WEBVTT - Ep 60 Giving birth to "The Pill"

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<v Speaker 1>My name is Aaron Welsh and I am co host

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<v Speaker 1>of this podcast Will Kill You. I have been taking

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<v Speaker 1>some form of birth control since I was eighteen years old,

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<v Speaker 1>so fifteen years now, and I've tried the various ones

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<v Speaker 1>I've tried, you know, the combination oral contraceptive, I've done nuverarring,

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<v Speaker 1>and I currently have a hormonal IUD. I started taking

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<v Speaker 1>birth control because well, it was a combination of things.

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<v Speaker 1>One was my periods were so bad that I was

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<v Speaker 1>like laid out in my house for two days at

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<v Speaker 1>least every month just in horrible pain, couldn't leave. And

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<v Speaker 1>also because I didn't want to get pregnant. And as

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<v Speaker 1>soon as I started taking the oral contraceptive I it

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<v Speaker 1>was like night and day, like the pains were so

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<v Speaker 1>much less, my periods almost disappeared. It was like I

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<v Speaker 1>was so so grateful to be able to just like

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<v Speaker 1>function normally, is what it felt like. And I've been

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<v Speaker 1>really fortunate and that I haven't had very many problems,

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<v Speaker 1>and all these various forms have continued to do the

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<v Speaker 1>trick for me. So you know, I don't want to

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<v Speaker 1>get pregnant. And the birth control that I've taken has

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<v Speaker 1>been very effective in that way, and so I'm I'm

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<v Speaker 1>really grateful for, you know, for having access to birth

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<v Speaker 1>control and continued access to birth control, and I hope

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<v Speaker 1>that it stays that way.

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<v Speaker 2>My name is Aaron Alman Updike, and I am the

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<v Speaker 2>other co host of this podcast, Will Kill You. And

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<v Speaker 2>I first started birth control when I was twenty, which

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<v Speaker 2>was about twelve years ago, and I started exclusively to

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<v Speaker 2>try and prevent getting pregnant. It was very effective. I

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<v Speaker 2>started on like a combination oral pill. I never had

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<v Speaker 2>any real issues with it. I tried. I think I

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<v Speaker 2>had to increase my dose like one and then I

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<v Speaker 2>did have one very stressful year where my insurance got

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<v Speaker 2>wonky and I wasn't able to get access to birth control,

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<v Speaker 2>and that was very stressful because I very much didn't

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<v Speaker 2>want to become pregnant. But I was able to get

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<v Speaker 2>back on until I decided a few years ago to

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<v Speaker 2>start trying to get pregnant. So I'm really grateful that

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<v Speaker 2>I was able to make that decision when it was

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<v Speaker 2>right for me and my partner and our family. And

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<v Speaker 2>then after I had my baby, I got the copper IUD,

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<v Speaker 2>which is a non hormonal option of contraception and that's

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<v Speaker 2>been really great for me too. I one year in

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<v Speaker 2>and I'm still not pregnant, so that's nice. Yeah. I

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<v Speaker 2>also am just really grateful I had, you know, only

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<v Speaker 2>one year when I wanted and needed access to birth

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<v Speaker 2>control and I didn't have it, and that was a

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<v Speaker 2>really really stressful year. So I can't imagine, like never

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<v Speaker 2>having access to it, how different my life could have been.

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<v Speaker 3>Hi, I'm Aaron Welsh again.

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<v Speaker 2>I'm Aaron owen Updyke one more time.

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<v Speaker 1>And this is this podcast will kill you.

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<v Speaker 2>Those were our birth control stories.

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<v Speaker 1>It was. It was a strange feeling to be in

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<v Speaker 1>the first and account chair. I don't know if I

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<v Speaker 1>liked it. Let's not do it again, deal.

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<v Speaker 2>Okay, So welcome everyone to our sixtieth episode.

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<v Speaker 1>Our sixtieth episode. It's unbelievable that we've made it this far,

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<v Speaker 1>I feel, and sadly, we have to note it is

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<v Speaker 1>our season finale, so this is the last episode of

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<v Speaker 1>season three.

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<v Speaker 2>Not all sad. That's also it's exciting too, like.

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<v Speaker 1>Woohoo, Yeah, yeah, it's exciting, Like I can't I look

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<v Speaker 1>back and I'm like syphilis was a year ago?

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<v Speaker 3>How wow?

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<v Speaker 1>It just feels like a lifetime yeah, yeah, Hey.

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<v Speaker 2>That's funny. We started with syphilis and we're ending with

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<v Speaker 2>birth control.

