Birthday cakeHappy 50th Birthday, Pill.The media are making a big deal out of fêting the Pill on its 50th birthday, but forgive me if I don’t see much reason to celebrate.

Of course I’ll grant that the birth control pill has vastly improved the lives of many women — more than 100 million are taking it right now — giving us unprecedented control over our bodies and our futures.

But right from the start — May 9, 1960, when the FDA announced that it would approve the Pill — things weren’t rosy.  Laws in many states barred women from actually getting their hands on it, and where laws weren’t on the books, disapproving doctors got in the way. When the Pill first became available, even Planned Parenthood wouldn’t give it to single women. It took a 1965 Supreme Court ruling to establish the right of married couples to use birth control, and then another Supreme Court decision in 1972 to ensure that unmarried people could access contraceptives as well.

It would be nice to think barriers are behind us now. Don’t kid yourself. They’re not. 

Retrograde school-board decisions block many American teens from learning the basic facts about birth control.  As Nancy Gibbs reports in Time:

A study by the National Campaign to Prevent Teen and Unplanned Pregnancy found that … 63% [of young women and men] say they know little or nothing about birth control pills, and much of what they think they know is wrong. More than 40% think that even when using the Pill, a woman has a 50% or higher chance of getting pregnant in any given year; actually, the Pill is 92% effective.

Low-income American women lack info and access too, and are far more likely than their wealthier counterparts to have unintended pregnancies. More than 17 million women in the U.S. need subsidized birth control, and Title X, the federal program started in 1970 to offer family-planning services to needy women, is seriously underfunded

Even American women who are financially stable and covered by health insurance don’t have it easy, as many insurance companies don’t fully cover prescription birth control (this is the big reason why women of childbearing age pay 68 percent more in out-of-pocket medical expenses than men). And some pharmacists [PDF] and even doctors refuse to dispense birth control. 

All of this contributes to a sobering statistic: 49 percent of pregnancies in the U.S. are unintended

Let’s repeat that point: It’s been 50 years since the Pill became available, and still almost 50 percent of pregnancies in this country are unplanned

And that’s just in the U.S., where we have far greater access to far more options than women in the developing world.

Check out these harrowing global stats:

  • At least 200 million women around the world don’t have adequate access to family-planning tools and information, according to the U.N. Population Fund.
  • The “unmet need” for family planning is expected to grow by 40 percent over the next 15 years, the Population Fund says. 
  • If we satisfied just the current unmet need, 52 million unwanted pregnancies in the developing world could be prevented every year, according to the Guttmacher Institute [PDF].
  • That in turn would save more than 1.5 million lives and prevent 505,000 children from losing their mothers, Guttmacher says.
  • That’s because 529,000 women die each year from complications related to pregnancy or childbirth, and about 10 million more suffer injury, infection, or disease in the wake of childbirth, according to the World Health Organization.

Baby stroller crossed-out in greenIf you like this article, you’ll love my piece on being a GINK: green inclinations, no kids

It’s outrageous — as in, cause for outrage — that in the year 2010 every woman everywhere doesn’t have free and easy access to family-planning tools. Contraceptives are win-win-win-win propositions.  They improve the lives of women and the children they choose to have.  They prevent unnecessary maternal deaths.  They save money for families and governments that would otherwise have to provide for additional kids.  And they cut down on the environmental strain caused by a growing population — at far lower cost than many high-tech solutions we’re pursuing

And the problem isn’t just access to contraception — it’s a lack of good, new options.  We’re still agog over a pill that Margaret Sanger dreamed up in 1912 — one that we have to take every single day, one that messes with our hormones, one that has unpleasant side effects for many women, one that contaminates our water supplies. Where are the genuinely easy, truly effective, totally accessible options that should be plentiful by now?  And, while we’re at it, where’s the equivalent of the Pill for men? 

Think of the innovations made over the last 50 years in non-contraceptive pharmaceuticals, in computing, in telecommunications, in renewable energy.  How could something as critical as our fertility get so little top-notch R&D?  Read “Birth Control Stuck in the Dark Ages” for some answers; the article is two years old, but it’s not like any great progress has been made since then. 

So, on the Pill’s 50th birthday, let’s acknowledge that we’re better off with it than without it.  But it damn well isn’t good enough. 

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Read more about population and the option of going childfree: