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The History of Birth Control and Eugenics

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I’m a 30-year-old woman in a long-term relationship. If I had a dollar for every time someone made the comment, “If you wait until you’re ready to have a baby, you’ll never have one,” I could retire. This statement is an oxymoron to our behavior as a species, because we have been trying to control family planning as early as 1550 B.C. The first known contraception attempt was found in an Egyptian manuscript called the Ebers Papyrus. It directs women on how to mix dates, acacia and honey into a paste, smear it over wool and use it as a pessary, a medical device inserted into the vagina and held in place by the pelvic floor musculature, to prevent conception.

Today, hormonal contraception is used by 98 percent of women at some point in their lifetimes. Politicians and religious leaders still battle the rights and responsibilities of family planning in 2012. Even more controversial than the current reproductive legislation is the history of the little pill that changed the world. I don’t want children (if I ever find myself at the doors of motherhood it will be purely by accident), I can’t take hormonal birth control, and I think the battles over birth controls and abortions are simply ridiculous (it’s 2012 and this is what we have to fight in the ‘modern’ world?); however, as a woman it is important to understand the history of how modern birth control was conceived.

Contraception

From the Egyptians, contraception evolved from sheep-bladder condoms, to lemons cut in half and used as a cervical cap, to chastity belts, to the various products we have today. In a previous article, I wrote about the various hormonal and non-hormonal birth controls for men on the market or in the research phase. But, more than the interesting inventions for contraception worldwide (check out Time Magazine’s timeline of birth control here), I’d like to look specifically at the long battle for birth control in America.

Comstock Act

As a libertarian, I believe that society could run more efficiently without many of the ridiculous laws that pass through legislation. History and current legislation show that our politicians and leaders think the opposite. In 1873, in an attempt to regulate morality in this country, the Comstock Act was passed. The “Act for the Suppression of Trade in, and Circulation of, Obscene Literature and Articles for Immoral Use,” banned everything from obscene literature, to birth control and abortion devices. Doctors could not even pass on information about sexually transmitted diseases.

Margaret Sanger

Margaret Sanger was a nurse who saw women suffer and die from unwanted pregnancies. Her own mother had 18 pregnancies, 11 children and died at the age of 40. Sanger worked in New York’s Lower East Side with immigrant and lower class women who often died from complications from unwanted pregnancies and illegal abortions. She opened up the first birth control clinic in 1916 passing out diaphragms, condoms and literature on STD’s and birth control. Nine days later she was arrested and charged under the Comstock Laws. Sanger appealed the conviction, but lost; however, the New York appellate court gave doctors the right to hand out contraceptive information, if prescribed for medical reasons. In 1921, she founded the American Birth Control League, which later became Planned Parenthood. These two organizations later merged and became what we now know as Planned Parenthood.

In 1936, Sanger helped bring the case of United States v. One Package to the U.S. Circuit Court of Appeals which allowed physicians to legally mail birth control devices and information throughout the country. Yet, it wasn’t until 1965, in the Supreme Court case of Griswold v. Connecticut, that the private use of contraceptives was deemed a constitutional right.

In her lifetime Sanger published various magazines and pamphlets about birth control. She traveled through Europe and Asia promoting and helping develop spermicidal jellies, foam, powders and hormonal contraceptives. It wasn’t until 1950 that the first oral contraceptive, AKA the pill, was developed.

Birth Control and Eugenics

Sir Francis Galton, the cousin and disciple of Charles Darwin, is the father of the applied science of eugenics. One the goals of eugenics was to encourage people of above average intelligence and physical capabilities to breed in order to make an improved human race. The offshoot was racism, classism and discrimination against physically/mentally handicapped.

An often hidden and/or denied history of Margaret Sanger is her beliefs and practice of eugenics. Prior to Hitler’s attempt to create a ‘master race’ there was a strong eugenics movement in America. As many as fifteen states had eugenics laws on the books by 1924, but Virginia was the only state to rigidly enforce the marriage laws prohibiting interracial marriages with the Racial Integrity Act of 1924. Also popular amongst the eugenics movement was forced sterilization. By 1956, twenty-four states had laws providing for involuntary sterilization on their books. These states collectively reported having forcibly sterilized 59,000 people over the preceding 50 years.

How does this tie into birth control and Margaret Sanger? In a lot of her writing she refers to the Eugenics movement. In one of the issues of Birth Control Review she writes, “Birth Control is not merely of eugenic value, but is practically identical in ideal with the aims of Eugenics.” (The article titled “The Eugenic Value of Birth Control Propaganda” can be viewed here). She did not deny or hide her ties to eugenics practices, yet history often overlooks this fact. Even Planned Parenthood glosses over the issue and simply states, “Her views on eugenics and racial issues remain a subject of bitter debate to this day.”

