A Timeline of Contraception
One of the oldest references to birth control comes from the Bible. In the book of Genesis men are called upon to practice coitus interruptus, commonly known as the "withdrawal" method.
The Greek philosopher Aristotle is thought to be the first person to propose using natural chemicals such as cedar oil, lead ointment or frankincense oil as spermicides.
Pliny, the Roman writer of Natural History, counsels his readers to refrain from sex to avoid pregnancy. He is the first known advocate of abstinence as a form of birth control.
Casanova includes in his memoirs details of his experimental forms of birth control. He recounts his attempts to use the empty rind of half a lemon as a primitive cervical cap.
In a major scientific breakthrough, scientists discover the existence of the female egg -- the ovum. Prior to this, it is only known that semen must enter the female body for conception to occur. This is the first step in understanding the science of human reproduction.
Charles Knowlton, a Massachusetts physician, invents a birth control solution to be injected into the uterus by syringe after intercourse. Various recipes for the water-based solution include salt, vinegar, liquid chloride, zinc sulfite or aluminum potassium sulfite. The syringe method will remain in popular use for the next 40 years.
A German doctor, Friedrich Wilde, offers patients a small cervical cap to cover the cervix between menstrual periods. This method is never widely adopted, but the "Wilde Cap," as it became known, is the precursor to the modern diaphragm.
Charles Goodyear invents the technology to vulcanize rubber and puts it to use manufacturing rubber condoms, intrauterine devices, douching syringes, and "womb veils" (diaphragms).
Scientists learn that conception occurs in human reproduction when the sperm enters the female egg. Prior to this it was assumed that men created life and women just provided the home for it.
A wide assortment of birth control devices are available in America -- such as condoms, sponges, douching syringes, diaphragms and cervical caps -- from catalogs, pharmacists, dry-goods stores and even rubber vendors.
March 2: Congress passes the Comstock Law, an anti-obscenity act that specifically lists contraceptives as obscene material and outlaws the dissemination of them via the postal service or interstate commerce. At the time, the United States is the only western nation to enact laws criminalizing birth control.
Scientists conclude definitively that for human fertilization to occur there must be a union of the egg and the sperm.
Katharine Dexter McCormick is born into a wealthy and prominent family in Dexter, Michigan.
Born Maggie Louise Higgins, Margaret Sanger becomes the sixth child of a poor, working class, Irish Catholic immigrant family in Corning, New York.
Dr. Wilhelm Mensinga, a German scientist, invents a larger cervical cap. His model will gain widespread popularity and come to be known as "the diaphragm."
The first commercially manufactured birth control suppository is produced in England by London chemist W. J. Rendell. The quinine and "cacao-nut butter" suppository, known as "Rendell's," was somewhat effective and commonly used in England until World War II.
March 24: JOhn Rock and twin sister Eleanor are born in Marlborough, Massachusetts to a working class Irish Catholic family.
Viennese gynecologist Emil Knauer discovers the existence of chemicals that control the body's metabolic processes. After he observes a wide variety of these chemical substances, in 1905 the mysterious chemicals are named hormones, from the Greek hormaô, "stir up" or "incite.".
Gregory Pincus is born in Woodbine, New Jersey to Russian Jewish immigrants.
Katharine McCormick, after majoring in biology, becomes one of the first women to graduate from the Massachusetts Institute of Technology with a degree in science. Despite her accomplishment, she does not pursue a career and marries Stanley McCormick, heir to the International Harvester Company fortune.
McCormick's husband is diagnosed with schizophrenia. Fearing his disease is hereditary, McCormick vows never to have children and develops a staunch belief in the value of contraception.
The U.S. Food and Drug Administration (FDA) is established to protect consumers from fraudulent medical products and quackery.
Margaret Sanger, now a nurse on New York's Lower East Side, dreams about finding a "magic pill" as easy to take as an aspirin that could be used for contraceptive purposes.
March: In her radical journal The Woman Rebel, Margaret Sanger instructs women on times when it would be wise for women to avoid pregnancy, such as in the case of illness or poverty. She does not give any instructions regarding specific methods for contraception, but the New York City postmaster bans the journal under the Comstock Law category of "obscene, lewd, lascivious" matter.
