Course:CSIS200/2025/Freedom with Conditions: The Birth Control Pill and Gendered Responsibility

Introduction

The birth control pill is a hormonal contraceptive first approved by the Food and Drug Administration for use in the United States in 1960, and within 2 years of its release, 1.2 million American women were using “the pill,” as it is popularly known. By 1970, “60 percent of all American women—married and unmarried alike—were on the pill, had an IUD, or had been sterilized”. Closer to today, in the year 2000, over 100 million women globally have taken the pill. The introduction of the pill marked a major shift in the social, cultural, and medical landscape of the twentieth century. Birth control has become a basic requirement for women to manage their bodies safely, and by allowing users to reliably prevent pregnancy, the pill plays a central role in transforming sexual behavior, family planning, and gender relations across the world.

Often associated with the sexual revolution and second-wave feminism, the pill has been widely interpreted as a tool of sexual liberation. It enabled greater control over reproduction, expanded access to education and employment for many women, and contributed to changing norms surrounding dating, marriage, and premarital sex. At the same time, the pill has been connected to longstanding systems of sexual regulation. Its availability and distribution were shaped by political debates, religious, opposition, and medical gatekeeping, and its widespread use contributed to the expectation that pregnancy prevention should be managed primarily by women.

The history and cultural impact of the pill reveal ongoing tensions between empowerment and regulation in the governance of sexuality. As both a medical technology and a social artifact, the pill continues to inform discussions about the politics of reproduction.

Historical Context

Bottle of Enovid 10 mg Oral Contraceptive — Note the caution text

Ortho Tri-Cyclen oral contraceptives with Ortho Dialpak dispensers

Long before the birth control pill, people used a wide range of methods to try and prevent pregnancy, including sponges, condoms, spermicidal foams and jellies, douching, and withdrawal. None of these methods were entirely effective, and many were uncomfortable, unreliable, or emotionally taxing. Despite these limitations, family planning was already common in the United States by the nineteenth century, as couples sought to limit family size and better manage economic and domestic life. This makes it clear that the desire to control reproduction existed long before modern medical technologies made it easier.

How The Pill Works

The birth control pill represented a major shift in how contraception worked. Unlike earlier methods that physically blocked sperm, the pill functioned by using hormones to prevent ovulation altogether, removing the egg from the reproductive process. First approved for contraceptive use in 1960, the pill was marketed as Enovid by G. D. Searle & Company. As seen in the image of the bottle, the pill was distributed exclusively as a prescription medication (image citation). This meant access to the pill required interaction with doctors and pharmacists, placing reproductive control within medical institutions rather than purely private decision-making.

Early versions of Enovid came in small brown bottles containing 50 identical pills, along with detailed instructions that required strict adherence to a specific schedule. Users were expected to follow a 20-day pill cycle that imposed a standardized 28-day menstrual rhythm, regardless of individual variation. This complexity made consistent use difficult and led to concerns about “patient compliance,” particularly when pregnancies occurred during clinical trials. In response, the Dialpak was introduced in 1963 as the first compliance-focused contraceptive package, arranging pills in a circular blister to visually guide users through a monthly cycle.

Reproductive Justice

A pro-abortion rally in 2012

The pill did not emerge in isolation. Its development was part of a longer history of reproductive activism and legal restriction in the United States. Throughout the late nineteenth and early twentieth centuries, laws such as the Comstock Act criminalized the distribution of contraceptive information and materials, reinforcing medical and moral authority over reproduction. Advocates like Margaret Sanger and countless local organizers worked against these restrictions, eventually contributing to the formation of organizations such as Planned Parenthood. By the early 1960s, millions of women—primarily married—were using the pill, even as religious and social resistance persisted.

Even today, organizations such as Planned Parenthood continue to play a central role in reproductive justice by providing access to contraception, abortion care, sexual health services, and education. Images of pro-abortion rallies, including demonstrations in support of Planned Parenthood, highlight how debates over reproductive autonomy are not confined to the past.

The Pill as Sexual Liberation

The birth control pill is often understood as a powerful tool of sexual liberation for women, because it made it possible to separate sex from the constant risk of pregnancy. Prior to the pill’s introduction, many contraceptive methods were unreliable, disruptive, or dependent on male cooperation, which limited women’s ability to fully control their reproductive lives. The pill offered a privately managed and medically reliable form of contraception that allowed women to make decisions about sex and family planning with greater confidence and predictability.

