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 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

Let’s Talk Contraception: Dispelling Myths About Emergency Contraception

EmergencyContraceptionSince 1998, when the Food and Drug Administration first approved the morning-after pill, there have been controversies about its sale and use. Initially, age restrictions were enforced to regulate its sale, and some hospitals and pharmacies refused to provide it to their patients. After considerable pressure from public and medical groups, emergency contraception (EC) is available for sale to anyone at their local pharmacy, with the exception of ella and the copper IUD, both of which require prescriptions.


Emergency contraception is widely available, easy to use, and safe!


And yet, after almost 20 years of remarkably safe use, there are still myths regarding its safety, actions and use. Let’s look at some of those myths right now!

First, there are misunderstandings regarding EC’s availability:

Myth: EC is hard to get and you need a prescription.

Since 2013, most ECs are available to buy in pharmacies over the counter to anyone, regardless of age or gender. There are two exceptions: If you need ella, another morning-after pill, you do need a prescription, and the copper IUD requires placement by a health care provider.

Myth: There is only one type of EC available.

There are several different pills available, such as Plan B One-Step or generic equivalents. These all contain levonorgestrol, a progesterone hormone that is also in many other contraceptives. Ella contains ulipristal acetate and works effectively and evenly up to five days after unprotected sex. Ella is dispensed with a prescription. The copper IUD also needs a prescription but is the most effective EC when placed within five days of unprotected sex. It is recommended for obese women or women who have had several episodes of unprotected sex, and its contraceptive effect lasts 10 years. Continue reading

Birth Control Helped Me Plan My Future

condom and handI just graduated from Arizona State University with a bachelor’s degree, and as a young man I’m ready for the next stage in my life. I’m ready to move out for the first time; I’m ready to start my career; I’m ready to take risks and seize every opportunity I can.

I’m not ready for a kid, however, and I certainly wasn’t ready for the past four years.


Sex education is about making choices that will protect you — and your partners — your whole life.


I’ve been in a couple of serious relationships during my college years, and I practiced safe sex consistently. I wanted to throw myself into my work and not into raising a child. Even though my partners were on birth control, I always used condoms because you can never be too safe.

Birth control isn’t only a concern for women, it’s a concern for us guys too. The way I saw it was if I didn’t want to have a child in the immediate future, then it was my responsibility to do what I could to make sure that didn’t happen. I didn’t even have to worry about the price of condoms either, because the Planned Parenthood health center near my school offered them for free.

I’m thankful I had easy access to birth control methods, because I wouldn’t have been able to do what I’ve done without it. If you aren’t ready to have a child, then don’t risk it by placing the burden for birth control entirely on your partner’s shoulders. Take matters into your own hands by finding a contraceptive method that works for you, so you and your partner can share that responsibility. Continue reading

Let’s Talk Contraception: What Contraception Does Your Doctor Choose?

IUD in hand croppedHave you ever wondered what birth control method your health provider has chosen to use for her contraceptive? Though it is usually not relevant or ethical for your provider to disclose something so personal, you might find it helpful and reassuring to know this information when you are deciding which contraceptive is a good choice for you.


Thanks to the Affordable Care Act, you might not have to worry about footing the bill for an IUD or implant yourself.


New research by Planned Parenthood has some answers to this question. In a recent study published in Contraception, the official journal of the Association of Reproductive Health Professionals and the Society of Family Planning, Planned Parenthood researchers found that women’s health care providers are three-and-a-half times more likely to choose long-acting reversible contraceptives (LARCs) such as IUDs (intrauterine devices) and implants as their contraceptive of choice. Forty-two percent of providers use LARCs, compared to just 12 percent of women in the general population. The birth control pill is used far less often, by only 16 percent of providers surveyed. Earlier studies have also shown these differences, but the Planned Parenthood study shows an increasing trend of women health care providers choosing LARCs.

The Centers for Disease Control and Prevention also conducts surveys and studies to look at contraceptive usage across the general population. Their surveys have shown an upward trend in LARC use — a five-fold increase in the last 10 years. Most of the women using these methods are 25 to 34 years old. But women in general use LARCs far less often than the percentage of health care providers reporting they use LARCs in the Planned Parenthood study. Continue reading

Let’s Talk Contraception: How Effective Is My Birth Control?

