For as long as people have been having sex, they have been trying to prevent unwanted pregnancies and sexually transmitted diseases. Milly Newham looks back at historic methods of contraception, including the dubious and the enduring.
Women have inserted acid, jellies and pastes into their vaginas to create a hostile environment for sperm for thousands of years in an often fruitless attempt to avoid pregnancy. Vaginal douches like the ‘Omega Spray’ above, made during the first half of the 20th century, were used to insert substances intended to remove and kill sperm.
Douching was recommended by doctors during the 19th and early 20th centuries as a method of contraception. It was also often advertised as essential to “feminine hygiene” – women were encouraged to believe they would smell unpleasant if they didn’t douche – and because kits were inexpensive, they were a popular choice. Unfortunately, some solutions had harmful effects, causing irritation, inflammation and burns. Even worse than that, douching is a totally ineffective contraceptive method.
Barrier methods also date back centuries, with items such as leaves, lemons and sponges being used to block sperm from the uterus. Sponges, both natural and synthetic rubber, were a popular method in the 1930s and 40s, as they were readily available and easy to use. Contraceptive sponges are no longer available in the UK today, as they are inferior to other methods.
Unlike the sponge, barrier methods like diaphragms and caps have stood the test of time. The Prorace rubber cap was developed by Dr Marie Stopes, who opened the first family-planning clinic in the UK in 1921. ‘Prorace’ refers to the eugenics movement, a racist and ableist ideology supported by Stopes, which advocated contraception to remove ‘undesirables’ from society. In the early 2000s caps and diaphragms made from silicone became available in the UK.
Spermicidal products, which kill sperm, made barrier methods more effective. In 1885 English pharmacist Walter Rendell developed the first commercially available spermicidal suppository, which contained cocoa butter and quinine sulphate. In the 1950s more effective spermicidal chemicals were developed, including nonoxynol-9, which is still available on prescription in the UK.
The intrauterine device (IUD) prevents sperm from fertilising the egg. Examples like Gräfenberg’s ring, from the 1920s, used silver wire, and in the 1960s copper IUDs were developed; this type is still used today. IUDs became increasingly popular until a scandal caused by one 1970s product, the Dalkon Shield, which had an unacceptably high risk of pregnancy. Another problem was its ‘string’ (to make its removal easier), which caused infections, serious complications and even fatalities. This tragedy damaged the popularity of the IUD, which has only recently began to recover.
Although it had long been known that there was a fertile time and non-fertile time in a woman’s cycle, no one identified the timings of these fluctuations until the 1920s. Independently of each other, gynaecologists Kyusaku Ogino and Hermann Knaus connected ovulation to fertilisation, which then allowed people to calculate fertility using a calendar. This method was popular with the Catholic Church, which denounces all other forms of contraception. Other signs, like body temperature and changes in vaginal mucus, helped to refine the method. This research also paved the way for hormonal contraception.
In 1961 decades of research and the combined efforts of many accomplished scientists led to the contraceptive pill being approved for use in Great Britain. During the late 20th century the number of individuals using the pill increased rapidly, and it is currently the most popular prescribed method of contraception in the UK.
Male contraception has its own, less diverse history, which is as much focused on avoiding disease as preventing pregnancy. There are records of sheaths being used to protect users from disease as far back as ancient times – in the Greek legend of Minos and Pasiphaë a goat’s bladder is used. In the 16th century the anatomist Gabriel Fallopius recommended a linen sheath to prevent syphilis. Animal guts were used to make condoms like the one pictured for hundreds of years.
From the 17th century onwards, the use of the sheath as a contraceptive is well documented. In this 18th-century drawing Casanova is shown blowing up his condom to check for holes while entertaining prostitutes. There was controversy over the invention of the condom because people worried that it would encourage premarital sex, sex with prostitutes and the demise of marriage.
With advancements in manufacturing, people no longer had to blow up their condoms to check for holes. In 1843 Charles Goodyear invented vulcanised rubber, which meant that reusable rubber condoms replaced animal condoms. However, repeated use led to cracking and breaking. In the 1930s rubber was replaced by latex. Single-use latex condoms were thinner, stronger and seamless: a greatly improved product.
Condoms serve a dual purpose: contraception and the prevention of sexually transmitted infections. In the 1980s, advertising during the HIV and AIDS epidemic emphasised that condoms save lives, and sales increased. During the 1990s, condom innovation resulted in the huge variety of condoms available today. Despite research efforts to develop a hormonal method of male contraception, the condom remains the main male method of contraception available.
There is a more definitive method of contraception too: sterilisation. During the 19th century, female sterilisation was a major operation that was often fatal, but developments in keyhole surgery in the 1960s greatly improved outcomes. Surgeons first experimented with male sterilisation in the early 19th century, and during the 20th century it became widely available. In 1972 the NHS recognised vasectomy as being equal to other contraceptive methods.
About the author
Milly Newham is a medical student from Barts and the London School of Medicine and Dentistry. She has completed a degree in Reproductive and Developmental Sciences at Imperial College London and has undertaken research on pre-conception health.