The Long, Strange History of Birth Control

11 minute read

Writing in the New York Review of Books last year, Carl Djerassi declared that with the invention of the birth control pill, “sex became separated from its reproductive consequences” and “changed the realities of human reproduction.” Djerassi would know. The pioneering chemist, who died on Jan. 30 of complications from liver and bone cancer at the age of 91, was dubbed the father of the birth control pill after he created the key ingredient used in oral contraceptives.

The importance of his discovery — and the dogged research of numerous other scientists — can’t be understated. Today, a staggering 99% of American women of childbearing age report using some form of contraception at one time or another.

Yet while Djerassi’s discovery and other modern advancements have led to the ubiquitous use of safe and effective contraception, pregnancy prevention has a long and determined history. As Jonathan Eig writes in his book The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution, “For as long as men and women have been making babies, they’ve been trying not to.”


Not that every historical effort was all that effective. Some methods are still used today, such as coitus interruptus — or “pulling out” — which was referenced in the Old Testament, but have never been a reliable form of pregnancy prevention. And other methods seem, by today’s standards, straight-up bizarre. In ancient Egypt, for example, around 1500 BC, women would mix honey, sodium carbonate and crocodile dung into a pessary — a thick, almost solid paste — and insert it into their vaginas before sex. (Crocodile dung was later found to possibly increase the likelihood of getting pregnant, due to its effects on the body’s pH levels.) In ancient China, concubines are thought to have used a drink of lead and mercury in order to prevent pregnancy. (Possible side effects: sterility, brain damage, kidney failure and death.) In the year 200, the Greek gynecologist Soranus advised women to abstain from sex during menstruation, which he mistakenly believed to be their most fertile time of month. (Not true.) He also recommended that women hold their breath during intercourse, followed by sneezing afterwards to prevent sperm from entering the womb. (Just silly.) In 10th-century Persia, women were told to jump backwards seven or nine times after intercourse to dislodge any sperm, as those were believed to be magical numbers. And in the Middle Ages in Europe, women were advised to tie the testicles of a weasel to their thighs or around their necks during intercourse. (Really.)

Yet it wasn’t all a shot in the dark. Many researchers today believe that several archaic methods of birth control actually had the dual perks of being somewhat effective and not lethal. This is perhaps not so surprising considering that certain methods were passed along from one woman to another. For instance, the ancient Egyptians weren’t completely off the mark with their pessaries: some documents reveal that women would also use pessaries made with acacia gum, which was later found in 20th-century studies to have spermicidal effects. Several other plants used in the ancient world were later found to have contraceptive qualities as well.