According to the Guttmacher Institute, 62 percent of women of child-bearing age (roughly 15 to 44 years of age) currently use a contraceptive method. Most contraceptive users are married and on average would like to have two children. This means that a woman might be using a contraceptive method for more than 30 years.

Studies have calculated that if a sexually active woman is not using any contraceptive method, over the course of a year she has an 85 percent chance of becoming pregnant. Using contraceptives greatly decreases this chance, but there are still some possibilities that her contraceptive method could fail to prevent pregnancy.


To maximize your contraception’s effectiveness, use it as correctly and consistently as possible.


When choosing a contraceptive method, you might want to use the safest and most reliable method available. How likely is it that your choice could fail? With the many types of birth control at your disposal, how do you know which is most effective? And why, with even the most effective contraception around, do women still have unintended pregnancies?

If we rank birth control methods according to most effective to the least effective, how do they compare? How is effectiveness measured?  Continue reading

The Best of 2014: Our Bloggers Pick Their Favorite Posts

The year 2014 was a big one here at the blog — we published 146 new pieces, many of which educated our readers about our endorsed candidates during the midterm elections. In addition to energizing voters, we fostered health literacy with our pieces about sexual, reproductive, and preventive health care, and promoted social justice causes with articles on women’s and LGBTQ rights. Below, we share our bloggers’ best pieces from 2014!

kidsCare joined our blogging team this year, and hit the ground running with two consecutive posts about her experiences as a Peace Corps volunteer in Western Africa. In August, she observed National Immunization Awareness Month with a reflection on the importance of vaccination — both in the developing world and here in the United States. During her time in the Peace Corps, Care saw the devastation that diseases like measles, meningitis, and chickenpox wrought in the communities she served. Access to vaccines was not taken for granted in Western Africa — it was seen as a matter of life or death. Later, when Care returned to the United States — where many of us do take this access for granted — she discovered first-hand what happens in states with high vaccination-refusal rates. So if you don’t think skipping shots is a big deal, think again!

pillflag thumbnailMatt’s posts tackled a lot of topics this year, but in light of last month’s less-than-stellar election results, we’d like to shine the spotlight on his post from last June, Six Things Arizona Is Doing Right. Across the state, communities are recognizing the importance of comprehensive sex education, affirming transgender rights, promoting body acceptance, and fighting against domestic violence! So if Arizona politics have been bumming you out lately, read about six things we’re doing right, from the Capitol to the Pascua Yaqui Nation, and from Tempe to Tucson!

zombies thumbnailAnna focused mostly on sexually transmitted diseases this year, but one of her favorite posts was an evaluation of different birth control methods’ suitability during the zombie apocalypse. Maybe if more female writers were hired in Hollywood, “minutiae” like family planning would be addressed in zombie-filled scripts and screenplays. But instead, the female characters that populate these narratives don’t seem overly worried about unintended pregnancies (and somehow find the time and the supplies for the removal of their underarm hair). Until our zombie dramas are more realistic in their handling of women’s issues, be prepared for the worst and read Anna’s assessment of your best bets for birth control. (Her pick for the apocalypse, by the way, is the implant!)

afghan girlRachel observed the International Day of the Girl Child in October by focusing on sexual violence against girls. Unsurprisingly, this problem can be found in every corner of the earth, and Rachel discusses atrocities in both the developing world and in industrialized nations. Despite deep-seated misogyny that permeates many cultures, positive changes are made possible by the work of activists, from young girls risking their lives fighting for the right to education in Pakistan, to advocates lobbying to strengthen penalties for convicted rapists, as in the case of Audrie’s Law, signed by California’s governor last October. Rachel’s provocative, disturbing, and informative post asks us if empowering girls is good enough — or if we also need to address the root of the problem, which lies with the perpetrators and their enablers.

clinic escortsStacey, a former clinic escort, helped our patients for more than a year, and in March she drew from that experience in an incredibly powerful piece on the importance of protecting the buffer zone, the distance that anti-abortion protesters were made to keep between themselves and patients. The buffer zone was one of the tools we used to protect our patients’ dignity and safety. It was no surprise, then, that the buffer zone came under attack this year when it was challenged in front of the Supreme Court. What did come as a surprise to many reproductive-justice advocates, however, was the highest court’s unanimous decision to strike down buffer zones for protesters at abortion clinics, helping to make 2014 a dismal year in women’s rights.

