Birth control in the United States is available in many forms. Some of the forms available at drugstores and some retail stores are male condoms, female condoms, sponges, spermicides, over-the-counter progestin-only contraceptive pills, and over-the-counter emergency contraception. Forms available at pharmacies with a doctor's prescription or at doctor's offices are oral contraceptive pills, patches, vaginal rings, diaphragms, shots/injections, cervical caps, implantable rods, and intrauterine devices (IUDs). Sterilization procedures, including tubal ligations and vasectomies, are also performed.
Various unsafe birth control methods were available throughout the 18th and 19th centuries. Effective and safe forms of birth control became available in the United States in the 20th century with advances in science that led to the advent of safe methods and various Supreme Court decisions, including Griswold v. Connecticut in 1965 and Eisenstadt v. Baird in 1972, that struck down "Comstock laws" that imposed government restrictions on contraceptives.
In 2015-2017, 64.9% of women aged 15-49 used a form of birth control. The most common forms of birth control were female sterilization (18.6%), oral contraceptive pills (12.6%), long-acting reversible contraceptives (10.3%), and male condoms (8.7%).
History
Birth control before 20th century
The practice of birth control was common throughout the U.S. prior to 1914, when the movement to legalize contraception began. Longstanding techniques included the rhythm method, withdrawal, diaphragms, contraceptive sponges, condoms, prolonged breastfeeding, and spermicides.Engelman, pp. 3–4. Use of contraceptives increased throughout the nineteenth century, contributing to a 50 percent drop in the fertility rate in the United States between 1800 and 1900, particularly in urban regions.Engelman, p. 5. Fertility rate dropped from 7 to 3 children per couple. The only known survey conducted during the nineteenth century of American women's contraceptive habits was performed by Clelia Mosher from 1892 to 1912.Engelman, p. 11. The survey was based on a small sample of upper-class women, and shows that most of the women used contraception (primarily douching, but also withdrawal, rhythm, condoms and pessaries) and that they viewed sex as a pleasurable act that could be undertaken without the goal of procreation.Tone, pp. 73–75.Engelman, pp. 11–12.
Although contraceptives were relatively common in middle-class and upper-class society, the topic was rarely discussed in public.Engelman, pp. 5–6. Rarely in public: Engelman cites Brodie, Janet, Contraception and Abortion in 19th Century America, Cornell University Press, 1987. The first book published in the United States which ventured to discuss contraception was Moral Physiology; or, A Brief and Plain Treatise on the Population Question, published by Robert Dale Owen in 1831.Engelman, p. 6.Cullen DuPont, Kathryn (2000), "Contraception" in Encyclopedia of women's history in America, Infobase Publishing, p. 53 (first book in America).Year of publication is variously stated as 1830 or 1831. The book suggested that family planning was a laudable effort, and that sexual gratification – without the goal of reproduction – was not immoral.Engelman, p. 6. Owen recommended withdrawal, but he also discussed sponges and condoms.Engelman, pp. 6–7. That book was followed by Fruits of Philosophy: The Private Companion of Young Married People, written in 1832 by Charles Knowlton, which recommended douching.Riddle, John M. (1999), Eve's Herbs: A History of Contraception and Abortion in the West, Harvard University Press, pp. 226–7. Knowlton was prosecuted in Massachusetts on obscenity charges, and served three months in prison.Engelman, p. 7.
Birth control practices were generally adopted earlier in Europe than in the United States. Knowlton's book was reprinted in 1877 in England by Charles Bradlaugh and Annie Besant, View original copy. with the goal of challenging Britain's obscenity laws.Engelman, pp. 7–8. They were arrested (and later acquitted) but the publicity of their trial contributed to the formation, in 1877, of the Malthusian League – the world's first birth control advocacy group – which sought to limit population growth to avoid Thomas Malthus' dire predictions of exponential population growth leading to worldwide poverty and famine.Engelman, pp. 8–9. The first birth control clinic in the United States was opened in 1917 by Margaret Sanger, which was against the law at the time. By 1930, similar societies had been established in nearly all European countries, and birth control began to find acceptance in most Western European countries, except Catholic Ireland, Spain, and France."Contraception", in Women's studies encyclopedia, Volume 1, Helen Tierney (Ed.), Greenwood Publishing Group, 1999, p. 301. As the birth control societies spread across Europe, so did birth control clinics. The first birth control clinic in the world was established in the Netherlands in 1882, run by the Netherlands' first female physician, Aletta Jacobs.Engelman, pp. 9, 47. The first birth control clinic in England was established in 1921 by Marie Stopes, in London.Ahluwalia, Sanjam (2008), Reproductive Restraints: Birth Control in India, 1877–1947, University of Illinois Press, p. 54.
