Contraception Then and Now: A Brief History of Birth Control and Your Available Options

"It is not feminism's goal to control any woman's fertility, only to free each woman to control her own." -Baumgardner and Richards.

Women have strived to attain control of fecundity since time immemorial. Although hormonal birth control is relatively new in human history, birth control has existed for thousands of years in one form or another.

The earliest recordings of birth control methods date back to Egypt's ancient civilizations and Mesopotamia (circa 1850 BC). Papyrus scrolls discovered in Egypt dictated a contraceptive recipe for women in need. It was a simple concoction: "...a mixture (of) acacia leaves, honey and lint as a block inside the vagina to keep out unwanted sperm."

A more dangerous option existed in ancient China. Women would drink a mixture of lead, mercury, and arsenic to prevent conception, but at a considerable cost to their health.

In the 1700s, early forms of male condoms, made of animal membranes, became available. Condoms have since garnered mass popularity because of their ease of use, their ability to be applied at a moment's notice, and their superior protection against both pregnancy and STDs.

Fast forward to 1955 when the birth control pill hit the market. Suddenly a woman's sex life could be private for the first time, as she was able to have sex without getting pregnant.

This revolutionary technology-enabled women to decide for themselves whether or not they wanted pregnancy at any given time. This led to many women joining the workforce, and hopes were high as a cultural shift was underway. While the invention of the pill was viewed as a great equalizer in the struggle for gender equality, it also had its side effects.

By the late 1960s, journalist Barbara Seaman had written a book called The Doctor's Case Against the Pill, which exposed the dangerous side effects of the high-estrogen pill — namely, blood clots, heart attacks, strokes, and loss of libido. Eventually, estrogen levels in birth control pills were lowered by pharmaceutical companies after Senate hearings exposed these dangers in the 1970s.

Unsurprisingly, women with access to birth control can achieve higher education levels and greater economic stability. We also know that better quality of life for children can often be tied to planned pregnancy versus unplanned pregnancy.

Birth control should cater to our needs, not the other way around. There are a plethora of hormonal and non-hormonal birth control methods that are accessible, affordable, and don’t always require a prescription.

Finding what works best for you can often require some trial and error, but knowing your available options is an imperative part of advocating for your own health. Below is a list of the currently available birth control options.

Some Non-Hormonal Methods Include:

The Copper IUD (99+% effective)

An intrauterine device (IUD) is a little t-shaped piece of plastic or copper that is inserted into the uterus by your doctor to provide birth control. A copper IUD can last up to 12 years and can serve as emergency contraception if inserted within five days after unprotected sex. It does not, however, protect you against sexually transmitted diseases.

Updated Rhythm Method (93+% effective)

One way to utilize this method is the FDA-verified app Natural Cycles. The user measures their temperature upon waking and enters it into the app for analysis to identify fertility status, a very natural, scientifically-sound way to avoid pregnancy. This method is 93% effective with typical use, and 99% effective with perfect use. It does not protect you against sexually transmitted diseases.

Diaphragm (88+% effective)

A diaphragm is a reusable rubber or silicone cup that is inserted into the vagina and covers the cervix. The diaphragm is used with spermicide before sex to prevent pregnancy. It does not protect you against sexually transmitted diseases.

Contraceptive Sponge (76% to 88% effective)

This option is a round, plastic sponge that is saturated with spermicide and can be left in the vagina for up to 24 hours. The sponge prevents pregnancy in two ways: It fits snugly against your cervix, blocking the entrance to your uterus, and it also contains spermicide, which slows sperm down so it can't reach your egg. No prescription is needed and it does not protect you against sexually transmitted diseases.

Male Condom (82+% effective)

The most well-recognized birth control option is the male condom, a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection. With an effectiveness percentage of 82% when used correctly, this method has the best protection against both pregnancy and sexually transmitted diseases.

Cervical cap (80+% effective)

A cervical cap, or FemCap, is a silicone cup inserted into the vagina, up to six hours before sex to prevent pregnancy. The cap can be left in for multiple sexual sessions, up to 48 hours. It must be used with spermicide; however, it does not protect you against sexually transmitted diseases.

Cervical caps must be prescribed by a doctor and can be filled at a pharmacy, drugstore, or health center. They are also not one size fits all, and comes in three dimensions.

Female Condom (79+% effective)

A female (or internal) condom is a pouch inserted in the vagina or anus before sex for birth control and protection against sexually transmitted infection. It works similarly to male condoms, except that it's worn internally.

As Far As Hormonal Birth Control Goes, Options Include:

Implants (99+% effective)

The implant is a small plastic rod placed under the skin, where it releases progestin to prevent pregnancy. Progestin is a synthetic version of the hormone progesterone. This method prevents pregnancy by thickening the uterine lining and inhibiting ovulation. It is 99% effective for contraception but does not protect you from STIs and STDs. The implant lasts for three years but can be removed by your doctor at any time.

Hormonal IUDs (99+% effective)

The intrauterine hormonal device is the second type of IUD. Like the implant, it works to prevent pregnancy through progestin release and has approximately the same effectiveness rating. It does not protect you against sexually transmitted diseases.

Shots (98% effective)

The Depo-Provera shot is a hormonal birth control method that slowly releases progestin into your bloodstream. The shot must be administered every 90 days. It works by suppressing ovulation, keeping your ovaries from releasing an egg, and is up to 98% effective. It does not protect you against sexually transmitted diseases.

Patches (92% effective)

The birth control patch for women is a type of contraception that contains the hormones estrogen and progestin. You place the small patch on your skin once a week for three weeks, a total of 21 days. During the fourth week, you don't wear a patch — which allows menstrual bleeding to occur. It does not protect you against sexually transmitted diseases.

Vaginal Rings (92% effective)

The vaginal ring is a 2-inch wide flexible ring placed inside your vagina, where it slowly releases estrogen and progestin. The ring is left in for three weeks and removed for one week to allow the wearer to have a period. This method is 92% effective but does not protect you against sexually transmitted diseases.

Pills (91+% effective)

Like the vaginal ring, the birth control pill contains a combination of estrogen and progestin and has an effectiveness of 91%. It is fundamental to take this pill at the same time every day if you are not using a backup contraception method. The mini pill is similar to the combo pill and has the same effectiveness, but only contains progestin. Like the vaginal ring, the birth control pill contains estrogen and progestin and has an efficacy of 91%. It does not protect you against sexually transmitted diseases.

It can be helpful to keep a journal or a note on your phone for any adverse reactions from any contraception methods you have tried. It can be challenging to track which methods worked and which did not, so keeping notes can be helpful. If you are considering discontinuation, do not hesitate to discuss it with your doctor.

Kahun Gynecological Papyrus via pandiahealth.com