The history of contraception is a long one, going back thousands of years to a time when women used mixtures made from fruit acids as a natural spermicide. In the 1600s, women used vaginal douches after intercourse, and the first commercial vaginal suppository was invented in 1885 by an English pharmacist, Walter Rendell, who used a mixture of cocoa butter and quinine sulphate.
Condoms in one form or another are known to have been around since early Egyptians used penis protectors to prevent disease. From the 18th century various animal intestines were used until the vulcanisation of rubber in 1843 and rubber condoms were produced. In the 1930s rubber was replaced by latex, and the first polyurethane condom was produced in 1997, followed by non-latex synthetic condoms in 2005.
Barrier methods of contraception are known to have existed for centuries, with early methods being items such as lemons, sponges, leaves, and other things that could be used as vaginal barriers. In 1882 the diaphragm was invented by Dr C. Hasse, and closely followed in 1883 by a vulcanised rubber cap (Dutch Cap) which used a watch spring to hold it in place. Female condoms were available in the early 1900s, and barrier methods have continued to develop over the years.
Oral contraception also has a long history, with willow shoots, internal scrapings from male deer horns, and bees all being consumed to prevent unwanted pregnancies. But the most well-known form of oral contraception is what is familiarly known as ‘The Pill’ of various formulas, which was approved (with restrictions) in the USA in 1957, and approved for use in the UK in 1961.
The term ‘Family Planning’ was coined to describe the way in which contraceptives and information about birth control was available to the general population. As early as 1916 in the US, Margaret Sanger (founder of what became ‘Planned Partenthood’) opened the first birth control clinic in Brooklyn, which led to her arrest and trial in 1916 for distributing information about contraception.
Sanger’s clinic in Brooklyn was closed down by the police in 1920 and she proposed opening a clinic in London. Sanger’s was never able to open her London clinic, but a young British woman, Marie Stopes, and her husband, Humphrey Roe, opened ‘Mother’s Clinic’ in Holloway, North London which offered birth control advice and instruction on how to use the cervical cap.
Both Sanger and Stopes went on to establish, and become involved in, birth control movements, and establish themselves as pioneers of widespread family planning advice and services. Today, two major international organisations have evolved from their original work. ‘Planned Parenthood’ evolved from Sanger’s work, and ‘Marie Sropes International’ has evolved from Stopes’ work.
Family planning clinics and birth control organisations continued to grow through the 1930s, but access to advice and contraception was limited to married women, and in some states in the US could only be given for medical reasons.
Through to the 1960s, condoms were the main form of contraception in many parts of the world. Often seen as an ‘under-the-counter’ item, they were primarily available to buy in pharmacies, or in male dominated environments, such as barber shops.
Widespread availability of contraception started in the 1960s. With the advent of ‘The Pill’, doctors were able to prescribe a highly effective contraception method to women. ‘The Pill’ was introduced in the USA in 1960 and was being used by 1.2 million women within two years. In the UK, ‘The Pill’ was introduced in 1961 and was initially restricted to married women with ‘menstruation problems’. It is estimated that the number of UK women using ‘The Pill’ rose from about 500,000 in 1962, to around one million by 1969.
The introduction of the ‘The Pill’ was not accepted by all areas of society. Faith and extreme conservative groups claimed that there would be widespread promiscuity, and that use of the pill was a form of abortion or genocide. Some of these views are still held today.
In 1974, it became legal for ‘The Pill’ to be prescribed to single women in the UK, and since then various formulas have been developed with a wider choice available to women, the public have generally accepted it as a viable form of birth control, it has been attributed as being the main reason unwanted pregnancies and abortions have been reduced, has continued to cause controversy, and there have been concerns over the effects of oral contraception on women’s health. It is estimated that around 75% of women have used oral contraception at some point between the ages of 16 and 49 in the UK.
Various forms of contraception are now widely available in our society, and more people look at contraception as a way of controlling their lives. Men and women can choose to have children or not, and can control the size of their family and decide to have children when they feel the time is right.
Society has shifted from restricting contraception availability from those who are married or have medical problems, to contraception being available to anyone, which has caused further controversy.
Contraception has also been available to children aged 13 years and under in the UK. Some children as young as 10 have been prescribed contraception treatment, and there has been a rise in the number of under age children requesting the ‘morning after’ pill.
In UK law and professional guidance, a doctor can prescribe contraceptive treatment to a person under 16 without the permission of, or informing, the child’s parents, stating ‘the duty of confidentiality owed to a person under 16 is as great as that owed to any other person’ and ‘any competent young person, regardless of age, can independently seek medical advice and give valid consent to treatment’.
The criteria for prescribing contraceptive treatment are that the young person understands the advice, the young person does not want parents informed, that the young person is likely to continue to have sexual intercourse with or without treatment, that without treatment the young person’s mental or physical is likely to suffer, and that the doctor (or other appropriate professional) is required to give contraceptive advice or treatment in the patient’s best interest.
It is not only the medical profession that has come under scrutiny for allowing under age children to access contraception. Some youth clubs and schools in the UK distribute condoms and information on contraception and sex to children as young as 9 years old.
In today’s society, contraception methods are not only seen as a way to prevent unwanted pregnancies, but also as a way to prevent sexually transmitted diseases. Barrier methods (such as condoms) are promoted as the only primary way to have safe sex. Condoms are available from family planning clinics to local supermarkets (usually right next to pregnancy testing kits).
The availability of, and developments in, contraception methods have changed significantly since 1969 when Dr Day spoke to the group in Pittsburgh. Contraception has gone from a highly controlled and medically focused ‘treatment’, to being widely available to anyone who wants to have sex without the consequences of producing children or contracting sexually transmitted disease.
Attitudes to contraception have changed through legislation, birth control movements, and social shifts towards sex being an activity rather than for the purpose of producing children. We have also seen a change where younger people, even children, are able to access contraception without having to have ‘permission’ from parents