August: Margaret Sanger coins the term "birth control" and dares to use the phrase in the June 1914 issue of The Woman Rebel. For this crime and others, Sanger is indicted for nine violations of the Comstock Law. Rather than face the charges, she flees the country to continue her work in England.
Anthony Comstock dies, but his anti-birth control laws remain entrenched.
March: In New York City a group of women form the National Birth Control League, an antecedent of the International Planned Parenthood Federation.
Sanger returns to New York to face trial. The charges against her are dropped, but she continues to challenge the Comstock Laws and brazenly launches a new publication dedicated to her cause, Birth Control Review.
Oct.16: Sanger, with her sister and a friend, opens the first birth control clinic in America, in Brooklyn, New York. For the first time in American history, women can receive organized instruction in birth control.
Oct. 26: After only 10 days, Sanger's clinic is raided by the vice squad and shut down. The women are arrested and all the condoms and diaphragms at the clinic are confiscated.
Margaret Sanger and Katharine McCormick first meet at one of Sanger's Boston lectures, and strike up an enduring friendship. Sympathizing with Sanger's movement, McCormick makes small contributions to the cause and smuggles diaphragms into the United States for Sanger's clinics.
The Crane decision, in the case against Sanger's operation of the clinic, is the first legal ruling to allow birth control to be used for therapeutic purposes.
August: The Nineteenth Amendment is ratified, giving women the right to vote.
Margaret Sanger establishes the American Birth Control League, the antecedent of the Planned Parent Federation of America.
Margaret Sanger successfully opens the first legal birth control clinic in the U.S. with the stated intent of only using contraceptives for medical purposes, such as the prevention of life-threatening pregnancies and in accordance with the Crane decision.
Scientists working independently in Japan (1924) and Austria (1927) devise the "Rhythm Method" of birth control. After figuring out that women are fertile approximately midway through the average menstrual cycle, they conclude that pregnancy can be avoided by abstaining from sex during that fertile period.
After graduating from Harvard Medical School and completing a residency in surgery and internships in maternity medicine and gynecology, Dr. John Rock is appointed an assistant in obstetrics at Harvard Medical School. He focuses his practice on treating women with fertility problems at Boston clinics.
Scientists make a crucial breakthrough in reproductive biology. The discovery that the pituitary gland functions as a "remote control system in human reproduction" leads directly to the invention of the first pregnancy test.
Almost 30 years after the discovery of hormones, scientists at the University of Rochester in New York identify progesterone, the ovarian hormone. They conclude that this hormone plays a crucial role in preparing the womb for and sustaining a pregnancy.
The human sex hormone estrogen is isolated and identified by Edward Doisy at Washington University in St. Louis.
During the Great Depression, companies eager to sell women contraceptives, but not permitted to by law, use the term "feminine hygiene" to market a wide array of over-the-counter products that are believed to have a contraceptive effect. One of the most popular products is the simple and cheap "Lysol douche," and scores of women rely solely on this ineffective and dangerous method to prevent pregnancy.
Gregory Pincus receives an appointment at Harvard University to teach in department of general physiology.
August 15: At the world assembly of Anglican bishops, known as the Lambeth Conference, a resolution is passed favoring limited acceptance of birth control. This resolution is a watershed for the Protestant Church.
December 31: The Roman Catholic Church makes its first definitive statement on birth control. Pope Pius XI issues an encyclical titled Casti Canubi (Of Chaste Marriage) calling birth control a sin, and opposing birth control by any artificial means.
In her dogged pursuit of birth control legalization, Margaret Sanger targets Massachusetts' puritanical laws. A petition is circulated to end the state's anti-birth control law. It is defeated, but Dr. John Rock is one of 15 physicians -- and the only Catholic -- to sign petition.
While an assistant professor at Harvard University, Gregory Pincus gains fame and notoriety at the age of 31 when he claims to have achieved in-vitro fertilization of rabbits. Pincus is vilified in the national press for tampering with life. Harvard does not grant Pincus tenure.
John Rock opens a rhythm method clinic in Boston -- the first of its kind in America.
Margaret Sanger orchestrates a court battle over a shipment of Japanese diaphragms to a doctor in the U.S. In a decision titled U.S. vs. One Package, the court rules that physicians can receive contraceptive devices and information via the mail unless prohibited by a specific local law. It is a major victory for Sanger and birth control advocates. The case legitimizes birth control commerce among the medical profession and leads to the American Medical Association (AMA) officially recognizing birth control as part of a doctor's medical practice.