Sex Ed Books Through the Ages

“Those who look at our bodily dwelling can gain a very good idea of what we are... The care of our body, then, adds to our value,” advised Barbara Wood-Allen in 1897's "Self and Series: What a Young Girl Ought to Know."
"When the organs peculiar to woman are displaced or disordered ...pangs shoot through her like winged piercing arrows or darting needlepoints" wrote mail order doctor Lydia Pinkham in 1907.
Published by the Christian Education Service, of Nashville, Tennessee, during the 60s, it was written by one of the founders of SIECUS
"When the natural God-designed and God-honored sex instinct is perverted and base desire supplants love, in the choice of a companion, the home instinct is degraded, love dethroned and inharmony prevails," wrote Thomas Washington Shannon in 1913.
"It is probably best, that the life-like illustrations, some of them photographic, in books of human anatomy be kept away from boys of early adolescent age" counseled Maurice Alpheus Bigelow in 1916.
"... the woman so under the influence of liquor is, for the time being, little more than a "cave woman," or barbarian, with all the lax sex morality of the latter," wrote R.B. Armitage in 1917
This 1928 volume was directed to the "young man whose aim is to be sturdy, strong and successful."
"Dr. Norman Carr," the pamphlet informed readers in 1934, "is probably the most widely read author on this subject in the entire world."
First issued in 1949, this booklet warned: "Don’t forget that any woman who lets you use her, or who consents easily, is not safe."
From 1941, "An intellectual and frank discussion of subjects of Social Hygiene, Physiology, the Science of Sex, Moral Living, Character Building, Motherhood and PreNatal Care."
This 1941 manual includes a diagram entitled "Facts you Should Know for Defloration on Bridal Night."
This 1943 book kept in simple with little line drawings accompanying text like: "Here is the way you looked when you were ready to be born..."
The author of this 1944 guide, Belle Mooney, was touted as "a well-known physician pioneer and lecturer on hygienic and sociological subjects."
"Sooner or later your children are going to learn about sex. They ought to. They must," wrote Fathers Rumble and Carty in this 1950 textbook for Catholics.
Written in 1950 by pioneering sexologist David Cauldwell, who's credited with inventing the term transexual.
In cheerful 1950 parlance it reads: "Lucky boys and girls whose parents, teachers and leaders provide this book for them! It would be a good idea for the old folks to read it too."
"The smart writer... who says flatfootedly or insinuates cleverly that sex experience before marriage is necessary for happiness in marriage is a plain liar and an elaborate traitor to young people," cautioned Daniel Lord in 1951.
"Here is a complete analysis of young people's sexual problems and mores—from kindergarten to college —a comprehensive case-history study of the new rebellion," promised this 1962 paperback.
"Before boys are ready to get married and start a family, they must at least be able to earn a living," claimed this otherwise very hip Lutheran church publication in 1967.
"At the most basic level, a concern with sex education must stem from the recognition that human socio-sexual development is a learning process," said this scholarly 1974 journal.
This 1974 pamphlet was part of a collection of self help books from Ms. Landers including: “Teen-age Sex. And 10 Ways to Cool It!” and “Love or Sex. And How to Tell the Difference.”
From 1983: "Ugly women have boyfriends, mean women have boyfriends, hopelessly insecure women have boyfriends, stupid women have boyfriends, women covered with hideous warts have boyfriends."
This 1993 book claims that "classroom sex education is always wrong and always harmful; that it destroys modesty; awakens the passions; promotes sexual activity and fosters acceptance of sexual sins."
"Sex is many different things, and people have many different feelings and opinions about it," says this 1994 classic, in admirable understatement. Read more: Why Schools Can't Teach Sex Ed

And it wasn’t just plants. A cave painting that researchers believe could be 15,000 years old, found in France, depicts what some think is the first illustration of a man wearing a condom. The condom also shows up in legends that date back to 3000 BC, in which King Minos of Crete — son of Zeus and Europa — would use goat bladders for that purpose.

Later, the European doctor Gabriel Fallopius, for whom the fallopian tubes are named, suggested a linen version, prompted by a syphilis epidemic that spread across the continent in the 1500s. In Giacomo Casanova’s memoirs, written in the late 18th century, he takes credit for inventing a primitive version of the cervical cap, when he describes using partly squeezed lemon halves during sex. (A painting of the Italian writer also exists where he appears to be blowing into a condom-like prophylactic, but researchers believe that Casanova’s covers were for protection from venereal disease, not pregnancy.)

Condoms turned another technological corner in the year 1844, when American manufacturing engineer Charles Goodyear patented the vulcanization of rubber, which he had invented five years earlier. The move led to the mass-production of rubber condoms and the appearance of rubber cervical caps. It would be several decades before cervical caps — and later diaphragms — would catch on in the U.S., where the earliest rubber diaphragms were known as “womb veils.” Condoms caught on much more quickly. The first advertisement for the condom appeared in The New York Times in 1861, for a brand called Dr Power’s French Preventatives. The advertisement’s tagline read: “Those who have used them are never without them.”

Birth-Control Backlash

But just when it looked as if contraceptives were taking off — becoming not only safe and effective, but also more widely available — an American post inspector named Anthony Comstock began crusading against obscenity. His campaign led to the Comstock Act, passed in 1873, which banned the spread of information about contraceptives in the United States — even from doctors.

The 20th century would eventually see the most advanced and revolutionary development of birth control in history, but at the start of the century the phrase “birth control” wasn’t part of the common parlance. Margaret Sanger — a determined nurse and activist who would revolutionize reproductive rights in America — first coined the phrase in 1914 with the launch of a monthly newsletter called The Woman Rebel. The newsletter offered information about birth control and was a flagrant challenge to the country’s obscenity laws. It wasn’t long before Sanger was indicted for breaching the obscenity laws and fled the country to avoid trial. By 1916, Sanger was back and opening the first family-planning clinic in the U.S. It was shut down within a week and a half. Five years on, Sanger founded the American Birth Control League, which would later become the Planned Parenthood Federation of America.

