The drug of choice

SOCIETY: America and the Pill: A History of Promise, Peril, and Liberation, by Elaine Tyler May, Basic Books, 171pp, $25.95
IT WAS going to cure everything that ailed us – marital strife, unwanted pregnancies, war. By lowering the birth rate in the developing world, it would create healthy markets and decrease poverty, acting as a “magic bullet” against communism. As the first nearly-one-hundred-percent-effective form of birth control that required neither the co-operation nor the knowledge of men, it would enable women to take control of their lives. It was the pill, and it is celebrating its 50th birthday.
In her new book, American historian Elaine Tyler May traces the pill’s development, reception, and social, political and cultural ramifications. The pill was approved by the US Food and Drug Administration (FDA) in 1960 for use as an oral contraceptive (it first became available in Ireland in 1963 as a “cycle regulator”). It grew out of the combined efforts of several individuals – scientists Carl Djerassi, John Rock and Gregory Pincus, along with feminist activists Margaret Sanger and Katharine Dexter McCormick (McCormick effectively bankrolled the R&D). Highly controversial, it created unlikely bedfellows on both sides of the divide. Would-be social engineers allied both with feminists and with the Playboy brigade, who celebrated the pill because it liberated female sexuality for men.
The Church was against it. But so were male Black Power leaders (claiming it promoted genocide) and certain Beats. Poet Richard Brautigan equated his girlfriend’s use of the pill with the Springhill mine disaster, in which scores of miners died. Many men felt it undermined masculinity, by nullifying their procreative power.
The pill quickly became embroiled in policy debates. US presidents from Kennedy to Carter supported family planning programmes as part of foreign aid. Reagan reversed the position, suspending government support to any agency at home or abroad that used its own funds to support abortion services, counselling or referral. Clinton reversed the ruling five days into office. George W Bush restored it three days into his term. Four days after his swearing in, Obama reversed it again.
The pill’s safety record was initially troubling. As May points out, it was linked in the early years with blood clots – fatal, in some cases. It carried an increased risk of stroke. (While a minority of women today experience negative side-effects, the lower hormone dosages have resulted in decreased risks.) May also looks at efforts, so far unsuccessful, to develop a pill for men, and asks whether the hurdles are physiological or psychological. She notes that Viagra, a drug that enhances the potential for men to impregnate women, was the most successful prescription drug ever launched in the US.
The pill serves throughout the book as a keyhole through which to view history. “Without the political and cultural upheavals of the last 50 years,” May writes, “ . . . the pill would have been just one more contraceptive . . . Instead, it became a flash point for major social transformation.” Debates around its safety contributed to standards of informed consent in medical research and regulations on consumer information. It disrupted power relationships between genders, and – in light of the Church’s continued ban on artificial birth control – it weakened the power of the official Church and turned many Catholics away altogether.
May’s interesting and accessible history also illuminates how the world has changed around the pill. Once, young women had to pretend that they were married in order to obtain it; now they sometimes complain of being pressured into it when other forms of contraception are more suitable. Women use the pill for reasons their foremothers wouldn’t have dreamed of – to arrest menstruation during military service, for instance. And, what once seemed a boon to women – taking full responsibility for their fertility – now seems to many an unfair burden.

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Molly McCloskey is a novelist, essayist and short story writer