Oral contraceptives, which transformed society when they were first available, seem to be losing traction among American women as other forms of birth control have become more popular.
When the pill first debuted in 1960, 9 million American women started taking it immediately. They saw it as an answer to their prayers in preventing unwanted pregnancies. The pill was so popular that it led to a sexual revolution in the 1960s, changing the idea that casual sex had to be linked to procreation for women. By 1973, more than a third of American women were on the pill, the most popular it has ever been.
But by 2017, the proportion of American women on the pill had dropped to just over one fifth (22%), according to the Centers for Disease Control and Prevention (CDC)(pdf).
There were probably a few reasons for the pill’s fall in popularity. One of them was likely the proliferation of other types of contraceptives, particularly the intrauterine device (IUD). For decades, the IUD had a rocky reputation, known for injuring or even killing women who had the device implanted. But by 2014, thanks to improvements to IUD designs and a new generation of women who didn’t grow up with the same stigma, made the tiny implant a favored option. Doctors began recommending IUDs over other forms of contraceptives as a fuss-free, safer, and more effective option.
The IUD’s reputation rehab seems to have worked. The CDC study found that the use of IUDs increased from 2% to 14% between 2002 and 2017. In a 2018 survey of 2,000 women by Cosmopolitan Magazine, 70% of respondents said that they have quit or are considering quitting oral contraception; 25% of respondents reported they have an IUD or are considering one. Additionally, IUDs became the go-to birth control for women who feared that president Trump’s election would make it more difficult for them to access birth control pills.
The proliferation of others types of birth control that are more convenient, more effective, and less invasive have also made the pill less appealing. While other contraceptives require just a quick procedure to function for years, oral contraceptive has to be taken every day, making the pill less marketable and less convenient.
Another reason behind the pill’s fall in popularity: the rise of the wellness movement. The long-term effects of hormone usage not only comes with health risks, but also changes in mood, sex drive, weight, psychology, and behavior. The discussion around these effects is more popular than ever and it’s in part because of influencers and the wellness industry that more people are doubting the pill. Now women are questioning how well it fits into their healthy lifestyle, instead turning to non-hormonal IUDs, cycle-tracking apps, condoms, and the pullout method.
The realization that they need to stop taking the pill is one that I, along with thousands of women, have come to in the past few decades. Being prescribed the birth control pill always seemed like a normal part of my “growing up” to-do list. I, like many women my age, was first prescribed the pill when I was 16 years old in order to make my periods more regular. When it came time to visit my gynecologist, I didn’t ask about any of the risks associated with the pill, instead trusting the fact that all the other women I knew were also popping the tiny contraceptive daily. When I was 21, I suffered from a transient ischemic attack, or mini stroke, at work. Recognizing that I was young, healthy, and had no history of blood clots in my family, my doctor recommended that I stop taking my birth control pill. After spending three days in a stroke unit, I was done with the pill forever and forced to look for other options.
That’s not to say that the pill is going away completely. Today, close to 9.6 million American women take the pill daily, which means oral contraceptive is still the leading most popular form of birth control.
But it seems likely that birth control pills will continue to decline as IUDs and other contraceptives rise in popularity. Those who have not had any problems with the pill and don’t view it as a hassle will most likely be the ones who keep using it. Younger women may be more likely to opt for an IUD when choosing their first prescribed contraception because it’s what their doctors are suggesting. This is an age in which women publicly acknowledge that they deserve reproductive rights, that they have more birth control options than ever, and the possibility of a male oral contraceptive on the shelves in the near future. The pill isn’t seeing its final days, it just isn’t the it girl of reproductive health anymore.