As a writer of historical romances, I guess you could say I have a professional interest in birth control methods of the past. Basically, humans have been trying to prevent pregnancy, with varying levels of success, ever since we figured out what causes it. People think of the Comstock Laws and don’t realize that contraception has been part of American life since the beginning.
Colonial women grasped the implications of controlling their reproduction early. Before obstetrical medicine developed, 1 out of 10 pregnancies ended with the mother’s death, according to centuries of parish records in both Europe and America. Add to this the number of deaths from complications, infections from dirty hands exploring the birth canal, and general lack of basic hygiene, and maternal mortality approaches 25 out of every 100.
One less mouth to feed meant more resources were available for a family‘s existing children, and eased the husband’s economic burden. Women could not compel their husbands to use abstinence (and probably didn’t like it much themselves) or withdrawal. Breast-feeding provided some protection, but lacked dependability. Vaginal sponges and condoms don‘t seem to have been common. That left plants in cottage gardens that could be used to induce abortions. There are North American plants with similar qualities, and I would be very surprised if Native American women did not know how to use those.
During the nineteenth century, Americans continued to search for ways to manage the size of their families:
1839: Charles Knowlton publishes the first pamphlet in America describing various methods of contraception, aimed at married couples. He advocated douching after sex as the best method. A hundred years before the FDA, no one realized that douching has a 90% fail rate and can lead to painful pelvic inflammations. The same year, Charles Goodyear invents vulcanized rubber, enabling the manufacture of rubber condoms in the 1840s. Compared to the porous condoms made of animal skin or intestines since the 16th century, the 50% fail rate of these ‘capotes’ and ‘cundrums’ is hailed as a miracle by married couples.
February 1840: Queen Victoria, a figure of fascination for many Americans, marries Prince Albert and discovers sex, which she privately describes to her doctor as “fun in bed”.
November 1840: Queen Victoria gives birth to her first child. She does NOT consider this fun and discusses birth control with her doctor. He suggests she and Albert use the rhythm method. At the time, doctors believed that a woman’s ‘safe’ days were midway through the woman’s menstrual cycle. You know, the days when she is actually most fertile. To her dismay, the Queen went on to have eight more children. She never lost her passion for Albert, although she shared a dread and loathing of pregnancy with women on both sides of the Atlantic.
1842: German physician W. P. J. Mensinga invents the diaphragm. Copies are soon available in the U.S.
1860s: Newspapers from New York to Charleston to Cleveland carry adds for ‘capotes’, douching syringes, penis caps, ‘wife protectors’ (rubber cervical caps or diaphragms), sponges and ‘female solutions’. Quality was dubious, making them undependable and in some cases dangerous. They become connected with the sex trade and promiscuity in the minds of many who might otherwise have taken advantage of them.
1873: The Comstock Laws, a series of anti-commerce laws are passed, which define contraception as ‘obscene’ for the first time. The U.S. becomes the only country in the Western world to criminalize family planning. Dr. Edward B. Foote advocates the benefits of ‘fertility limitation’ for married couples, citing improved health for mothers and infants as well as relief of the husband’s economic burden. (Sound familiar?) In spite of the Comstock Laws, he distributes birth control devices and information about them.
1876: Dr. Foote is tried for breaking the Comstock Laws and sentenced to a fine of $3,000, equivalent to $67,000 to $73,000 today. When he asks for help paying it, 300 people come forward to offer support.
1879: Connecticut passes the stiffest anti-contraceptive law in the country: Even married couples cannot legally obtain from a doctor birth control to protect the wife’s health. For both health and economic reasons, It is regularly flouted for nearly 100 years.
1888: Dr. W. R. D. Blackwood writes “Is it proper, is it human, is it desirable that the lot of a married female should be a continual round of impregnation, delivery and lactation?…I do not hesitate for an instant to say NO! And I look with more than suspicion on those who, assuming superior virtue, condemn any and all attempts to control conception.”
1892-1920: Gynecologist Clelia Mosher asks her married patients to fill out questionnaires on their sexual practices and beliefs. Only 45 did so over the years, but their comments are interesting. 41 of the women used birth control, including douches, condoms, and ‘womb veils’, all illegal. One woman used a rubber ring around the cervix, which was apparently painful, but not as bad an another child. Many of the 41 considered reproduction a secondary reason for martial sex.
1913: On October 16, Margaret Sanger and her sister Ethel Byrne, both nurses, open America’s first birth control clinic in Brooklyn. They see 488 women in the ten days before they are shut down. At their trial, the judge rejects the idea that “a woman has the right to copulate with a feeling of security that there will be no resulting conception.”
1920s: Spermicidal gels and suppositories (some foaming — how festive!) are sold over the counter as ‘feminine hygiene products’ to get around laws forbidding the sale and use of contraceptives. Adding spermicides reduced the failure rate of diaphragms to 20%, the most reliable birth control until the Pill. Although more effective, this method as it is messy and pretty much kills spontaneity.
1936: In the face of the Depression, 70% of Americans favor birth control in a national survey. An upswing in abortion as a method of birth control also occurs during the decade. One doctor in Chicago reported after his arrest that the majority of his patients were married women aborting third pregnancies or higher. He didn’t say whether they had tried contraceptive measures that failed.
1945: Alabama becomes the first state to establish a tax-supported family planning program. Several southern states follow suit. Poor families shrink and illegitimate births drop across the region.
1950: Katherine McCormick, one of the wealthiest widows in America, finances the research that would lead the first Pill.
1955: The Margulies spiral, the first American made IUD, is invented. Its long tail intrudes into the vagina, causing “pain and trauma” to partners. Unsurprisingly, it never catches on.
1960: Enovid, the first pill, goes on sale. It causes headaches and weight gain, but users flock to their doctors demanding prescriptions anyway. It becomes the best-selling drug in U.S. history to that time, thanks to its dependability and ease of use.
1965: The first American-made IUDs prove popular long-term permanent birth control solutions. The modern IUD was invented in Germany in 1920, but could not be legally imported.
1965: The U.S. Supreme Court strikes down the 1879 Connecticut ban on all contraceptive use and confirms that a “right to marital privacy” exists in the spirit of the First, Fourth and Fifth Amendments. In 1972, the Supreme Court extends the right to privacy in deciding to use contraceptives to unmarried people.
1971: The Dalkon Shield hits the market. Eventually two million women will use this IUD. Undisclosed problems include severe pain and a tendency to cause uterine infections. 18 known deaths are eventually associated with it, along with hysterectomies, infections, birth defects and miscarriages (not always a problem with other IUDs.)
1988: High dose pills are taken off the market.
2002: Contraceptive patches are introduced. Changed once a week, they have fewer side effects than pills, but are more expensive.
For more reading:
A History of the Wife, Marilyn Yalom
Devices and Desires: A History of Contraceptives in America, Andrea Tone
A Distant Mirror, Barbara Tuchman
The Weaker Vessel, Antonia Fraser
The universal flouting of the Comstock Laws amazed and amused me! What do you think is the most surprising thing about the history of birth control in the U.S.?
Also, here is a fun slideshow on WebMD on some of the things people have used in the past to prevent pregancy. Think fish bladder condoms and crocodile poop.