Neither legal restrictions, nor religious condemnation—during the 1930s, Pope Pius XI declared that using birth control was a “grave sin”—could actually stop women from trying to prevent pregnancy. In 1935, TIME reported that “[d]espite furtiveness, commerce in contraceptives has become big business. More than 300 manufacturers today are engaged in it…. Three ‘feminine hygiene’ manufacturers last year spent $250,000 advertising in general magazines alone.”

Some advertisements for products marketed to women emphasized their “feminine” uses, with obvious euphemisms for contraceptives. Throughout the 1920s, even Lysol was advertised as a product that could “protect your married happiness” with a series of terrifying ads, depicting desperate women trying to keep the family harmony—so desperate, in fact, they were willing to use a household cleaner as a douche. Lysol didn’t have any contraceptive qualities—and could actually be quite harmful when inserted into the body—but that wasn’t the impression given by the company‘s marketing campaign. Another household product that many believed could prevent pregnancy was Coca-Cola. (Unsurprisingly, it did not actually prevent unwanted pregnancies: though later research suggested that a douche of cola did kill sperm, it didn’t work fast enough.)

In 1937, headway in Sanger’s fight was made when the American Medical Association officially recognized birth control as a legitimate part of doctors’ practice. A year later a judge lifted the federal obscenity ban on birth control, though laws against contraception remained on the books in most states. America went from 55 birth control clinics in 1930 to more than 800 in 1942.

The Pill Arrives

By the 1950s, Sanger landed on a better way to serve that demand. She approached biologist Gregory Pincus — who had something of a reputation as a Dr. Frankenstein-like character, due to his experiments with in-vitro fertilization of rabbits — and asked him to conduct research on the use of hormones for contraception. Unbeknownst to Sanger and Pincus, a scientist in Mexico City had already had success creating a progesterone pill, synthesized from wild yams, which could block ovulation. That scientist was Carl Djerassi, then just a twenty-something but already the associate director of research at the pharmaceutical company Syntex.

Fighting Teen Pregnancy: Portrait of a Radical High School Program, 1971

Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. At Citrus High School in California, honor student Judy Fay works at the blackboard during an English class the school's program for pregnant girls started in 1967.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. Using her son Charles, Linda Twardowski, a recent Citrus graduate, explains the basics of diaper-changing in a childcare class. The girls also are taught prenatal care, cooking and budgeting.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. Lupe Enriquez, 17, takes notes on nutrition in homemaking class and gets a playful pat from another expectant mother, Lynda Kump (see frame #5). Like several of the girls in the maternity program at Citrus, Lupe got married after learning she was pregnant.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. During a social studies class, Cheryl Gue, 17, quiets her son Michael with a bottle. Although the sound of crying babies is a normal disruption at Citrus, the more vocal ones are usually hustled out of class. The school is equipped with playpens, cribs and toys. The mothers are required to come to school for the morning child-care courses, but may study academic subjects at home.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Pregnant high schoolers, Azusa, Calif., 1971.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
High schoolers with babies, Azusa, Calif., 1971.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Vicki Conger, 17, with her 13-month-old daughter, Shawn Michelle, Azusa, Calif. 1971.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. Sandy Winters, 13, who recently enrolled at Citrus, talks about her courses with principal James Georgeou, founder of the program for young mothers.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. Expectant mothers are allowed to take naps in homemakeing class. Here Lori Cardin, 17 and six months pregnant, tries to catch 40 winks despite playful attention from young Shawn Conger.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. In the courtyard outside the school, Vicki Conger, 17, takes a stroll with her 13-month-old daughter, Shawn Michelle.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. Judy Fay chats with a group of students outside class. Now that there are pregnant girls at Citrus, the boys have cleaned up their language, courteously hold open doors and even push strollers.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. Toward the end of her pregnancy, Judy Fay's father, and aerospace worker, drove her to and from school each day.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. Judy's parents, Henry and Luella Fay, found to their relief that the neighbors were sympathetic to Judy's plight. 'We have had a lot of compliments because of the way we faced up to the problem,' said Mrs. Fay.Ralph Crane—The LIFE Picture Collection/Getty Images
Photo from a LIFE magazine article on teen pregnancy, 1971.
Caption from LIFE. In the canopied bed where she has slept since childhood, Judy cuddles her son Dylan, who was born in late February. 'My son may have been unplanned,' Judy says, 'but he is not unloved.Ralph Crane—The LIFE Picture Collection/Getty Images

