I recently became curious about how we came by our current birth control options. The history of the evolving options is fascinating, but it isn’t the whole story of birth control. Not by a long shot. The story of birth control is about the story of body control—who can exercise control over a woman’s body. It should come as no surprise that there are a lot of takers.
I. If a Tree Falls in the Woods… The Question of Access
Everything I learned about sex and birth control I did NOT learn at school. Tenth grade health covered sex ed. Being a nerd, I had opted to take that class in summer school the summer before tenth grade, so I could fit more elective classes into my schedule. I’m pretty sure everyone else saw a graphic movie about reproduction, but I never heard more than vague rumours. I felt a bit left out. I have no idea if birth control was covered. In summer school the teacher made a joke about a banana and a condom. That was pretty much it. There was never an actual banana or condom. I was disappointed by this. I hoped to one day have sex, and understanding how a condom worked seemed like pertinent knowledge. Looking back, I suppose I could have googled it. Thinking back on the thoroughly prudish teenager I was, I’m glad I didn’t. All this is to say that what kinds of birth control are available only matter if everyone has education about and access to them.
The National Conference of State Legislation (NCSL) website summarises the current state legislation on sex education:
- 22 states require schools to teach sex ed.
- 3 states require parental consent in order for students to receive education.
- only 19 states require that any sex education provided must be factually accurate.
A 2006 Centers for Disease Control and Prevention (CDC) study found that only 58% of US high schools taught methods of contraception. 87% of schools taught abstinence. Abstinence-only education is one of the legacies the George W. Bush administration left us—abstinence-only programmes received a spike in funding while he was in office.
What kind of results does uneven and insufficient education produce? The United States has one of the highest rates of teen pregnancy in industrialised nations. A 2007 study sponsored by the US Department of Health and Human Services found that teens who receive abstinence-only education become sexually active at the same age as anyone else, though students participating in ‘virginity pledges’ are less likely to use contraception when they do start having sex.¹ A 2013 survey from the CDC found that 14% of sexually active teenagers had not used any form of birth control in their last sexual encounter. According to the NCSL, ‘roughly one in four girls will become pregnant at least once by their 20th birthday.’
Women of all ages face immense restrictions on their access to one of the oldest and still most contentious forms of birth control: abortions. The US has a long tradition of humiliating and shaming women seeking abortions. From the 1930s through the 1960s, women had to appear before ‘abortion boards’ in hospitals to plead their cases. Rickie Solinger notes in her book Reproductive Rights that physicians writing about the boards in professional publications ‘rarely addressed the issues of fetal life. Most typically, they wrote about the responsibility board members faced to protect and preserve the links between sexuality, femininity, marriage, and maternity.’ Abortion boards have disappeared, but other organisations with similar goals have proliferated in the wake of Roe v Wade. Today there are about 4,000 Crisis Pregnancy Centers in the US. They draw in pregnant women seeking abortions without advertising that they are anti-abortion, and in fact only provide counseling and ultrasounds in an effort to actively dissuade women from seeking abortions. In 2006 the federal government gave anti-abortion centres more than $60 million.
Only 13% of counties within the US have an abortion provider.¹ Legislation in some states places unnecessary standards on facilities performing abortions, preventing more clinics from opening. More than 20 states require pre-abortion counseling that forces women to view literature that is deemed necessary not by their doctors but by state legislatures. Such literature in some states includes scientifically unproven information about links between abortions and breast cancer and/or mental illness. Some states require the women to view an ultrasound. Many also have mandatory waiting periods between the forced ‘counseling’ and the procedure, meaning women have to travel to the clinic twice. Women in the many areas that don’t have any abortion clinics are forced to travel significant distances twice, forced to miss more work, forced to spend more time and money on a procedure that they have also been shamed by law for having.
II. Marriage—An Unequal Partnership
In 1871 the first law rescinding the right of chastisement was passed in Alabama. The case was Fulgham v State. The State Supreme Court noted: ‘The wife is not to be considered as the husband’s slave… And the privilege, ancient though it be, to beat her with a stick, to pull her hair, choke her, spit in her face or kick her about the floor, or to inflict upon her like indignities, is not now acknowledged by our law.’ How can a decision stating husbands do not have a legal right to beat their wives hold much water when it also calls beating wives an ancient privilege? It didn’t. The criminal justice system would continue to shy away from interfering in domestic matters. It was a matter of privacy. The court had no business interfering in a marriage. A man beating his wife or forcing her to have sex with him deserved the court’s privacy.