While birth control has allowed women and men to have control over their reproduction rights and responsibilities, and Margaret Sanger has opened many doors for women, it is important to understand the history of why it was developed. An often overlooked piece of American History is that Hitler actually took his ideas for genocide and creating a master race from the American Eugenics movement. A majority of the states had sterilization and marriage laws that weren’t overturned until the 1950’s and 60’s. Don’t get me wrong, I’m ecstatic that we have condoms, birth control pills, and other forms of protection from unplanned pregnancies and STDs. I’m also glad that we have the right to these medications, devices, and basic information without a ridiculous law on morality, but with our ability to genetically modify children, I wonder how long it will be until a new and modern eugenics movement starts to develop; especially since we often overlook this snippet of American history.

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Birth Control – Reflected in the Numbers

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The National Center for Health Statistics recently published a report that found pregnancy rates in the United States have declined since 1990, with the exception of women in their 30s and 40s.

The data was compiled between 1990 and 2008 and analyzed by The National Center for Health Statistics, which allowed the agency to observe trends over the past two decades. What they found was a decline in pregnancies, an overall reduction in abortions, and fewer live births.

Pregnancy rates for black and hispanic teenagers are still two to three times the pregnancy rate of white teens, but there has been an overall drop in the number of pregnancies for black and hispanic teens. In fact, the number of teenage pregnancies in 2008 was 40% lower than the number of teenage pregnancies in 1990 – and the teenage pregnancy rate has not been so low since 1976.

In addition, the number of abortions among teenagers declined 56%, with fewer abortions among all age groups. These statistics suggest there have been fewer unwanted or unplanned pregnancies.

Though the highest pregnancy rate was among women between the ages of 25 and 29, there has still been a decline in the number of pregnancies for this age group (albeit slight), with the only increase in pregnancy rates among women in their 30s and early 40s.

The data hints at an increased use, or more effective form, of birth control, which would allow more women to better plan their pregnancies. The rise in pregnancies among 30- and 40-year-old women may reflect an increase in the number of women that want to start a family after establishing their careers.

Decreased pregnancy rates may not be a result of birth control methods alone; a combination of other factors, such as further education, increased accessibility to information (the Internet), and the economy, may have played a part in the pregnancy decline as well.

Even so, birth control has empowered women in the United States by giving us the ability to choose when and if we want to start a family and how big that family will be. With more freedom (whether it’s due to having no children or just fewer mouths to feed), women can focus on their education, pursue career paths, and live adventurously. Of course, birth control methods could still use some improvement.

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Why Citizens United, Feckless Politicians and Misogynist Radio Hosts are good for Women’s Rights

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Yes, you read that correctly. The current diatribes and debates about women’s health and our rights to health care are a good thing. We are seeing, perhaps for the first time in a very long while, what many individuals and organizations really think about women’s rights. For this we have the Supreme Court and Citizens United to thank.

Citizens United, the infamous Supreme Court decision that decreed corporate personhood, cemented a long brewing trend in American political conscience favoring the rights and goals of corporations and institutions over those of individuals. More than simply allowing organizations or the super-rich to buy politicians of their choosing and do so entirely unencumbered by messy citizen-based fundraising or even approval, Citizen’s United capped, like an exclamation point, the corporate and institutional priorities of the last half of the 20th century.

Unhindered by legality, or even the good sense to mask a blatant trampling of the rights of human citizens, organizational power, under the corporate personhood decision, can now progress to its logical absurdity, which it is doing with astonishing alacrity. And women’s rights are in the cross-hairs.

Nothing but the pure hubris that comes with the unbridled power of corporate sponsored politicians can explain the all-male congressional hearings on women’s health, the Blunt Amendment or the continued political capitulation to the vile diatribes of a male radio host who debases women with every breath. Did they really think these events would go unnoticed by the female population? Obviously, they did. How else does one explain such a huge strategic error in political engineering? Even a neophyte political operative, if asked, would have suggested at least giving the appearance of inclusion of women or paying lip-service to those with differing opinions, if only to manage the optics.

With corporate personhood and corporate sponsored politicians, many politicians, it appears, believe that managing the optics is no longer necessary. Forget about working for the citizenry that the politician was elected to represent (that was lost long ago) it is much more expedient to manage the ‘corporate persons’ that sponsor one’s political longevity.  In many ways, politicians in this post-Citizen’s United world are freer to behave in accordance with their actual beliefs. This includes favoring the prerogatives of the corporation or large organization over those of individuals; and as we’ve seen in recent weeks, throwing women’s health under the bus.

