Efforts to prevent pregnancy can be traced as far back as ancient Greece. Until just a few decades ago, however, women relied on breastfeeding which serves as an effective means of contraception through suppression of ovulation. Throughout the centuries, women's diaries described their lives in a permanent transition from pregnancy to breastfeeding and then back to pregnancy. Freeing oneself from the constant act of reproduction was regarded as the key to liberation.
The first birth control clinic was opened in 1916, in Brooklyn, New York, by Margaret Sanger, becoming a major catalyst for changing laws pertaining to the use and dissemination of contraception. The clinic remained open for 10 days and served 500 women during that time. However, it was forced to close, as it was challenged by the Comstock Law of 1873, which deemed information on birth control obscene, and outlawed its distribution. In 1936, U.S. v. In a package, Margaret Sanger and federal laws on birth control were successful in arguing that physicians were exempt from provisions of the Comstock Law that restricted the dissemination of information on contraception. In Griswold v. Connecticut (1965), the Supreme Court overturned one of the last state laws restricting the use of contraceptives by married couples. Several various types of initiatives were aimed at funding family planning services, first in 1965 through the War on Poverty, funded by the Office of Economic Opportunity; and later in 1970 (Title X), a federally funded program to serve low-income women.
In the early 20th century, corticosteroids, the rhythm method, early versions of condoms and diaphragms, abortion, and surgical sterilization were common methods of birth control. At the end of the century, the birth control pill, first approved as a treatment for irregular periods and menstrual cramps, became the most widely used form of reversible contraception. The Food and Drug Administration (FDA) approved the use of birth control pills in 1960. Early versions of the birth control pill contained high levels of estrogen; their use was associated with elevated risks of blood clots, heart disease, and stroke. As a result, increasing use was made of contraceptives that carried fewer systemic effects, such as diaphragms and condoms.
The intrauterine device (IUD), first introduced in the 1960s, was later discontinued in the 1980s, following the FDA's 1974 ban on the use of one type of IUD, the Dalkon Shield, due to its association with uterine infections. In the 1990s, longer-acting and reversible forms of contraceptives were introduced, such as Norplant (implant) and Depo-Prova (injectable). The latter product, which was often prescribed to young, sexually active women, was seen as a product that may have contributed to the decline in teenage births in the United States during the previous decade. Condom use subsequently increased as a result of the HIV/AIDS epidemic, as it also presented an effective way to prevent sexually transmitted diseases (STDs).
Despite these advances in the development of effective methods of contraception, the topic of birth control remains taboo, and many pregnancies occur without planning, and/or are intentionally terminated. The use of contraceptives requires careful planning; unfortunately, access to contraceptives can be limited in some circumstances. The use of some of the most effective forms of family planning methods require consultation with a physician and a willingness to undergo a gynecological examination. This is a significant barrier for young women, who may also find a physical examination and disclosure of their sexual history to health care providers embarrassing and/or frightening. For others, this process is difficult or impossible due to financial barriers, including lack of adequate insurance, or logistical difficulties, such as travel and childcare. While the responsibility for ensuring family planning is ideally shared by sexual partners, the burden associated with unsafe sexual activity is typically borne by women.