While teaching at Harvard Medical School, Dr. John Rock engages in unheard of and subversive activities, covertly breaking Massachusetts' law by teaching medical school students about birth control.
The diaphragm is the most effective form of birth control available in America, but the least popular method due to its high cost and the need to see a physician. Instead, most women rely on inexpensive but less reliable commercial douches for contraception.
Chemistry professor Russell Marker discovers a way to make synthetic progesterone with Mexican wild yams known as cabeza de negro. His discovery makes progesterone production affordable and will become the basis for hormonal birth control.
John Rock puts his reputation on the line and publicly asks the state to let Massachusetts physicians advise patients on birth control.
Together with a former colleague from his Harvard days, Gregory Pincus founds a small, private laboratory in Shrewsbury, Massachusetts, the Worcester Foundation for Experimental Biology, to pursue research away from the politics and restraints of academia.
Harvard endocrinologist Fuller Albright writes a seminal report that will come to be known as "Albright's Prophecy." As part of an analysis of serious menstrual disorders, he writes that preventing ovulation prevents pregnancy and explores the possibility of "birth control by hormone therapy."
Katharine McCormick's husband dies, giving her full control over his fortune.
Although still a devout Catholic, John Rock co-authors the book Voluntary Parenthood, aimed at explaining birth control methods to a general audience tired of coping with unwanted pregnancies.
Americans spend an estimated $200 million a year on contraceptives. Due to massive improvements over the past decade in condom quality and a growing awareness of the inadequacies of douches, "rubbers" are the most popular form of birth control on the market.
Although the vast majority of doctors approve of birth control for the good of families, anti-birth control laws on the books in thirty states still prohibit or restrict the sale and advertisement of contraceptive devices. It is a felony in Massachusetts to "exhibit, sell, prescribe, provide, or give out information" about them. In Connecticut, it is a crime for a couple to use contraception.
October: At the age of 75, Katharine McCormick turns her full attention to the problem of birth control. She writes Margaret Sanger a letter inquiring about current research and asks where her money might be best spent funding efforts to improve birth control.
The Catholic Church remains resolutely opposed to artificial birth control, but Pope Pius XII announces that the Church will sanction the use of the rhythm method as a natural form of birth control. Previously, the only option approved by Rome was abstinence.
The Planned Parenthood Federation of America runs 200 birth control clinics. Margaret Sanger has been successful in fighting legal restrictions on contraceptives, and birth control has gained wide acceptance in America. Still, Sanger remains deeply unsatisfied, because women have no better methods for birth control than they did when she first envisioned "the pill" over 40 years earlier.
January/February: Margaret Sanger, now 72 years old, makes one last ditch effort to find someone to invent her "magic pill." At a dinner party in New York City she is introduced to Gregory Pincus and implores him to take up her quest. To her surprise, he tells her that it might be possible with hormones, but that he will need significant funding to proceed.
April 25: Sanger manages to secure a tiny grant for Gregory Pincus from Planned Parenthood, and Pincus begins initial work on the use of hormones as a contraceptive at The Worcester Foundation. Pincus sets out to prove his hypothesis that injections of the hormone progesterone will inhibit ovulation and thus prevent pregnancy in his lab animals.
October: Pincus goes to the drug company G.D. Searle and requests additional funding from them for the pill project. Searle's director of research tells Pincus that his previous work for them was "a lamentable failure" and refuses to invest in the project.
October 15: Unbeknownst to Pincus or Sanger, a chemist named Carl Djerassi working out of an obscure lab in Mexico City creates an orally effective form of synthetic progesterone -- a progesterone pill. The actual chemistry of the Pill has been invented, but neither Djerassi nor the company he works for, Syntex, has any interest in testing it as a contraceptive.
January: In less than a year, Pincus confirms that progesterone works as an anti-ovulent in rabbits and rats. He informs Planned Parenthood of his findings and requests more funding. The organization, deciding his work is too risky, decides not to continue funding his research. The Pill project stagnates for lack of funding.
Frank Colton, chief chemist at G.D. Searle, independently develops another oral form of synthetic progesterone.
