What You Thought You Knew About the Pill
On the pill’s 50th anniversary, historian Elaine Tyler May reveals the surprising truth: The pill changed little about American women’s sexual behavior.
“I love the pill!” “The pill sucks!”
These two comments from young women today—revealed in an online survey—sum up the range of experiences women have had with the birth control pill. On May 9, as we mark the 50th anniversary of the U.S. Food and Drug Administration’s approval of the pill, we can celebrate its many benefits to women, and also recognize what the pill did not achieve.
“Between my parents, my religious upbringing, and poor sexual education I was under the impression that girls that used the pill were sluts.”
The pill’s arrival in 1960 marked the culmination of years of development and testing. For the first time, a method of contraception separated birth control from the act of sexual intercourse itself, and was nearly 100 percent effective. And never before was there a birth control method totally in the control of women. They could take the pill without the consent or even knowledge of their sex partners.
But contrary to popular belief, the pill was not solely responsible for the sexual revolution. And the pill did not lead to mass numbers of young women engaging in premarital sex for the first time—in actuality, single women have historically had trouble accessing the drug, and most who sought it were already sexually active.
In its early years, the pill did not erase the powerful shame and stigma that still prevailed against young women who engaged in sex before marriage. Typical was the experience of a woman who was a college student and a feminist in the late 1960s. She recalled that she knew about the pill, but was “just not enough in charge of my life” to go about getting it. She faced “the enormous struggle with my parents’ huge disapproval and shame. On the one hand I really rejected it. On the other hand, I had internalized it.” When she finally had sex with her boyfriend, “I had a horrific confrontation with my mother who asked me if I was a virgin and I said, ‘I’m not and it was beautiful,’ which it wasn’t.”
Like so many others, she got pregnant and had an abortion. This woman’s comments suggest that the early phases of the sexual revolution may have been more liberating for young men than for young women.
The double standard prevailed throughout the 1960s. A poll of 1,900 female students at the University of Kansas in 1964 revealed that 91 percent disapproved of intercourse among unmarried couples who were not engaged to be married. By the end of the decade, the vast majority of college women were still virgins when they graduated. Clearly the extent of the sexual revolution in the 1960s has been widely exaggerated. As for the pill’s use by unmarried women, in 1972—the first time the question was asked—a national survey found that three-fourths of sexually active young single women rarely or never used any form of contraception.
That said, many American women couldn’t wait to get hold of the birth control pill. As early as the mid-1950s when the pill was approved for use to regulate the menstrual cycle, suddenly half a million American patients showed up at their doctors’ offices with “menstrual irregularity”—a condition rarely diagnosed or treated previously—and walked out with a prescription for a pill they knew would prevent pregnancy.
When the FDA explicitly approved the pill for pregnancy prevention in 1960, women demanded prescriptions—a surprise to doctors, who normally told their patients what to take, rather than the other way around. Within two years of its approval, more than a million American women were taking the pill every day. By 1964 the pill was the most popular contraceptive in the country, used by more than 6.5 million women.
The pill was not just a matter of private life. It became an important vehicle for challenging the authority of a wide range of institutions. Women soon went public with their contraceptive concerns. When risks and side effects became known, they demanded that pharmaceutical companies develop safer pills and include information packets so that women could make informed decisions about their birth control options. They pressured lawmakers to lift restrictions on access to contraception, resulting in Supreme Court decisions that ruled state laws against birth control unconstitutional. When the Catholic Church refused to approve the use of contraceptives, many Catholics ignored the prohibition. Within a few years, Catholic women were taking the pill at the same rate as non-Catholic women.
The pill was undeniably a boon to married women, but much less so for the unmarried. Although the pill is widely credited—or blamed—for the sexual revolution, there is no evidence that it actually affected the behavior of single women. The sexual revolution began in the 1950s and continued to unfold in the '60s and '70s. There was no immediate change in sexual behavior among unmarried couples in the early 1960s, when the pill first became available. Single women could not easily gain access to the pill. Many states prohibited doctors from prescribing it to unmarried women. Although some young single women did manage to get prescriptions, often through the ruse of a fake wedding ring or the cooperation of a sympathetic doctor, most of these women were already sexually active.
In spite of the pill’s half century on the market, difficulties persist today. Although hormonal contraceptives are now much safer and come in many varieties—pills, patches, implants, injections—there is still no perfect contraceptive. Side effects remain, and problems of access and affordability continue. Although emergency contraception, known as the “morning after pill,” is now on the market, women report that it is not always easy to get. Many young women are outraged that “conscience clauses” allow health-care providers and pharmacists to withhold products and services that are legal and should be readily available.
And sexually active young single women still face a stigma. While some express great appreciation to feminist foremothers and are grateful for parents who support their sexual and contraceptive choices, others struggle with the same issues that faced earlier generations of women. Many young women complain that “abstinence only” sex education classes deprive them of the information they need to make wise choices. As one remarked, “Between my parents, my religious upbringing, and poor sexual education I was under the impression that girls that used the pill were sluts.”
That comment alone is enough to remind us that although we have come a long way in the last 50 years, we still have a long way to go.
Elaine Tyler May teaches history and American studies at the University of Minnesota, and is the author most recently of America and the Pill: A History of Promise, Peril, and Liberation.