I would argue, however, that this is dire mistake, because despite the apparent victory that Citizen’s United granted corporations and other large organizations, it was rooted in 20th century trends (and even earlier ideological foundations). Romney’s ill-fated “corporations are people” bespoke a critical truth, too quickly ignored. A corporation is not a unified entity, with a monolithic point-of-view, no matter how much money those at the top decide to throw at their chosen politician or desired political goals.

Corporations are comprised of millions of actual citizens (>50% are women) who are technologically connected and capable of launching powerful movements for or against their corporate or political leaders. Indeed, corporations and politicians are far more dependent upon the goodwill the citizenry than most realize. Consider the social media onslaught that befell proponents of the heavy-handed, industry-sponsored legislation to curtail online piracy (SOPA/PIPA) or the more recent attempt to block public access to tax-payer funded scientific research (HR3699/RWA). Both bills were blocked by internet activism. And these were relatively arcane bills. Imagine the power of millions of angry, connected women?  Talk about a countervailing force to Citizen’s United, corporate shenanigans and feckless politicians; yes, this war on women is a good thing. It is awakening a sleeping giant. What this giant will do is anyone’s guess, but I’d hate to be the wrong side.

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Underinsured, Underdiagnosed, and Anonymous: Endometriosis and Cancer Part 4

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I just learned, after years of endometriosis pain and misdiagnoses, I had cancer.

My husband and I were suspended in a state of utter shock and disbelief, as the GI/endoscopy center rushed us referrals for a variety of different radiology and imaging services. We were feeling overwhelmed and under pressure, but had precious little time to openly react or otherwise respond to my diagnosis. Right now, we had to have my cancer staged and graded sooner than seemed humanly possible. I drank barium contrast and fasted for digestive system x-rays, I went on a clear liquid diet and temporarily stopped my meds for full-body PET scans, I repeated barium prep for CT scans, and fasted again for MRIs. My diet consisted mostly of chalky colon cleansers, plain water, 7-Up, chicken broth, boiled ham, and scrambled eggs. As trifling as it sounds, this made me crave a juicy steak and pulpy fruit juice like nothing else. By the end of the month, I was allowed to give into my cravings for a night—a bittersweet reward at best—while we waited in high anxiety for my pending results to come in.

My Cancer Diagnosis

I had a greying, high-grade, stage II-B neoplasm, with partial bowel obstruction, which had enlarged to about three centimeters in size. The tumor had grown through the wall of my colon, but had not yet metastasized to my lymph nodes, bone marrow, or other organs. I did not yet have necrosis or jaundice either, but compromised liver function and tissue death were both very real concerns for me now. The fast-growing lump had apparently started out as a benign polyp, but had turned malignant having gone undiagnosed and untreated.

I was young, I’d never smoked, I didn’t drink or do drugs, and I wasn’t promiscuous, so nobody could easily explain how or why this was happening to me (as if those were the only reasons that something like this could happen to anyone). Likewise, no one could tell me how the polyp could have been missed, or why I was denied the medical attention that I had actively and continuously sought– for years, which could have prevented my case of cancer altogether. I did finally and inexplicably get to stay off birth control pills this time though—and, coincidentally, my tumor never increased in size after I discontinued the use of oral contraceptives, hmmm…

Navigating Cancer without Insurance

The diagnostics and staging completed, we were then referred to a local oncologist, radiologist, surgeon, and hematologist for consultation, healthcare review, and treatment selection. The oncology specialist wanted to do an immediate total colectomy with long-term, post-surgery, high-dose chemotherapy port, and a permanent colostomy bag. The radiation specialist wanted to start with daily, low-dose, external beam radiation, personalized intensity modulation radiation therapy, and low-dose oral chemo, for six months. The surgical oncologist did not recommend surgery for temporary or permanent bowel resection or any surgical procedures for chemo pump placement—in fact, they suggested radiation with or without chemo. The hematology lab would be doing my tumor marker and blood panels one to three times per week as needed throughout my treatment, whichever option we chose. And, me–I wanted biological treatment, but it wasn’t covered by insurance, so I reluctantly had to settle for beam radiation and oral chemo in lieu of extreme abdominal resection surgery, since I wasn’t rich.

Next, everybody gave us the obligatory best-case/worst-case scenarios, after which I was scheduled for my radiation tattoos, body molds, and chemo instruction in preparation for my first treatments and corresponding blood monitoring tests. Having turned down radical surgery and the chemo port (per the surgeon specialist’s advice), my oncologist was suddenly and inconveniently unavailable to see me now. So, my radiologist had to reach the oncology nurse to confirm arrangements for my ongoing blood work and prescription refills, since her boss was neglecting to do so on a regular basis. The oncology nurse also secretly stepped in and reduced my chemo pill dosage by half without telling the oncologist (she told me not to tell him about it either), because as she said—off the record—he had prescribed me a dangerously high amount, comparable to that given to a terminal prostate cancer patient. I had to quit the job I loved, my husband had to stay at the one he hated, and I had to take incompletes and signup for medical leave at school…where only last year I had been hopeful, I was once again despondent.

