The contraceptive pill is 50 years old – but as controversial as ever. Julia Llewellyn Smith charts its devastating impact on sex and family life
Around three million women in Britain are
thought to take the pill to prevent pregnancy, and 100 million worldwide
Photo: GETTY
Welch joined a long line of detractors, holding the Pill responsible for every contemporary ill from Katie Price to binge-drinking. But others hail it as the greatest medical advance of the 20th century, enabling women to cast off their domestic shackles and plan families around careers.
By far the most popular contraceptive worldwide, with 99 per cent reliability if used correctly, the Pill has been taken by 200 million women. It is currently prescribed to 3.5 million British women, one quarter of all 16- to 49-year-olds.
Although birth control has been practised since the days of Ancient Egypt, before the advent of the Pill contraceptives were either the responsibility of men, or messy, unwieldy devices. Research for a “magic pill” began in 1950, driven by Margaret Sanger, an American Catholic. Sanger founded America’s first birth control clinic in 1916, after seeing her mother die, aged 50, exhausted by 18 pregnancies. A trained nurse, Sanger had also witnessed the dire consequences of DIY abortions.
After slapdash clinical trials on 221 Puerto Rican women, the first Pill was approved by the US Food and Drug Administration in May, 1960. A year later, it arrived in Britain to huge anticipation, although until 1964 it was available only to married women.
Jennifer Worth, a midwife in London’s East End between 1953 and 1973, and author of the bestselling Midwife trilogy of memoirs, recalls its impact as “drastic and almost immediate”.
“Families were huge, six children was average,” she says. “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 in younger women, resentment was building. They’d had experience of the workplace during the war and wanted more out of life than the endless childbearing that had been their mothers’ lot. As soon as they could take contraception into their own hands, they did. Within a few years of the Pill arriving, deliveries on our ward went down from about 100 a month to five.”
Already Britain was in the throes of extraordinary upheaval. Six years after the Pill arrived, the Rolling Stones were singing Let’s Spend the Night Together. Women rejected their mothers’ perms and twinsets for long hair and mini-skirts.
Despite this, by the end of the 1960s, only one in 10 British women had ever taken the Pill. Its heyday came in 1974, with the introduction of free contraception. After that, Pill usage quadrupled within five years from 9 per cent of all women to 36 per cent. Over the next couple of decades, the average age for a woman to marry started rising gradually from 22 to 29 today, while the number of women in the workforce began to multiply, with its consequent impact on family life.
“The Pill didn’t trigger social change, it merely accelerated it,” says Dominic Sandbrook, author of White Heat, a social history of Britain between 1964 and 1970. “New white-collar jobs were emerging that suited women’s capabilities, education was expanding, and for the first time women were making inroads into professions like medicine and law. They used the Pill to defer marriage and babies, to explore these new opportunities, but they would have entered the workforce, Pill or no Pill.”
Yet although rapidly developing society prompted the Pill’s invention, once here, it contributed to profound cultural shifts. The author and broadcaster Libby Purves, 60, considers contraception a “great, great boon”. Yet she warns that the Pill did not bring “unalloyed joy”.
“Before the Pill, you could always use the excuse, however disingenuous, of ‘I might get pregnant’. It was like pulling a sickie, saying: ‘I can’t come in, I’ve got a sore throat’, and it helped women be sure if this relationship really was the right thing for them. Afterwards, it made it much harder for young women to prolong their courtships and to say ‘no’.”
“After the Pill, I remember being pressured for sex. The phrase you always heard was ‘Surely you are fixed up?’. If you weren’t, even if you didn’t have a boyfriend, you were held in contempt. It was like not having a toothbrush – everybody came prepared. I remember a friend being made to feel very dog-in-the-manger by a man, who was a platonic friend, but felt he was entitled to sex and told her ‘Don’t be so foolish, why not?’ when she said no.”
Even more disastrously, says Purves, the Pill deceived millions of women into “taking the phrase ‘family planning’ a touch too literally.
“We thought we could put babies on hold and then have them when we wanted. But what many women found was that either there was a delay or the babies didn’t happen at all.”
Certainly, my post-Pill contemporaries have enjoyed careers our grandmothers could never have imagined. But many also postponed family life until it was no longer an option. One in five women of my generation will never have children; and the Office for National Statistics reports that the more successful women are professionally, the less likely they are to breed.
Remembering my “gang” at university in the early 1990s, only one of us had her first child in her twenties. Three had them after 35, four have just produced their first in their early forties, mostly after IVF. Five are still childless, only two by choice.
“Jackie magazine warned us endlessly about taking precautions,” says one ruefully. “Housewife was a dirty word. It never occurred to me I might one day want to be pregnant.”
Not only were the first generation of Pill-users oblivious to the social fallout, they ignored the physical consequences brought on by huge doses of oestrogen (today’s versions contain around eight times fewer hormones than the prototypes). “To us, they were like magic sweeties, vitamin pills,” Purves says. “Then a friend nearly died of a stroke brought on by the Maxi-Pill, and we were brought to our senses.”
As the first medicine to be taken regularly by people who were not sick, the Pill has been blamed – among others – for causing thrombosis, devastating fish fertility and lowering female libidos. Yet statistics show taking the Pill is still far less risky then either pregnancy or childbirth. A recent 40-year study of 46,000 women showed Pill-users live longer and are less likely to die prematurely of all sorts of ailments, including various cancers and heart disease, than women who had never taken it.
Despite the increased prescription of hormonal “implants” such as uterine coils or skin patches, the Pill remains a doctors’ favourite. Consultant gynaecologist Tina Cotzias calls it “absolutely great”.
“The Pill has real benefits, which all gynaecologists love, and most women will be very happy on it,” she says. “It regulates menstrual flow, makes periods less painful, minimises ovarian cysts and offers symptomatic relief from conditions like endometriosis.
“Not all women can tolerate the hormones, some become bloated on it, some say it turns them into loonies. Some, with underlying health conditions, are not suitable at all. You have to prescribe the right type of Pill for the right woman.”
But what of our moral fabric, as so bewailed by Ms Welch? Jennifer Worth laughs. “That’s an outrageous statement. The Pill saved far more marriages, by reducing the pressure on women. It certainly saved millions’ mental and physical health.”