The Pill at 50: Unhappy Un-Birthday

Posted on | May 8, 2010 | 52 Comments

The 50th anniversary of The Pill — oral contraceptives were first marketed in May 1960 — has resulted in a good deal of thoughtless journalism. Gail Collins spins a wondrous myth of The Pill as the pharmaceutical sunshine of a sexual-scientific enlightenment.  The Associated Press calls The Pill “America’s favorite birth control method,” which is not true:

Female Sterilization is the method used by 17.8% of American women 15-44. . . . Oral Contraceptives are second at 17.3%.

Well, having cleared up that little misconception about contraception, how about the idea that The Pill, by erasing worries about pregnancy, enhances women’s sexuality? Also not true:

Researchers found a link between using hormonal contraception and female sexual dysfunction, a condition most often caused by a lack of desire.
The findings back up previous anecdotal evidence that the pill reduces libido and also calls into question the long term use of the contraception especially in ever younger women. . . .
The researchers found that the women who took hormonal contraception suffered the most sexual dysfunction . . .
Dr Irwin Goldstein, Editor-in-Chief of the Journal of Sexual Medicine, said this had huge implications for women at the beginning of their sexual lives.
“The irony is that these women are provided a medication that enables freedom from reproductive worries but these same women are not provided information that there are significant adverse sexual effects that may ensue,” he said.
“Agents that interfere with the hormonal milieu of women may adversely affect their sexual lives.”

To anyone with a basic knowledge of biology, isn’t it just common sense that there would be serious side effects from administering artificial hormones to an otherwise healthy person? And yet the Contraceptive Culture has become so pervasive that this common-sense skepticism is seldom even voiced, let alone taken seriously — until people start dying. Let’s hear from the tort bar about that little problem:

Regarding pregnancy, [a recent Time magazine] article says that “63 percent say they know little or nothing about birth control pills, and much of what they think they know is wrong.” I would venture a guess that over 63 percent are unaware of more than 1,100 lawsuits filed by women who were injured after using Yaz or Yasmin, and that women taking these fourth-generation pills containing the hormone drospirenone face a risk twice as high as other oral contraceptives. Research has shown that 35 to 40 women out of 100,000 experience thromboembolic effects (formation in a blood vessel of a clot that breaks loose and is carried by the blood stream to plug another vessel) each year.
Nowhere did this in-depth article mention the risks involved in fourth-generation birth control pills, nor did it mention countless women who have suffered — and some have died — from Yasmin and Yaz.

The recent Time magazine article on the 50th anniversary of The Pill included this heavily freighted sentence:

“Its supporters hoped it would strengthen marriage by easing the strain of unwanted children; its critics still charge that the Pill gave rise to promiscuity, adultery, and the breakdown of the family.”

Well, the critics were right, of course. And what is seldom comprehended — even by most people who consider themselves pro-life — is this: Contraception causes abortion.

The Arithmetic of Death

I don’t mean merely that methods like The Pill and so called “emergency contraception” can act as abortifacients, although that is certainly true. What I mean is that all contraceptive methods, except abstinence or surgical sterilization, have a failure rate. And when contraception fails, abortion is a likely consequence of the unexpected pregnancy that results.

Let us stipulate, arguendo, that The Pill is 98% effective. Sounds “safe,” huh? But what that means is that The Pill fails in 1 out of 50 uses. Now apply The Law of Large Numbers to that statistic: With hundreds of thousands of American women relying on The Pill to keep them “safe,” there are then many thousands of women each year who are surprised to find themselves pregnant anyway.

Given that they wouldn’t have been taking The Pill if they felt they were ready for motherhood, and quite justified in feeling that their pregnancy is unfair — they were doing what they had been told was the “responsible” thing, and this unintended outcome was not due to their failure — these women easily convince themselves that abortion is now necessary.

Therefore, it was hardly surprising that the decade after The Pill was introduced, there was an alarming rise in abortion. It is true that illegal back-alley abortionists — as well as more “respectable” doctors who sometimes performed abortions privately and illegally — had existed for decades. But after the advent of The Pill in 1960 (just as the first Baby Boomers were becoming teenagers), hospitals experienced a horrifying influx of bleeding and infected victims of botched abortions. If you go back and read contemporary accounts of the abortion debate in the late ’60s, you discover that the pressure for legalization came not so much from radical feminists or sexual revolutionaries as from doctors and nurses who were simply exhausted by this dreadful problem.

The Pill — and the accompanying media hype about how this scientific miracle would free women of sexual worries  — was therefore a major paving stone on the road to Roe v. Wade.

