The pill


A watercolour in reds, pinks, oranges and gold

Since its invention, the birth control pill has met with resistance from several groups for different reasons. In this chapter, we'll explore religious as well as secular controversies involving the pill.

Religious opposition

As the Roman Catholic Church had been outspoken in its criticism of sexual activities outside of the context of marital reproduction for centuries, it comes as no surprise that artificial contraception met with harsh opposition too.

In 1963 Pope John XXIII established the Pontifical Commission on Birth Control, which continued its work under the aegis of Pope Paul VI, though in a much expanded composition. In 1964 Paul VI convened the first European Congress of Catholic Doctors in Malta, which was almost entirely devoted to birth control. Ferdinand Peeters was one of the speakers. While Gaudium et Spes (Hope and Joy), Pope Paul VI’s Pastoral Constitution of 1966, opened the door to a shift in the debate by endorsing that love between wedded partners was ‘not only aimed at procreation’, things heated up just a few years later. In 1968, Paul VI published Humanae Vitae, in which he condemned all forms of birth control - abstinence was the only way to prevent women from having babies.

A newspaper extract showing a news piece about something related to the catholic faith. A picture shows a priest in white dress wearing a wooden cross necklace and a white cap signing a piece of paper.

This encyclical on birth control was binding to all Catholics, meaning that the use of the pill and all other artificial devices to prevent pregnancies was considered a mortal sin. Moreover, birth control could no longer be regarded as a subject of debate among theologians. Doctrine differs from practice, though, and many practising Catholics use artificial birth control methods instead of natural family planning. Despite that reality, the point of view expressed in Humanae vitae has remained supported by the four popes following Paul VI.

In an interview for BBC, a woman with a large family discusses her pill regimen. She didn’t inform her priest of the decision to go on the pill, and does go to services but no longer to confession, 1968, British Broadcasting Corporation. In copyright

Non-Catholics and practising Catholics give their opinions on the instructions of the Pope John Paul II regarding sexuality, 7 November 1983, National Audiovisual Institute France - Antenne 2. In copyright

Other prominent religious institutes have expressed critical opinions on the contraceptive pill, and contraceptive methods in general, as well.

Contrary to traditional Jewish views on birth control, modern Jewish ideas tend to be more favourable to contraception since the use of methods such as the pill could benefit health and family stability. Jonathan Eig, who wrote the book The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution, recalls: '10 or 12 years ago I heard a sermon at a synagogue where a rabbi talked about the birth control pill and said it was perhaps the most important invention of the 20th century'.

One hand is opened, palm facing the sky, showing different kinds of birth control methods. Another hand points at one of the implements.

The Qur'an doesn’t make an explicit statement about the ethics of birth control. Again, modern Muslims are not strictly opposed to the use of contraceptive means as long as both parties agree, no permanent sterility can ensue, and no damage is done to the body in any way.

Secular struggles

While since 2007 26 September is celebrated each year as World Contraception Day, the widespread use of the pill has not been a walk in the park. Since its very inception and increasingly from the 1960s onwards, the pill was regarded by many as a driver for upward mobility and an instrument of freedom. A process of acceptance and liberalisation of contraception ensued, but nonetheless European governments remained divided.

Germany was the first country in the world to legalise the pill in 1961, followed in 1967 by France where the Neuwirth law lifted the ban on birth control methods including oral contraception. In the UK, the pill was allowed to be used as early as 1961, but only for married women. In Ireland, the import and sale of contraceptives were forbidden by law until 1979.

Selling the pill is not a crime anymore in Italy, 1971, Sette G, Istituto Luce - Cinecittà. In copyright

Members of the Irish Women's Liberation Movement travel to Belfast by train to buy contraceptives as a protest against the law which forbids the importation and sale of contraceptives in the Republic of Ireland, 1971, Ireland's National Television and Radio Broadcaster / RTÉ. In copyright

In Italy, the contraceptive pill circulated illegally since 1963, and it is estimated that, by 1968, 135,000 women were using it. Yet advertising the use of the pill was forbidden: until 1971 article 553 of the Fascist-era Penal Code stipulated that it was illegal to publicly incite to practices against procreation.

