#17 The History of Contraception
Contraception, Women's Health
Articles used (please see also links throughout the doc which relate directly to certain parts)
https://www.sciencedirect.com/science/article/pii/S1744187006000874
https://pmc.ncbi.nlm.nih.gov/articles/PMC10615352
https://www.damninteresting.com/the-birth-control-of-yesteryear/
https://www.reproductiveaccess.org/2024/03/a-history-the-iud/
https://en.wikipedia.org/wiki/Marie_Stopes#cite_note-85
https://pmc.ncbi.nlm.nih.gov/articles/PMC3520685/
https://litfl.com/gabriele-falloppio/
https://www.webmd.com/sex/birth-control/ss/slideshow-birth-control-history
Disclaimer
This episode includes mention of sensitive topics such as eugenics and sterilisation as well as cultural attitudes towards birth control. This research reflects on past beliefs and practices that may now be seen as outdated and controversial. The purpose of this content is to provide education and not create listener discomfort.
Questions answered by the research (don’t have to use them all!) – can be used as a framework for the podcast episode…
1921 marked the first birth control clinic being set up in the UK in South London by Marie Stopes.
Early attempts to control contraception
involved methods such as
coitus interruptus (the process of a man removing his penis from a woman’s vagina prior to ejaculation) however this method did not prove to be entirely reliable!
Use of materials like cotton or wool and soak in various substances such as oils and fruit juices to form a sort of plug
A female condom was described in Greek lit from 300 BCE
Casanova reported asking his lovers to use lemon halves because high levels of acidity can kill semen
The pulp was scooped and put into the vagina and the rind used as a cervical cap (acting as the spermicide). It semi worked!!
Old Wives’ tales
Old Wives’ tales believed that if a woman did things such as blowing her nose immediately after sex this would prevent pregnancy as well as jumping backwards and shouting loudly this would release the sperm from the body and jumping forward would promote pregnancy.
Herbs (most commonly tansy and pennyroyal) were also used to initiate a miscarriage but required such a high dose that severe damage would have been created to the liver and kidneys
Alongside these common herbs another plant was very in demand in ancient Greece
Silphium plants (giant fennels) became highly popular in Greece and eventually all through ancient Europe, Africa and Asia.
It was considered an effective contraceptive at the time
It is unlikely if we will ever determine if it was an effective contraceptive as it became extinct by the end of the first century AD
1564 marked the initial stages of the first condom!
Developed by Gabriele Fallopio
Whilst he managed to get 1100 men to trial his linen sheath coated in lotion, he reported that none developed STIs but didn’t actually find the efficacy of the sheath as a contraceptive method
More about Gabriele Fallopio
Initially named the fallopian tubes “uteri tuba” (tuba translates to trumpet in Latin) because he thought they looked like musical trumpets. Tubae is plural or tuba and when it entered the English language doctors misread tubae for tube and created the now know fallopian tubes! – QI medley of Maladies
When Gabriele was 10 his father passed away from Syphilis which led to his investigation on the effectiveness of condoms to prevent Syphilis as explained above.
Condoms
Early condoms were made from animal intestines or bladders as well as treated linen
Whilst some believe the word condom comes from the doctor who supplied King Charles II with sheaths it is more plausible that the name is actually derived from the Latin word Condus translating to receptacle
When the process of vulcanising rubber came about in 1839 condoms started to become more readily available and accessible.
This was furthered by the development of liquid latex making condoms stronger and safer in mid 1930s
Since 1990s Polyurethane condoms have been available which are thinner than latex ones and less likely to break and be affected by heat or lubricants making them a more effective form of contraception
Female barrier methods
Early barrier methods for females involved trialling many different materials to Casanova advocated for the use of a half-squeezed lemon as a female barrier method whilst French women preferred the use of sponges soaked in brandyattempt blocking sperm entering the vagina
These included fabric, paper discs and fruit,
The main method of female contraception was one promoted by Marie Stopes. Cervical caps were used from the 1920s until the contraceptive pill was developed and then became the most used contraceptive for women
Female barrier methods were often used in conjunction with spermicide
Modern spermicides, developed in 1950s come in the form of creams, gels, foam or suppositories
An early form of spermicide came from the ancient Egyptians who inserted pessaries containing crocodile dung, honey and sodium bicarbonate.
However, these pessaries promoted sperm mobility due them being alkaline.
Marie Stopes https://www.bbc.co.uk/history/historic_figures/stopes_marie_carmichael.shtml
https://en.wikipedia.org/wiki/Marie_Stopes#cite_note-85
Born in October 1880
Stopes developed first birth control clinic in Britain in South London in 1921
Offered free service to married women on family planning and also gathered data on contraception
1925 – the clinic moved into central London and other clinics opened across the country
In 1911, she married Reginld Ruggles Gates but their relationship broke down when Marie realised he was impotent and therefore the marriage had been unconsummated. The marriage was annulled in 1914
As a result of this she wrote her first book titled “Married Love” published in 1918
The book was considered highly controversial due to the discussion of topics such as birth control and sex within marriage – a big taboo topic at the time. This resulted in the church, press and medical establishment condemning the book.