Gay Liberation Front 1969Marcy’s post on the Stonewall Riots broke traffic records on our blog — not bad for one of our newest bloggers — so if you missed it the first time around, check it out now. Forty-five years ago, the modern LGBTQ movement was born as the patrons of a gay bar called the Stonewall Inn rose up against police. The LGBTQ population was often a target for harassment by police, and the Stonewall Riots turned that violence back on their oppressors. We now celebrate Pride every June in honor of the Stonewall Riots, and while our society has made tremendous gains over the past 45 years, we still have a lot of work to do. Learn about the riots themselves, as well as the current state of LGBTQ rights in the United States.

two women thumbnailMichelle is another new blogger, and her inaugural post discussed a gynecological disorder called PCOS, or polycystic ovarian syndrome. PCOS is characterized by a constellation of symptoms that can include irregular periods, weight gain, sluggishness, thinning hair, depression, acne, infertility, and ovarian cysts. It affects an estimated 5 million Americans, but it’s thought to be underdiagnosed and its symptoms are largely stigmatized. Michelle lays out an interesting case for how this stigma might contribute to doctors failing to recognize it: It’s easier to blame someone’s dietary choices or physical-activity levels for weight gain and fatigue, rather than look more closely at underlying physiological problems, such as hormone imbalances, that could actually be causing the sufferers’ symptoms. For Michelle, awareness is key, so check out her informative post!

NOW thumbnailTori taught us about the Scheidler v. NOW “trilogy” of Supreme Court cases, which pitted anti-abortion activist Joseph Scheidler against feminist advocacy group National Organization for Women. In case you’re scratching your head, wondering what the heck Scheidler v. NOW is and why it’s important, check out Tori’s fantastic summary of this series of cases. She describes the atmosphere of violence that increasingly characterized the anti-abortion movement throughout the 1980s, eventually giving rise to a lawsuit, filed by NOW, claiming that abortion protesters’ tactics qualified as extortion under the Racketeer Influenced and Corrupt Organizations (RICO) Act. Now that the Supreme Court has struck down buffer zones, the anti-abortion movement’s history of harassment, vandalism, and violence is more relevant than ever.

SILCS_diaphragm thumbnailRebecca is a pharmacist who brings her passion for reproductive autonomy into focus with her series of posts on contraceptive methods. In August, she informed us about a one-size-fits-most, over-the-counter diaphragm that should hit U.S. pharmacies in 2015. Although it might kick off a resurgence in the diaphragm’s popularity in the industrialized world, it was actually developed to make effective contraception more accessible in developing countries. As Rebecca told us, we Americans are very privileged to have access to such a wide range of contraceptive options — but it’s important to remember that the variety of choices we enjoy isn’t available to everyone, who might face cultural, financial, or logistical barriers when it comes to having the means to control their fertility. Check out Rebecca’s post about Caya, the next generation of diaphragms, coming to a pharmacy near you but helping women worldwide!

Let’s Talk Contraception: Is Spermicide Effective?

According to the Guttmacher Institute, 0.5 percent of all contraceptive users surveyed in 2010 relied on spermicides as their contraceptive. Although not used often, they are a part of the contraceptive choices sexually active people have to prevent pregnancy. How effective are they, however?

The only available spermicide in the United States is nonoxynol-9. It is available in many products, such as a foam, cream, gel, suppository, or dissolvable film. Nonoxynol-9 is also the main ingredient in the Today contraceptive sponge.


Some spermicides increase risk of HIV transmission.


As a contraceptive by itself, it is not very effective at preventing pregnancy. Throughout the course of one year, and with proper use at every sexual act, 18 women out of 100 will become pregnant using spermicides alone. If used less than perfectly, that number rises to 29 out of every 100 women becoming pregnant. When used with a condom, however, the effectiveness is greatly increased. And spermicides are regularly used in combination with diaphragms and cervical caps. Continue reading