Contraception Then and Now

When it comes to contraception, one thing is for sure: We’ve come a long way! And while the future might have even better things in store, like reversible male birth control, superior condoms, or remote-controlled implants, a look into the past reveals that modern contraceptors have a bevy of fantastic options to choose from. Unlike couples who had to forgo contraception or obtain birth control from the black market, nowadays Americans wishing to prevent or postpone pregnancy can select from a variety of legal, effective, and increasingly accessible family-planning methods.


While the history of birth control is fascinating, today’s contraception is the very best.


Let’s look at some old-fashioned birth-control methods and see how they stack up to their modern-day counterparts.

Linen and Guts vs. Latex and Polyurethane Condoms

Most people think of female condoms as new inventions, but the first condom recorded in history was made out of a goat’s bladder and inserted into the vagina — way back in 3000 BC. Ancient civilizations, from the Romans to the Egyptians to the Japanese, made penile sheaths and caps with a variety of materials, including linen, leather, lubricated silk paper, intestines, and tortoise shells. Linen and intestines remained popular through the Renaissance era.

A condom, with a user manual, from 1813. Photo: Matthias Kabel

A condom, with user manual, 1813. Photo: Matthias Kabel

Charles Goodyear might be most famous for tires, but his discoveries in vulcanizing rubber also led to the development of rubber condoms in the mid-1800s. Unfortunately, the Comstock Act of 1873 outlawed the manufacture and sale of contraception, and condoms were driven into a shadow economy. In the 1880s, New Yorkers might have been lucky to find black-market condoms made from surplus animal intestines, which were manufactured by Julius Schmid, a German immigrant who otherwise specialized in sausage casings — before his business was shut down by the New York Society for the Suppression of Vice. Condoms weren’t legal in the United States until the Crane ruling of 1918, just in time for the 1920 invention of latex, a form of rubber that was much stronger and more elastic — and with a shelf life of five years vs. rubber’s three months. By the 1920s, Schmid was once again on top of the condom game, peddling brands like Sheik, Ramses, and Sphinx.

Condoms made out of intestines are still on the market, sold as lambskin or “natural” condoms. However, they are not recommended for STD protection: Just as intestines need to allow nutrients to enter the body from digesting food, so too are viruses able to pass through condoms made from intestines. (Sperm, on the other hand, are thought to be too big.) These days, latex is the gold-standard material for condoms, while polyurethane can be used by people with latex allergies. Condoms constructed with these modern materials protect users from unintended pregnancy as well as many sexually transmitted infections, such as HIV and chlamydia. Continue reading

The Roots of Resistance: The Social Justice Context of Sexual Harassment Law

wga_posterEarlier this year, Scandal star Kerry Washington brought sexual harassment into the spotlight with her portrayal of the embattled Anita Hill in HBO’s Confirmation. The movie dramatizes how Hill herself made sexual harassment a topic of high-profile, nationwide debate when she came forward to speak out against Clarence Thomas during his 1991 Supreme Court confirmation hearings.

Hill’s testimony gave resolve to others who had experienced similar treatment in the workplace, ushering in a 40-percent increase in the number of sexual harassment claims filed with state and federal agencies in 1991 and 1992. But as inspiring as her testimony was, Hill stood on the shoulders of brave women before her who confronted sexual harassment and helped advance a body of law that makes workplaces, schools, and other institutions safer spaces. That body of law now protects people against “unwelcome sexual advances, requests for sexual favors, and other verbal or physical harassment of a sexual nature,” as the U.S. Equal Employment Opportunity Commission summarizes.


The fight against sexual harassment is closely connected to the long struggle for freedom among African Americans.


The breakthrough cases in sexual harassment law provide a revealing look at the short and surprising history of the battles, both in and out of court, that brought the issue into public consciousness. It is a history that shatters popular perceptions of feminism’s second wave and brings to light an overlooked dimension of another fight for social justice: the Civil Rights Movement.

Two Landmark Legal Decisions

When Mechelle Vinson applied for a job at Capital City Federal Savings in 1974, she was only 19 years old, but she had already had part-time jobs at several businesses around Washington, D.C., including a shoe store and an exercise club. For Vinson, lessons in supporting herself had come early. A strained relationship with her father had led her to drop out of high school and make repeated attempts to run away from home. She got married at “14 or 15,” because, as she recounted later, “I thought if I get married, I don’t have to go through problems with my father.” Continue reading

AIDS at 35: The Anniversary of the First Report on a Mysterious New Disease

mmwrOn June 5, 1981 — 35 years ago this Sunday — the Centers for Disease Control and Prevention published a report with an inauspicious title: “Pneumocystis Pneumonia — Los Angeles.” Nestled between pieces on dengue and measles, the article in the Morbidity and Mortality Weekly Report briefly described five patients, all young men from Los Angeles with cases of life-threatening pneumonia. While it didn’t immediately grab headlines, its publication represented a turning point in public health: the beginning of the AIDS era.