With funding from Katherine McCormick, a wealthy widow and dedicated feminist, Pincus had also begun developing and testing a synthetic hormone and found that it could suppress ovulation in animals. A gynecologist named John Rock then began testing the hormone on women. In 1956, the United States Food and Drug Administration (FDA) approved the hormone pills for menstrual disorders, such as irregular periods or PMS. Promoting birth control was still illegal in many states, but as TIME winkingly noted in 2010, the late ’50s tellingly saw “a sudden epidemic of menstrual irregularity among women across the U.S.”

Then came the landmark date, marking the biggest change to America’s contraceptive potential in history. On May 9, 1960, the FDA approved Enovid, an oral contraceptive pill released by G.D. Searle and Company. By 1965, almost 6.5 million American women were on “The Pill,” the oral contraceptive’s enduring vague nickname, which is thought to have stemmed from women requesting it from their doctors as discreetly as possible. That same year, the Supreme Court struck down state laws that prohibited contraception use, though only for married couples. (Unmarried people were out of luck until 1972, when birth control was deemed legal for all.)

Even by 1966 the Pill’s effects were apparent. That year, TIME wrote, “No previous medical phenomenon has ever quite matched the headlong U.S. rush to use the oral contraceptives now universally known as ‘the pills.’” Indeed, by the time 1973 rolled around, a whopping 70% of married women between the ages of 15 and 44 were using some form of contraception.

The Pill was an international revolution as well. In 1967, TIME reported that despite the Pill’s necessarily strict routine, uneducated women could still manage: “[The] latest reports show that illiterate women who can’t count can still take their pills on schedule. In Pakistan, Denver’s Dr. John C. Cobb got dozens of them to do it, simply by starting them on the night of the new moon. In semiliterate Taiwan, where IUDs have won wide acceptance, more and more women are switching to the pills. The number of users outside the U.S. is about 5,000,000, and the figure is rising.”

Not that the Pill was without critics. The fact that its rise coincided with second-wave feminism and the sexual revolution meant that many people pointed to the contraceptive as the trigger that changed society. (Many researchers have pointed out that cultural views on sexuality and women’s roles were shifting well before the Pill was introduced.) Some African-American leaders were especially critical of the Pill, claiming that it was being peddled in their community for the purpose of a “black genocide.” But nothing stopped the Pill from catching on. Today, more than 100 million women around the world use the Pill in order to prevent pregnancy. And that’s not counting the women using other safe and effective forms of birth control, from DepoProvera and the NuvaRing to the contraception patch and the intrauterine device (IUD), which is considered by many health care experts to be one of the best forms of birth control available.

The Future of Birth Control

Yet access to safe and effective birth control still isn’t a universal privilege. A report from the Guttmacher Institute in 2012 found that around 222 million women in developing countries want to use birth control but aren’t currently able to access modern contraceptives.

Even in the U.S., there has been a political push to restrict access. The rise of “conscience clauses” has also meant that hospital employees, pharmacists and employers with religious views on birth control can refuse to fill prescriptions or cover employees’ coverage for contraception.

History — both ancient and more recent — has shown that women (and men) will risk their lives or reputations for effective birth control. Restricted access to contraceptives doesn’t necessarily mean that women won’t be able to prevent pregnancies, but, like the ancient Egyptians and Chinese, they just might resort to methods that could be harmful. That hasn’t changed, but thanks to the dogged determination of activists, such as Sanger, and the pioneering research by scientists and physicians, such as Djerassi, that level of risk seems like the most preventable thing of all.

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