The pill turns 50, but who’s in control?
OPINION - Black women have the highest rate of unintended pregnancies, despite that fact that they "are more positively inclined toward family planning than white women...."
On June 23, 1963, the Federal Drug Administration approved a pill for hormonal contraception. It required a prescription from a medical doctor and the initial recommendations were for the pill to only be given to married women for health reasons. One small pill represented a huge gain for the rights of women to control their body and reproductive freedom but its distribution was clearly subject to the choice and whim of the person prescribing it.
The birth control pill serves as a classic example of the subjective intersection of the judicial and health care systems attempting to legislate and monitor social and moral discipline. There is a long history of racism in medicine as it relates to reproductive rights, with the example of forced sterilization of blacks and the poor, as well as the eugenic movement (which supported selective mating of “genetically superior” people to better the human race) that is well documented in Drs. Clayton and Byrd’s book, An American Health Dilemma.
Out of the eugenic movement, nurse Margaret Sanger emerged in the early 1920s. She is widely credited as a birth control pioneer who, after witnessing the deaths of women during childbirth and from self-induced abortions, became an active proponent of eugenics. She is frequently quoted as stating that birth control would benefit unfit persons because “the American public is heavily taxed to maintain an increasing race of morons, which threatens the very foundations of our civilization.”
Wow, what insight! (And that was pre-Jersey Shore.)
Her case New York vs. Sanger (1918) was heard in the New York State of Appeals Court and was pivotal in overturning the Comstock Laws of 1873 which classified birth control information and materials as obscene. From that victory, the movement for birth control emerged, but issues related to rights for race and reproduction and in particular ‘control’ of contraceptives continued. Sanger’s comments about racial betterment and birth control led to conflicting views about racist undertones in her campaign.
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The introduction of the pill in the 1960s coincided with the civil rights movement and the women’s rights movement. In the black community during that time, black women — while standing in solidarity with black men over civil and equal rights — had to contend with the notion from those same black men that the pill was a method of genocide.
Even organizations like the NAACP and The Urban League revoked their support of contraception and neighborhood Planned Parenthood programs. The Black Panthers concluded that contraception was only part of a wider design to decimate the black race.
Black women countered that argument. Author Toni Cade famously wrote a response titled “The Pill: Genocide or Liberation” that asked black men, “What plans do you have for the care of men and the child?”
She supported the need to reproduce, but rejected the “irresponsible, poorly thought-out call to young girls, on-the-margin scufflers, that every Sister at large to abandon the pill.” Most black women were in support of the pill, black liberation and their own sexual freedom.
An irony remains, however, since contraception is still largely controlled by one’s access to the health care system. Understandably, there are potential medical risks with various methods of contraception, and it needs to be monitored. But women choose a contraceptive method based on convenience, simplicity and affordability.
Many women have barriers to getting hormonal contraception. A recent study by the Pharmacy Access Partnership indicated that most women in the United States believe that hormonal contraception should be available without a prescription in women screened for medically safe use.
The societal, financial and human cost of unintended pregnancies is huge. Black women have the highest rate of unintended pregnancies, despite that fact that “black women are more positively inclined toward family planning than white women” (Journal of Social History, Spring 1998). There are 3 million unintended pregnancies in the United States annually, adding to an estimated 13 billion dollars in medical costs. Improved access to contraception could prevent up to one half of unintended pregnancies and save managed care and public funding medical costs by $243,232,000 and $92,496,000 respectively, per year. The Guttmacher Institute reports that for every dollar spent in helping women avoid pregnancies that are unintended, four dollars is saved in Medicaid expenditures.
Black women have a long and determined history of concern and control related to reproduction. When asked to comment on the past 50 years of the pill, Byllye Avery, founder of the National Black Women’s Health Imperative (‘The Project’) and noted Reproductive Scholar said: “The birth control pill, when taken by healthy black women, provides her with unmeasured control over her reproductive future. It allows her to make choices and commitments that ultimately enhances the African-American community.”