It would be more than a hundred years before it was illegal for a husband to rape his wife. Rape within a marriage, according to law, didn’t exist. A wife gave herself to her husband when she married him: gave her husband permission to have sex with her, anytime. She did not have the right to revoke that permission. Here once more we see the concept of privacy invoked. In her article ‘Contest and Consent‘, Jill Elaine Hasday explains that defenders of marital exemptions claim that the privacy inherent in a marriage should not be breached by legislation or legal marriage cannot be preserved if the husband can be prosecuted for raping his wife. Hasday quotes one woman, a mother of six, who became pregnant with five of those children after being raped by her husband: ‘I vowed I’d never ever marry again. I’d never be in a position where men have authority over me. Marriage is license to do anything you want. You’re not a whole person because no one respects your rights as a human being.’
I am using the hetero-normative terms ‘husband’ and ‘wife’ because every state has made changes to its laws, albeit startlingly recently in some cases. The first laws recognising marital rape were passed in 1975. It wasn’t until 1993 that marital rape was illegal in all 50 states. The Seattle Times reported in a 1997 article that Washington (along with Arizona, Delaware, Louisiana, Ohio, and Tennessee) still had an exemption for third-degree rape, which is defined as ‘nonconsensual sex in which the aggressor does not use physical force.’ In the article, a Seattle woman talks about her 10-year marriage to a man who would initiate sex while she was asleep. She didn’t know if any charges were possible in her case, because the Washington law on third-degree rape specified it only occurs when a ‘person engages in sexual intercourse with another person, not married to the perpetrator’ where the victim did not consent to intercourse. It wasn’t until 2013 that Washington finally passed a bill to remove the spousal exemption for third-degree rape. There were 96 yea votes, 1 excused, and 1 nay. For the record: Representative Elizabeth Scott cast the sole nay vote.
For some women, lack of control of their own persons goes even further. Women as well as girls throughout the United States are victims of forced marriage, even today. Warren Jeffs, the leader of the Fundamentalist Church of Jesus Christ of Latter-Day Saints (a sect of Mormons who left the church when it banned polygamy) was convicted in 2011 for sexually assaulting minors. DNA evidence revealed he had fathered a child with a 15-year-old girl. Ruby Jesop, a former member of the community, finally escaped just over two years ago. She had first tried to escape as a 14-year-old, when she had been forced to marry her second cousin, a man in his 20s. She gave birth to six children before she escaped. Jeffs continues to lead his congregation to this day from his prison cell.
A 2013 article in Haaretz profiled Faidy Russ, who founded a nonprofit organisation called Unchained at Last in 2011, after escaping from an arranged marriage in an ultra-Orthodox Jewish community. Since then, the organisation has helped at least 85 women and girls, providing legal support and counseling. It’s only a start. The Haaretz article reported that a survey conducted by the Tahirih Justice Center found ‘nearly 3,000 suspected cases of forced marriage in the United States, involving individuals from 56 different countries.’ The actual number could be much learger: less than a quarter of organisations surveyed said they had an adequate screening process to identify victims of forced marriage. (You can donate to either organisation by going to their website. You can volunteer or advocate. If you live in New York City, you can join Unchained at Last at a ‘chain-in’ happening on 14 April 2015 in Union Square.)
III. Your Rights Are Whatever We Say They Are
Ever since the passage of Roe v Wade, abortion rights have slowly but surely been chipped away. Rust v Sullivan upheld in 1991 that it was not a violation of the first amendment right to free speech to institute gag-rules on doctors to prevent them from counseling abortion to patients. In Planned Parenthood of Southeastern Pennsylvania v Casey, the Court ruled that states have the right to enact parent consent laws as well as mandatory waiting periods. The Partial-Birth Abortion Ban Act was passed in 2003, and upheld by the Court in 2007 in the case of Gonzales v Carhart. The New England Journal of Medicine commented: ‘This is the first time the court has ever held that physicians can be prohibited from using a medical procedure deemed necessary by the physicians to benefit the patient’s health.’¹
Now we have Hobby Lobby. On 30 June 2014 the Supreme Court ruled that some companies had the right to refuse to provide birth control coverage as part of their health care plans, if they had a religious objection to contraceptives. Hobby Lobby sought exemptions specifically for emergency contraceptives (Plan B, Ella) and certain IUDs, claiming that these methods of birth control are abortifacients. They are not abortifacients. Not in the eyes of the FDA, or the medical community, or federal regulations. Justice Alito admitted as much: ‘The owners of the companies involved in these cases and others who believe that life begins at conception regard these four methods as causing abortions, but federal regulations, which define pregnancy as beginning at implantation, do not so classify them.’ The court ruled that Hobby Lobby’s false beliefs granted the company the right to deny employees who do not share their religious beliefs coverage for these important forms of birth control.
