The nationwide legalization of the birth control pill in 1965 was a key milestone for the second-wave feminist movement. Today, the pill empowers its 151 million users worldwide to decide if and when they have children and has thereby granted many the opportunity to access higher education and the labor market in new ways which are not dictated by their biology. Meanwhile, the narrative that birth control is solely liberating has developed primarily out of white liberal feminism and has overshadowed the experiences of WOC (Women Of Color). By assessing the introduction and use of the birth control pill in the USA through an intersectional lens, it is evident that the experience of the birth control pill is not homogenous and that the dominant discourse surrounding the liberating power of the pill is not a universal truth.
An undeniable success of the birth control pill was the way it allowed people with uteruses to enter the labor market and develop their careers without the risk of unplanned pregnancy. When we compare female cohorts born in 1940 to those born in 1955, we see an increase of 24 percentage points in regard to labor market participation. This shift perfectly aligns with the 1965 legalization of birth control in the US. We know that motherhood significantly contributes to the pay gap, especially since women often take on a significant proportion of the care burden even after maternity leave. When a person with a uterus can have fewer or no children, they can gain more experience in the labor market, which can advance their career and increase their earnings. Those who have access to birth control from the beginning of adulthood (ages 18-21) earn up to 11% more by the age of 40. The decreased risk of falling unexpectedly pregnant has granted many the opportunity to enter the workforce and earn their own money. This has liberated many women from being economically dependent on the men in their lives, who have traditionally been the breadwinners.
Although the birth control pill granted its users economic freedom, it also comes with a hefty economic cost. Birth control is still only issued by prescription, and users must often attend annual check-ups—estimated to amount to $87 annually for those insured. Moreover, it is estimated that out-of-pocket birth control costs are around $226 for those with insurance. It is evident here that those with low income and a lack of insured pay a significant economic cost for access to control over their bodies. Condoms are cheap and widely accessible; one in five women says she has purchased them before. Meanwhile, the birth control pill and its prescription aspect require a much more intentional cost split between two partners, meaning men are less likely to contribute financially to birth control costs. Women who have sex with men are left to bear the responsibility and economic burden of birth control as some kind of price she must pay for her “promiscuity.” The cost of birth control is a tangible example of women paying a literal price for their right to liberation.
The ability to control when and if one has children also encourages women to advance in their education since they are more likely to gain a return on this investment. A study in Colorado found that the expansion of affordable contraception access resulted in a 14% decrease in high school dropout rates among females. Similarly, being a mother before the age of 20 reduces schooling attained by three years. Higher education often correlates with better job opportunities and earning potential, and thus affordable birth control can contribute to economic liberation for many, particularly those trying to break away from a generational poverty cycle.
Despite the birth control pill allowing so many women to access higher education and enter male-dominated educational fields, women still have little influence in the pharmaceutical industry and on the development of the pill. In fact, men still occupy 9 in 10 biopharma CEO positions. As a result, those consuming the pill and facing its side effects have little say about how it's developed. The male-dominated pharmaceutical industry has concluded that side effects are, again, just a price women must pay for their “promiscuous” lifestyle.
Members of the actual consumer group are not involved in decision-making processes, and their concerns are often dismissed. For instance, the first pills on the market contained 150 micrograms of estrogen, and after their launch, knowledge emerged that the pill increased the risk of blood clots, and thus the product was changed. In comparison, today’s pills contain only 20-40 micrograms, an alteration made after real consumers' lives were affected. It is also important to note other reported side effects, such as “moodiness” or weight gain, which have been dismissed as vain or overreactions by male scientists. However, These side effects have significant social meanings that amplify their effects: women are valued largely by their weight and are already judged to be overly emotional. The side effects of the birth control pill again reflect a cost women must pay for their sexual and economic liberation. While many of the side effects presented by the pill would never be acceptable in the development of other prescription medications, the male-dominated pharmaceutical industry continues to push these complaints aside.
It is also significant to note that the pill granted a separation between sex for procreation and sex for pleasure by curtailing the risk of pregnancy. Alongside the second-wave feminist movement, which campaigned for sexual liberation, the pill was said to liberalize societal morals around sex. The cohorts who pioneered the birth control pill can be seen to have a decrease in the age of first sexual encounters and a delay in marriage. As expected, however, this sexual revolution was met with a great deal of backlash. The 1960s U.S. media was fuming, and my favorite headline from 1968 suggests that the effects of the birth control pill might even be “more devastating than the nuclear bomb.” Even though sex now posed less risk of pregnancy, this didn't exactly liberate women from the sexist narratives of purity culture and preparation for monogamous marriage. Moreover, true sexual liberation goes beyond the bodily autonomy to choose when and if to have children and encompasses abortion rights, pleasure, LGBTQIA+ rights, and the unapologetic expression of desires.
I think it's clear by now that the birth control pill has benefited a subgroup of individuals more than others. This subgroup is typically white, cis, middle-class women. To understand the extent of the inequalities surrounding the birth control pill, we need to begin before the pill was launched onto the market. Puerto Rican cisgender women were used in the birth control trials of 1955 to test the product on humans. As a low-income US territory, many female inhabitants were too vulnerable to say no to participating in these trials. The highly unethical and exploitative operations of this experimental trial, alongside a high dropout rate, make it difficult to claim any conclusions from this trial. Still, the pill was launched on the market. Puerto Rican women involuntarily risked their lives in medical trials so that white women could reap the benefits of the birth control pill.
It is also significant to note the eugenics-based sterilization law passed in 1937 in which cisgender women in the US and its territories were sterilized under the knowledge that this procedure was reversible. Over 60,000 women, primarily Latina women and WOC, were sterilized as part of this paternalistic intervention supported by the eugenicist beliefs that some populations were more or less appropriate parents. WOC were sterilized at three times the rate of white women between 1950 and 1966. It is unsurprising, then, that birth control was experienced as an extension of the eugenic laws that stripped the right to motherhood from so many. The loud campaigns and celebrations led by white women regarding their access to birth control overshadowed the years of oppression that stripped away the bodily autonomy of so many others.
While the birth control pill has granted many women in the US increases in economic and career opportunities, these effects have not been universal. Cisgender white women’s economic liberation emerged from the exploitation of women of color who paid the price of their bodily autonomy for this scientific advancement. Low-income individuals still face a high economic cost when attempting to access the liberating effects of birth control. The argument for birth control as a liberating force for all kinds of women in the US is thus grounded in a liberal, capitalist perspective that ties worth to capital accumulation and production. Even those who have been able to access these advantages have had to face some cost for these liberties. True liberation for all women involves addressing systemic barriers, acknowledging intersectional experiences and advocating for radical forms of reproductive justice.
Written by Ellen Gisto.