At a scientific conference, Pincus has a chance encounter with the renowned Harvard obstetrician and gynecologist Dr. John Rock. Pincus is astonished to learn that Rock has already been testing the chemical contraceptive on women and demonstrating that it works. Rock has been giving the same drug to his infertility patients with the eventual goal of stimulating pregnancy after his patients finish a 3 to 5 month regimen of progesterone injections.
June 8: Sanger realizes McCormick can fund Pincus' research and brings her to Shrewsbury to meet the scientist. The visit is a huge success. Katharine McCormick writes Pincus a check for a huge sum -- $40,000 -- with assurances she will provide him with all the additional funding he will need. The Pill project is restarted.
Pincus knows progesterone will work, but in order to get FDA approval he will need to test the drug on humans, which only a clinical doctor can do. Finally with adequate funding at hand, Pincus joins forces with Dr. John Rock to test the drug on Rock's female patients. In Massachusetts, a state with extremely restrictive anti-birth control laws, Rock and Pincus begin the first human trials with 50 women, under the guise of a fertility study. Searle provides the pills for the trial.
The Pill regimen still in use today is established. Pincus persuades Rock to administer the progesterone for only 21 days, followed by a 7-day break to allow for menstruation. They know the Pill will be controversial and want oral progesterone to be seen as a "natural " process, not something that interferes with the normal menstrual cycle.
Katharine McCormick, eager for results, stays in Boston for the winter to keep tabs on Rock and Pincus' progress.
The results from the first human trials are conclusive. Not one of the 50 women in the experiment ovulates while on the drug. Pincus and Rock are positive that they have found the perfect oral birth control pill.
October: Margaret Sanger invites Gregory Pincus to the 5th Annual International Planned Parenthood League conference in Tokyo, Japan, where Pincus announces the results of his progesterone study. Despite the magnitude of his announcement, the press at the conference remains skeptical and does not pick up the story.
December: At the prestigious Laurentian Conference on Endocrinology in Canada, before an audience of scientists involved in hormone research, Rock presents a paper stating that the progesterone pill inhibits ovulation. Word spreads quickly through the scientific world and drug industry that Pincus and Rock have found a birth control pill.
After comparing the data from studies using both Syntex's and Searle's drugs, Rock picks Searle's formulation, called Enviod, to be the first birth control submitted for FDA approval in America.
April: Since anti-birth control laws in Massachusetts and many other states make it impossible for Rock to conduct the larger human studies necessary for FDA approval, Rock and Pincus launch the first large scale clinical trials for the Pill in San Juan, Puerto Rico.
November: The news of the Pill spreads to the general public. An article in Science magazine informs readers that women have taken a synthetic hormone as an oral contraceptive and it works.
December: The medical director in charge of the Puerto Rico trials informs Pincus and Rock that "Enovid gives 100% protection against pregnancy," but reports that the Pill causes too many side effects to be "accepted generally." Pincus and Rock proceed with the trials, convinced that while the Pill may cause discomfort, it is safe.
Pincus and Rock discover that Searle has been sending them pills contaminated with a minuscule amount of synthetic estrogen in addition to the progesterone -- a major set back for the trials. However, after testing new shipments of uncontaminated Enovid, they conclude that the combination of estrogen and progesterone (the same combination still used today) reduces some problems like breakthrough bleeding.
Rock selects a high dosage for the Pill in order to be absolutely certain that Enovid will prevent pregnancy without fail.
Spring: In addition to the Puerto Rico trials, Pincus also sets up full-scale trials in Haiti and Mexico City.
Summer: The FDA approves the use of Enovid for the treatment of severe menstrual disorders and requires the drug label to carry the warning that Enovid will prevent ovulation.
President Dwight Eisenhower states in a press conference that birth control "is not a proper political or government activity or function or responsibility" and adds emphatically that it is "not our business."
Less than two years after FDA approval of Enovid for therapeutic purposes, an unusually large number of American women mysteriously develop severe menstrual disorders and ask their doctors for the drug. By late 1959, over half a million American women are taking Enovid, presumably for the "off-label" contraceptive purposes.
Oct. 29: Excited by the vast potential market for the Pill, Searle files an application with the FDA to license the 10 milligram Enovid -- the same pill approved for menstrual disorders -- for use as a contraceptive. The application is based on field trials with 897 women, making it one of the most extensively tested drugs to ever come before the FDA for approval.