In another 35 years, will AIDS be a fading memory?


These patients’ pneumonia had been caused by a particular species of fungus, which back then was responsible for fewer than 100 pneumonia cases annually. Young, healthy people weren’t supposed to be vulnerable to this fungal infection, and the fact that men with no known risk factors were suddenly falling victim to it was a huge red flag that something strange was afoot.

The patients shared other characteristics as well, and at that point, scientists could only speculate what, if any, of these traits were associated with the strange new disease. All five patients were “active homosexuals,” were positive for cytomegalovirus (CMV), had yeast infections, ranged in age from 29 to 36, and used inhalant drugs (aka “poppers”). The CDC knew right away that this mysterious cluster of illnesses must have been caused by “a common exposure that predisposes individuals to opportunistic infections” — an observation that, in hindsight, was incredibly accurate, as HIV destroys the immune system and opens its host to normally rare infections. The editors posited that “some aspect of a homosexual lifestyle” might increase risk for this type of pneumonia — perhaps a sexually transmitted disease that somehow caused pneumonia. Continue reading

The 26th Amendment at 45: Bringing More Voters to the Fight for Reproductive Rights

Image of a button showing support for a lower voting age from the Smithsonian National Museum of American History

When the question of same-sex marriage went before the Supreme Court in the summer of 2013, it was clear that millennials, the nation’s youngest adults, had already reached their verdict; 66 percent were in favor of recognizing it, putting them among the most supportive demographic groups in the U.S.

That same year, millennials were in the spotlight in another fight for social justice. Refusing to accept their university’s mishandling of sexual assault reports, two survivor activists at the University of North Carolina at Chapel Hill fought back with federal complaints. Their activism turned up the pressure on their institution and evolved into the founding of the organization End Rape on Campus, or EROC, a networked movement against sexual assault that linked survivor activists and other advocates for change on college campuses throughout the U.S. Following EROC’s founding, supportive faculty formed Faculty Against Rape, or FAR, bringing the movement to more stakeholders in campus communities.


Young voters have the power to shape political futures.


Jennings Randolph, a Democratic member of Congress from 1933 to 1947 (and later a senator from 1958 to 1985), said the nation’s youth “possess a great social conscience, are perplexed by the injustices in the world and are anxious to rectify those ills.” With that faith in the collective power of young Americans, Randolph made it his mission, beginning in 1942, to introduce legislation that would lower the voting age to 18. Historically it had been 21. His hopes, though, would not be realized until decades later, in the 1970s.

The United States entered the 1970s bearing the toll of what became one of the longest and most unpopular wars in its history. By the time the Vietnam War ended in 1975, 2.5 million Americans had served in the conflict, a quarter of them because of the draft. More than 58,000 of them lost their lives. Continue reading

“Instrument of Torture”: The Dalkon Shield Disaster

This Dalkon Shield is archived at the Dittrick Medical History Center and Museum at Case Western Reserve University. Photo: Jamie Chung

This Dalkon Shield is archived at Case Western Reserve University. Photo: Jamie Chung

These days, IUDs, or intrauterine devices, have stellar reputations as highly effective contraceptives. Along with implants, IUDs can be more effective than permanent sterilization, and their safety record is fantastic. We also have powerful regulations in place to keep dangerous medical devices off the market, and the FTC can keep manufacturers from making false claims in advertising.

But a previous generation of birth-control users might associate IUDs with dangerous pelvic infections and miscarriages. That’s because a single device, called the Dalkon Shield, almost single-handedly destroyed an entire generation’s trust in IUDs. At the time of its debut, there were dozens of IUDs on the market — but the Dalkon Shield unfairly tainted the reputation of all of them. With no FDA or FTC regulations reining in untested devices or false advertising, women in the late 1960s and early 1970s didn’t enjoy the protections that we take for granted today. And it was actually the Dalkon Shield’s string, which was made with a material and by a method that hasn’t been used in IUDs before or since, that made it dangerous.


