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The PILL

It has been 50 years. Of course, that's if you accept a particular date and a particular time as the definitive one, which some do and some don't, making even its conception controversial.

Which is apt.

Because nothing about it has been uncontroversial since.

Oh, you could go way back, to the 1920s, when Margaret Sanger begged a nation to consider the health of its poorest women and their legions of children. Or you could trace its origins to a few years later when a rich woman named Katherine McCormick put her money where her mouth was and got scientific types to think about the idea in the first place.

But you could also date the whole enterprise as being a later invention. That would be when it became available to the masses in 1960.

Or you could go with Oct. 15, 1951, the day that Carl Djerassi, an ambitious chemist in an obscure little lab in Mexico, working from a substance found in the wildly improbable foot-tall wild yam, synthesized, for the first time ever, a female hormone. What he had in his test tube was pure crystalline progesterone.

And he figured it'd be a swell thing for women with menstrual problems and recurrent miscarriage because, hey, it suppressed ovulation.

After all this time, we're still not sure if we like what that means or not. Some women were sure that they liked it; then they didn't; now they do again. Some did not and will never. Others liked it so much that they defied their faith daily to take it.

Some, of course, trustingly took it and learned, too late, that doctors didn't always know what was best for them.

And some _ a lot actually _ don't even think about it anymore because they simply take it every day and live their lives oblivious to the debate.

But rest assured, a lot of women took it. In fact, 80 percent of American women born after 1945 have, at one time or another, taken the pill. It is still the most popular reversible method of birth control among American women. In 76 countries, it is the most popular of any kind of birth control.

And 50 years after we could, for the first time ever, scientifically, physiologically and biochemically alter women's bodies so that sex could be separate from reproduction, we are changed.

But can you blame or credit the pill for that?

That is, did the pill loosen the biological confines on women's lives, or did it just loosen our morals? Is it responsible for a culture that allows each of us glorious space to grow and flourish? Or is it responsible for a culture that has destroyed manhood, the family and women in the process?

Did it create a drug culture that wanted chemicals to fix our lives instead of to merely heal us?

Did it make women go to the doctor more, or trust them less?

Did it ultimately play to our human strengths, or to our weaknesses?

One famous philosopher _ his name is Ashley Montagu _ calls its manufacture as important as the discovery of fire and the invention of tools.

An evolutionary anthropologist _ his name is Lionel Tiger _ argues that the pill has alienated men from their own role in reproduction and, with less control over their own sexuality, they lost control altogether. All of which has led to the evolutionary triumph of the female psyche.

Oh, my.

It was supposed to end overpopulation, you know. But 76-million new bodies are still added to the Earth every year.

It was supposed to end unwanted pregnancy. Yet 56 percent of all pregnancies in the United States are still unplanned ones.

It didn't end abortion.

The ambitious chemist Carl Djerassi lives in Northern California now. He writes plays and owns great art and, by the way, did not get rich because of the pill, but because of other things. He makes no apologies for being an ambitious chemist. He is sorry only that it wasn't a woman chemist who made this thing. It would have been easier, he has said, if it didn't seem like men had foisted the whole thing upon women somehow.

There are gains and losses to be summed here. We asked some prominent folks to tell us what they thought the cultural impact of the pill has been.

We also note that no less a notable than John Updike has weighed in on the debate. Wrote he, in the New Yorker, in a piece that neither deifies nor demonizes the pill:

"The sideways glance, the glimpse of underwear, the whiff of perfume, the perhaps accidental touch, the intimacy achieved bit by bit, like a painstaking mapping of the heavens _ all this would be forfeit in a Plato's Retreat of consummation on demand. We value what we need to fight for. We risk allowing sex to seem paltry."

And lastly, know that in recent years, the Food and Drug Administration has considered making the pill available without prescription. That debate also continues.

Carl Djerassi is the chemist who in 1951 first synthesized the female hormone progesterone into a drug called norethindrone; here are excerpts from his book, This Man's Pill (Oxford University Press):

"During the early years of the pill's introduction, an informed and highly motivated minority of women _ primarily North American and, by world standards, exceedingly affluent _ unleashed an indictment of male domination that, in its attempt to account for the full scope of that oppression, swept up the pill in its general charge.

"I have no regrets that the pill has contributed to the sexual revolution of our time and possibly expedited it, because most of those changes in sexual mores would have happened anyway _ no matter what (anyone) may think.

"In our increasingly technocratic society, we seem to be much better at perfecting means than we are at deciding to what ends they should be used. Much of the debate over contraception has assumed that means create ends _ that access to contraception, for instance, invariably tempts otherwise chaste teens to copulate. If fear of pregnancy is the only justification for chastity, then in my opinion a practical, but not a moral or ethical case, has been made for abstaining from intercourse.

"I am (also) convinced that if we had synthesized norethindrone on 15 October 1966 rather than 1951, and if no other organized chemist had appeared in that interval with a similar invention, oral contraceptives would not have existed in the year 2000 . . . because hardly any pharmaceutical company with the financial, logistic and marketing muscle necessary to bring oral contraceptives to the market (because of clinical trial restrictions and litigation fears) would have been willing to carry on during the 1980s and 1990s."

Roberta Lessor, Ph.D., medical sociologist, professor of sociology, Chapman University, Orange, Calif.:

"The pill emerged in an era marked by technological innovation in every field, an era in which we had great faith in technology to solve social ills. It was a natural outgrowth. During the war years, we'd made great technological leaps and we almost felt an imperative to apply it to social problems. This was about population control. In 1950, there was a general recognition of the world population threatening to outstrip our resources.

"On the other hand, the social movements _ like the civil rights movement, the student movement, ethnic rights, Gray Panthers, anti-war _ were already growing. There was this climate of consciousness, of speaking of past bitterness among those previously not able to speak their truths. Women were radicalized from within.

