America and the Pill: A History of Promise, Peril, and Liberation (7 page)

was the best way to reduce poverty. In 1974, when the world population reached 4 billion, the United Nations held a con- ference in Bucharest on population and development. Dele- gates from developing nations claimed that population control was an attempt to conceal the huge gap in wealth between rich and poor countries. They argued that the best contraceptive is development. Pointing to trends in Europe and North Amer- ica, they noted that population growth slowed as a result of economic development and education.
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In spite of suspicions about Western motives, the most dra- conian efforts at population control were promoted not by American or other Western agencies but by governments in Asia. Some governments offered incentives such as money or transistor radios as rewards for sterilization, or provided “finder’s fees” to anyone who brought a man to a vasectomy clinic. The Population Council and the Rockefeller Foundation opposed all such forms of coercion or financial incentives in family planning programs in developing countries. As Frank Notestein, Princeton demographer and former president of the Popula- tion Council, said in 1974: “Coercion or the perception of co- ercion will bring down a government before it brings down the birth rate.” He was right. In 1977 Prime Minister Indira Gandhi of India was not returned to office in large part be- cause of her imposition of mandatory family planning meas- ures.
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The most coercive measure to be officially enacted is China’s “one child per couple” policy, instituted in 1979. At that time the population of China was growing by 20 million each year. Twenty years later China’s fertility rate had dramat- ically declined.

But such coercive policies were rare. By the end of the twentieth century, most governments in the developing world provided birth control services to their citizens. Access to con- traception alone did not reduce population growth. The most important factor in lowering the birth rate was the education of women. As women gained more rights, opportunities, and access to education, they were able to assert themselves more fully in their families and society and to take more control over their lives. Contraception was critical to women’s emancipa- tion in the developing world. Without the ability to control their fertility, women would not have been able to take advan- tage of new opportunities for employment and participation in public life.

Sheldon Segal of the Population Council criticized those who promoted contraceptive saturation programs: “They seemed to have a dogged concern for numbers rather than for people and their needs. . . . Women were seen as objects through which to implement population programs and policies.”
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Segal noted the direct correlation between female illiteracy and fertility rates, demonstrating that when women are educated they have more opportunities and motivation to limit the number of children they bear.
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He said that if he had one dol- lar to spend on population control efforts, he would spend it on the education of women.
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The fertility rate declined dramatically in the last half of the twentieth century, even if the population did not. The World Health Organization estimated that in developing countries the average number of children per woman declined from 6.1 in 1970 to 3.9 in 1990. In the 1960s, fewer than 10 percent of

couples in the developing world used birth control; by 2000 nearly 60 percent did.
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The availability of the pill (as well as the IUD and other forms of contraception) had been critical both in emancipating women and in reducing the fertility rate. One could not have happened without the other.

As it turned out, the pill played a minor role
in curbing population growth. It did not live up to dramatic predictions that it would solve the problems of overpopulation, poverty, and hunger. Across the world, middle-class women were much more likely to use the pill than poor women. Pop- ulation planners saw the pill as part of the solution, but not necessarily the most practical contraceptive for use among the poor. In fact, in the early 1960s, the pill was rarely used in pop- ulation control programs. Many preferred the IUD, because it required only one visit to a clinic and could remain in place for years. Using the IUD, women did not need to remember to take a pill every day, nor did they need to see a doctor for pre- scription refills. The pill was one among several contraceptive options available to women who wanted to control their fertil- ity, assuming they had the opportunities that made fertility control possible for them.

In many areas, access to birth control depended on foreign aid provided by Western countries. In the United States, after Eisenhower’s initial refusal to consider contraception as part of public policy, John F. Kennedy, the nation’s first Catholic pres- ident, supported family planning programs as part of foreign aid, as did every president who followed until the United Na- tions conference on population in Mexico City in 1984. At

that time, President Ronald Reagan reversed the United States’ position. This reversal of long-standing policy was a di- rect result of abortion politics within the United States. The

U.S. delegation to Mexico City included the Conservative Party senator James Buckley of New York and Republican Allan Keyes, both ardent foes of abortion. At the conference they established what came to be known as the “Mexico City policy”: a global gag rule that refused U.S. government support to any agency, American or foreign, that used its own funds to support abortion services, counseling, or referral, even though these services would be legal and no U.S. money was involved. Many clinics that provided contraceptives also offered abortion services. The Mexico City policy prohibited these facilities from receiving any U.S. funds for family planning, even if those funds would not be used for abortion-related services. The vast majority of Americans opposed Reagan’s gag rule, favoring the inclusion of family planning information and supplies as part of foreign aid, and disapproved of withholding funds to health organizations that provided abortion services with non-U.S. funds.
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Nevertheless, the rule prevailed through the Reagan years and the presidency of George H. W. Bush.

In 1993, five days after taking office, President Bill Clinton dropped the Mexico City policy. The following year, the United Nations sponsored a population conference in Cairo. The “Cairo Agenda” focused on issues of women’s rights, in- cluding reproductive rights, “free of discrimination, coercion, and violence.” In spite of widespread support for Clinton’s policies and the Cairo Agenda, President George W. Bush re- stored the Reagan-era gag rule three days after he took office

in 2001. One staunch anti-abortion physician told a television news reporter that “the United States has to stop all those abortions caused by contraceptives, like the pill and the IUD.” Sheldon Segal, who worked for decades to make contraception available to women throughout the world, was “astonished” by the lack of scientific accuracy as well as the hostility to women’s reproductive rights that supporters of the gag rule ex- pressed. The official position of the United States had come full circle—from initial reluctance to strong promotion of for- eign aid for contraceptive services, then to a policy that de- prived women throughout the world of access to birth control because of ideological hostility to abortion rights. During the administration of President George W. Bush, funding for fam- ily planning programs, including contraceptive services within the United States, declined in favor of “abstinence only” pro- grams, which have been proven to be unsuccessful. The Bush administration’s refusal to support any “unnatural” forms of birth control severely diminished worldwide efforts to make contraceptives available to poor women, including methods that inhibit the spread of AIDS.
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On January 24, 2009, four days after taking office, President Barack Obama reversed the policy once again, lifting the gag rule. Politically, the pill has traveled a bumpy road. But politics has not stopped women the world over from using birth con- trol. There is no question that access to safe and reliable con- traception, including the pill, has shown major benefit to women’s lives. Today, over 60 percent of the world’s married women in their reproductive years use contraception, and 90 percent of them use the pill, the IUD, implants, or injectables.

