The pill 50 years on

How it's changed...

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It's been variously blamed for sparking the sexual revolution of the 60s, loosening society’s morals and encouraging teenage promiscuity.
And that’s when the Pill is not being attacked for changing women’s taste in men, making them fat and even – honest! - altering the sex of fish.
But as we mark 50 years since the oral contraceptive became available on the NHS, it’s time to consider the impact for the better that the drug has had on women’s health worldwide.
Invented by an American-Austrian chemist, funded by New York women’s campaigner Margaret Sanger and first used in Puerto Rico in 1956, the Pill finally arrived for use on UK shores on 4 December 1961.
Today, it’s taken by around 3.5 million British women – roughly one in three females of reproductive age - and 100 million globally.
Despite the controversy that has surrounded the drug since its introduction, it remains one of the most popular and effective forms of contraception to this day.
So what is it and how has it changed over the past 50 years?
In simple terms, the Pill is a tablet containing two female hormones, an oestrogen and a progestogen, which is why it is often known as the ‘combined pill’.
The hormones stop women from ovulating and also thicken the secretions around the cervix, making it more difficult for sperm to get through. Its effectiveness is almost 100 per cent, compared to 98 per cent for condoms and around 94 per cent for the diaphragm or cap.
Its formulation now is actually quite different from its original make-up, with the hormone doses being much lower, radically reducing the likelihood of side effects.
There can, of course, occasionally be complications but recent studies have suggested fears about the damage the Pill may do to women’s health have been overstated: A 2010 report from The Royal College of General Practitioners revealed that Pill-users have a 12 per cent reduction in the risk of developing cancer and are also less likely to die of heart disease or stroke.
There remains a small proportion of women advised not to take the Pill because of pre-existing medical conditions, such as blood clotting abnormalities, and those who smoke and/or are overweight are warned that they have an increased risk of Deep Vein Thrombosis.
For the vast majority, however, its benefits far outweigh the potential risks. And those benefits, say supporters, are widespread.
The Pill didn’t cause the sexual revolution – studies showed half of all women were having premarital sex as early as 1953, while in Britain only married couples were permitted to have the Pill. But for American feminist Gloria Steinem the contraceptive’s advent “really changed the image of women and of women’s lives”, ensuring that expressing their sexuality was no longer coupled with a fear of society’s backlash.
With the Pill, women were able to become “mistresses of their own bodies”: they could choose whether or when to have children and were freed of the worry surrounding unwanted pregnancy and abortion.
It may be difficult for us to contemplate now, but 50 years ago maternal health in the West was as much of an issue as it is today in the developing world: unplanned and unavoidable pregnancies were forcing women out of higher education and the job market, trapping them in a cycle of poverty and contributing to ill health. If you were an unmarried women, add being socially ostracised to that list.
Margaret Sanger saw that without control over their reproductive lives women could never have full equality; for her, birth control also gave a means for women to escape poverty.
In fact, her own mother died at 50 after 18 pregnancies – she reportedly blamed her father for the tragedy, saying: “Mother is dead from having too many children."
As Sanger’s grandson has said: “She came out of that world where women were having more children than they could support or care for. They were dying young, and their children were dying young."
Jennifer Worth, a midwife in London’s East End between 1953 and 1973, has recalled the Pill’s impact as “drastic and almost immediate”:
“Families were huge, six children was average. Diaphragms didn’t really work and men poured scorn on contraception, calling them ‘sissy’. Unmarried mothers were usually disowned by their families, backstreet abortionists were thriving, and orphanages were full of illegitimate children.”
But within a few years of the Pill arriving “deliveries on our ward went down from about 100 a month to five”.
The oral contraceptive was also a leap away from the previous messy, unsexy barrier methods, allowing women to actually have sex for pleasure as well as avoid getting pregnant.
Novelist Margaret Drabble said: "The other methods were quite remarkably unreliable and fairly repulsive, and the people who worked in the clinics fitting them were rather unfriendly and punitive. So, yes, it made a very considerable difference to one's life.”
Meanwhile, early concerns about the risks of the initial, high dose Pill galvanised women to campaign for safer options, giving rise to the consumer movement in medicine.
Reproductive health aside, the Pill has many other medical benefits, too. "It has so many… from protecting against ovarian cancer to helping to alleviate painful periods," said Peter Bowen-Simpkins of the Royal College of Obstetricians and Gynaecologists. "In developing countries, where anaemia is a huge problem, the pill can even help to reduce blood loss."
World renowned sex therapist Dr Ruth Westheimer is in no doubt of the Pill’s positive impact: “How wonderful that a woman doesn't have to worry all the time. [It] shouldn't be taken for granted by young people because it was such a big fight and such a revolutionary event that all of us have to be grateful.
"Young people today can't even imagine that there was a world without it.”