Today, IUDs are the most popular form of contraception among physicians wishing to avoid pregnancy.


We’ve known about IUDs for more than a century, and have made them out of ebony, ivory, glass, gold, pewter, wood, wool, and even diamond-studded platinum. These days, IUDs release hormones or spermicidal copper ions, but these older devices were simply objects inserted into the uterus that acted as irritants, possibly enlisting the immune system to kill sperm. They were not as effective as modern-day IUDs.

The Dalkon Shield was invented in 1968, was made primarily of plastic, and had “feet” — four or five on each side — to prevent expulsion. In 1970, after being marketed independently, it was sold to family-owned pharmaceutical giant A.H. Robins Company, of Robitussin fame. It was manufactured in the same factory where ChapStick was produced, and retailed for $4.35.

Dr. Hugh J. Davis, the Dalkon Shield’s primary inventor, claimed that users of his device had a 1.1 percent pregnancy rate — but that number was based on a small, methodologically flawed study conducted over eight months. In fact, the Dalkon Shield had a 5.5 percent failure rate over the course of a year. The fact that the Shield didn’t provide high protection against pregnancy was a huge problem, but its design also dramatically increased risk for pregnancy complications. Of the tens of thousands of users who became pregnant while wearing the Dalkon Shield, 60 percent of them had miscarriages. Continue reading

Dr. Joycelyn Elders, a Champion of Teen Sexual and Reproductive Health

EldersIn honor of Black History Month, Planned Parenthood Advocates of Arizona would like to recognize an outstanding and inspiring black woman who championed adolescent sexual and reproductive health and rights: Dr. Joycelyn Elders. Dr. Elders served as surgeon general to the United States under President Bill Clinton, and famously said, “I want every child born in America to be a planned and wanted child.”

She started her life in rural Arkansas, picking cotton to help support her family, and in 1978, she became Arkansas’ first board-certified pediatric endocrinologist. Dr. Elders’ work in endocrinology is what first piqued her interest in adolescent sexual health — some of her young patients, such as young girls with diabetes, would face serious health risks if they were to become pregnant.


Dr. Joycelyn Elders is an inspiring, passionate, and outspoken advocate for sexual and reproductive health and justice


In 1987, Dr. Elders became the director of the Arkansas health department. In this role, Dr. Elders championed an initiative that required sex education in the K-12 curriculum. She also aggressively campaigned to make birth control more readily available, particularly for teens, widened the state’s HIV testing and counseling programs, and advocated for greater access to abortion.

Then, in 1993, Dr. Joycelyn Elders became the first African-American and only the second female surgeon general. In an interview, Dr. Elders stated that her No. 1 priority for her tenure as surgeon general was to “to do something about unplanned and unwanted pregnancies.” Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 25: Lost Tampons

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl never knew about.

tamponPlanned Parenthood Arizona offers a wide variety of services, and someday we hope to cover every last one of them in this series. But today, I’d like to talk about one of the odder services: helping you with a lost tampon.

OK, so “lost” might be a weird word. I mean, you probably know the general area where that tricky tampon is lurking … But it happens even to the best of us: Sometimes, when you go to retrieve a tampon, you just … can’t find it. Maybe it was forgotten about, and then pushed farther up the vaginal canal by a subsequent tampon, or smooshed against the cervix during intercourse, and now you can’t find the string to remove it.


The presence of a certain strain of bacteria in one’s vagina can increase risk for toxic shock syndrome, especially when absorbent tampons are used.


The vagina can be a hiding place for all kinds of things — not just tampons, but sex toys, the remnants of broken condoms, and other foreign objects. And vaginas aren’t the only cavity with magical, or possibly just embarrassing, powers of concealment. When I worked at a medical journal, I came across ample (and very, very detailed!) documentation of all sorts of things getting “lost” in people’s rectums, urethras, ears, and throats. Believe me, a seasoned health care provider has probably seen it all, so if you can’t for the life of you remove something from your vagina on your own, don’t be afraid to ask Planned Parenthood for help. (You might ask about making an emergency, same-day appointment.)

Tampons aren’t designed to be used in a vagina for more than a few hours, and leaving them in for too long might increase risk for certain infections. For example, you might have heard of toxic shock syndrome (TSS), which is probably the No. 1 condition that comes to people’s minds when they think of tampons being left in for way too long. While it’s true that TSS is associated with tampons, tampons aren’t the only cause — they play just one role in the infection process. Continue reading