This World Contraception Day, it's time to pop the big question: Why do women end up being the CEOs of birth control? Sure, contraception is often labelled as a ‘women's issue,’ but let’s be real—it affects everyone. So how did we get here, with women holding the reins of reproductive responsibility? From ancient myths to modern medicine, society’s expectations and a serious lack of male contraceptives, women have been handed the keys to this ship for way too long. Let’s unpack the history, social dynamics, and the shifting conversations around contraception to see how we landed here—and why it’s time for a change.
Historical Overview: The Burden From the Beginning
It’s been a long road for women and contraception, and unfortunately, it hasn’t always been paved with fairness. Throughout history, reproductive health has been seen as a “women’s problem.” Ancient methods like herbs, pessaries, and even crocodile dung (yep, that was a thing in ancient Egypt) were focused on women preventing pregnancy rather than shared methods between partners.
While men have had the simple option of withdrawal or abstinence, the lack of male-centric innovations left the weight of reproductive control on women. In the early 20th century, movements led by figures like Margaret Sanger, the birth control pioneer, further pushed for contraceptive options, but they were, once again, female-focused. The invention of the birth control pill in the 1960s was heralded as a liberating moment for women, giving them control over their reproductive choices. But with this newfound freedom came a subtle expectation that women should take the lead.
Societal Expectations: Contraception as Women's Work
It’s not just history that shaped this gender divide—society also plays a huge part. For centuries, reproductive roles were tightly tied to gender roles. Women were considered the caregivers, and with that came the expectation to manage reproduction, whether through pregnancy or prevention. Even today, contraception conversations often centre around women: Which pill is best? Should you try the patch or an IUD? Rarely do we ask men about their role.
From the family dinner table to doctor’s offices, the narrative has been: ‘It’s your body, so it’s your responsibility.’ This thinking isn’t just outdated—it’s exhausting. Women are expected to not only bear children but also bear the mental and physical burden of preventing them.
Medical Innovations (Or Lack Thereof): Where's the Male Pill?
If you thought we’d be celebrating World Contraception Day by talking about both male and female birth control options in 2024, well... think again. Medical innovations have disproportionately focused on women, and the development of male contraceptives remains glacial. The birth control pill for women was a game-changer, but where’s the male equivalent?
With the rise of scientific inquiry during the Renaissance and Enlightenment, new perspectives on human biology and contraception emerged. This period marked the beginning of modern contraceptive practices, though limited by technology.
Condoms (1600s): The earliest use of condoms was recorded in Italy by physician Gabrielle Falloppio, who promoted linen sheaths soaked in chemical solutions to prevent the spread of syphilis. Later, animal intestines and fish bladders became popular materials for condoms, primarily used for disease prevention but also as a form of contraception.
The “Rhythm Method” (1800s): The early understanding of a woman's menstrual cycle led to the development of the rhythm method, which encouraged couples to abstain from intercourse during a woman's fertile days. This method was the first to be based on scientific observation but remained unreliable due to the imprecise knowledge of ovulation.
Rubber Condoms (1839): In 1839, Charles Goodyear's invention of vulcanised rubber revolutionised contraception. Rubber condoms, diaphragms, and cervical caps became more durable, affordable, and widely accessible.
The Spermicide Revolution (1880s): The first spermicides, which were mixtures of natural substances like vinegar or quinine, were introduced in the late 19th century. Though not entirely effective, these chemical agents marked the beginning of innovations designed to kill sperm.
The 20th century brought a seismic shift in contraception, thanks to scientific advancements and changing societal attitudes toward family planning. Birth control became a global conversation, with innovations shaping modern reproductive health.
Margaret Sanger and the Birth Control Movement (1910s – 1950s): In the early 1900s, activists like Margaret Sanger pushed for birth control access, leading to the development of new contraceptives. Sanger’s efforts, combined with scientific innovations, would eventually lead to the creation of the birth control pill.
The Diaphragm and Cervical Cap (1920s): In the early 20th century, the diaphragm became widely available and was one of the most effective methods of contraception before the pill. It was promoted by reproductive health advocates like Marie Stopes in the UK and Margaret Sanger in the US.
Intrauterine Devices (IUDs) (1920s – 1950s): Although IUDs were invented in the early 20th century, they gained popularity after World War II. The first plastic IUDs were developed in the 1950s, with German doctor Ernst Grafenberg playing a key role in refining the technology.
The First Oral Contraceptive Pill (1960): In 1960, the first oral contraceptive, Enovid, was approved by the U.S. Food and Drug Administration (FDA). Developed by biologist Gregory Pincus, the pill gave women unprecedented control over their reproductive health. It also sparked broader conversations about sexual freedom, reproductive rights, and women’s liberation.
IUD Evolution (1970s): The 1970s saw advancements in IUD technology, with the development of the copper IUD (Paragard) and the hormonal IUD (Mirena). These devices offered long-term contraception without the daily commitment required by the pill.
Hormonal Patches and Rings (1990s): The contraceptive patch (Ortho Evra) and the vaginal ring (NuvaRing) provided women with more options for hormonal contraception that didn’t require daily pills. These innovations offered weekly or monthly dosing, adding convenience for users.
Contraceptive Implants (1990s): Long-lasting contraceptive implants, such as Norplant (introduced in the 1990s) and Nexplanon (2000s), offered an effective method of birth control that could last up to three years, delivering a steady dose of hormones to prevent pregnancy.
21st Century Innovations: A Focus on Male Contraception (2010s – Present)
Although women have been the focus of most contraceptive innovations, recent developments have aimed to balance the scales and explore male contraceptive options.
Non-Hormonal Contraceptives (2010s – Present): Efforts to develop non-hormonal methods, like Vasalgel, a reversible gel injected into the vas deferens, offer hope for a future where male contraceptives play a significant role in family planning.
Male Birth Control Trials (2010s – Present): Research into male hormonal contraceptives, such as pills, injections, and gels, has been ongoing for decades. Clinical trials for male birth control have either stalled or been scrapped due to side effects that, ironically, women have been tolerating for decades (think mood swings, weight gain, and reduced libido). Even though condoms exist, the weight of consistent, reliable contraception still rests squarely on women's shoulders, thanks to more effective and long-term methods like IUDs, implants, and hormonal birth control.
Modern Shifts: Sharing the Load
Fortunately, the conversation around reproductive responsibility is shifting. As gender roles evolve and more people challenge traditional norms, there’s an increasing call for shared responsibility in contraception. Men are becoming more vocal about their role, with discussions around vasectomies and shared decision-making gaining traction. However, there’s still work to be done.
The burden of contraception has been ingrained in women’s lives for so long that many don’t realise it can and should be shared. Modern movements for gender equality emphasise the importance of reproductive justice, where both partners are equally engaged in decision-making about birth control. Social media and feminist movements have sparked discussions around this, but real change requires more than just conversation—it requires action from both individuals and the healthcare system.
Call to Action: Let's Rebalance the Scales
World Contraception Day is the perfect opportunity to reflect on how far we’ve come—and how much further we need to go. It's time to rebalance the scales of responsibility when it comes to birth control. Here’s a quick call to action for everyone:
Educate: Make contraception conversations a two-way street. Men should be equally educated about all birth control options.
Advocate: Push for more funding and research into male contraceptives. Women shouldn’t have to shoulder the entire burden.
Communicate: Couples need to engage in open discussions about shared responsibility, whether it’s through a pill, IUD, or vasectomy.
It’s high time we recognize that contraception isn’t just a women’s issue—it’s a people’s issue.