Just one month into chemo-radiation, I quit menstruating, and was no longer able to be intimate with my husband (my still fairly new husband) for the duration of my treatment (my fairly long treatment). I lost all of my lower body hair from the bellybutton down, and went through major skin tone and skin color changes, along with startling food taste changes, and contemptible chemo fog. It had become a challenge for me just to get off the couch to catch a ride to the doctor’s, so much so that my time was predominantly spent asleep, in treatment, or in diagnostics, by this point.

And, when it didn’t feel like things could get any worse, my husband’s company announced their looming bankruptcy and liquidation. That’s when the rejection letters for my previously pre-approved (and thusly documented) life-saving medical procedures began to arrive from the insurance company. It’s also when we found out that because my husband’s employer was liquidating, not restructuring, that we would only qualify for one month, not one year, of COBRA benefits, and that the one month of COBRA coverage we were eligible for would cost us $1,300 even in light of the hundreds of thousands of dollars (literally $300,000+ in just one month of the bankruptcy/liquidation notice) in bills which had abruptly begun to flood our mailbox.

To Be Continued.

Read earlier parts of the story. Part1, Part2, Part3.

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Are We Marks? The Greed and Chicanery of 21st Century Corporate Culture

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Chandler Marrs

Corporate Culture has Run Afoul

By now everyone is aware of Bank of America’s latest in a long stream of fee gouging practices- the $5 debit card fee. This is on top of an endless array transaction fees charged to customers that generate billions in profits annually, and of course, the billions from the bailouts and the foreclosure crisis. Although blatantly evident on Wall Street, the shift in corporate ideology that rewards chicanery pervades every aspect of American life, especially healthcare and most especially women’s and children’s healthcare.

We’re at a place in time where corporations would rather spend billions lobbying favorable regulations and billions more fighting and paying out consumer or patient lawsuits for faulty products than build a quality product or provide a quality service in the first place. How else does one explain the medical marketing of dangerous drugs to otherwise healthy women– think HRT, Yaz and Yasmin, Prozac, Wellbutrin and other anti-depressants to pregnant women (and to rest of the un-depressed population for that matter)? How else does one explain why incredibly dangerous products like Yaz/Yasmin are still on the market despite having more serious adverse events than drugs already off the market because of safety issues (VIOXX) (see  comparison of Yaz side effects below, from www.adverseevents.com  or click on the graphic below).  How else do we explain why it took so many years to remove DES from the market place despite evidence of both teratogenic and carcinogenic effects from the onset or why HRT, was allowed to be marketed as the magic pill that cured all, without any evidence whatsoever? How else do we explain why we not only bought these drugs but demanded them (besides the fact that many are addictive)? How else does one explain that in the 21st century only 30% of practice guidelines for obstetricians and gynecologists are evidence based? Thirty-percent!!!


I guess one really doesn’t need evidence if the treatment choices are limited to bad and worse. Indeed, it’s probably a good thing that more people, patients and doctors alike, don’t question the prescribing practices, the medical efficacy or the very real risk some of these meds pose. Maybe we are marks.

Where did this racket of corporate miscreance come from? I would argue it came from us, or rather because of us. For some reason, we the consumer, the citizen, the patient, the physician, the politician, checked our common sense and personal responsibility at the door of mega-marketing. Somehow we convinced ourselves that we deserved everything, but had to pay for nothing. We abdicated our personal responsibility for our own health, happiness and financial stability to others. And now we are facing the consequences: ill-health, physical and economical, personal and global.

The economic crash exposed the fealty of our financial system and is exposing the very real flaws in our corporate, insurance-based, medical system. The system has taken medical decision-making away from the physician and the patient and placed it squarely in the hands of pharma marketing engines and insurance companies. We’re at a juncture in time, where the sheer economic reality of buying pills to solve all medical problems, is contrasted by the fact that many simply cannot afford their meds anymore and must look to alternative solutions for health.

With all crises comes innovation and change, maybe with this one, we can get back to the “first do no harm” principle of medicine. Maybe we can get back to personal responsibility for health. I think Bill Maher said it best “We’ll stop being sick,when we stop making ourselves sick.”

For a laugh-out loud assessment of modern healthcare by Bill Maher click here.

To look up or report adverse reactions to common medications go to: www.adverseevents.com

Warning: This site does not offer medical advice. If you have questions about your medications or your health, please consult your physician. Do not attempt to discontinue any medication without physician approval and supervision.

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