With an eye on maximizing profits, Searle attempts to license lower doses of Enovid (2.5 and 5 milligram doses), but the FDA demands complete field trials for the lower dose versions as well.
Winter: The FDA reviews Searle's application for the first drug in history to be given to a healthy person for long-term use. Searle is doing $37 million in annual sales of the Pill for "menstrual disorders" and pushes the FDA for approval.
April: John Rock tells the national press that the Pill, since it simply extends a woman's "safe period," should be considered an extension of the Vatican-approved rhythm method.
May 11: Searle receives FDA approval to sell Enovid as a birth control pill. Searle is the first and only pharmaceutical company to sell an oral contraceptive and it has a lucrative monopoly.
As soon as Searle completes the requisite field tests demonstrating the effectiveness of the Pill at lower doses, the FDA approves the drug for contraceptive use at 2.5 and 5 milligrams.
The pharmaceutical industry awakens to the huge market for effective contraception, and 13 major drug companies, nine of them American, work to develop new birth control methods and their own versions of the Pill.
December: It is still a crime to use birth control in Connecticut. In bold defiance of Connecticut law, Dr. C. Lee Buxton, the chairman of the Yale Medical School department of obstetrics and gynecology, and Estelle Griswold, the executive director of Connecticut Planned Parenthood, open four Planned Parenthood Clinics. They are promptly arrested, but their case brings national attention to the anachronistic state laws.
The American public learns that Thalidomide, a sedative given to pregnant women in Europe to control morning sickness, causes horrible birth defects. In the U.S., the drug has never received FDA approval, but the age of faith in "wonder drugs" appears to be over, and the American public begins to question the safety of drugs. In the wake of the Thalidomide tragedy, the FDA will enact stricter regulations for human drug tests.
With 1.2 million American women on the Pill, Searle's corner on the Pill market comes to an end. Syntex receives FDA approval to sell the drug Carl Djerassi developed in the 1950s under the trade name Ortho Novum.
September 1: Word of serious side effects, such as blood clots and heart attacks caused by the Pill, begins to spread. Searle receives reports of 132 blood clots, including 11 deaths, but the company declares that there is no conclusive evidence demonstrating that the blood clots are a direct result of the Pill.
2.3 million American women are using the Pill.
In his crusade to make the Pill acceptable to the Catholic church, John Rock publishes The Time Has Come: A Catholic Doctor's Proposal to End the Battle over Birth Control, and becomes the de facto public spokesman for the Pill.
One quarter of all couples in America using birth control choose the Pill. Parke-Davis, another drug company eager for a share of the market, sells its version of the Pill. Despite the competition, Searle earns $24 million in net profits from Pill sales, but neither Gregory Pincus nor the Worcester Institute receive any royalties.
Less than a decade after President Eisenhower declared that the government should not get involved with birth control, President Lyndon B. Johnson pushes through legislation for federal support of birth control for the poor.
June 23: Pope Paul VI creates the Papal Commission on Population, the Family and Natality, informally known as the "Birth Control Commission." This is the year of Vatican II and monumental reforms in the Catholic Church. Many within the church support the use of the Pill. Both clerics and the laity are extremely hopeful that the Pope will approve the use of the Pill for Catholics.
The Pill becomes the most popular form of reversible birth control in America.
Despite general public approval for birth control, ghosts of the Comstock Laws linger. Eight states still prohibit the sale of contraceptives, and laws in Massachusetts and Connecticut still prevent the dissemination of information about birth control.
June 7: Estelle Griswold and Lee Buxton take their Connecticut case all the way to the U.S. Supreme Court. By a vote of 7-2 in Griswold v. Connecticut, the Court strikes down the Connecticut law prohibiting the use of birth control as a violation of a couple's right to privacy.
Just five years after the Pill's FDA approval, more than 6.5 million American woman are taking oral contraceptives, making the Pill the most popular form of birth control in the U.S. Searle still dominates the market, and does $89 million in sales of Enovid.
Vatican II comes to an end and the Roman Catholic Church implements some reforms -- but a decision on the Pill is not made.
