Birth control in America: An evolving picture

BALTIMORE -- Next year marks 100 years since the term “birth control” was coined, and laws and practices have certainly seen a number of changes in that time especially within the last decade.

Forms of birth control have been used for thousands of years with varying degrees of success, according to a report published by Planned Parenthood. Many early methods were dangerous or not very effective.

“What you see is women struggling to find a means that works for them,” said Dr. Carole McCann, professor and the chair of Gender and Women’s Studies department at University of Maryland Baltimore County.

While contraceptive methods were part of public discourse before 1914, McCann explained that year was the first time advocate Margaret Sanger used the term “birth control” synonymously with contraception of all kinds.

The term stuck.

Through much of the early 20th century, it was a violation of federal law to share information about contraceptives, said McCann, who has done extensive research on the issue. There were also a number of states that prohibited the distribution of contraceptive devices or information about them.

To get around the law, contraceptives were branded as feminine hygiene products. Even so, use of the products was publicly condemned, McCann said.

“We have a long history of women’s health needs being tied up with politics and sexual propriety,” McCann said. “That issue continues to plague the provision of women’s health care.”

Birth control options shifted greatly in 1965 as laws began to change following the U.S. Supreme Court decision, Griswold v. Connecticut. The decision struck down a Connecticut law that, until then, made the use of birth control illegal for married couples.

“The court’s landmark decision -- coming five years after oral contraceptives became available to American women and 49 years after Margaret Sanger opened the first birth control clinic in the U.S. -- provided the first constitutional protection for birth control and paved the way for the nearly unanimous acceptance of contraception that now exists in this country,” according to Planned Parenthood.

In 1972, birth control was legalized for all people regardless of marital status, Dr. Kathryn Taber, head of women’s wellness center at Northwest Hospital, said.

Methods and laws surrounding birth control continue to change, particularly in recent years.

“It’s just kind of exploded since 2000," Taber said of birth control developments.

These changes include the introduction of hormone patches, lowered doses of estrogen in oral contraception leading to lower risk for blood clots as well as advances in IUD (Intrauterine Devices) and implantable rods that dispense hormones.

Taber said IUD's and implantable options are increasingly popular in women in their teens and early twenties.

“It is now really encouraged that women who want long term protection -- three to five years without a pregnancy -- use these methods," Taber said.

In years past, these long term options were thought to cause sterilization or infection with prolonged use.

“The data doesn’t support it," Taber said.

She explained that many birth control options also have health benefits outside of preventing pregnancy. Condoms are known to protect against sexually transmitted diseases. Birth control pills and IUD's can help treat several health issues including acne, ovarian cysts, painful periods and endometriosis (a condition in which the uterine lining is outside the uterus).

Birth control methods aren't the only things that have changed in recent years. Laws have also changed.

This summer, the federal government agreed to comply with a judge’s order to allow girls of any age to buy emergency contraception without a prescription. The Affordable Health Care Act requires insurance plans cover eight new preventative services for women without charging them anything out of pocket. Birth control is among these requirements.

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