Unnatural Ideas Have Natural Consequences

More generally, The Pill fostered a prevalence of the belief that sex without pregnancy is normal. This utterly unnatural idea is the foundation of the Contraceptive Culture.

Throughout human history, recognition of the natural connection between sex and procreation was fundamental to society’s laws, customs, attitudes and behaviors in regard to relationships between men and women. These traditions had varied from place to place, and shifted slowly from time to time, but in all times and all places, social norms had been founded on the understanding that sex and pregnancy were intrinsically linked. Indeed, from a strictly biological perspective, reproduction is the sole purpose of sex.

The Contraceptive Culture, by contrast, is based on the negation of what we may rightly call natural sexuality. As previously mentioned, The Pill was launched in 1960 with a blitzkrieg of media hype, much of it sponsored by non-profit foundations. Historian Donald L. Critchlow chronicled this phenomenon in his excellent 2001 book, Intended Consequences: Birth Control, Abortion, and the Federal Goverment in Modern America, and as I explained last July:

The population control movement . . . was largely the brainchild of John D. Rockefeller III. Rockefeller funded much of the movement himself and through a number of family trusts and foundations, and he encouraged other foundations (Ford, Scaife, Carnegie) to do the same. . . .
[B]etween 1959 and 1964 one organization alone, the Population Council, got more than $5 million from the Rockefellers, $8.4 million from the Ford Foundation and $2.1 million from Scaife. So that’s $15 million in five years, back when a million dollars was a lot of money.

The Population Council was among a number of groups that helped promote positive publicity for The Pill, a P.R. campaign orchestrated by some of the best marketing strategists in the business. Among the ideas central to that public-relations blitz were (a) that unwanted pregnancy was a horrible burden on families, as well as on society at large, and (b) that The Pill, by exempting women from the dreaded prospect of becoming pregnant, would usher in a carefree new era of sexual fulfillment.

What actually happened, of course, was something quite different.  The 1960s were a decade of unprecedented increases in divorce, drug abuse and teen suicide. Most especially, the ’60s saw skyrocketing rates of sexually-transmitted diseases, an ugly reality that Tom Wolfe described after visiting San Francisco in 1968, the year after the famous “Summer of Love”:

At the Haight-Ashbury Free Clinic, there were doctors treating diseases no living doctor had ever encountered before, diseases that had disappeared so long ago they had never even picked up Latin names, diseases such as the mange, the grunge, the itch, the twitch, the thrush, the scroff, the rot.

So if the Contraceptive Culture failed to deliver on its propaganda promises of sexual bliss, does this mean that The Pill has failed? Not in the least.

What ‘Success’ Looks Like

Remember that the promoters of The Pill weren’t really interested in their product’s alleged emotional benefits or personal convenience to women. Both the development of The Pill and its marketing campaign were funded by wealthy donors who could fairly be described as fanatical advocates of population control.

In this regard, it is important to note that by the time The Pill was introduced in 1960, the Baby Boom peak of the U.S. birth rate had already passed. From 1952 to ’57, the rate had exceed 25 births per 1,000 population, with the total fertility rate (TFR, i.e., projected lifetime births per woman, based on current annual rate) peaking at 3.77 in 1957. The birth rate declined 6.3 percent (from 25.3 to 23.7 births per 1,000) from 1957 to ’60, a 2.1 percent average annual decrease which if extrapolated forward would have amounted to a decline of more than 30 percent (to about 17.5 births per 1,000) by 1972.

What this means is that the propaganda push which accompanied the introduction of The Pill — ushering in the Contraceptive Culture — came at a time when birth rates were already beginning to trend downward. The result was what can only be described as demographic overkill:

Year       Birth Rate    Total Fertility Rate
1957 . . . 25.3 . . . . . . . 3.77
1958 . . . 24.5 . . . . . . . 3.71
1959 . . . 24.3 . . . . . . . 3.69
1960 . . . 23.7 . . . . . . . 3.65
1961 . . . 23.3 . . . . . . . 3.62
1962 . . . 22.4 . . . . . . . 3.46
1963 . . . 21.7 . . . . . . . 3.31
1964 . . . 21.0 . . . . . . . 3.19
1965 . . . 19.4 . . . . . . . 2.91
1966 . . . 18.4 . . . . . . . 2.72
1967 . . . 17.8 . . . . . . . 2.55
1968 . . . 17.5 . . . . . . . 2.46
1969 . . . 17.8 . . . . . . . 2.46
1970 . . . 18.4 . . . . . . . 2.48
1971 . . . 17.2 . . . . . . . 2.27
1972 . . . 15.6 . . . . . . . 2.01
1973 . . . 14.9 . . . . . . . 1.87
1974 . . . 14.9 . . . . . . . 1.83
1975 . . . 14.8 . . . . . . . 1.77
1976 . . . 14.8 . . . . . . . 1.74

