Birth Control Options

History of Contraception

Although condoms may have been used as far back as 3000 B.C., the earliest known examples date to about 1640 in Birmingham, England. These were made of fish and animal intestines and probably used to prevent sexually transmitted diseases rather than for contraception.

Two hundred years later, in 1844, Charles Goodyear—the founder of Goodyear Tire—patented the vulcanization process of rubber and mass produced modern condoms—nicknamed “rubbers”. These were the first “disposable” condoms—earlier models were washed, stored and reused. The great playwright George Bernard Shaw called the new condoms “greatest invention of the nineteenth century”.

For the next 2 decades the U.S. contraceptive industry flourished. In addition to condoms there was widespread use of early intrauterine devices (IUDs), douching syringes, vaginal sponges, diaphragms, and cervical caps. Even “male” caps” that covered only the tip of the penis were used.

The “sexual revolution” of the mid-19th century came to a screeching halt when the U.S. Congress enacted the Comstock Law. The law was named after Anthony Comstock (1844-1915), a civil war veteran who objected to the profanity used by Union soldiers.

In the late 1860s Comstock began supplying New York City police with information for raids on sex trade merchants and began an anti-obscenity crusade. He was offended by the advertisements for contraceptive devices and soon targeted the “birth control” industry, which he felt promoted lust and lewdness.

In 1872 Comstock set off for Washington with an anti-obscenity bill he had drafted that specifically banned contraception. On March 3, 1872 Congress passed the new law and defined contraception as obscene and illicit, making it a federal offense to disseminate birth control information through the mail or across state Even anatomy textbooks could not be delivered by the U.S. Postal Service to medical students! Not surprisingly, Margaret Sanger, was a major political adversary as well as a host of other civil libertarians.

Twenty-four states enacted their own version of the Comstock laws and restricted contraceptive trade, abortion and sale of “lascivious” materials. New England laws were among the most restrictive in the country but the most far-reaching laws were passed by Connecticut–passing laws allowing for the arrest of married couples for using birth control in the privacy of their own bedrooms—a one-year prison sentence.

Like Newton’s third law—every action has an equal and opposite reaction—the restrictive laws provided “fertile” soil for innovative minds. An so, New York’s Julius Schmidt, a sausage casing maker by day and a condom maker by night, used animal intestines to fashion into disposable condoms. He founded Ramses and Sheik brand condoms still marketed today.

Condoms became legal in the United States after WWI (1918) when GIs ignored official Army advice to abstain from sex. American soldiers obtained them in Europe and brought them home to the U.S.

Within 10 years, by the end of the 1920s, the U.S. birth rate dropped by half. Condom reliability is still terrible by modern standards, but people achieved effective birth control by combining condoms, the rhythm method, male withdrawal, diaphragms, and/or intrauterine devices.

The Victorian era eventually passed and beginning in the “roaring ’20s” states began repealing their restrictive contraceptive and obscenity laws. Unbelievably, the Comstock laws of 1873 banning contraceptive sales were not struck down by the U.S. Supreme Court until 1965! That very same year the Connecticut law was invalidated in, the now famous, Griswold v. Connecticut decision in which the U.S. Supreme Court established a constitutional “right to privacy” for married couples. Then, in 1972 the high court’s decision in Eisenstadt v. Baird overturned a Massachusetts law banningsingle people from obtaining contraceptives.

Back in 1898 Margaret Sanger’s mother died at age 50 following the birth of her eleventh child. Sanger, 19 at the time, became a nurse and devoted many of her efforts aiding the survivors of botched abortions. She later turned her attention to the development of better contraception. Her dream was a pill that women could take to control their fertility.

The lack of absolutely reliable contraception led to many home “remedies”. Unbelievably Lysol disinfectant was the most commonly used contraceptive between 1930 and 1960!

Katherine McCormick, a wealthy woman whose husband made his money developing the mechanical harvester, later formed a partnership with Sanger and used her sizeable fortune to fund contraception research. This work eventually led to the development of the birth control pill.

Thanks to funding from Katherine McCormick and Margaret Sanger Dr. Gregory Pincus’s research was encouraged. Synthex and Searle Pharmaceuticals had already developed a synthetic form of progesterone and allowed Dr. Pincus to explore the use of this hormone in his work.

In 1960 the FDA approved Searle’s Enovid—the first oral contraceptive marketed in the U.S. Despite its early promises it had many undesirable and occasional dangerous side-effects—but none more dangerous than the results of an unplanned pregnancy.

In 1962 the Lippes Loop intrauterine device (IUD) was invented. Other intrauterine devices followed including the Dalkon Shield (1970) and the T-shaped copper IUD, “the copper T” (1976). Because of an increased risk of pelvic inflammatory disease the Dalkon Shield was taken off the market and the IUD, as a method of contraception, suffered a tremendous public relations setback from which it is just now recovering. Today’s IUDs an “engineered” to have many benefits—among them easing heavy menstrual flow.

In 1992 the FDA approved Depo-Provera, an injectable progestin-only contraceptive that lasts for 3 months. The copper IUD was re-introduced in 1984 as the ParaGard IUD which is an excellent 10-year contraceptive device that can be removed at any time a woman wishes to resume childbearing.

The last 5 years has seen an explosion in various contraceptive technologies—contraceptive patches (2001), rings (2001), hormone-containing IUDs (2001), even implantable contraceptives (2006). Sterilization—once a major surgical procedure–is now a simple office procedure requiring no incisions and can be accomplished in minutes using permanent tubal plugs (2002).