DEVICES AND DESIRES: A History of Contraceptives in America

There were the dark days of frequent unwanted pregnancies, quack remedies and backstreet abortions; then there was the Pill. Or so we often believe about the history of birth control in America. But the subject, as Tone, associate professor at the Georgia Institute of Technology, shows, is much more complex. Indeed, our Victorian forebears were familiar with several contraceptive choices, from condoms to pessaries and douches, which were readily available from small shops or by mail order until the Comstock Act deemed them obscene in 1873. But the new law succeeded only in driving the contraceptive business underground, as regulations were inconsistently enforced. By the 1920s, birth control began to be seen as a public policy issue; activist Margaret Sanger, who focused particularly on birth control for the poor, was instrumental in gaining legitimacy for the movement by making contraception the purview of the medical profession. Her efforts led to the popularity of the custom-fitted diaphragm and, later, to the development of the Pill. Tone focuses on contraception as a matter of customer demand and market responses, while also dealing with major controversies, including the Pill's health risks; religious objections to it; alleged racism in birth control policy; and the Dalkon Shield tragedy, in which business decisions contributed to the marketing of an unsafe IUD. Bringing the story up to 1970, Tone ends with a plea for increased research, sex education and affordable over-the-counter options for both men and women. Although some might argue that condoms already fill this need, Tone points out the irony that "the most frequently used contraceptive in th[is] country—by a wide margin—is irreversible female sterilization." Though some readers may find its conclusions oversimplified, this overview remains lively and informative. Illus. not seen by PW. (June 7)