In the decade 1957-67, the birth rate declined 23.3 percent, and TFR declined 27.8 percent. Demographers refer to a TFR of 2.1 as the “replacement rate,” at which births are sufficient to replace the existing population (2 parents, 2 babies, with a 0.1 allowance for infant mortality, etc.) in modern industrial nations. The U.S. fell below 2.1 TFR in 1972 — the year before the Supreme Court’s landmark Roe v. Wade ruling.

By 1976, the U.S. birth rate declined still further to 14.8 (41 percent below the 1957 rate) while TFR declined to 1.74 — 54 percent below 1957 TFR and, significantly, 17 percent below “replacement rate.” It was not until 1987 that the total fertility rate again reached as high as 1.9. Not until 2006 did TFR again reach the replacement level of 2.1; the United States experienced sub-replacement fertility for 34 consecutive years.

The social, economic and political consequences of this demographic decline — the “graying of America” — have been widely discussed (see, for example Mark Steyn’s America Alone.) Whatever those consequences might be, we might shrug with indifference if it were the case that all this was the result of people acting independently and voluntarily in accordance with their own wishes, based upon a more or less rational assessment of their own needs and interests. This is not the case, however, because Americans were deliberately misinformed, their opinions actively influenced and, in some cases, their choices directly controlled, by the population-control advocates who popularized The Pill.

False ‘Crisis,’ Real Results

In 1967, by which time birth rates were already declining rapidly, an influential article in Science magazine was published by Kingsley Davis, a University of California professor who had been a leading population-control advocate for 20 years. Davis complained about colleagues who believed that “something they vaguely call population control can be achieved by making better contraceptives available,” a belief he declared to be dangerously mistaken:

“By sanctifying the doctrine that each woman should have the number of children she wants, and by assuming that if she has only that number this will automatically curb population growth to the necessary degree, the leaders of current policies escape the necessity of asking why women desire so many children and how this desire can be influenced.”

Davis advocated not merely greater efforts to influence women’s desires, but also coercive government measures to achieve the sort of “drastic” reductions he believed necessary. Keep in mind that the American public was already being bombarded by anti-baby propaganda, as Critchlow chronicles in Intended Consequences:

[T]o raise the public’s consciousness about the threat of overpopulation . . . the population movement undertook a concerted public relations campaign through a steady stream of books, pamphlets, and magazine and newspaper articles. This campaign was aided by the involvement of key publishers and editors who were actively involved in the movement, including George Hecht, editor of Parents Magazine. The drumbeat around the population crisis reached crescendo by the early 1960s. Readers of popular magazines were faced with a barrage of articles warning of an impending population crisis . . . Women readers were inundated with articles like “Are We Overworking the Stork?” (Parents Magazine, 1961), “Why Americans Must Limit Their Families” (Redbook, 1963), “Intelligent Woman’s Guide to the Population Explosion” (McCall’s, February 1965), “Overpopulation: Threat to Survival” (Parents Magazine, 1967) and “Population Increase: A Grave Threat to Every American Family” (Parents Magazine, 1969).

This incessant output of birth-control propaganda reached its apex with the 1968 publication of Paul Ehrlich’s book, The Population Bomb, which went through 13 printings in two years with the help of a massive publicity campaign that included Ehrlich’s multiple appearances on “The Tonight Show.”

Having fomented a false sense of crisis — issuing dire warnings about overpopulation even while U.S. birth rates were declining precipitously — the population-controllers then pushed through Congress the “Family Planning Services and Population Research Act of 1970,” known as Title X. From the official federal description:

The Title X program is designed to provide access to contraceptive services, supplies and information to all who want and need them. By law, priority is given to persons from low-income families. . . .
In fiscal year 2006, 88 Title X grantees provided family planning services to approximately five million women and men through a network of more than 4,400 community-based clinics. . . . In approximately 75% of U.S. counties, there is at least one clinic that receives Title X funds and provides services as required under the Title X statute. . . .
The Title X program also supports three key functions . . . (1) training for family planning clinic personnel through ten regional general training programs and three national training programs that focus on clinical training, enhancing quality family planning services for males, and/or coordination of training activities on the national level; (2) data collection and family planning research aimed at improving the delivery of family planning services; and, (3) information dissemination and community based education and outreach activities.

