As birthdays go, 50 is always something of a watershed in a woman’s life. But this year, 4 December marks a different kind of fiftieth; one that holds huge significance not just for individuals born that day 50 years ago but for millions of women in the UK, because it will be five decades since Enoch Powell, health minister at the time, announced that oral contraception would be made available to women on the NHS.
That the Pill changed women’s lives by giving them control over their own fertility and freeing them from fear of unwanted pregnancy is beyond dispute. Whether it changed women’s lives for the better has been hotly debated ever since.
Asked to comment on the fiftieth anniversary of the oral contraceptive in the US, actress Raquel Welch, famous as a sex object in the Swinging Sixties and who might have been thought to favour it, told CNN that she held the Pill responsible for marital decline and rampant promiscuity.
I doubt Raquel remembers, or is even aware of the fact, that for the first few years after its introduction, the Pill was only available to women who were married (and therefore less likely to be promiscuous). It could be given to engaged women at the discretion of family planning clinics and on presentation of a letter from the vicar.
Only gradually, and when sexual mores had moved on thanks to feminism and other seismic social shifts, did the Pill become available, and for free, to sexually active single girls.
For those who don’t align themselves with the backlash against the Pill from the conservative right or from a religious point of view, concerns are more likely to focus on possible long-term health effects than a sense of moral panic.
If I had a sexually active teenage daughter today, would I advise her take the Pill? I would certainly run through the alternatives first. When I first went on the Pill, aged 17, I did so in total ignorance about long-term side effects, which hadn’t yet been documented.
I was knocked sideways, though, by the short-term ones – breasts so tender I wanted to cry, horrible headaches and an insatiable appetite – for food, not sex. I tried several different oral contraceptives over the years, but never found one that I could comfortably tolerate.
No one should treat taking a powerful chemical compound on a day-in day-out basis lightly. I would explain to my daughter that, far from being an easy option, finding the right oral contraceptive might be a long-haul effort of trial and error if side-effects became troublesome.
I would want her to know of the susceptibility to deep-vein thrombosis and certain cancers, and of the good news, such as the result a Cancer Research UK study, for example, which shows that long-term use of the Pill lowers the risk of ovarian cancer. And I would explain the fact that overall the Pill is less risky to health than pregnancy and childbirth.
I would certainly warn my daughter that the Pill offers no protection whatsoever against increasingly common STIs and condoms – far from being made redundant by the Pill – should be used in addition. And that the Pill should never, ever make her less selective about her sexual partners on a well-why-not-at least-I-won’t-get–pregnant basis.
And if my poor daughter wasn’t put off sex altogether by this point and asked me what I think she should do, I’d probably tell her that since the Pill is still the most effective contraceptive there is, it would be worth giving it a go to see if suited her.
The Pill is not a panacea, but it has hugely helped women to control their own destinies. And that control is certainly something I’d want my daughter to have access to. For that alone it deserves a very happy birthday indeed.