NEWSWEEK: What are the earliest recorded methods of birth control?
Andrea Tone: The Egyptian “[Petrie] Papyrus” [the oldest known guide to contraception], which dates back to 1850 B.C., mentions the use of suppositories for women made out of crocodile dung. So we know that birth control dates back to ancient times.
Wasn’t that dangerous?
It’s hard to say because it has never been replicated in studies. But I’m sure it was unhealthy and made sex uncomfortable. Some studies have suggested that elephant dung [recommended in 13th-century Islamic guides] may have had some spermicidal properties. But we certainly don’t advocate these as birth-control methods today.
How long have people been using condoms?
The first mention of condoms dates back to the 1500s. They used linen sheaths mainly to protect men from sexually transmitted diseases [STDs]. But linen probably didn’t protect women from pregnancy. That was not the emphasis. The first explicit mention of condom use for protecting against pregnancy as well as STDs is in the 1600s. Rubber condoms only became available in the United States after the discovery of vulcanization technology in the 1830s.
Weren’t skin condoms also used?
They were using skin condoms, mainly skins made from animal intestines, which still goes on. Today they are called natural-membrane condoms.
What are some other contraceptives no longer in use today?
Womb veil was the 19th-century term for the diaphragm and the cervical cap. There were also abbreviated condoms called male caps, which would cover a smaller part of the male organ. Douching powders and solutions were based on the belief that you could wash away sperm and sterilize the vagina with different kinds of potent chemicals.
Weren’t some of these products unhealthy?
Some douches were very unhealthy and doctors today don’t recommend it at all as a form of birth control. Women sometimes douched with boric acid [and other chemical solutions]. A lot of women were burned, while at the same time they were disheartened to find out that it had absolutely no impact on preventing pregnancy. Doctors also prescribed intracervical pessaries, which were made out of metal and could be up to four or five inches long. It was the 19th-century version of the modern-day IUD. The evidence is somewhat fuzzy about whether any of these devices worked. We can say the fertility rate dropped astronomically throughout the 19th century, actually reaching an all-time low during the Great Depression. A lot of women would double, triple and quadruple up on contraceptives. They recognized that these technologies were often flawed and that the best way to beat the odds was to use multiple methods simultaneously.
It’s hard to believe-considering the ways things are today-that contraceptives were illegal in this country in the late 19th century. Why were they outlawed?
Criminalization on a larger level began with the passage of the Comstock Act in 1873. It was a response to the growing commercial visibility of contraceptives and the belief that contraceptives, like pornography, were obscene. Some people said that pregnancy was the only brake on lust and the availability of contraceptives encouraged people to have premarital and extramarital sex. One of the points in my book is that historically there has been a real disconnect between official dogma regarding contraceptives and sexuality and what goes on in everyday practice. So even at the height of Victorian prudery-and the Comstock Act was the epitome of that prudery-there was still a wide swath of the American population that were using contraceptives in violation of the law and really not worrying about it.
Was the Comstock Act enforced?
The Comstock Act allocated very few funds for enforcement. So it was enforced but not terribly well. The result was that it was very easy for individuals to violate the law with impunity…. While people who were arrested were often found guilty, judges and juries were surprisingly sympathetic to the argument that birth control should be a private matter and therefore were very lenient to birth-control violators. So the federal law was a lame duck-you can’t legislate away the desire to have sex or the desire to prevent pregnancy.
When did things begin to move toward the way they are today?
The change back was gradual, over a long period of time. As late as 1972 it was illegal in the state of Massachusetts for a single woman to receive a prescription for birth control from a doctor.
Why do you think that women, with the exception of using a condom, are almost always responsible for birth control?
That’s a big issue in the book. Since the marketing of the pill in 1960, most birth-control methods have been medical, female and hormonal methods. People are of two minds about it. Some think that men should claim more responsibility for pregnancy prevention. There are certainly male methods that are being developed and tested. The question is, do we subscribe to the feminism of Margaret Sanger, who believed that female control of birth-control technologies empowered women? Or do we want to say that since men participate in pregnancy, they should have to deal with the side effects of birth control too?
Are male contraceptives still being developed?
They are. A contraceptive clinician [I spoke to] from UCLA couldn’t go into detail but she said they were doing clinical trials on a male hormonal method. I know there has been talk of injections, pills, implants, a hormonal-flow-release patch. I think the stumbling block is how these affect the overall chemical balance of the man and how they affect his testosterone levels.
Do you believe that one day it will be reality?
I have faith in science and the wonders of the pharmaceutical business. But the scientific answer is only one part of the equation. An equally important obstacle may be cultural attitudes: How many men will be willing to take a pill every day or to have an injection on a monthly or quarterly basis? In the end, will women feel comfortable handing over the control of birth control to men? It’s a double-edged sword. One way to explain the warm reception of the pill in the 1960s is to realize that it was the first time women could control their procreative destinies unilaterally, discreetly and completely. They could do it without consulting their male partners. That was really revolutionary. It’s one of the reasons millions and millions of women went on the pill. It’s still the most popular form of reversible contraception in the country.
What ever happened to the female condom. Is it still around?
Very few people use it. It’s expensive-a lot more expensive than a male condom. I don’t know if you’ve ever seen one close up, but they are a little scary looking. They are large and bulky, some women and men claim that they squeak during sex, and they are a little more difficult to use, I would say, than the male condom. And once you use it, you have to get rid of it. On the other hand, it is the only female-controlled method available that protects women from STDs. So it certainly has something going for it. It’s more popular overseas than it has been in the United States.
How can current methods of birth control be improved on?
I would like to see more over-the-counter methods because there are still 45 million Americans without health insurance in this country, and as most women with health insurance know, prescription drug plans typically do not cover contraceptives. So a lot of women who cannot afford very effective, safe birth control like the pill are left out in the cold. And I think, setting aside Catholic opposition to birth control, which I acknowledge is a big setting aside, there may be consensus in some parts of the pro-life camp and the pro-choice camp that no matter how you feel about abortion, abortion rates could be reduced if we encouraged people to use more birth control. There are a lot of people who are pro-choice who still don’t think of abortion as a desirable thing but share the commitment of others to reduce abortion rates even while they preserve the right to have that choice. And so maybe we can forge a political coalition. This was Margaret Sanger’s dream. She did not support abortion, and she believed that birth control was important in part because it would reduce abortion rates.
How do you think the methods themselves could be improved upon?
I think if more male methods were developed, that could possibly revolutionize things. It would be nice to see more methods that are not tied to hormonal birth control. There is talk about a one-size-fits-all diaphragm and talk about popularizing the cervical cap, which has long been popular in European countries. I think that would be a welcome addition to birth-control options. I also think we need to beef up our sexual education in the classrooms. We can learn from the past and from the mistakes that history shows us and realize that abstinence-only policies are not effective for many Americans. We need to follow the models set by countries like Sweden, which has very comprehensive birth-control education in the classroom. And we need to make sure that all people from all walks of life have access to birth-control methods.