Title X resulted from a 1969 request by Richard Nixon (not exactly a progressive hero) to create a Commission on Population Growth and the American Future and, in signing Title X into law, Nixon said:

This measure provides for expanded research, training of manpower, and increased family planning services. In addition, it provides for the development of family planning and population growth information and education.

Note that word “education.” Few appreciate the degree to which the population-control message was embraced by textbook publishers and the public school system, and promoted with the assistance of federal grants under Title X. This was in addition, of course, to the cooperation between Title X clinics and school officials to refer teenagers for “family planning services,” with or without parental consent.

It would be worth the effort and expense, I think, for some pro-life organization to commission scholarly research into the content of the “information and education” disseminated with Title X funding, especially during the 1970s when — as Nixon noted in his signing statement — such programs enjoyed “strong bipartisan support.” (The pro-life “family values” movement did not become an influential force in GOP politics until the 1980s.)

Research into Title X’s education element might examine whether there was adequate emphasis on the health risks and failure rates of various contraceptive methods, the potential complications of abortion, and the dangers of sexually-transmitted disease. It would seem obvious that these risks were inadequately emphasized, when you consider the prevalence of abortion and STDs among the “persons from low-income families” toward whom Title X was targeted. (Does anyone familiar with the political climate of 1970 doubt that “low-income families” was a euphemism for “ghetto blacks”? And does anyone doubt that this accounted for the “strong bipartisan support” of which Nixon boasted? Is anyone surprised to learn that, 40 years into the Title X program, blacks account for 36 percent of all abortions in the U.S.?)

Across the Barren Plain

What is at issue is whether, given the “crisis” atmosphere incited by population-control advocates, women were properly informed about the consequences of the choices they were being encouraged to make. Because as we approach Mother’s Day 2010, half a century past the advent of The Pill, more American women than ever are childless:

About 18 percent of women ages 40 to 44 in 2002 had never had a child, compared with 10 percent in 1976. Women in the same age group, on average, had 1.9 children in 2002, considerably fewer than the 1976 average of 3.1 children . . .

In case you flunked statistics, that’s a 90 percent increase in childlessness (and a 39 percent decline in the number of children borne by the average woman) in the span of a single generation. It would be one thing if all these childless women were “childless by choice,” but they aren’t. The mainstream media has given insufficient notice to America’s silent plague of infertility, a direct consequence of the Contraceptive Culture.

“Fertility delayed is fertility denied,” as demographers say, and a major effect of the Contraceptive Culture has been to encourage women to delay motherhood. The average age of U.S. first-time mothers is now over 25 — four years later than in the 1970s — and this trend has consequences, including an increase in the number of women who will never become mothers:

Marcelle Cedars, a reproductive specialist at the University of California-San Francisco, said that fertility in women peaks around age 22 and that pregnancy becomes much more difficult to achieve after age 35. After age 35, “[e]ach egg is more likely to be genetically abnormal. And a genetically abnormal egg is less likely to fertilize,” Cedars said, adding, “It’s less likely to develop. It’s less likely to implant. If it implants, it’s more likely to miscarry.”

Beyond this inescapable fact of age-related infertility, there is the damage to women’s reproductive systems wrought by STDs. A half-century ago, nearly all public-health efforts to control “veneral diseases” (as they were once known) focused on syphilis and gonorrhea, infections that were readily diagnosed and treated with antibiotics.

Ah, but that was before The Pill unleashed that pathological avalanche of “the mange, the grunge . . . the scroff, the rot” which Tom Wolfe saw doctors confronting in Haight-Ashbury clinics in ’68. These exotic disorders were eventually disagnosed with appropriate Latin terminology, by which time they were far less exotic than had been true in the immediate aftermath of the Summer of Love.

Nowadays, once-rare STDs like herpes, chlamydia and human papillomavirus (HPV) are quite widespread, resulting in an increased number of severe obstetric complications. As a recent Los Angeles Times article reported:

Chlamydia infections in the United States now top 1.1 million, the most since record-keeping for the disease began . . .
Women bear the brunt of both chlamydia and gonorrhea, especially their long-term consequences, CDC officials said.
Untreated, both can lead to pelvic inflammatory disease — an infection of the uterus and fallopian tubes that can cause chronic pain, infertility and life-threatening ectopic pregnancy, or pregnancy outside the uterus. . . .
The report found that chlamydia infections occurred at a rate of about 370 per 100,000 people in 2007. That’s a 7.5% increase from 2006. . . .
[M]any people with the disease are not identified, and public health officials believe that the true number of chlamydia infections is closer to 3 million.

