The Pill that Changed the World: A Complicated History 

Birth control pills are the most common form of contraception in the United Kingdom, with 28% of women between ages 15 and 49 using them as their main method of contraception. These statistics, however, only show part of the story. Male sterilisation is cited by Statista as the third most common form of contraception. With the average age of a vasectomy occurring around 35, we can assume that if a younger age group, such as 15–35-year-olds were studied, the percentage of women using the pill would be even higher. The point is, that many women use the pill. It is something that is part of a high proportion of people’s everyday life. Figures from The Guardian even show that nine in ten women who receive contraception from GPs or pharmacies are prescribed either the combined or mini pill, with more than 3.1 million women in the UK between 2017 and 2018 taking the pill either as a contraceptive method or as a method of regulating hormones and periods, for which it is often prescribed. If use of the pill is so widespread, then why do we know so little about its history? 

We are often told that oral contraceptives were created by doctors in the 1950s, that married women in England were able to get them in the early 1960s, and that unmarried women were, by 1967, also able to legally acquire them. We are taught that this led to a sexual revolution in the 1960s, the famous ‘Summer of Love’ in San Francisco in 1967. More importantly, we are taught that the availability of oral contraceptives led to a break from outdated frigidity and a shift to modern attitudes towards sex. Notably, this is not true – or at least it isn’t the whole story. 

The story of oral contraception is complicated in two main ways. Firstly, through the idea that contraception was new and led to the ‘scientific liberation of the “feminine spirit”’. Secondly, through the controversial legacy of one woman, Margaret Sanger, a pioneer of the birth control pill and the founder of what would later become Planned Parenthood in the United States. 

The lack of awareness of the long history of contraception seems to start with the 1803 Ellenborough Act in England, which made abortion and drug contraceptives illegal, and with the 1873 Comstock Act in the United States, which made the distribution of contraceptives and most importantly contraceptive information illegal. In his work ‘Contraception and Abortion from the Ancient World to the Renaissance’, John M. Riddle argues that, prior to the Comstock laws, women had knowledge of contraception and controlled childbirth; according to Harriet S. Meyers, this was ‘by law, chemistry and physical acts’. There appears to be a clear repeal in the literature of the idea that contraceptive methods did not exist before the Scientific Revolution facilitated their creation. According to Meyer,  

Riddle argues that the long chain of abortion and contraception knowledge from  antiquity to the present essentially was forged with invisible links made from female vocal cords. 

These ‘female vocal cords’ are unsurprisingly more difficult to find in the records – women were prosecuted as witches for their use of abortifacients and contraceptives, so it is reasonable to assume that they did not write these methods down. But the real nail in the coffin for female-controlled contraception knowledge was the rise of the physician. According to Riddle, medical organisations, churches, and national political institutions gave over fertility control from women and wisewomen to physicians. It is arguable that this medicalisation of contraception, which would have mostly positive repercussions in the long run, slowed down female agency within the practice of contraception and in many cases, marked a step backwards. 

It has been the common view that while there may have been historical ideas on how to avoid unwanted pregnancies, many of these ideas were ‘dangerous, magical and unscientific’. Historians have assumed that antifertility agents could not have worked, and if they did appear to then it was merely coincidental. But, as Meyers notes  

The Classical, medieval, and Renaissance brilliance that built aqueducts and bridges, cathedrals and castles… also created contemporary medical recipes and case histories of contraceptives and abortifacients. These were not charlatanry or empty hope. They successfully regulated conception and birth. 

In his work, Riddle looks at the testing that has taken place in modern labs of historical substances and has found:

Variously exerting antifertility effects chemically, some are isoflavones or uterine contractors or estrogenic steroids that act on the hypothalamus and pituitary glands or prostaglandin stimulants inhibiting sperm transport or uterine implantation.  

In other words, some historical methods worked.   

Another issue within the historiography of oral contraceptives that needs confronting is the legacy of Margaret Sanger. Sanger was termed ‘one of history’s great rebels and a monumental figure of the first half of the twentieth century.’ Sanger’s legacy within the birth control movement is so well-acknowledged that Dr Gregory Pincus, one of the principal developers of the pill, inscribed a 1959 report on oral contraceptives ‘to Margaret Sanger with affectionate greetings – this is a product of her pioneering resoluteness.’ However, Sanger’s darker legacy comes from claims that she was a racist and a eugenicist – these two claims shall be dealt with in turn. 