An FDA task force looks into the issue of side effects from the Pill, especially the danger of blood clots, cancer and diabetes. The task force finds no smoking gun, but does allow the drug companies to bring lower doses of the pill to market with less red tape.
September 6: Margaret Sanger dies in Tucson, Arizona, just shy of her 87th birthday.
Over 12.5 million women worldwide are on the Pill.
Massachusetts liberalizes its birth control laws, but still prohibits the sale of birth control to unmarried women.
August 22: In the prime of his career, Gregory Pincus dies in a Boston hospital at age of 64 from myeloid metaplasia, a rare disease of the white blood cells, due to exposure to lab chemicals.
December 28: Katharine McCormick dies at the age of 92 in Boston, Massachusetts. No major newspaper gives her an obituary, and with her passing, her contribution to the birth of the Pill is forgotten.
December: The Pittsburgh branch of the NAACP charges that Planned Parenthood clinics, which provide the Pill and other forms of birth control in low income and minority neighborhoods, are devoted to keeping the black birth rate as low as possible. In a public statement the organization declares that birth control is being used as an instrument of racial genocide. A strong accusation, it touches a cord in minority communities and the term "black genocide" catches on.
Sales of the Pill hit the $150 million mark. American women can now select from 7 different brands.
David Niven and Deborah Kerr star in the Hollywood film Prudence and the Pill. Birth control, once considered obscene and vulgar, is now a pop culture icon.
July 25: Pope Paul VI reveals his decision on the Pill in an encyclical titled Humanae Vitae (Of Human Life). To the dismay of Catholics around the world — and ignoring the recommendations of the Papal commission on birth control -- the Pope states unequivocally that the Church remains opposed to all forms of birth control except the rhythm method.
September: Medical journalist Barbara Seaman publishes the controversial book The Doctor's Case Against the Pill and brings national attention to the dangers of the Pill.
Catholic Americans make their own decisions about birth control. In spite of Church doctrine, two-thirds of all Catholic women are using contraceptives, and 28% of them are on the Pill.
January - March: Influenced by Seaman's book, U.S. Senator Gaylord Nelson convenes Senate hearings on the safety of the Pill. Radical feminists disrupt the male-dominated hearings and demand women taking the Pill be informed of all the potential dangers and side effects.
June: In a victory for feminists and the women's health movement, the FDA orders that all oral contraceptive packages must contain a patient information insert detailing possible side effects from the Pill.
In the wake of the Pill hearings, sales drop by 20%, but the oral contraceptive remains America'sbirth control method of choice.
Scientists determine that smoking is major factor contributing to blood clotting in Pill users, but that the lower doses of pill not only greatly reduce the risk of clots but also reduce other side effects such as weight gain, headaches and nausea.
March 23: The U.S. Supreme Court, ruling in Eisenstadt v. Baird that a state cannot stand in the way of distribution of birth control to a single person, strikes down Massachusetts law prohibiting the sale of contraceptives to unmarried women.
Although sales of the Pill dropped for a brief period after the Senate Pill hearings, American women return to the drug in record numbers. The number of users reaches 10 million.
Just 15 years after President Eisenhower declared that birth control is not the government's business, the government supports birth control clinics in 2,379 of the nation's 3,099 counties. Of all the methods dispensed, the Pill is most popular.
The FDA reports that 10.7 million American women are on the Pill. Confidence in the safety of the pill has risen dramatically in the years since the Pill hearings.
In spite of the Pope's ruling against the Pill and birth control, almost 80% of American Catholic women use contraceptives, and only 29% of American priests believe it is intrinsically immoral.
New versions of low-dosage oral contraceptives are introduced. These products vary the amount of progesterone and estrogen in the drug during the 21-day cycle. Only 3.4% of birth control pills on the market are the original high-dosage pills.
The Pill's impact on women in the work force is significant. With highly effective birth control now at their disposal, 60% of women of reproductive age are employed in America.
December 4: John Rock dies at the age of 94 in Temple, New Hampshire.
An estimated 50 to 80 million women worldwide take the Pill.
At the FDA's urging, drug companies remove the original high-dose oral contraceptives from the market.
Surveys show that birth control has disappeared from the list of medical research's 35 top priorities.
According to the annual FDA Consumer report, the Pill is considered safe and effective by the government, medical establishment and public.