Racism, Classism & Eugenics: The Complicated History of Contraception & Family Planning
Today, women and men have more choices than ever when it comes to their reproductive health. Reproductive technology has advanced to the point where families can forego pregnancy altogether or help families conceive through less traditional means. Though many of us are used to the reproductive advances that have been made available throughout the years, it’s arguable that none of that would have been made possible without one of the most profound inventions of the 20th century: the birth control pill.
Just over fifty years ago, birth control revolutionized the lives of women in the so-called First World. As fundamental inventor Carl Djerassi wrote in 2015, after the invention of the birth control pill, “sex became separated from its reproductive consequences” and “changed the realities of human reproduction.” According to recent UN data, contraceptives are used by 64% of married and unmarried women in almost all regions of the world, arguably making it one of the most profound inventions to come out of the 20th century.
Djerassi’s discovery, backed by the lifelong work of reproductive rights activist Margaret Sanger and numerous other researchers, has allowed millions of women to make reproductive choices about their own bodies. While the road to legal contraception has been fraught with conflict, birth control isn’t without its historical flaws, most of which have been forgotten by the general public. Although we should celebrate how contraception has changed many women’s lives for the better, we also must acknowledge that parts of its history are problematic.
Before being sent out to the mass market, the pill was tested on women – specifically, women of color, who later experienced forced sterilization. In fact, many journalists have written about the darker sides of birth control, noting that two doctors inflicted a lot of damage on marginalized women from outside of the U.S. Mic author Marcie Bianco wrote: “Dr. Gregory Pincus and Dr. John Rock effectively sterilized hundreds of women, from non-consenting psychiatric patients in Worcester State Hospital to destitute Puerto Rican women living in housing projects of Rio Piedras, by testing variations of the pill on them.” Puerto Rico became a prime location for testing, as officials in the area hoped that it would help to curb poverty. By 1965, “one-third of every married woman aged 20-49 had been sterilized, two-fifths of them before the age of 25,” writes sociology professor Harriet B. Presser.
Today, women of color continue to lack safe access to contraception; these racial and ethnic disparities exist due to the history of forced sterilization. As researchers note, the adoption of sterilization laws and eugenic promotion of birth control in the early 20th century has since resulted in a general medical mistrust among women of color. Further, low-income women have similar issues. One in three low-income women in the US relies on a clinic, either a health center, Planned Parenthood or other publicly-funded clinic to get contraception. Birth control options are out of reach for many low-income women. A Cadanian study highlighted low-income women are less likely to use more effective methods of birth control like the pill, and more likely to use no contraception or condoms only.
Though the pill was brought forth due to the eugenical and genocidal suppression of women of color, it was certainly not advertised as such. 1960s advertisements for the pill touted women’s liberation, and within five years, over 6 million women had begun taking contraception.
Today, birth control presents its own issues. Doctors often still pressure women to use pharmaceutical birth control and dismiss women’s experiences with various side effects. Recent studies published in the journal JAMA Psychiatry confirmed that there was a strong link between clinical depression and the use of the pill—side effects women had been reporting for years.
“Even in an age when HIV/AIDS has brought new relevance to condom use, women still struggle with partners who insist that it is better for them to bear the costs of contraception in their veins than cause sexual inconvenience,” Laura Eldridge writes. Although recent efforts were made to create a birth control alternative for men, research was killed after men reported severe side effects.
Similarly, a number of class-action lawsuits have been filed when a non-surgical form of permanent birth control, called Essure, has caused a number of women’s fallopian tubes to perforate, and many women have been forced to have hysterectomies as a result. Other forms of birth control merely “disappear” inside of women’s bodies. Despite the severe side effects that can be caused by the pill and other forms of contraception, the onus of responsibility to take charge of family planning is nearly always on women.
Transgender women face a similar issue. Approximately 0.3% of individuals within the United States and 0.3–0.5% of the global population identify as transgender, however, the exact prevalence of this population remains unknown, and their contraceptive needs should be addressed more actively. A paucity of research data and clinical protocols of care for clinicians continues to exist, especially in regard to the transgender individual’s family planning needs.
The history of contraception is long and complicated. While it has undoubtedly brought reproductive freedom for numerous women and men worldwide and continues to aid in family planning today, the history of birth control and family planning came through the suppression of poor women of color. Even today, birth control is not without its faults. Perhaps Bianco summarized it best: “History in general isn’t pretty – and it’s no different for the pill. But by being cognisant of the pill’s past, advocates for reproductive justice and for women’s rights, in general, can form a more nuanced, and more ideologically diverse, politics for our collective future.”
by Abby Sullivan