The History of Emergency Contraception

By Shirin Keshvani

Today, emergency contraception is a readily available resource and its importance goes almost unquestioned. However, a closer look at its history reveals that this was not always the case. Before we dive into the history of emergency contraception, we must first take a closer look at the invention of contraceptive pills themselves.

Infertility or Anti-fertility?

As ironic as it sounds, the invention of contraception was chanced upon during research on how to treat infertility. In the 1920s, researchers A.S. Parkers and C.W. Bellerby discovered that they could manipulate the menstrual cycle by injecting an estrogen compound known as estradiol. This causes the destruction of the corpus luteum (the lining of the mature egg that contains estrogen and progesterone) and the restarting of the menstrual cycle. In 1938, Parkes later went on to discover that synthetic estrogen could be used as a form of postcoital contraception and could be administered conveniently by mouth, as opposed to injection. However, these researchers sought to use this information to treat reproductive treatment disorders by developing an in vitro form of fertilization (i.e. fertilising the egg with sperm outside the body), and what we know now as “test tube babies”. Although their findings for treating infertility inadvertently uncovered information regarding contraception, the researchers initially did not pay much attention to this.

A Woman in a Man’s World

Enter: Margarent Sanger, birth control activist, sex educator, writer and nurse. Sanger had been campaigning for the invention of a “reliable, female-controlled form of birth control” when she chanced upon the research of Parkes and his colleagues. After teaming up with John Rock, Parkes and friends discovered that the same principle of restarting the menstrual cycle to encourage fertility could be applied to prevent pregnancy as well. Sanger, an acquaintance of one of the researchers, galvanised them to further explore this vital discovery.

Given the immense opposition on the grounds of religion and morality, research funding was hard to come by. Eventually, Sanger partnered up with suffragist and philanthropist Katharine McCormick to fund Parkes’ team’s research on contraception.

This led to the invention of what we colloquially refer to today as “the pill”. By May 1960, the pill was approved for use in the US, and by 1965, 80% of women aged 20-24 were reported to have used it - a true testament to its relevance and necessity for women.

Sexual Liberation or the Disease of Unwanted Pregnancy?

While feminist-leaning Sanger viewed the contraceptive pill as a means of liberation for women, the forefathers of the pill saw it as a means of improving marriages and resolving issues of poverty in the US through controlling overpopulation. Sanger initially sought to protect women from unscientific solutions and information regarding contraception, but soon started to lean towards the research team’s disease-oriented model, framing unwanted pregnancy as something to be eradicated.

A Critical Discovery

In the 1950s/60s, while continuing his research on contraception in conjunction with Parkes, Chang discovered that while progesterone was effective in preventing pregnancy when administered before ovulation, estrogen proved to be a more effective means of contraception when administered after ovulation. This critical discovery paved the way for research on postcoital (i.e. post-sexual intercourse) contraception. Once again, this scientific discovery in the field of reproduction was met with disdain, causing the departure of John Rock from the initial team of researchers who saw postcoital contraception as an “abortifacient”.

What’s in a Name?

Fast forward to today, what was initially termed as “postcoital contraception” by scientists was picked up by the popular press who coined the quippier term “the morning after pill”. This phrasing created the inaccurate, and potentially harmful, impression that the pill was only to be consumed the morning after intercourse, rather than as early as possible. Finally, the term that we are all so familiar with emerged – emergency contraception – and became the most appropriate name for its purpose.

What began as research on fertility issues, led to the discovery of a piece of medicine that is so important to women today. Beyond the vital role it plays for victims of rape, this gives women immense autonomy over their reproduction. While it is still met with considerable pushback today, emergency contraception has come a long way, even being available over the counter in some countries.

Prescott, H. (2011). Mainstreaming Emergency Contraception. In The Morning After: A History of Emergency Contraception in the United States (pp. 91-106). Rutgers University Press. Retrieved June 6, 2020, from j.ctt5hj1vg.11)