However, the book became very popular and many women wrote to her for advice.
Eugenics and Sterilisation
When June Rose wrote Stopes’ biography she alluded to the idea that Stopes was in favour of the Eugenics movement. This was furthered by her joining the Eugenics education Society in 1912
Stopes furthered this by advocating for the compulsory sterilisation of people considered unfit for parenthood in both 1918 and 1920.
Intrauterine devices (IUDs)
https://www.reproductiveaccess.org/2024/03/a-history-the-iud/
The first IUD developed was made from silkworm gut by Dr Richard Richter in 1909
This was then furthered by Karl Prust, Ernest Gräfenberg, and Tenrei Ota who developed similar versions of this
Gräfenberg later formed a version of this ring with pure silver wrapped around the ring
However, what ended up happening was the silver was absorbed and as a result people’s gums would turn a blue-black colour
This resulted in him developed another variation with a wire made from an alloy of a mix of metals surrounding the ring which resulted in the pregnancy rate decreasing to 1.6%
IUDs became used on a larger scale in 1960s when flexible plastic devices were developed
Since then, copper IUDs have been most commonly used and can now be left in place for up to 10 years.
The Dalkon shield
Around the time when IUDs became very popular one of the IUDs marketed known as the Dalkon Shield became linked to pelvic infections and mortality due to the nature of its tail string which caused bacteria to travel from the vagina into the uterus
Hormonal contraception
Hormonal contraception first became a thing in 1920s when the roles of oestrogen and progesterone in reproduction were discovered
Dr Russell Marker (American Chemist) discovered plants containing certain hormone substances in 1940s so began to purify progesterone from yams
As a result of this discovery, synthetic forms of progesterone were formed (known as progestogens) because it was quickly realised progesterone does not absorb
1956 marked the first trial of the combined contraceptive pill in Puerto Rico and the first combined pill became available to buy in the USA in 1960
End of 1960s the pill had some associated risks such as blood clots and strokes. Early pills contained high amounts of oestrogen but by 1973 the first pill to contain a small amount of oestrogen was developed
Low dose progesterone-only pills were also created around a similar time
the contraceptive pill
Developed during 1950s by a group of American scientists led by Dr Gregory Pincus and supported by Margaret Sanger
First oral contraceptive became available to buy in 1960 in USA under the name Enovid
Britain trialled the pill at the time and had mixed results but still approved its distribution through the NHS
The pill changed how contraceptives were accessed — it required medical advice.
This meant doctors and pharmacists took on a greater role in contraception.
As a result, the medical profession became more involved in family planning services.
Sterilisation
Vasectomies started out as a treatment for an enlarged prostate gland
It quickly became realised the impact on fertility that vasectomies had and as a result they were used for eugenic sterilisation
1907 in Indiana first law passed allowing compulsory sterilisation of people in state institutions who were:
“Confirmed criminals”
“Idiots”
“Rapists”
“Imbeciles”
This was adopted by 29 other states over time
First sterilisation of a woman was in 1881 in Ohio and involved blocking the fallopian tubes
By 1974 vasectomy was a widely accepted method of male sterilisation
China also developed a no-scalpel method of sterilisation which was faster and less invasive
Impacts of contraception https://www.webmd.com/sex/birth-control/ss/cm/slideshow-mini-pill
Early contraception developed after the population spike in the 20th century
This allowed women to have more control over pregnancy and there for more autonomy
Especially important as pregnancy still risky at this time and so meant lowered overall maternal mortality rate
Early contraception involving chemicals were dangerous and fatal
E.g Lysol soap in the great depression was used.
Lysol is a sanitiser used to clean door handles and countertops and not meant to be used on the skin let alone on the vagina
Unsurprisingly women reported inflammation and burning as a result of using and some even died from it.
Another contraceptive method used was a wooden block placed in the vagina
Luckily it was banned in 1930s when it was declared an instrument of torture
The impacts of the block must have been extremely painful!
Some crazy contraceptives (from around the world)!! https://www.bbc.co.uk/bbcthree/article/e671cb02-4e5e-4f52-a835-25a5dd2a5963#:~:text=Casanova's%20lemon&text=This%20method%20involves%20half%20a,bathroom%2Dfresh%20all%20day%20long.