Despite its widespread use, Italy remains in need of awareness raising and information campaigns concerning the pill, 1967, Sette G, Istituto Luce - Cinecittà. In copyright

Today, contraceptive pills, IUDs and condoms are allowed in most countries. However, religious, societal, medical and cultural reasons for a lower availability of modern birth control in certain parts of the world persist. Moreover, despite the invention of the birth control pill having been a big step forward for the women’s movement, it didn’t stop the fight for equal rights nor the need for this.

Illegal in Spain until 1978: flashback to a 20th-century gamechanger at the occasion of its 40th birthday, 2004 TV3 Televisió de Catalunya (TVC). In copyright

Though the debate has changed, the pill remains controversial. Instead of symbolising women’s freedom of choice and stirring the traditional and reactionary views, today the very emancipatory character of the pill has become a topic of discussion, as well as its possible health implications.

One small pill, a societal revolution. Looking back upon 34 years of oral contraceptives, 1995, Deutsche Welle. In copyright

Health concerns

The previous chapters made it clear that the pill was a game changing invention of the 20th century and has manyadvantages. Next to preventing unwanted pregnancies, it changed the lives of millions of people who menstruate as it can reduce heavy bleeding, painful cramps or irregular periods. The combination pill makes it, in some cases, even possible to skip a period.

A cardboard box in white with green lettering is flanked by a leaflet and a blister pack in white, green and red holding an array of circular white pills. The box reads 'Pregnon 28'

The efficiency of the pill in terms of avoiding pregnancy is rated highly nowadays, considered to be safer than withdrawal, a diaphragm, fertility tracking or condoms. When using these forms of birth control there is a 12-24% risk of getting pregnant. The pill outranks these methods by lowering that risk to 6-9%. IUDs, implants and sterilisation are deemed even more effective with only a 1% risk of getting pregnant.

A cardboard box is flanked by a paper leaflet and some implements in a blister pack. The cardboard box reads 'Norplant'

IUDs and implants also work for a longer period of time and need attention only once in every few years or - in the case of sterilisation - are of a permanent nature. The birth control pill, in contrast, needs to be taken every day.

A couple gets counselled on the use of the pill, the woman expressing the hope that her partner will help installing the daily routine of intake, 1978, Belgian Radio-television of the French Community. In copyright

When intake is ceased or accidentally skipped, chances of pregnancy increase immediately. The 'morning after pill' - developed in the late 1960s but not frequently used until a decade later - can offer an emergency solution.

A cardboard box stands on a blue surface. The box is white, with orange accents and black lettering. It reads 'Shering PC 4'

from 22’04” Dutch doctors discuss the newly available ‘soft’ morning-after pill, 1983, Netherlands Institute for Sound and Vision. In copyright

Next to the close monitoring of intake needed, the use of the birth control pill can come with side effects, mostly depending on the person’s medical history and the composition of the pill. For those who smoke, the progestin-only pill is recommended, since pills with oestrogen can lead to serious illness. People who have suffered from breast cancer, blood clots, or a heart attack are also advised against using the combination pill.

A watercolour in reds, pinks, oranges and gold

More common than these high-risk scenarios are temporary inconveniences such as headaches, nausea or changes in the menstrual cycle. While such symptoms usually disappear after a few months, they do serve as a reminder that birth control management through oral contraception has a firm impact on all aspects of the life of the person taking it, from societal status and professional circumstances, to emotional wellbeing and physical fitness.

Several women testify to their use of the pill. For one a life-changing liberation, for the other a method only fit to the happy few, a daily hassle or a health risk, 1979 British Broadcasting Corporation. In copyright

The World Health Organization has a rich online platform where reading tips, guidelines, statistics, briefs and explanatory videos are made accessible. It’s a good place to start for anyone who’d want to read up on or delve deeper into rationales of family planning and current or obsolete contraceptive methods.

Introductory video on the WHO’s work on contraception and family planning, s.d.