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

Lucky Girl

The following guest post comes to us from Dr. Monica J. Casper, a sociologist, women’s health advocate, and creative writer who lives in Tucson, Arizona. Monica served as a member of the Planned Parenthood Arizona, Inc., board from 2012 to 2013. You can learn more about her work at www.monicajcasper.com.

ChicagoI want to tell you a love story.

A cautionary note: This is not the kind of tale you’re used to (or maybe it is?). There is no sweeping soundtrack, no Hollywood superstars falling blissfully in love onscreen, their whiter-than-white teeth dazzling a rapt audience. In this love story, there are no flowers, no sappy cards, no fairy tale endings with double rainbows and confetti.

This is not a romance.

But it is a story about people who love each other and the unexpected life choices we make. It is a memoir fragment about how some of us learn to map our uncertain futures in the warm clutch of parental benevolence. And maybe it is a ghost story, as well. The kind that haunts you, but also challenges you to imagine anew what you believe to be true and to reconsider who you believe you are, or will become.

***

The scene is Chicago, 1986, late July. It is hot, sticky, and intolerable, not even a whisper of cooling lake breeze. This is a typical sweltering summer day in my hometown.


Our whole lives unfurl before us, lives whose shape and direction we have not yet begun to fully imagine.


I fidget impatiently on the stoop of my parents’ basement apartment on the city’s North Side. They have recently sold our house in Wisconsin and moved back to the city to be closer to their work and my grandmother. Our house in the country now belongs to another family, farm people who have migrated off the land to live in town, and we are again urban dwellers. I have urgent news for my mom, who should be home any minute. I crack my knuckles and stretch my arms above my head.

What is taking her so long?

I stand up, needing to move. Concrete blisters my bare feet and sweat pools in my armpits as I pace nervously. Cars zip by on Fullerton Avenue and I am reminded of childhood, playing Kick the Can and Stranger Danger in the city’s gritty, familiar streets and alleyways. I am 19 now, not so many years older than when I patrolled the neighborhood with my sassy friends wearing bell-bottoms and halter-tops, owning the world. 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!

Hobby Lobby: Birth Control and the Law

Birth control activists Margaret Sanger and Fania Mindell inside the Brownsville birth control clinic, circa October 1916

Birth control activists Fania Mindell and Margaret Sanger inside the Brownsville birth control clinic, circa October 1916

In 1964, when I was a 16-year-old college freshman, my Bronx pediatrician asked if I was sexually active, and offered to prescribe birth control whenever I started having sex.

In 1964, his doing so was legal in New York because of a 1918 ruling by Judge Frederick E. Crane of the New York Court of Appeals, but not in Massachusetts, where I was in school.

Birth control is only legal in this country because of a concerted campaign of civil disobedience carried out by Margaret Sanger and her followers. Here is a brief look at the legal history of birth control in the United States.


In 1917, a judge opined that women did not have “the right to copulate with a feeling of security that there will be no resulting conception.”


In 1873, the Comstock Act was passed into law, making the dissemination of “obscene” material through the mail illegal. Any attempts in the early part of the 20th century to teach about sexuality and the prevention of pregnancy — including Margaret Sanger’s work as well as Mary Ware Dennett’s The Sex Side of Life, which she wrote for her sons when she could not find any adequate literature to assist in educating them — were prosecuted under the Comstock Act.

Margaret Sanger witnessed her mother’s early death after 11 live births and seven miscarriages. Later, as a nurse on New York’s Lower East Side, she witnessed poor women dying from attempting to abort unwanted or dangerous pregnancies. She decided to challenge the Comstock Act. Continue reading

Contraception in the Zombie Apocalypse

The zombie hoard approaches. Photo: Caio Schiavo

The zombie horde approaches. Photo: Caio Schiavo

If you’ve watched a zombie movie with your friends, you’ve probably talked about what kinds of weapons you’d be packing in case of a zombie apocalypse. The Centers for Disease Control and Prevention even has a list of supplies you’ll need for a zombie preparedness kit, which includes smart choices like water, duct tape, and bleach. (I would add toilet paper to that list. How you’ll miss it when you’re on the run!) But how many of you have discussed birth control?


You’ve probably picked out which weapons to use during the zombie apocalypse. But have you chosen a birth control method?


Even if your greatest dream is to have a baby, you must admit that the zombie apocalypse is the worst time to be pregnant, give birth, and raise a child. Fleeing and hand-to-hand combat can be a drag while pregnant, and childbirth can kill you, especially without access to trained personnel or hygienic supplies. And if you do manage to birth a baby into this cruel new world, diapers can distract from more pressing duties, and the infant’s cries can attract undead attention.

When you’re in hardcore fight-or-flight mode, taking a pill at the same time every day might be difficult, and besides, a supply of pills can take up valuable backpack real estate. Plus, even if you find an abandoned pharmacy to raid, birth control pills and condoms come with expiration dates and can be affected by high temperatures. The same goes for contraceptive patches and rings. For these reasons, you need a contraceptive method that’s well suited to the zombie apocalypse. Besides abstinence, what are your options? Continue reading

Let’s Talk Contraception: The One-Size Diaphragm, a New Contraceptive

SILCS diaphragmIn June of 2013, a new barrier contraceptive, the SILCS diaphragm, entered the market in Europe, and in May of this year, it became available in Canada. The new diaphragm is called the Caya contoured diaphragm, and it’s being marketed as “not your mother’s diaphragm.” This is exciting because Caya is a user-friendly, one-size diaphragm that can fit most users without the need of a pelvic exam. It is being sold through pharmacies and health care providers.


An over-the-counter, one-size-fits-most diaphragm could be available in U.S. pharmacies as early as next year.


The SILCS diaphragm was developed with the financial help of the U.S. Agency for International Development (USAID), by CONRAD and PATH, nonprofit leaders in global contraceptive research. USAID was created in 1961 by President Kennedy, and provides financial support to improving the lives of people in developing countries, including support to find safe, effective, and acceptable contraceptives in low-resource areas. CONRAD began in 1986 as a division of the obstetrics and gynecology department of East Virginia Medical School in Norfolk, Virginia, and collaborates on research to improve reproductive health around the world. PATH is a Seattle-based international nonprofit that works globally to develop and deliver health solutions that are affordable and effective, including vaccines, drugs, and medical devices.

Caya works as well as traditional diaphragms, but has been redesigned to make it easier to insert and remove. During its development, many women, their partners, and health-care providers on four continents had input on its design. Continue reading

Let’s Talk Contraception: Is Spermicide Effective?

VCFAccording 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