Reliable contraception had wide-reaching effects, as sex no longer had to be framed primarily around reproduction, which opened space for pleasure, desire, and intimacy to exist more independently. The pill allowed women to delay childbirth, pursue education or employment, and reconsider the timing of marriage and family life. In this sense, the pill expanded women’s capacity to participate more freely in both sexual and public life.

Loretta Lynn — The Pill

This sense of liberation is reflected in Loretta Lynn’s 1975 song The Pill, which captures the shift from a personal, emotional perspective. The song tells the story of a woman who has spent much of her married life pregnant and exhausted, only to finally gain control over her body through access to contraception. With the pill, she can enjoy sex without fear of another unwanted pregnancy, framing contraception as a source of relief and long-overdue freedom. While the song does not represent all women’s experiences, it illustrates how the pill became symbolically associated with freedom from compulsory motherhood and constant reproductive labor.

This narrative of liberation often emphasized individual choice while overlooking the institutional conditions that shaped access to the pill. Regardless, the pill’s ability to give women greater control over when and whether they became pregnant remains one of its most significant contributions to sexual liberation and autonomy.

The Pill as Sexual Regulation and Gendered Responsibility

Although the birth control pill is often celebrated as a symbol of freedom, feminist scholars have shown that it also plays a role in regulating sexuality. Rather than simply giving women more choices, the pill has become tied to social expectations that place the responsibility for preventing pregnancy almost entirely on women. Kara Granzow, a professor in the Department of Sociology at the University of Lethbridge, argues that discussions about the pill often rely on the idea of “choice,” even when women feel that continuing to use the pill is expected rather than freely chosen.

Many women use the pill not because it is their preferred option, but because it fits social expectations around convenience, responsibility, and heterosexual sex. Other contraceptive methods are often seen as disruptive, unreliable, or embarrassing, especially in comparison to the pill. As a result, the pill becomes the default method of contraception, even when it causes unpleasant side effects or discomfort. In this way, what is framed as a personal choice is often shaped by limited alternatives and social pressure.

Granzow also highlights how responsibility becomes built into everyday life through pill use. Women are expected to take the pill daily, even when they are not sexually active, reinforcing the idea that they must always be prepared to prevent pregnancy. This turns pregnancy prevention into a constant obligation rather than a shared responsibility between sexual partners. The pill’s daily routine makes reproductive control feel natural and expected, rather than something imposed.

Granzow further argues that “choice” itself has become a form of regulation. In a social context that values self-control and planning, women who successfully avoid unplanned pregnancy are seen as responsible, while those who do not are often blamed or judged. This creates a situation where choosing the pill is framed as freedom, but not choosing it—or failing to manage reproduction—is treated as irresponsibility.

Alexandria Masse's Birth Control Tapestry as of November 16, 2025

On Social Media

This contradiction is clearly reflected in contemporary discourse. One X post states, “They shame women for abortion and still shame women for using birth control lol. We will never be free.” This comment captures the double standard women face: even when they follow expectations to prevent pregnancy, their sexual behavior remains subject to judgment. The pill does not remove regulation—it changes the way it operates.

Another response to this pressure appears in a creative project documented on X in which a woman is crocheting the birth control information sheet word for word. As of November 16, 2025, the tapestry measures 12 feet by 6.75 feet and represents only one-sixth of the full document after nearly a year of work. This project visually emphasizes the overwhelming amount of information, discipline, and responsibility placed on pill users. Together, these examples show how the pill functions not only as a tool of sexual freedom, but also as a powerful system of gendered regulation.

Conclusion

The birth control pill is often remembered as a straightforward symbol of sexual freedom, but its history and continued use reveal a more complicated reality. On one hand, the pill gave many women greater control over their reproductive lives, but on the other hand, the pill became a core part of social systems that place the responsibility for managing reproduction almost entirely on women, reinforcing gendered expectations around control, discipline, and sexual behavior.

Rather than eliminating sexual regulation, the pill reshaped it. Responsibility was reframed as individual choice, even when access, alternatives, and social pressures limited that choice. Contemporary responses—from public discourse criticizing the constant policing of women’s reproductive decisions to creative projects that highlight the labor of using birth control—demonstrate that these tensions persist today. Together, these examples show that the pill functions not only as a medical technology, but as a cultural artifact that continues to structure how sexuality, responsibility, and autonomy are understood.

Bio

Dang Nguyen is a third-year Sociology student in the Faculty of Arts at the University of British Columbia. Their academic interests center on culture, identity, and the everyday social forces that shape how people relate to one another. Outside the classroom, they enjoy exploring creative projects and community-focused work that help them understand how social theory plays out in real life.