The pill

Contraception in Ancient History

sepia drawing of a man carrying two baskets, with more people harvesting plants or roots in the distance, a large botanical root is pictured in the foreground

After thousands of years of development, relatively safe and reliable ways to prevent unwanted pregnancies are widely available. But before modern birth control methods were in place, numerous other contraceptives were invented, tested, and either adopted or discarded. In this opening chapter, we revisit early strategies to control pregnancies before the invention of the pill.

Greece and Rome

In ancient Greek and Roman times, silphium - a plant generally used for seasoning - was discovered to have contraceptive effects. How effective it actually was is hard to say. We do know that silphium was worth more than its weight in silver and therefore was harvested to extinction.

a page from a botanical book, with writing on the top and bottom and a detailed botanical drawing of a plant with several leaves in the middle

After the disappearance of silphium, asafoetida - the dried latex obtained from the taproot of plants of the Ferula species - came into use as a replacement. However, consuming an excessive dose of asafoetida could be lethal.

a detailed coloured botanical drawing of a plant, with bulbous roots, green leaves, and white buds with branching flowers on top

Other societies are documented to have used stones and garlic to block the vaginal passage, a practice also known as barrier contraception. Others chose to apply plugs of grass, cloth or sea sponges. The method proposed in the 4th century BCE by Hippocrates, often hailed as 'the father of Western medicine' was more elaborate. The legendary physician suggested that women could drink copper saltwater to prevent pregnancy and even claimed that the effects of the toxic concoction would last for an entire year.

a sketch of a bust of a man wearing a toga in a niche, the words 'Hippocrates' are engraved on a pedestal below.

Hippocrates’ wasn’t the only questionable method. The Greek physician and gynaecologist Soranus of Ephesus declared in the 2nd century CE that women should hold their breath during sex, and sneeze afterwards to expel the semen. Moreover, he advised women to jump backwards seven times.

a detail of a manuscript illumination showing two people in elaborate draped clothing gesturing at each other

Other unreliable methods, such as ejaculation interruption, were widely used as well and considered quite harmless but not very trustworthy. Because of the discomfort, difficulties, and fallibility of these ancient methods, the search for better contraceptive solutions continued.

The condom & the IUD

Throughout the Middle Ages, new birth control methods emerged while previously unknown effects of existing ones were discovered. Birth control amulets were commonly used; next to the expected dried herbs, these objects could consist of beaver’s testicles, mule’s earwax, the bones of a black cat or any other animal matter thought to exert magical protection.

While the knowledge of such methods started to wane in later centuries - as women risked being accused of being a witch - a new era dawned as the first syphilis outbreakhit Europe in the 15th century. Barrier contraception was then found to be a useful method to stop the spread of sexually transmitted diseases as well.

detailed drawing or etching showing doctors and carers trying several cures for diseases, including a bedridden person, something heated above a billowing fire, and a large barrel in the foreground.

This discovery, in turn, led to the development of the first condom in 1564: a linen sheath tied with a ribbon. Despite the increasing popularity of this method, the main objective of use of the condom was to protect men when they visited brothels. Women were left little choice whether or not they wanted their partners to wear it. By the 18th century, condoms were sold at sky-high prices in bars, barbershops, chemists and theatres both in Europe and the United States.

a sheath made of a thin membrane in an off-white colour lies on a black background

In 1855 the first rubber condoms came into use. Vulcanising rubber made them more elastic, and this ignited a global rise in condom production. The use of condoms as birth control became even more widespread when latex condoms were invented in the 1920s. Contrary to earlier versions, which could only be stored for three months, these could be stowed away for several years.

 a square cardboard condom wrapper in white and purple, with the words 'Durapac' and 'A Durex Product' on it

The Intrauterine Device (IUD), another form of birth control still in use today, was also developed in the 1920s. It was Ernst Gräfenberg, a German-Jewish physician, who thought of a device working after conception, preventing an embryo from nestling and growing in the uterus. This contraceptive method was perceived as a threat to the Aryan race by the Nazis and therefore suppressed shortly after its invention.

 a closeup picture of a circle made of what look like stretchable ringlets, joined at the top with a small metal cylinder.
 a piece of molded plastic lies on a gray countertop, twisting and turning in on itself.

This intermediate ban didn’t stop the development of the IUD, though. Early examples, made of silkworm gut and silver wire were substituted in the late 1960s by a more advanced product that - thanks to the addition of copper - proved to be 95% effective. The hormonal IUD was a later invention. Like the copper version, this IUD changed the way sperm cells move, inhibiting them from reaching an egg. Nowadays IUDs are available as reversible contraceptive implants with potential long-term efficacy.

The cervical cap & the contraceptive sponge

The cervical cap - also called a vault or diaphragm cap - was inserted into the vagina. The early 20th-century rubber cup shown below was modified by Dr Marie Stopes, one of the pioneers of the contraceptive pill. It was her eugenic belief that selective breeding through the application of contraceptive methods could prevent 'undesirables' from being born.

a black rubber cylinder ending in a rounded top lies on a black reflective countertop. On the top of the cylinder the words 'Racial Trade Mark' are printed in white

Stopes also promoted the use of sponges. These usually contained a mix of liquids that were believed to have a spermicidal effect.This method echoed the use of barrier contraceptives almost 2.000 years earlier.

an orange sponge enclosed in a net attached to a string is placed onto a small metal cylindrical tin

Like the cervical cap and the condom, the sponge was re-invented time and again to make it safer and more effective. It was widely used in the early 20th century, as was the contraceptive tampon which functioned similarly.

a piece of organic material fabric is attached to a piece of string

While not perfected to provide optimal protection, these contraceptive methods provided a much-needed alternative for highly unreliable methods to prevent pregnancy, such as withdrawal or vaginal showers in the pre-pill era.

a yellowed pamphlet has in red uppercase lettering the title 'Frauenheil' written across the top, continued by explanatory text and a drawing