynaecologist, however, advises: "Emergency pills should not be taken regularly as they have severe side-effects that make a woman’s menstrual cycle go for a complete six.”

The decision makers
Twenty-nine-year old Rakhi Chopra (name changed), mother of a baby girl who turns one this year, doesn’t plan to have any more children.

“Raising a child is not an easy task, especially if you are working,” she says. “I have been taking oral contraception to avoid pregnancy though my husband is trying to have another child.”

Chopra, who has been on the Pill for the past six months, like many others around the world, is an empowered woman, all thanks to it.

Women, today, can control their decisions. They are self-reliant, confident, and protected because of this tiny power in their hands, available over the counter at every medical shop in the world.

Do they feel liberated? “Yes,” says Dr Gayathri Kamat, consultant gynaecologist, Fortis Hospital. “Women have been liberated ever since the Pill’s inception.”

But awareness of the Pill, supposedly, has also led to women becoming more promiscuous. “Many teenage girls, who are on the Pill, are doing sexual favours for money these days," says Dr Pallavi. "The Pill with all its benefits also has a few bad effects on society and this is one among those.” She adds that short-term use of the Pill is safe, but prolonged use (more than five years), studies show, has a direct link to breast cancer.

Time magazine recently discussed the cynicism surrounding the Pill: “Well into the modern age, contraception met with unified opposition from across the religious spectrum, Protestants and Catholics, Western and Eastern Orthodox. Sex, even within marriage, was immoral unless aimed at having a baby. Fear of pregnancy was a powerful check on promiscuity — and information about contraception was treated as the equivalent of pornography. In 1873 Congress passed a law banning birth control information as obscene.”

Birth of the Pill
Margaret Sanger, born in the year 1879 to a Catholic mother and a father who carved angels and saints out of marble in New York, was the mother of this tiny tablet. She pledged to fight unwanted pregnancy after her mother died. She had borne 18 children. At the funeral, the young Sanger confronted her father and said, “You caused this. Mother is dead from having too many children.”

Training to become a nurse in 1912, Sanger was busy harbouring dreams of a ‘magic pill’ that would prevent pregnancy. In 1914, she coined the term ‘birth control’. Forty-eight years later, when she was in her eighties, Sanger heard about the approval of her ‘magic pill’ by the FDA.

It was only when the Great Depression hit America that family planning played a crucial role. America went from 55 birth control clinics in 1930 to more than 800 in 1942.

The idea of oral contraception remained in its foetal stage for a while. But genius came in the form of a researcher named Gregory Pincus, a promising assistant professor of physiology at Harvard, who met Sanger at a dinner party.

Pincus conducted the first clinical trials in Puerto Rico in 1956 to test the Pill as a contraceptive. The Pill proved effective at blocking ovulation and was approved for the treatment of “female disorders” in 1957.

In 1959 the pharmaceutical firm GD Searle and Co applied to the FDA for approval of the Pill. On May 9, 1960, the FDA gave its blessing — the ‘magic pill’ was born.

In India, access to contraceptives through pharmacies and other commercial outlets was stimulated through ‘social marketing’ programmes, beginning with a condom distribution programme in the year 1967. These programmes provided subsidised contraceptives, mostly oral, to married couples.