Fertility rates changed not because of the efforts of experts and population planners, but because at last women could decide whether they wanted more or fewer children.
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Of course, the extent to which women could exercise their contraceptive op- tions depended upon many circumstances, public policies among them. But besides her own desires, the most significant influence on a woman’s use of birth control was likely to be her sexual partner. To understand the role of the pill in women’s lives, it is necessary to consider men.

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Bedfellows

With my wife on the pill, any moment is the right moment for love. No plans. No calculation. Unpre- meditated sex is marvelous! We are in love, and it seems the right way for people in love to have sex.

Ladies Home Journal
, 1969

Many wives feel sexually liberated by birth-control pills. But some husbands feel enslaved. It’s as if their sense of maleness and self-esteem has been threatened.

T

he birth control pill made it possible, for the first time ever, to separate contraception from the act of sexual intercourse. Women could take the pill with or without the approval of their sexual partners—even without their knowledge. For women, this could be enormously liberating and empowering.

Men also benefited from the pill. They no longer had to con- tend with the clumsy condom or the awkward withdrawal method. The pill offered men the additional advantage of more eager and responsive partners freed from the fear of pregnancy. Without devices, appliances, or interruptions, and assured that their sexual encounters would not result in pregnancy, couples could unleash their passions freely. Uninhibited sex was one of the pill’s most potent promises. But as the quotes above sug- gest, the pill might lead to sexual bliss, or it might do just the opposite. Not all men shared the profound sense of relief and freedom the pill offered women.

Along with preventing pregnancy, the pill challenged deeply entrenched sexual codes and attitudes. For men, the pill promised to relieve the worries of unplanned pregnancy: the burden of another mouth to feed, the anguish of a partner fac- ing an illegal abortion, or the pressure of a shotgun wedding. Yet it could also undermine a sense of masculine potency grounded in procreative power. For women, the pill’s benefits were obvious: freedom from the fear of pregnancy, conven- ience, and total control over contraception. Women had the most to gain from the pill, and the most to lose without it.

Before the emergence of the second wave of feminism and the powerful movement for reproductive rights, women strug- gled to avoid the dangers of unwanted pregnancy. The stakes were highest for single women. The powerful punitive culture at mid-century came down especially hard on sexually active single women. Even if an unmarried woman avoided preg- nancy, she risked a tarnished reputation. If she had the misfor- tune to become pregnant, she faced the dire options of rushed

marriage, dangerous abortion, or the shame, ostracism, and burdens of unwed motherhood. Married women also felt cul- tural pressures in the midst of the celebration of domesticity and motherhood that reigned during the baby boom era. They tended to emphasize the pill’s promise of family planning and marital happiness, keeping the liberating potential of contra- ception under the radar.
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Meanwhile, it was men—especially those who considered themselves among the cultural avant-garde—who led the pub- lic charge for sexual liberation. They hoped to break down the barriers of prudery and restraint but with little regard for the reproductive consequences, and even less interest in women’s empowerment. Among the most visible and outspoken propo- nents of sexual freedom in the 1950s and early 1960s were the Beats, who publicly flaunted their defiance of all forms of sex- ual propriety, both heterosexual and homosexual. Although the Beats included some “chicks” in their circle, the culture of male bonding and adventure among them was notoriously sexist. The women, according to Beat memoirist Joyce Johnson, were minor characters.
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The Beat philosophy of sexual freedom did not necessarily include women’s right to use contraception, which would thwart men’s procreative powers. Beat poet Richard Brautigan expressed this sentiment in his poem “The Pill Versus The Springhill Mine Disaster”:

When you take your pill it’s like a mine disaster. I think of all the people lost inside of you.

The poem, dedicated to his girlfriend at the time, equates the pill with the 1958 mining disaster in Springhill, Nova Sco- tia, in which trapped miners died. His poem likens the pill not to liberation but to death.
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A less dismal view of the pill came from another
proponent of liberated manhood: Hugh Hefner, publisher of
Playboy
magazine. In the 1950s, Hefner created and promoted the ideal of the suave, urbane, unencumbered bachelor. He built his Playboy empire by offering men the trappings of the “good life” without its burdensome responsibilities. Hefner was an instant celebrity and his magazine became a source not only of soft porn for mainstream men but of wide-ranging discus- sion of controversial issues, including sex and birth control. The magazine reached an audience of a million readers a month and had a profound impact on popular visions of the good life. The Playboy ethic encouraged men to enjoy the sex- ual pleasures of attractive women without the chains of mar- riage, and to pursue the rewards of consumerism as single men in well-appointed “bachelor flats” rather than as husbands and fathers in appliance-laden suburban homes. Hefner’s magazine offered tips on how to achieve this lifestyle, along with center- fold airbrushed photographs of nearly nude young female “bunnies” who seemed to promise sex without commitment. Hefner’s “Playboy Philosophy” promoted sexual freedom pri- marily for men, with women depicted as eager and willing “playmates.”
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