It wasn’t until 1965 that the law banning birth control was struck down by the U.S. Supreme Court.
This case, however, Griswold v. Connecticut, applied only to married couples. Millions of unmarried women were still denied the pill. Finally, in 1972, the Supreme Court case Baird v. Eisenstadt legalized birth control for everyone, notes Our Bodies Ourselves Today.
Manufacturers worked hard in the 1980s to improve the pill, offering women new dosages, new progestins, and multiphasic pills.
According to the Guttmacher Institute, today’s birth control pills have a failure rate of 0.3 percent with perfect use and a 7 percent failure rate with typical use.
The pill remains a sought-after method of reversible birth control. Between 2017 and 2019, 14 percent of all women ages 15 to 49 were on the pill in the United States, according to the Centers for Disease Control and Prevention (CDC).
In 2018, 21 percent of contraceptive users ages 15 to 49 used the pill, making it the second-most popular form of birth control after female permanent contraception (28 percent), per the Guttmacher Institute.
The First Intrauterine Birth Control Devices Faced a Rocky Road
With women clamoring for additional birth control choices, the FDA approved the first intrauterine devices (IUDs) in 1968, notes Our Bodies Ourselves Today. These early devices did not use hormones, primarily serving to prevent fertilization.
In 1974, however, sales of one of these IUDs, the Dalkon Shield, were suspended after it was linked to numerous infections and seven deaths. Although only that one brand was implicated, other manufacturers feared expensive lawsuits and also pulled their IUDs from the market.
In the 1980s, a new copper IUD called Paragard was approved. The Paragard nonhormonal IUD (also called the copper IUD) is a small piece of flexible plastic shaped like a T that has copper wrapped around it.
The copper IUD can be used as a regular form of birth control, or as a form of emergency contraception. Per Planned Parenthood, Paragard IUDs are the most effective form of emergency contraception. If you have one inserted within five days after having unprotected sex, it’s more than 99.9 percent effective against pregnancy and also provides very reliable contraception for up to 10 years.
In 2000, the Mirena IUD came on the market. Like the nonhormonal IUD, Mirena and other hormonal IUDs are small pieces of flexible plastic shaped like a T. They release a tiny amount of progestin into your body over time, which helps prevent pregnancy, and they can remain effective for three to eight years depending on the brand, notes Planned Parenthood. They are also used as treatment for heavy or painful periods and symptoms of conditions such as endometriosis and polycystic ovary syndrome (PCOS).
According to the Guttmacher Institute, hormone-releasing IUDs have a failure rate that ranges from 0.1 to 0.4 percent.
Among contraceptive users ages 15 to 49 in 2018, 13 percent relied on an IUD.
Low-Tech Birth Control Methods Are Still Around
Coital methods of contraception — which are methods used at the time of intercourse such as condoms and withdrawal — remain in use today, but the effectiveness of these methods varies widely. In 2016, one-quarter of all contraceptive users ages 15 to 44 relied on a coital method as their primary form of contraception, according to the Guttmacher Institute.
Condoms were the most commonly used primary coital method (15 percent), followed by withdrawal (7 percent).
More Hormone Delivery Systems Keep Coming
Over the last few decades, hormonal contraceptives have become available in methods beyond an oral pill. These range from injectables and vaginal rings to hormonal patches and implants.
In the United States, the term “injectables” refers to the Depo-Provera shot or birth control shot, which contains progestin to prevent ovulation, notes Planned Parenthood. According to the Guttmacher Institute, injectables, if used perfectly, have a 0.2 percent failure rate and a 4 percent failure rate if used typically.
The vaginal ring, also known as the birth control ring and by brand names NuvaRing and Annovera, is a small ring that a woman wears inside her vagina. The ring contains estrogen and progestin to prevent ovulation, explains Planned Parenthood.
Like the vaginal ring, the patch (brand names Xulane or Twirla) releases estrogen and progestin, but through a patch worn on your stomach, buttocks, or back, notes Planned Parenthood.
Vaginal rings and patches both have a 0.3 percent failure rate if used perfectly and a 7 percent failure rate if used typically.
According to Planned Parenthood, the birth control implant, also called Nexplanon, is inserted under the skin of your upper arm. It releases progestin to prevent pregnancy, and it’s more than 99 percent effective.
Other Forms of Emergency Contraception
Emergency contraceptive pills, designed to be taken after unprotected sex, first emerged in the late 1990s, according to Our Bodies Ourselves Today. The FDA approved the brands Preven in 1998 and Plan B in 1999. But their availability greatly improved in 2006 when the FDA approved over-the-counter sales of Plan B for people ages 18 and over, and again in 2013 when it approved over-the-counter sales for people under 18.
According to Planned Parenthood, levonorgestrel morning-after pills, including Plan B One-Step and other brands, can lower your chance of getting pregnant by 75 to 89 percent if you take them within three days after unprotected sex.
If you weigh more than 165 pounds (lbs), the copper IUD or Ella are better emergency contraception options for you, notes Planned Parenthood. Ella reduces your chances of getting pregnant by 85 percent if you take it within five days after unprotected sex, but you need a prescription to get it. (However, Ella may be less effective for those over 195 lbs.)
According to Planned Parenthood, Ella contains ulipristal, which delays or possibly prevents ovulation, while Plan B and similar brands contain levonorgestrel, which is similar to what’s in other forms of hormonal birth control.
Sterilization Is Still the Best Option for Permanent Prevention
Permanent contraceptive methods, sometimes called female or male sterilization, include tubal ligation (tying tubes) and partner vasectomy, according to the Guttmacher Institute.
Among contraceptive users ages 15 to 49 in 2018, female permanent contraception was the most common method used (28 percent), followed by pills (21 percent), male condoms, and IUDs (both 13 percent), notes the Guttmacher Institute.
In 2018, more than one-third (36 percent) of users ages 15 to 49 relied on some form of permanent contraception, although it was much more common among users ages 40 and over.
The popularity of these methods is likely due in large part to how effective they are. According to the Guttmacher Institute, tubal sterilization and vasectomy both have a failure rate of close to 0 percent.
Resources
Planned Parenthood
Planned Parenthood is a nonprofit organization with the mission of ensuring that everyone has access to the care and resources they need to make informed decisions about their bodies, their lives, and their futures. Planned Parenthood delivers sexual and reproductive healthcare, sex education, and information to millions of people every year.
Guttmacher Institute
The Guttmacher Institute is a leading research and policy organization committed to advancing sexual and reproductive health and rights worldwide. The institute dreams of a future in which everyone can realize their rights and access the resources they need to achieve sexual and reproductive health.
