IB History Impact of Changing Access to Contraception Notes

Contraception and Control: How the Pill Changed Everything

Before the Pill

1. For most of American history, women had almost no legal access to contraception.
   1. The Comstock Act (1873) made it a federal crime to distribute contraception through the US mail, treating birth control as obscene material.
   2. This law stayed on the books for nearly a century.

1. Into this landscape stepped Margaret Sanger, a nurse and activist who became the defining figure in the early birth control movement.
   1. Sanger opened the first birth control clinic in the US in Brooklyn in 1916, was arrested shortly after, and continued campaigning for decades.
2. Sanger founded the American Birth Control League in 1921, which later became the Planned Parenthood Federation of America.
   1. Her goal was to make contraception a medical and legal norm, not a criminal act.
   2. It took the better part of four decades before the law began to catch up.

The Pill and Its Impact

1. In 1960, the FDA approved Enovid, the first oral contraceptive pill.
   1. For the first time, women had a reliable, female-controlled method of preventing pregnancy.
2. Access was still sharply limited at first.
   1. Many states restricted who could legally obtain contraception.
   2. The Pill was prescribed almost exclusively to married women.
   3. Unmarried women were often simply turned away.
3. The legal landscape shifted with Griswold v Connecticut (1965).
   1. The Supreme Court struck down a Connecticut law banning contraceptive use, ruling that married couples had a constitutional right to privacy.
   2. This established a legal foundation for contraceptive access that had not existed before.
4. Seven years later, Eisenstadt v Baird (1972) extended that right to unmarried individuals.
   1. The Court ruled that the right to privacy belonged to individuals, not just married couples.
   2. This closed the legal gap that had left single women without protection.
5. By 1965, roughly 6.5 million American women were using the Pill, making it the most popular form of contraception in the country within five years of its approval.

Reproductive Injustice

1. The mainstream feminist narrative around the Pill focused on freedom and access.
   1. For many women, that was real.
   2. For others, the more pressing reproductive issue was not how to prevent pregnancy, but how to stop being forcibly sterilized.
2. Throughout the 1960s and 1970s, federally funded sterilization programs disproportionately targeted Black, Hispanic, and Native American women, as well as poor women on welfare.
   1. These were not isolated abuses.
   2. They were systematic and often carried out without genuine informed consent.

1. In response, activist groups formed to challenge this.
   1. The Committee for Abortion Rights and Against Sterilization Abuse (CARASA), founded in New York in 1977, pushed for a broader framework that went beyond contraceptive access.
2. CARASA and allied groups argued that reproductive justice required more than legal access to contraception or abortion.
   1. It required the right to have children free from state coercion.
   2. This reframing exposed the limits of mainstream feminist campaigns, which had largely centred on middle-class white women's desire to limit family size.
3. CARASA successfully lobbied for HEW sterilization guidelines in 1974 and 1978, which introduced mandatory waiting periods, age restrictions, and requirements for informed consent in multiple languages.
   1. These were hard-won protections that mainstream feminist organisations had been slow to prioritise.

Grassroots Health Education and Its Limits

1. The Boston Women's Health Book Collective published Our Bodies, Ourselves in 1970, a self-published guide that gave women plain-language information about contraception, sexuality and their own bodies that many doctors withheld.
   1. The book challenged medical gatekeeping directly and was revised repeatedly through the 1970s as new research and new court rulings changed the facts women needed to know.
2. The Hyde Amendment (1977) banned most federal funding for abortion, showing that formal legal rights did not guarantee equal access because the funding restrictions affected low-income women most sharply.