Anti-contraception laws
Contraception was not restricted by law in the United States throughout most of the 19th century, but in the 1870s a social purity movement grew in strength, aimed at outlawing vice in general, and prostitution and obscenity in particular.Tone, p. 17.Engelman, pp. 13–14. Composed primarily of Protestant moral reformers and middle-class women, the Victorian-era campaign also attacked contraception, which was viewed as an immoral practice that promoted prostitution and venereal disease.Engelman, pp. 13–14. Anthony Comstock, a grocery clerk Dennett p.30 and leader in the purity movement, successfully lobbied for the passage of the 1873 Comstock Act, a federal law prohibiting mailing of "any article or thing designed or intended for the prevention of conception or procuring of abortion" as well as any form of contraceptive information.Engelman, p. 15. After passage of this first Comstock Act, he was appointed to the position of postal inspector. Many states also passed similar state laws (collectively known as the Comstock laws), sometimes extending the federal law by additionally restricting contraceptives, including information about them and their distribution. Comstock was proud of the fact that he was personally responsible for thousands of arrests and the destruction of hundreds of tons of books and pamphlets.Engelman, pp. 15–16.
These Comstock laws across the states also played a large role in prohibiting contraceptive use and informing to unmarried women as well as the youth. They prevented advertisements about birth control as well as disabling the general sale of them. Because of this unmarried women were not allowed to get a birth control prescription without the permission of their parents until the 1970s.
Comstock and his allies also took aim at the libertarians and utopians who comprised the free love movement – an initiative to promote sexual freedom, equality for women, and abolition of marriage. The free love proponents were the only group to actively oppose the Comstock laws in the 19th century, setting the stage for the birth control movement.Engelman, p. 20.
The efforts of the free love movement were not successful and at the beginning of the 20th century, federal and state governments began to enforce the Comstock laws more rigorously. In response, contraception went underground, but it was not extinguished. The number of publications on the topic dwindled, and advertisements, if they were found at all, used euphemisms such as "marital aids" or "hygienic devices". Drug stores continued to sell condoms as "rubber goods" and cervical caps as "womb supporters".Engelman, pp. 18–19.
Birth control movement
From World War II to 1960
After World War II, the birth control movement had accomplished the goal of making birth control legal, and advocacy for reproductive rights began to focus on abortion, public funding, and insurance coverage.Engelman, p 186.
Birth control advocacy organizations around the world also began to collaborate. In 1946, Sanger helped found the International Committee on Planned Parenthood, which evolved into the International Planned Parenthood Federation and soon became the world's largest non-governmental international family planning organization.Esser-Stuart, Joan E., "Margaret Higgins Sanger", in Encyclopedia of Social Welfare History in North America, Herrick, John and Stuart, Paul (Eds), SAGE, 2005, p. 323. In 1952, John D. Rockefeller III founded the influential Population Council.Chesler, pp. 425–428. Fear of global overpopulation became a major issue in the 1960s, generating concerns about pollution, food shortages, and quality of life, leading to well-funded birth control campaigns around the world.Tone, pp. 207–208, 265–266. The 1994 International Conference on Population and Development and the 1995 Fourth World Conference on Women addressed birth control and influenced human rights declarations which asserted women's rights to control their own bodies.See also: Petchesky, Rosalind Pollack (2001), "Reproductive Politics", in The Oxford Companion to Politics of the World, Joël Krieger, Margaret E. Crahan (Eds.), Oxford University Press, pp. 726–727.
The sexual revolution and 'the pill'
In the early 1950s, philanthropist Katharine McCormick had provided funding for biologist Gregory Pincus to develop the birth control pill, which was approved by the Food and Drug Administration (FDA) in 1960.Tone, pp. 204–207.Engelman, Peter, "McCormick, Katharine Dexter", in Encyclopedia of Birth Control, Vern L. Bullough (Ed.), ABC-CLIO, 2001, pp. 170–171.Engelman, p. 182 (FDA approval). In 1960, Enovid (noretynodrel) was the first birth control pill to be approved by the FDA in the United States. The pill became very popular and had a major impact on society and culture. It contributed to a sharp increase in college attendance and graduation rates for women. New forms of intrauterine devices were introduced in the 1960s, increasing popularity of long acting reversible contraceptives.
In 1965, the Supreme Court ruled in Griswold v. Connecticut that the Constitution of the United States protects the liberty of married couples to use contraceptives without government restriction.
Also in 1965, 26 states prohibited birth control for unmarried women. In 1967 Boston University students petitioned Bill Baird to challenge Massachusetts's stringent "Crimes Against Chastity, Decency, Morality and Good Order" law. On April 6, 1967, he gave a speech to 1,500 students and others at Boston University on abortion and birth control. He gave a female student one condom and a package of contraceptive foam. Baird was arrested and convicted as a felon, facing up to ten years in jail. He spent three months in Boston's Charles Street Jail. During his challenge to the Massachusetts law, the Planned Parenthood League of Massachusetts stated that "there is nothing to be gained by court action of this kind. The only way to remove the limitations remaining in the law is through the legislative process." Despite this opposition, Baird fought for five years until Eisenstadt v. Baird. This was a decision of the U.S. Supreme Court on March 22, 1972, that established the right of unmarried people to possess contraception on the same basis as married couples. Eisenstadt v. Baird, a landmark right to privacy decision, became the foundation for such cases as Roe v. Wade and the 2003 gay rights victory Lawrence v. Texas.