"The women's health movement took off. The emphasis on alternative birthing, awareness of and attention to one's own sexual organs, the Boston Health Collective's writing of My Body, My Self _ these were not the offspring of technology. The women's health movement was a response _ even in the popular culture there was this Marcus Welby worship _ to this be-all, end-all confidence in medicine, mostly as administered by men.

"If anything, the pill taught us to stop believing in all that. When we were given the pill, there was no one who asked if this was going to affect our fertility, our endocrine function, what about breast cancer and blood clots?

"We are, I guess, more open to challenging existing norms and conventions and ways of viewing things and sexuality is just one of them.

"But in my view, the pill did not make one iota of difference to women in their ability to control their sex lives. Neither has it appreciably shifted the balance of power of women and men.

"In terms of the pill giving women more power, good grief, women have taken more power. Nothing gave it to us."

The Rev. Stephen J. Mather, Planned Parenthood board of directors, ordained Presbyterian minister, Anaheim, Calif.:

"The pill is a fundamental problem to established authority. It allows a woman to independently, if she wishes, make her own decision about her own life. It loosened the notions of autonomy and power that needed to be loosened because they were stultifying to the human spirit.

"Some will tell you it's giving women too much freedom. Too much freedom? Isn't that what the Israelites wanted?

"The pill fundamentally changes things because it gave women the grounds to exercise their freedoms.

"Historically, of course, if you give a woman more power to do anything, like have the vote or get information or enjoy sex, it's condemned as anti-nature, anti-religion. In fact, to some religious leaders, like Jerry Falwell, all things of postmodernity have angered God. America, they say, has turned its back on the natural order of creation. The pill brings that to a head. It creates chaos for them because it actually implies that we trust women to make choices _ choices that they can and do make in concert with their doctor and with, I might add, God.

"The pill is the place where religion, sex and politics all come out of the closet. It forced us to discuss the nature of sex _ was it only for reproduction? _ and the nature of power _ who has it, who doesn't?"

Peter Clecak, professor, comparative culture, faculty in residence, University of California, Irvine:

"In this society, the natural proclivity is toward sexual conquest. The moral bar has always been wielded by women. There has been, since the pill, a lowering of the moral bar. Women tend to mature in their early 20s; men, later.

"In my heyday (Clecak is 63), men had to go to college, get a degree and settle down to get sex. Now they don't have to wait, and I believe the maturation of men has declined. It has stunted their moral development. Men are less ready for the relationships they are having. They have less inclination toward commitment, and we have more disappointed females and a lot of relationship confusion as a result. . . .

"Another downside of the introduction of the pill is that it led us down a road that had us expecting that drugs would improve our lives, a general belief that drugs could short-circuit the challenges that produce pain and value in life. It's been harder for us, since then, to turn down comforts. We demand less risk. We've put more emphasis on protecting our children from physical harm but have lost our desire to protect their innocence. We look for a chemical fix to behavior problems. We give children Ritalin if they are not raised properly or are not fed properly.

"On the positive side, it freed women from some idiot who wanted them to have his 12 children and never leave his house. It increased women's options in every area. It increased men's, too. That's good if you know how to choose wisely. You can't allow yourself to drift into the popular culture, which is a blur of not very good options.

"Did the pill do that to the culture? Yes, I guess, but we are responsible for what we did with the freedom. You can't escape that."

Wendy Wright, 38, spokeswoman for the Concerned Women for America, based in Washington:

"Separating the sexual act from procreation made women mere objects of sexual pleasure. It also took away from men any role in determining the outcome of the procreative act. The only consequence most people noticed was that women could decide if they didn't wish to become pregnant. That was interpreted as a license to become sexual libertines. That helped to break down the family and the sense of your role inside that family. . . .

"After birth control, we see how the medical community changed. The American Medical Association all of a sudden decided that life did not begin at conception but rather at implantation. A lot of birth control devices are abortifacients; they simply scrap implantation after conception. That changed how doctors began to not respect life as its earliest phases.

"It changed, too, how women felt about their own pregnancies, as if they didn't control something at conception, then they were expected to control it later. You should see the pressure on women to abort. What is seen by some as an option has become an obligation. . . .

"Before, reproduction was seen as an integral part of life, family life, community life. We've isolated it. Demystified it, so it has lost its respect. It now seems like it's treated as a burden on women. Have they gotten as far as they need to in their career? Do they have enough money? It's like we have to justify pregnancy."

Nancy Naples, associate professor of sociology, University of California, Irvine, and Mary Bernstein, associate professor of sociology, University of Connecticut, in a joint interview:

Naples: "I think the advent of the pill is a moment in time _ it didn't mean a transformation for all women. There is so much generational and class difference, so many issues of access to medical assistance, even to insurance, that the effect is diffuse. Only recently, when insurers were eagerly paying for Viagra, did women feel they could challenge their insurers who weren't paying for birth control.

"People like to credit the pill for the sexual revolution and for control over our fertility. The conservative argument is that these mechanisms took the onus off men, as if access to information will promote promiscuity. It's a negative view of female nature and a negative view of male nature.

"The first wave of feminists and birth control advocates were looking for bodily integrity. The release from biological slavery. The second wave had a broader demand, to put reproductive rights in a larger context. They wanted to talk about accessible, quality child care, improved child health, better health care for women."

Bernstein: "The real shift was economic. Women went to work in greater numbers in the '50s. All of a sudden, we were told that breastfeeding wasn't great anymore. There was a shift toward bottle feeding. Why? Because economically, the country needed their cheap labor.

"Put in a larger context, the pill was made possible because women were in the workplace and needed that control over their reproduction."

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