Mother Jones reported on 2 July that the Court was already expanding the decision it had initially insisted would be interpreted narrowly: lower courts will now have to rehear cases involving companies seeking exemptions from covering any form of birth control. Within a month, the March for Life Education and Defense Fund filed a lawsuit arguing for an exemption from covering birth control pills, which it claims are also abortificients. A Colorado programme was hugely successful in lowering unwanted pregnancies by providing low income women with access to long-term birth control, including IUDs. It now faces dissolution, because opponents cite the Hobby Lobby decision as proof that IUDs are a form of abortion. (On a happier note: some Colorado lawmakers are wearing IUD earrings to show their support for the programme.)
Justice Ginsberg wrote a scathing dissent to the Hobby Lobby decision, asking: ‘Would the exemption… extend to employers with religiously grounded objections to blood transfusions (Jehovah’s Witnesses); antidepressants (Scientologists); medications derived from pigs, including anaesthesia, intravenous fluids, and pills coated with gelatin (certain Muslims, Jews, and Hindus); and vaccinations…?’ If it does extend only to contraception, why is that? Besides implying that the court is willing to endorse some religious beliefs and not others, it suggests that when the matter specifically involves the control a woman has over her own body, the government has a right to deny her that control.
It’s not simply a matter of religious freedom. In some cases the rights of the foetus have superseded the rights of the mother—including her right to religious freedom. If a woman in labour refuses a cesarean delivery or blood transfusion based on religious grounds, her physician can obtain a court order forcing her to comply with the recommended procedure. In lawsuits brought by women who had received such court orders, courts have in some instances ruled that the right of the foetus to be born healthy trumped the religious rights of the mother.¹
Foetal rights are a relatively recent development. When Anthony Comstock was crusading against contraception in 1873 and the American Medical Association was leading states across the US to enact laws banning abortion at the end of the 19th century, it was about sex. When women were forced to appear in front of abortion boards, it was about sex. The conversation about contraception and abortion had always revolved around the fear that sex would become divorced from the sacrament of marriage: that if women had control over their fertility, they would become something other than mothers, something fundamentally unnatural and dangerous.
The foetus made its debut, as it were, in LIFE magazine in 1965. By the 1970s foetal imaging was a common practice. Lawmakers exploit this technology to push legislation—in the case of foetal heartbeat bills, bringing pregnant women before an Ohio House committee and having ultrasounds performed live. Foetal heartbeat bills are being considered in Alabama, Kansas, and Oklahoma. North Dakota and Arkansas have both passed laws that were immediately blocked by courts. Heartbeat bills would ban abortions after a foetal heartbeat can be detected—at about six weeks—before some women even know they’re pregnant.
There are a variety of reasons women seek abortions beyond the first trimester (12 weeks). Younger women especially may have irregular cycles and may not know right away that they’re pregnant. It may take that long for women with low incomes to raise enough money for the procedure. Testing may not reveal genetic defects until after the first trimester has passed.
State legislators across the country are hard at work on a variety of bills that would expand foetal rights and limit women’s access to abortion. For a thorough and thoroughly dispiriting list of restrictions on the horizon, check out this article by Molly Redden at Mother Jones.
IV. My First Ultrasound
I’ve always considered myself a feminist. It’s always felt pretty easy. Exploring the ideas of birth control and body control, I realised I’ve taken my feminism for granted. I get to be outraged at a misogynist comment on some TV show, and then return to my life where I’ve never had to demand the right to have a job or go to school or choose if and who I will marry. Never had to demand the right to control if and when I have children. In the 1950s, for many women, the choices were: graduate from high school and get married, graduate from college and get married, drop out of high school and get married. My grandmother was 16 when she left high school to marry my grandfather and begin having and raising five children. One day my mom asked her if she had always planned on having five kids. Her reply: ‘Birth control was the best thing that ever happened to me.’
We’re not done. That’s what I’ve learned. We need to expand birth control education and access. we need to be vigilant about protecting the rights that have been recognised—we have not had those rights for long, and there is a minority that is powerful and vocal, and looking for any way to dismantle.
I’m 28 years old. Unmarried. Lucky to live in a time and place where I have access to a variety of contraceptives. At my last visit to the gynecologist, we happened to be in a room with an ultrasound machine. ‘Do you want to see it?’ she asked. How could I say no? I lifted my shirt. She put some gel on the wand and ran it over my stomach. ‘There it is.’ There it was. My little IUD, tucked securely inside my uterus. It was hard to know what to feel, in that moment. I’m still not sure what to feel. Here was this machine that existed to show mothers-to-be their babies-to-be. And I was looking at a piece of copper that would keep me from joining that long line of women who made all of us. I felt a little sad. Maybe because movies and TV have conditioned me to view the ultrasound as something specific and beautiful—the first glimpse of something that is hope, is family, is the future. Maybe because of something more primal—something that says, I should be growing something here. I am here to grow something and nothing is growing. But I felt… affectionate, too. My little IUD. My protector. My choice.
¹Reproductive Politics: What Everyone Needs to Know by Rickie Solinger, Oxford University Press, 2013