Ancient Greeks used to drink Blacksmith water (the stuff the blacksmith used to clean his tools)
Efficacy? Blacksmith water was filled with lead which worked as a contraceptive but had bad side effects obviously (nausea, kidney failure, seizures)
It was still being used as recently as WW1
Ancient Egyptians used to put crocodile dung up the vagina as a barrier method of contraception
In Canada in the 1500s people would dry the testicles and grind them into a powder and mix it with a very strong homemade alcohol known as moonshine
This was supposedly a contraceptive though it actually didn’t do much other than get people drunk
In Ancient China (around 900 BC) women were advised to swallow 16 tadpoles fried in Mercury straight after sex. This essentially acted as a form of poison
Whilst it worked as a contraceptive it also caused major damage to liver, kidneys and other organs and sometimes death
Ancient Sumatrans used the opium poppy plant as a contraceptive by inserting the seed pods into their bodies or sometimes even inserting the flower itself
The efficacy? Unknown
Not even that long ago (60 years ago!) Women would pour Coca Cola into their vagina as they believed it would work as a contraceptive
The theory behind this was that the sugar would explode the sperm cells and the carbonation would force the liquid up into the vagina
Modern contraceptives
Modern contraceptives are highly effective compared to older methods and offer a far safer solution
Emergency contraception, initially developed in late 1960s has come a long way and now had far safer levels of hormones for women to take
Long acting methods of contraception can include hormone injections which can be effective for up to 3 months and the implant in the r=form of a rod which can be inserted into the arm
Whilst women have mostly dominated the contraceptive history, male contraceptives have developed at a much slower rate besides condoms and vasectomy
Research is still evolving around male contraceptives, but gels and pills are being developed to stop sperm production in the short-term
There is also research being done on a non-hormonal male contraceptive pill
https://www.popularmechanics.com/science/a65486559/male-birth-control/
Researchers found no noticeable side effects
The pill works by stopping sperm production through targeting a molecule involved in this production however it does not affect hormones
Animal studies showed the effect to be reversible and once treatment is finished normal fertility returns
The trial done on this pill appeared safe and effective, but it is still in its early stages
Not only could this impact be a groundbreaking development but could also take the burden off women and provide more safety and security for women in sex and enable more freedom for these women and making birth control a shared responsibility where everyone has choices.
Ancient and Early Contraception Methods
What were some of the earliest methods used to prevent pregnancy, and how reliable were they?
How did ancient cultures use herbs and natural substances like tansy, pennyroyal, and silphium in birth control?
What were some of the strange or harmful contraceptive practices based on folklore or “Old Wives’ tales”?
What extreme or dangerous contraceptive methods were used around the world, such as tadpoles in Mercury, crocodile dung, or Coca-Cola?
How did early methods like coitus interruptus, lemon halves, or herbal pessaries reflect the understanding of reproductive biology at the time?
Condoms and Barrier Methods
Who was Gabriele Fallopio, and what role did he play in the early development of condoms?
How did the materials and technology of condoms evolve from ancient times to the modern era?
What female barrier methods existed before the contraceptive pill, and how effective were they?
How were spermicides developed and used historically, and what were their early forms?
How did innovations like vulcanized rubber and polyurethane improve condom safety and accessibility?
How did male and female barrier methods differ across cultures and time periods?
Marie Stopes and Early 20th Century Family Planning
How did Marie Stopes contribute to the birth control movement in the UK, and what services did her clinics provide?
Why was Marie Stopes’ book Married Love controversial, and how did it impact public discussions about contraception?
What connections did Marie Stopes have to the eugenics movement, and how did that influence her views on sterilisation?
Intrauterine Devices (IUDs)
What is the history of the intrauterine device, and how did it develop into the forms used today?
What problems were associated with early IUDs like the Dalkon Shield, and how did that affect public perception?
Hormonal Contraception and the Pill
What scientific discoveries about hormones led to the development of hormonal contraception?
How was the contraceptive pill developed, and what were some early challenges and health concerns?
How did the introduction of the pill change the role of doctors and pharmacists in family planning?
How did early trials of hormonal contraception in Puerto Rico and the USA shape public opinion and regulation?
How did developments in low-dose and progesterone-only pills reduce health risks?
Sterilisation and Eugenics
How did vasectomies evolve from medical treatment to a method of sterilisation linked to eugenics?
What laws enabled compulsory sterilisation in the early 20th century, and what groups were targeted?
How did sterilisation techniques evolve globally, including innovations like China’s no-scalpel vasectomy?
How did early sterilisation methods for women develop, and what were their medical and social implications?
Impacts of contraception
How did contraception influence population growth and maternal mortality in the 20th century?
How did contraception change women’s autonomy, sexual health, and access to family planning?
What dangers were associated with early chemical contraceptives, and how were unsafe practices addressed?
How have modern contraceptives, including emergency contraception and implants, improved safety and effectiveness?
How has male contraception developed over time, and what future developments could change gender roles in family planning?
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