TODAY   |  May 07, 2010

The pill at 50: Science, stigma, self-empowerment

TIME magazine’s Nancy Gibbs and NBC’s chief medical editor Dr. Nancy Snyderman take a look at breakthroughs and breakdowns in oral contraception.

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This content comes from a Full-Text Transcript of the program.

NATALIE MORALES reporting: This morning on TODAY'S WOMAN , the pill turns 50. In May of 1960 , in a controversial move, the FDA approved oral contraception . But this was only the first step in a long journey of access and acceptance. NBC 's chief medical editor Dr. Nancy Snyderman takes a look at the history and the future of the pill.

Dr. NANCY SNYDERMAN reporting: Fifty years ago a revolution took place in homes and bedrooms across America with the introduction of the first birth control pill . But even if you took it or knew someone who did, chances are you just didn't talk about it .

Ms. CECILE RICHARDS (Planned Parenthood Federation of America): It still wasn't legal in a lot of parts of the country . Its pretty recent history, where before women were actually allowed the ability to even just purchase birth control , particularly unmarried women .

SNYDERMAN: Today an estimated 12 million American women use the pill, and about 80 percent will use it at some point in their reproductive lives. And not only are they talking about it, they're shopping around.

SNYDERMAN: The revolution that started with a simple pill has become a multibillion-dollar business, with birth control pills that stop your period, pills that sooth your cramps, even birth control pills that help your skin.

Ms. RUTH MERKATZ (Population Council): The pill was a great discovery, but we have new methods of delivering contraceptives so that they can stay in the body for a longer period of time as well as be safe.

SNYDERMAN: Including this ring, which emits a steady dose of medicine to prevent pregnancy for up to one full year, being studied by New York City 's Population Council . Contraceptive sprays and gels are also on the horizon for women .

Dr. ANDREW COWNETTS: ...to have would be around this time.

SNYDERMAN: Gynecologist Dr . Andrew Cownetts agrees that science is headed in the right direction, because the pill isn't for everyone.

Dr. COWNETTS: I think it's important, therefore, to be able to offer women what you can call a contraceptive cafeteria, so we have different options and women can select the option that is most likely to result in contraceptive success for them.

SNYDERMAN: For the past 50 years, the responsibility of taking a daily birth control pill has fallen squarely on the shoulders of women . But that may soon be changing. In 2009 , Chinese researchers reported successful trials of what may become the world's first male birth control shot. And at Los Angeles Biomedical Institute , Drs. Christina Wang and Ronald Swerdloff have been hard at work on the study of a new male contraceptive gel.

Ms. RICHARD: I think if there is a male pill , we'll have to wage the same kind of campaign to mainstream it and make it accessible, affordable and frankly, socially acceptable.

SNYDERMAN: Acceptable to a new generation 50 years after one little pill changed everything. For TODAY, Dr. Nancy Snyderman, NBC News.

MORALES: And Nancy Gibbs is the executive editor of Time and the author of the e-book " Love , Sex , Freedom and the Paradox of the Pill ." Nancy , good morning.

Mr. NANCY GIBBS (Author, "Love, Sex, Freedom and The Paradox of the Pill"): Good morning.

MORALES: So then we're talking about the 50th anniversary of the FDA approval of the pill; as Nancy points out in her piece, the approval and acceptance of the pill didn't really happen overnight then, right?

Ms. GIBBS: It didn't. And in fact, Margaret Sanger , who was the founder of Planned Parenthood , she started talking about a magic pill back in 1912 .

MORALES: Mm-hmm.

Ms. GIBBS: So it was decades in the imagination and scientific development before its approval, and then it would be many more years before it became widely accepted for use.

MORALES: Still very, very controversial. And what I find interesting actually, that one of the founding fathers , if you will, of the pill was actually a conservative Catholic . Tell me more about that.

Ms. GIBBS: He was. His name was Dr. John Rock , and he was a Harvard -trained, very established physician, probably the most famous infertility specialist in the country . So he had devoted his life to helping infertile women become pregnant, and he ends up providing the means for fertile women not to become pregnant.

MORALES: And his goal really was to help regulate women 's cycles, is that what it was, with the infertility aspect in mind?

Ms. GIBBS: Well, he initially thought that you could use progesterone, the hormone...

MORALES: Right.

Ms. GIBBS: ...to maybe block a woman's cycle for a few months, an infertile woman's cycle, and then once you stopped giving progesterone maybe it would sort of turbo-charge their cycle and they would have an easier time getting pregnant. Those are the experiments he was doing. But once you are experimenting on using progesterone to block ovulation...

MORALES: Mm-hmm.

Ms. GIBBS: ...to help pregnancy, you could also use it to block ovulation to prevent pregnancy.

MORALES: It's interesting. You know, many people think, when they think of the pill, and they credit it for the beginning of the sexual revolutions in the 1960s . That wasn't necessarily the case, though, right?

Ms. GIBBS: It wasn't. It's probably natural to blame the sexual revolution on the pill, because they arrived together.

MORALES: Right.

Ms. GIBBS: But it doesn't mean one caused the other. Throughout the 1960s , in many states contraception was still illegal.

MORALES: Mm-hmm.

Ms. GIBBS: And even Planned Parenthood clinics would not prescribe the birth control pill to single women . You -- if you went to your doctor, you needed to be married to get it. Now, there were work-arounds. You know, girls were known...

MORALES: Right.

Ms. GIBBS: ...to borrow and engagement ring from a friend, and doctors were not detectives. But by and large it was not accepted for single women until really into the 1970s , and that's when you start to see the more dramatic social changes that resulted from that.

MORALES: But even -- I think there was a Kinsey Institute report in 1953 , years -- you know, six years before, seven years before the pill, women were having sex 50 percent of the women I guess in the survey were having sex . So even before the pill it was happening.

Recent study: women on pill are less likely to die prematurely

Ms. GIBBS: Oh, yes, the sexual revolution was well under way.

MORALES: Yeah, absolutely. And the pill was intended for preventing unplanned pregnancies. Is it -- is it really working in that way?

Ms. GIBBS: You know, that's one of the many anomalies. Here we are 50 years later, and to this day 49 percent of pregnancies in this country are unintended. This is not because contraception has failed.

MORALES: Mm-hmm.

Ms. GIBBS: It's mainly because of people choosing not to use it or not using it consistently. But the idea that half of all pregnancies were not intended is -- really distinguishes the United States from most other countries even in the world.

MORALES: All right, it's fascinating. It's great information in Time magazine . Again, Nancy Gibbs , thanks so much. Appreciate it.

Ms. GIBBS: Thank you.