The Complicated History and Troubling Future of Birth Control

Birth control condomsBY JANET COLM

None of us like to think of ourselves as “average” — but if you are the average American woman who has sex with men, you started having sex around age 17 and you will spend 30 years of your life trying to avoid pregnancy. And, if you are like 99% of American women, you will use birth control at some point in your lifetime.

Until 1936, birth control was considered “obscene” and the federal Comstock Laws prohibited distribution of birth control or even information about birth control.

One year after the Comstock Laws were overturned, North Carolina became the first state to begin providing contraception as part of the state’s public health program. By March 1938, more than half of all birth control clinics in the country were in North Carolina.

In the ‘30’s, the most common methods of  birth control were condoms, douching after intercourse, withdrawal, the “rhythm method,” sterilization, and use of the diaphragm. Perhaps as many as one-third of women who used contraception relied on the rhythm method. The trouble is, these women were severely hampered because even scientists didn’t know when ovulation occurred until 1928.

The North Carolina family planning program was initially funded by Dr. Clarence Gamble, a Harvard-educated physician and heir to the Proctor and Gamble fortune. Gamble was researching contraceptive foam, powders, and jelly — which he thought were better methods for low-income women than the barrier methods touted by Margaret Sanger, the founder of the modern birth control movement. Gamble thought barrier methods were too complicated for women who were less educated, who had limited access to medical care and who often did not have running water.

The primary motivation for starting the first birth control clinics in NC was that we had one of the highest infant and maternal mortality rates in the country. The birth control program was part of a 3-pronged effort to reduce mortality rates — prenatal and postnatal care; improving (and later restricting) midwifery; and birth control.

The state’s segregated health system meant that African-American women struggled to access family planning services. In 1939, two-thirds of North Carolina counties had public birth control clinics; but the counties with the highest African-American populations had either no programs or fewer than the rest of the state. The Birth Control Federation of America (which later became Planned Parenthood Federation of America) offered NC a grant to sponsor a pilot project for the African-American community and the state rejected the funds out of fear that it would “stimulate opposition” to the birth control program.

The North Carolina program, like many other early birth control programs, steered clear of Margaret Sanger. Gamble, for example, clashed with Sanger about what types of contraception women could — and should — use. Sanger was a proponent of barrier methods — like diaphragms — because they were most effective. Gamble’s priority was research and his classist and sexist assumptions dictated his research goals and methods.

There was also disagreement about which women should have access to birth control.  Margaret Sanger had a reputation of being  “supportive of providing contraceptives to any woman who requested them” — not just married women who already had several children.

There is no denying that issues of race, class, and gender equality are part of our state’s history around birth control and abortion. These issues continue to play out as the fight to expand — and maintain — access to good, affordable birth control continues.

The NC House of Representatives is currently considering a bill that would prohibit schools from teaching students about emergency contraceptives like Plan B (aka the morning-after pill). Right now, North Carolina high school students learn about all FDA-approved contraceptives, including the morning-after pill. Plan B and other emergency contraceptive methods enable women to take a pill within five days of unprotected sex in order to prevent pregnancy. Easier access to the morning-after pill has resulted in lower rates of teen pregnancy in NC (not to mention, been vital in cases of rape).

janet-colm-planned-parenthoodnc-280Janet Colm is the founder and former CEO of Planned Parenthood of Central North Carolina. She was arrested as part of the Moral Monday protests in July 2013 and lives in Chatham County, NC.




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