Birth control in the United States

Longstanding techniques included the rhythm method, withdrawal, diaphragms, contraceptive sponges,[citation needed] condoms, prolonged breastfeeding, and spermicides.

[citation needed][5] Use of contraceptives increased throughout the nineteenth century, contributing to a 50 percent drop in the fertility rate in the United States between 1800 and 1900, particularly in urban regions.

[12] That book was followed by Fruits of Philosophy: The Private Companion of Young Married People, written in 1832 by Charles Knowlton, which recommended douching.

Knowlton's book was reprinted in 1877 in England by Charles Bradlaugh and Annie Besant,[15] with the goal of challenging Britain's obscenity laws.

[21] Contraception was not restricted by law in the United States throughout most of the 19th century, but in the 1870s a social purity movement grew in strength, aimed at outlawing vice in general, and prostitution and obscenity in particular.

[22] Composed primarily of Protestant moral reformers and middle-class women, the Victorian-era campaign also attacked contraception, which was viewed as an immoral practice that promoted prostitution and venereal disease.

[18] Comstock and his allies also took aim at the libertarians and utopians who comprised the free love movement – an initiative to promote sexual freedom, equality for women, and abolition of marriage.

[27] The free love proponents were the only group to actively oppose the Comstock laws in the 19th century, setting the stage for the birth control movement.

[28] The efforts of the free love movement were not successful and at the beginning of the 20th century, federal and state governments began to enforce the Comstock laws more rigorously.

[34] Fear of global overpopulation became a major issue in the 1960s, generating concerns about pollution, food shortages, and quality of life, leading to well-funded birth control campaigns around the world.

[36] In the early 1950s, philanthropist Katharine McCormick had provided funding for biologist Gregory Pincus to develop the birth control pill, which was approved by the Food and Drug Administration (FDA) in 1960.

[40] In 1967 Boston University students petitioned Bill Baird to challenge Massachusetts's stringent "Crimes Against Chastity, Decency, Morality and Good Order" law.

In 1970, Congress removed references to contraception from federal anti-obscenity laws;[46] and in 1973, the Roe v. Wade decision legalized abortion during the first trimester of pregnancy.

[50] In 1982, European drug manufacturers developed mifepristone, which was initially utilized as a contraceptive, but is now generally prescribed with a prostoglandin to induce abortion in pregnancies up to the fourth month of gestation.

[57] In 2000, the Equal Employment Opportunity Commission ruled that companies that provided insurance for prescription drugs to their employees but excluded birth control were violating the Civil Rights Act of 1964.

In addition, a nationally representative survey in 2015 indicated that over 70% of women agreed that not having to make out of pocket payments helped with their ability to use birth control and also aided their consistency of use.

[a] The decision is an interpretation of the Religious Freedom Restoration Act (RFRA) and does not address whether such corporations are protected by the free-exercise of religion clause of the First Amendment of the Constitution.

[69] Zubik v. Burwell was a case before the United States Supreme Court on whether religious institutions other than churches should be exempt from the contraceptive mandate.

[71] Because the Petitioners agreed that "their religious exercise is not infringed where they 'need to do nothing more than contract for a plan that does not include coverage for some or all forms of contraception'", the Court held that the parties should be given an opportunity to clarify and refine how this approach would work in practice and to "resolve any outstanding issues".

[74] In 2017, the Trump administration issued a ruling letting insurers and employers refuse to provide birth control if doing so went against their religious beliefs or moral convictions.

[75] However, later that same year federal judge Wendy Beetlestone issued an injunction temporarily stopping the enforcement of the Trump administration ruling.

[80] A 2013 Lancet systematic literature review found that among reproductive aged women in a marriage or union, 66% worldwide and 77% in the United States use contraception.

[80] When examining reasons why women do not use birth control, a 2007 Pregnancy Risk Monitoring Assessment System (PRAMS) survey of over 8000 women with a recent unintended pregnancy found that 33% felt they could not get pregnant at the time of conception, 30% did not mind if they got pregnant, 22% stated their partner did not want to use contraception, 16% cited side effects, 10% felt they or their partner were sterile, 10% reported access problems, and 18% selected "other".

[84] Contraceptive use has been shown to reduce the rate of children born into poverty,[85] as parents are able to plan the correct financially stable time in which to have a child.

One study also concluded that if women under the age of 30 began using birth control pills as a preventative measure against unplanned pregnancies, the child poverty rate could drop around half a percentage point within a year.

[86] From data collected in the 2017-2019 National Survey for Family Growth, the statistics of birth control usage with respect to these factors with women ages 15–49 were studied.

[88] In the study, data was collected from adolescents residing in the countries of Canada, France, Great Britain, Sweden and the United States on their socioeconomic status and their varying degrees of sexual activity, including their use of contraceptives.

[91] In two major legal cases that were planned in 2014, the attorneys made an issue of whether a for-profit corporation can be required to provide coverage for contraceptive services to its employees.

[75][76] Some doctors and researchers, including the American Medical Association (AMA), would like the availability of the birth control pills to be extended to over the counter instead of prescription only status.

However, if the pill was to become over the counter, it would need to go through a rigorous check by the Food and Drug Administration (FDA) and be approved on the basis of safety, consistency, the ability of patients to properly take it without doctor guidance, and other factors.