Happy Birthdays!—The Pill at 20 and 40

The birth control pill came on the market in 1960—heralded by many as a revolutionary contraceptive that would allow women to control their bodies and reproductive lives, and demonized by others, who warned about the dangers of women’s liberation and sexual promiscuity. By the 1980 publication of The Pill at 20: An Assessment in Family Planning Perspectives, an estimated 150 million women worldwide had used the method, and concerns about its safety were rising. This study, by Howard W. Ory et al., assessed a number of the pill’s reputed health risks, most notably cardiovascular disease, various cancers, infertility and poor birth outcomes. It also examined several health benefits of the pill, such as reduced risk of breast disease, pelvic inflammatory disease and anemia. The authors concluded that many of the reported risks were overstated, and that the benefits of pill use outweighed the possible risk for most healthy, young women, especially if they did not smoke and did not have hypertension. Ory et al. noted that 20 years of safety studies had likely made the pill “the most systematically monitored medication in history.”

Twenty years down the publication road, in 2000, the journal published “The Pill at 40—A New Look at a Familiar Method.” This forum covered a range of issues related to the possible consequences of pill use—women’s contraceptive autonomy, men’s involvement in contraceptive decision making and behavior, mother-daughter communication, racial justice and birth control, and the future of contraception itself. The authors made a number of provocative arguments, among them that widespread adoption of the pill had fostered healthy communication about sexuality and contraception, and that for some minority men and women, the promotion of the pill recalled earlier coercive birth control policies.

Readers may wonder if “The Pill at 60—The Boomer Years” is just over the horizon. Check back with us in two years.

Cover illustrations of Margaret Sanger © Matthew and Eve Levine