In a nation of 300 million people, it may seem inconsequential that 1% are infected with chlamydia, except that (a) the infection rate is certainly much higher among sexually-active young people, with children and the elderly being largely exempt from the pandemic, and (b) the infection rate appears to be increasing rapidly. And here’s a news story for which an appropriate headline might be, “Sexual revolution triumphs; women, minorities hardest hit”:

About 16 percent of Americans between the ages of 14 and 49 are infected with genital herpes, making it one of the most common sexually transmitted diseases, U.S. health officials said on Tuesday.
Black women had the highest rate of infection at 48 percent and women were nearly twice likely as men to be infected, according to an analysis by the U.S. Centers for Disease Control and Prevention.
About 21 percent of women were infected with genital herpes, compared to only 11.5 percent of men, while 39 percent of blacks were infected compared to about 12 percent for whites, the CDC said.

Let’s not forget about the carcinogenic virus HPV:

Data from a national study suggests that about one in four U.S. females between the ages of 14 and 59 years may have the sexually transmitted infection human papillomarivus . . .

And there’s more:

A groundbreaking study . . .found more than half (56 per cent) of young adults in a new sexual relationship were infected with human papillomavirus (HPV).

Given the increasing prevalence of STDs, what about the reproductive consequences? The American Fertility Association:

Every year, people trying to create families make the awful discovery that their ability to achieve or sustain a pregnancy is compromised by the effects of an STD . . .
[O]ne in ten U. S. couples are affected [by STD-related infertility] . . .

These are the unintended medical consequences, then, of those promises of consequence-free sex that accompanied the introduction of The Pill. The population-control fanatics inadvertantly got what they wanted — a drastic decline in fertility — by ensuring that many thousands of women never got the children they might have wanted.

An Expert Prediction

If these specific consequences were entirely unintended, however, not all consequences of the Contraceptive Culture were entirely unforseen, and one expert made a few remarkable predictions in 1968:

[C]onsider how easily [the widespread acceptance of artificial contraception] could open wide the way for marital infidelity and a general lowering of moral standards. . . .
Another effect that gives cause for alarm is that a man who grows accustomed to the use of contraceptive methods may forget the reverence due to a woman, and, disregarding her physical and emotional equilibrium, reduce her to being a mere instrument for the satisfaction of his own desires, no longer considering her as his partner whom he should surround with care and affection.

Not all experts are recognized as scientific, of course, but a recent analysis by economist Timothy Reichert largely confirmed that prediction:

According to Reichert . . . contraception separates the traditional mating “market” into two separate markets: a market for marriage, and a market for free sex, created thanks to the significant cost reduction of sex uncoupled from pregnancy. . . . .
As it turns out, Reichert maintains, women end up entering the marriage market in greater numbers than men . . . Meanwhile, the economist notes that men . . face far fewer incentives to move from one market to the next.
“The result is easy to see,” writes Reichert. While women have higher bargaining power in the sex market as the “scarce commodity,” he writes, “the picture is very different once these same women make the switch to the marriage market”: “The relative scarcity of marriageable men means that the competition among women for marriageable men is far fiercer than that faced by prior generations of women.
“Over time, this means that the ‘deals they cut’ become worse for them and better for men.”

Ain’t that a kick in the head, ladies? The Pill has not only increased your potential for STDs and infertility, but also increased the chances you’ll marry a loser. Similar findings are cited by author Mary Eberstadt:

Eberstadt provides numerous examples of secular researchers who have followed the data, vindicating each and every one of Paul VI’s four primary predictions about the consequences of contraception: “a general lowering of moral standards throughout society; a rise in infidelity; a lessening of respect for women by men; and the coercive use of reproductive technologies by governments.”

Such are the unhappy consequences of the unnatural ideas of the Contraceptive Culture. A half-century after The Pill was introduced, there are more women than ever who will spend Mother’s Day hopelessly and inconsolably alone.

No tiny arms will embrace them, no childish smiles will greet them, no little hands will scrawl their love for “mommy” on a card, nor will these lonely women ever know a mother’s incomparable pleasure in hearing the sweet music of her children’s laughter.

I heard Satan laughing with delight
The day the music died.

What an unhappy “birthday” this is.

UPDATE: Understanding that the extreme length (4,400 words) can make for difficult reading online, I’ve cross-posted this essay at the Hot Air Green Room, which offers a print-friendly version.

As to the statistical arguments in the comment field over the actual failure rate of The Pill, this is a distraction from the larger point: The Pill is not fool-proof, and certainly there has been no shortage of fools in the past half-century who screwed around because they thought The Pill made it “safe.”

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