Claims about Sanger’s racism often come from right-wing political figures. In 2015, Republicans in the US House of Representatives campaigned to remove a bust of Sanger, with Ted Cruz’s office issuing a statement that they disapproved of Sanger’s ‘inhumane life’s work’ and the fact that she ‘advocated for the extermination of African Americans’. Whilst these claims are not completely unfounded, they misrepresent the truth and have been seen to have a negative impact on the perception of Planned Parenthood. As Imani Gandy argues, such claims are frequently used to shame Black women who have abortions. It is perhaps notable that those who are most likely to ‘cancel’ Sanger for what they regard as her racism are those who are anti-choice. So was Sanger racist, or is it just anti-contraceptive propaganda? Planned Parenthood’s article on opposition toward Sanger carefully lays out some of the major ‘facts’ that are commonly used against Sanger. Arguably the most damaging is Sanger being quoted as saying ‘We do not want word to get out that we want to exterminate the Negro population’. Whilst this is a quotation from Sanger, it is taken wildly out of context, and her statement was actually made in response to a 1939 memo written by Dr C. J. Gamble which said that ‘there is great danger that [the Negro Project] will fail because the Negros think it a plan for extermination’. ‘The Negro Project’ was a project undertaken between 1939 and 1942 which Sanger worked on alongside Black leaders such as W.E.B. DuBois, Mary McLeod Bethune, and Reverend Adam Clayton to bring contraception to Black communities in the American South. They opened clinics with Black doctors and nurses providing support to patients, and the project was also supported by Eleanor Roosevelt. Also, there is no evidence that Black women were coerced into taking contraception during the project.  

Whilst Sanger did have some highly controversial views which will be discussed later, she also had some recognisably modern views on what we would consider to be white privilege. In 1945, Sanger said,  

Discrimination is a worldwide thing. It must be opposed everywhere. That is why I feel the Negro’s plight here is linked with that of the oppressed around the globe… the white man is the problem. It is the same as with the Nazis. We must change the white attitudes. That is where it lies. 

However, these views are not the ones often quoted by those wishing to discredit Sanger’s work. 

It is imperative that whilst talking about the positives of Sanger’s work, there is also recognition of the negative and deeply troubling aspects of it, too – namely, Sanger’s role as a eugenicist. Whilst many educated white metropolitan elites within early twentieth American society were eugenicists, that in no way excuses Sanger’s beliefs, nor rectifies the impact that her beliefs had. 60,000 people were sterilised in the US in the twentieth century, with 25% of Native Americans being sterilised between 1970 and 1976 alone—this policy was based upon the 1927 Buck v. Bell decision which allowed for the forced sterilisation of those deemed as unfit to reproduce. Sanger believed that sterilisation was justified when people were ‘feeble-minded’ or ‘mentally defective’, something which should not be ignored when considering her character and her work.   

Sanger’s belief in eugenics is inseparable from her work, and therefore this is something that the pro-choice movement does have to wrestle with. However, if Sanger is viewed as only one important part of the whole history of contraception rather than as the sole figurehead for female bodily autonomy as she is commonly seen, then perhaps she can be treated more with nuance. Under current conditions of polarisation, anti-choice protesters highlight Sanger’s poor qualities and vilify her, while the pro-choice movement often brushes over the bad in order to highlight the great things that she did do. This should be avoided. Instead, we should acknowledge that the history of the pill is long and complex, and we have a duty to learn about in its entirety. 

Written by Sophie Whitehead 


Gandy Imani, ‘How False Narratives of Margaret Sanger Are Being Used to Shame Black Women’, Rewire News Group (2015) 

Kulczycki, Andrzej. “Contraception: A History
Translated by Vicky Russell.” Studies in Family Planning 41, no. 3 (2010): 236–238. 

Latson Jennifer, “What Margaret Sanger Really Said About Eugenics and Race’ TIME (2016) 

Lord, Alexandra M. Condom Nation: The U.S. Government’s Sex Education Campaign from World War I to the Internet. Johns Hopkins University Press, 2010. 

Parry, Manon. Broadcasting Birth Control: Mass Media and Family Planning. New Brunswick: Rutgers University Press, 2013. 

Planned Parenthood, Opposition Claims About Margaret Sanger (2021) 

“Reproduction, History: Eve’s Herbs: A History of Contraception and Abortion in the West.” JAMA: the journal of the American Medical Association 279, no. 1 (1998): 86–87. 

Riddle, John M. Eve’s Herbs: A History of Contraception and Abortion in the West. Cambridge, Mass. Harvard University Press, 1999. 

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