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<v Speaker 1>Ha ha, I know, I like it.

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<v Speaker 2>So this wasn't the episode that we had planned for

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<v Speaker 2>our season finale. We had planned a very very different episode, yes,

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<v Speaker 2>but in light of recent events, especially the passing of

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<v Speaker 2>Justice Ruth Bader Ginsburg and the impact that that's inevitably

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<v Speaker 2>going to have on reproductive rights in the United States,

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<v Speaker 2>we decided to focus this episode on birth control.

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<v Speaker 1>We decided that we wanted to honor the incredible amount

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<v Speaker 1>of work that the Notorious RBG did during her time

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<v Speaker 1>on the Supreme Court. And so, yeah, we're we're really

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<v Speaker 1>excited for this episode. I mean, we had been planning

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<v Speaker 1>on doing something like this in the future eventually, Yeah,

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<v Speaker 1>but now seemed like as good a time as any,

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<v Speaker 1>if not the most important time.

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<v Speaker 2>But speaking of time, before we jump into the episode,

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<v Speaker 2>it is in fact quarantiney time.

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<v Speaker 1>It is. You are absolutely correct about that, You are

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<v Speaker 1>exactly right about that. What are we drinking this week?

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<v Speaker 2>We're drinking notorious.

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<v Speaker 1>That's right, in honor of notorious RBG. Erin what is

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<v Speaker 1>in notorious?

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<v Speaker 2>Well, of course, in order to properly honor RBG. It's

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<v Speaker 2>a wine cooler or wine spritzer. I don't know what

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<v Speaker 2>you call it, what's the fancy term for it. We

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<v Speaker 2>aren't using what is it opus one or something? Is

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<v Speaker 2>her particular brand of wine. We can't afford that, No,

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<v Speaker 2>just use whatever wine you can afford.

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<v Speaker 1>Yes, and we will post the recipe for Notorious as

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<v Speaker 1>well as our non alcoholic placey rita. Oh, that's gonna

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<v Speaker 1>be another fun one to make a non alcoholic wine.

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<v Speaker 1>We'll post those recipes on our website, this podcast will

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<v Speaker 1>kill You dot com as well as on all of

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<v Speaker 1>our social media channels, which you can find links to

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<v Speaker 1>through our website as well. Yep, Well, Aaron, do we

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<v Speaker 1>have more business? Oh? Actually, I don't know why I

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<v Speaker 1>asked you. I have a couple pieces of business.

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<v Speaker 2>Oh okay.

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<v Speaker 1>This was more of just like a couple of things

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<v Speaker 1>that a bunch of people had reached out to us about.

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<v Speaker 1>So the first part is in relation to our herpes episode.

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<v Speaker 1>And you know, in the episode, I had asked about

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<v Speaker 1>stigma against genital herpes in other countries and whether it existed,

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<v Speaker 1>and multiple people reached out to us from a bunch

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<v Speaker 1>of different countries and said no, no one even thinks

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<v Speaker 1>about it here, like it's not a second thought, and

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<v Speaker 1>that if there is any stigma, it seems to be

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<v Speaker 1>lifted from American TV shows or movies that like either

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<v Speaker 1>joke about it or make fun of it or call

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<v Speaker 1>it out or something like that. So wow, there you go. Cool,

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<v Speaker 1>And then I mean, it is it is great that

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<v Speaker 1>there's like no stigma in other countries, so just let's

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<v Speaker 1>be more like that. And then the other thing is

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<v Speaker 1>that our last episode was Thelidamide, and apparently there's a

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<v Speaker 1>major storyline or plotline on Call the Midwife about thelidamide,

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<v Speaker 1>and Aaron, you and I watched like so much of that,

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<v Speaker 1>but I guess we still.

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<v Speaker 2>Yeah, we must not have made it that far. But dang,

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<v Speaker 2>I can't believe we miss that.

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<v Speaker 1>I know, I know, So I'm going to have to

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<v Speaker 1>start watching that again. It's on Netflix. It's a fun show. Okay.

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<v Speaker 2>Anyway, all right, well then is that all? Shall we

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<v Speaker 2>dive in?

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<v Speaker 1>Let's dive in.

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<v Speaker 2>Okay, we'll take a quick break first. Aaron you already

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<v Speaker 2>said that we're excited to talk about this, but I

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<v Speaker 2>have to just say, talking about birth control, it's one

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<v Speaker 2>of the things that makes me most excited, and it's

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<v Speaker 2>one of the things that I look forward to the

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<v Speaker 2>most in becoming a doctor is getting to talk about

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<v Speaker 2>birth control with future patients. Like I love reproductive health counseling.

