The Power of the Pill: Oral Contraceptives and Women's ... - Mail

732 journal of political economy
I. The Pill and Single Women
A. Diffusion of the Pill among Single Women
In 1960 the Food and Drug Administration (FDA) approved the use of
norethynodrel, a synthetic progesterone, as an oral contraceptive for
women. 2 The product was christened Enovid by its manufacturer, but
nearly everyone else called it and its successors “the pill.” Oral contraceptives—also
known as “the pill”—remain among the greatest miracle
drugs. 3 (See table 1 for the history of the birth control pill and landmark
decisions regarding contraception.)
The pill diffused rapidly among married women in the United States.
By 1965, only five years after its release, 41 percent of “contracepting”
married women younger than 30 years were “on the pill” (Westoff and
Ryder 1977, table II-3). 4 The fraction of married women using the pill
peaked around 1967, but it was then only just beginning to be used by
young, single women.
Both legal and social factors were responsible for the delayed dissemination
of the pill among unmarried women. 5 Until the late 1960s, single
women who were below the age of majority and did not have parental
consent were often denied access to the pill and other forms of contraception.
6 Before the late 1960s, it was not legal in any state for a
physician to prescribe an oral contraceptive to an unmarried minor
without consent of her parents. 7 But by 1972, on the heels of the Twentysixth
Amendment (1971), the “age of majority” had been lowered to
18 years old in most states. Beginning in the late 1960s, “mature minors”
in many states were enabled, by judicial decision and statute, to obtain
contraceptive services. The extension of family planning services to minors
and changes in community norms were reinforcing.
2
A closely related drug, norethindrone, had already been approved for medical uses,
not contraception, two years before. On the history of the pill, see Asbell (1995) and
Watkins (1998).
3
The Economist (“Oral Contraceptives: The Liberator,” 1999) named the pill the greatest
advance in science and technology in the twentieth century.
4
This figure includes only couples using any form of contraception, including sterilization,
rhythm, and withdrawal. Of all married women younger than 30 years old, 26
percent were on the pill in 1965, but many who did not use contraceptives were trying
to get pregnant, were pregnant, or recently had a baby.
5
The fraction of all women who ever used the pill reached a peak of 85 percent with
the cohort born in 1948 and then declined to around 80 percent (calculated from the
1987 National Health Interview Survey [Inter-university Consortium for Political and Social
Research 1990]).
6
Massachusetts and Wisconsin even had legislative proscriptions against the sale of
contraceptive devices to any unmarried individual. Not until 1972 was the Massachusetts
law overturned by the U.S. Supreme Court in Eisenstadt v. Baird.
7
No record exists of a doctor’s successful prosecution under a criminal statute regarding
provision of contraceptive services to minors (U.S. Department of Health, Education, and
Welfare 1974, p. 70).