The Pill and I – A personal and political reflection
It was in March 1964 that I swallowed my first oral contraceptive pill thoughtfully provided by a friend. I was 22 yrs old, in love and had already survived one unplanned pregnancy. The idea that I could be in charge of my own fertility by taking a pill which provided total protection against pregnancy and was not related to the sexual moment was breathtaking.
Better still, it was medically endorsed and therefore could be assumed to be safe. After all it was the sixties and no one questioned doctors. Our trust in the medical profession was absolute and the risks seemed minimal. The risk of an unplanned pregnancy was far greater for most young women. Access to abortion was secretive and limited and the procedure was often dangerous. Women still died from backyard abortions. Becoming a single mother or having to adopt a child out meant private anguish and public loss of reputation.
I was lucky that when faced with an unintended pregnancy, I had a committed partner who had a pharmacist friend who recommended a safe abortion clinic and as two professional people we could afford the fee (63 guineas). On reflection it is extraordinary that despite its expensive fees no one recommended I use birth control when I was discharged. Instead I was encouraged to think of myself as victim of a man’s sexual needs and was advised to not let him have his way with me again. There was no acknowledgement of an equal relationship and my own sexual feelings. I was incapable of expressing my needs and views and happy to no longer be pregnant.
The Pill was a recurring topic of conversation with my peer group who were marrying and a newly married friend told me she was taking the Pill and suggested I make a premarital appointment so I could start using it. It seems extraordinary to recall that at this time only married women were prescribed it. I duly presented myself to the recommended Gynecologist who advised I begin a course of Anovlar a week before our wedding and dated the prescription accordingly. He said he would not do a pelvic examination as I was a virgin and warned me of the inferior National Health Service in the UK. If consequences in terms of side effects were discussed I did not hear. I had no idea how to raise the issue of my abortion or my immediate contraceptive needs. How could I admit to being sexually active? I could not wait to exit the appointment.
When I related the experience to my friend she devised the perfect solution. She would lose her script and ask her doctor for another and I could take her existing six months supply. By then I would be a married woman and entitled to proper service and choices. In the interim the plan worked and without the benefits of either medical advice or physical examination I began my life with the Pill. I loved this Pill for the life choices it gave me.
In retrospect I know that the early dosages were high but that meant nothing at the time for I had no benchmarks and I relied on medical advice. I wanted safe and reliable contraception and a sexual life. For me it was never about a lack of desire for children. I wanted to be a mother. Terminating the pregnancy was about timing; I was not ready to be a parent. I loved my teaching career and motherhood would end that as the women in my staff room demonstrated daily. For married women the career options were single and permanent, or married/parent and casual.
After completing three years of teaching I married and left to work in the UK and the USA. It was not our intention to have children until we returned and I would be reliant on the Pill. Despite the warnings of the Sydney doctor, I enrolled in the British National Health Service to find it was efficient in family planning matters. My new GP said he did not really want to waste his time with contraception as the Family Planning Association was much better and I was directed to the Family Planning clinic Noting Hill. How I loved that it all seemed so normal and you were praised for being responsible just for being there. I felt empowered and liberated and for two years was a regular client and a happy pill consumer. It was also the beginning of my long relationship with the Family Planning Association whose advice I trusted.
Access to contraceptive services was not so easy in the US medical system and I was grateful to have supplies with me. Turning homewards and looking forward to being pregnant it came as an extraordinary surprise to find that I was not as fertile as I imagined. I did not conceive in the first three months after I stopped taking the pill and privately assumed this was related to my still private abortion as I had not revealed this in any medical consultation. The Pittsburgh gynecologist commented that this was a common side effect and if after returning to Australia I was not pregnant I should apply to adopt a child. I was 26.
Such drastic action was not required as within six months I was pregnant and back in Australia. Encouraged by my obstetrician in my desire to have a drug free birth I joined the Childbirth Education Association and began a political life around choices in childbirth, abortion, sex education and feminism. Three years away from Australia helped me see other lives and especially the choices women made. Glad as I was to be back home, I was a very different person.
What was private became political and public. The abortion was no longer a matter of private shame but a public statement and with others advertised in a national newspaper inviting police to arrest us for our illegal activity. They did not respond and we were encouraged to be braver. We marched for safe reliable contraception and the right to choose whether or not to be parents; for equal pay and education. The Pill was no longer my private method of contraception but rather as a method which should be available to all women.
I became one of the NSW convenors of the newly formed Women’s Electoral Lobby (WEL) and part of the takeover campaign for the Family Planning Association. No longer just a private consumer with WEL, I campaigned for the removal of the luxury tax on the Pill so that it was available to more women. We read the newest literature from the US and dreamed and planned to ensure that women had more choices. Our Bodies Ourselves from the Boston Women’s Health Collective forced us to consider health in a broader context. However even as I read this and campaigned for access and information for all I stuck with the Pill. I accepted the contemporary advice on two year child spacing and like most of my peers I resumed taking the pill despite the unpredicted consequence of losing my milk. I needed certainty so that I could return to work and manage an activist community life.
Three children later it was time to think of contraception for the rest of my fertile years. I had pill fatigue. I could not imagine taking a daily tablet for another 20 years. The Pill had fulfilled its promise and I decided on tubal ligation.
I was lucky to have my private reproductive decision making informed and supported by my professional life. As a feminist passionate about family planning and education in late 1975 I left my teaching career to pursue those passions and became the Education, Media and Information Officer for Family Planning NSW. It was a heady time. I taught sex education and family planning/personal development in schools, community settings and universities for a nearly a decade. I wrote the Cleo magazine sex advice column and became the conduit between its readers and the family planning association. These conversations were nearly always about the Pill
The Pill was the contraceptive of choice for Australian women and the public discourse around contraception reflected this. Teenagers wrote asking for information and the names of doctors who would “put them on the Pill.” Communities wrote saying their local doctors would not prescribe the Pill and how could they acquire a Family Planning clinic. This was a far cry from the sixties.
From 1978 to 1983 I was Executive Director of the national family planning body AFFPA. Simultaneously I was a member of the National Women’s Advisory Council advising the then Prime Minister Malcolm Fraser on women’s affairs, an appointment influenced significantly by my Family Planning role. AFFPA was the Australian member of the International Planned Parenthood Federation and was regional and global in outlook. It had been the lead agency in Family Planning becoming a Human Right and was tenacious in its advocacy for the rights of women and families in the developing world.
This remains unfinished business.
Today despite some recent improvement maternal mortality is the leading cause of death among young women aged 15 to 19 in the developing world. For the last thirteen years I have been a director of Plan International- a child rights agency- and worked in over thirty countries where access to family planning education or clinical services is inadequate. When I see the burden of unplanned pregnancies, the under nourished babies I compare with my healthy grandchildren I am impatient with the rate of change.
Why is the pill, 50 years on yet to reach parts of Africa and India? Why should these women be denied a proven method of contraception when we know that condoms and other forms of birth control and AIDS prevention are still far too difficult to obtain in many areas?
Without access to contraception there is no gender equality and without gender equality none of the 8 Millennium Development Goals will be achieved. Millennium Development Goal 5 – Improve maternal health has as its target to reduce by three-quarters by 2015 the maternal mortality rate. Currently it is the least likely to be achieved.
America’s widely respected Guttmacher Institute, which conducts research on reproductive health, says that 215 million women around the world are sexually active and don’t want to become pregnant — but are not using modern forms of contraception. If contraception were broadly available in poor countries, the report said, more than 50 million unwanted pregnancies could be averted annually. One result would be 25 million fewer abortions per year. Another would be saving the lives of as many as 150,000 women who now die annually in childbirth.
Australia’s newest Companion of the Order of Australia Dame Valerie Beral, a Professor of Epidemiology at Oxford University, was honoured for her work in breast cancer. In her longitudinal study of breast cancer, Professor Beral found that the Pill offered protection against ovarian cancer. She stated ‘The pill when it is being taken does have some adverse effects on blood clots and breast cancer. But for women taking the pill in their 20s and 30s these are small effects, and when they stop taking it the protection against ovarian cancer goes on for the rest of their life. The net effect is good.’ (Sydney Morning Herald interview June 14, 2010)
This should be good news for young women across the world. However being a teenager in a developing country means a new host of challenges for girls. Over 80 million girls will be married before their eighteenth birthday and they may just keep on producing babies. The Pill is not available for them.
Margaret Sanger, American social reformer and founder of the birth control movement, said in 1883 “No woman can call herself free who does not own and control her own body. No woman can call herself free until she can choose consciously whether or not she will be a mother”. The words are as true now as they were then.
She could never have imagined the freedom resulting from the invention of the Pill which has enabled us to be both mothers and workers. It is a choice which the rest of the women in the world deserve.