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<v Speaker 1>Okay, some minute, I know this about you, Aeron, and

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<v Speaker 1>I know that about you.

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<v Speaker 2>Like, I am so excited. I think my breath is

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<v Speaker 2>going to be like shaky, so I need to just

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<v Speaker 2>calm down.

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<v Speaker 1>It does like I think it was us having to

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<v Speaker 1>do the first hand accounts, but I feel like this

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<v Speaker 1>is our first time podcasting or something like, Yeah.

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<v Speaker 2>It feels that way. I'm nervous. Okay, But before I

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<v Speaker 2>can start talking about birth control, I want to back

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<v Speaker 2>up because, uh, we have to kind of talk about

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<v Speaker 2>the menstrual cycle and some general basic anatomy before we

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<v Speaker 2>can talk about how birth control affects your body. Okay,

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<v Speaker 2>I love it. Foundations foundations Okay, Okay, I'm going to

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<v Speaker 2>start off really basic here because a lot of people

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<v Speaker 2>with a uterus don't really know their own anatomy since

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<v Speaker 2>it's internal. So in general, in people with a uterus,

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<v Speaker 2>we have two ovaries and then Filippian tubes, which are

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<v Speaker 2>what kind of collect the eggs that is connected to

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<v Speaker 2>the uterus itself. The inside lining of that uterus is

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<v Speaker 2>called the endometrium, and then the bottom of the uterus

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<v Speaker 2>is called the cervix. I feel like that's an important one.

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<v Speaker 2>And then you have the vaginal canal, and then the

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<v Speaker 2>outside world. Okay, the outside world does that work? All right?

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<v Speaker 2>So then let's talk about the menstrual cycle, because this

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<v Speaker 2>is the thing that happens about every month or so

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<v Speaker 2>in most people who have a uterus. We're going to

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<v Speaker 2>go over the specific phases and hormones that are involved

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<v Speaker 2>in a second, but the cycle essentially begins weirdly with

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<v Speaker 2>the start of menstruation. So the start of like vaginal bleeding.

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<v Speaker 2>Isn't that weird that that's where we start it? I mean,

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<v Speaker 2>is it's just arbitrary, right, It's totally arbitrary. That's just

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<v Speaker 2>that's where we start it. And then it ends with

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<v Speaker 2>the kind of resumption of menstration like the next cycle,

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<v Speaker 2>or with implantation of a blastocyst, which would then be

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<v Speaker 2>called pregnancy. So at the beginning day one of your

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<v Speaker 2>menstrual cycle, you're bleeding, probably, and at this point in time,

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<v Speaker 2>almost all of the hormone levels in your body are

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<v Speaker 2>pretty low, and there are a complex series of feedback

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<v Speaker 2>loops between three organs or parts of organs, the hypothalamus

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<v Speaker 2>in your brain, the pituitary which is also in your brain,

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<v Speaker 2>and then your ovaries themselves, and all three of these

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<v Speaker 2>release hormones that result in the endometrial lining, so the

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<v Speaker 2>lining of your uterus proliferating and expanding, and then follicles

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<v Speaker 2>in your ovaries maturing, and then eventually egg release right ovulation.

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<v Speaker 2>So if day one is the start of menstruation, that

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<v Speaker 2>will usually last anywhere from two to seven days, and

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<v Speaker 2>then the process of follicle maturation, so basically eggs getting

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<v Speaker 2>ready to be released in your ovary is happening at

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<v Speaker 2>this time. So your brain is releasing two hormones FSH

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<v Speaker 2>and LH that are causing that follicle too mature. This

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<v Speaker 2>phase is called the follicular phase. Get it okay, pollicle okay.

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<v Speaker 2>And through this time period, your estrogen levels are slowly rising,

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<v Speaker 2>So they start off kind of low and then they

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<v Speaker 2>slowly start to rise. Around day fourteen, but this can

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<v Speaker 2>vary from like twelve to twenty days. Estrogen levels will

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<v Speaker 2>surge and that causes another hormone LH to surge, and

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<v Speaker 2>those two hormones surging is what triggers ovulation, okay, and

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<v Speaker 2>then after ovulation, the egg is released from those ovaries,

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<v Speaker 2>it has to travel down the Filippian tube. And now

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<v Speaker 2>you're in the next phase, or the luteal phase of

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<v Speaker 2>your menstrual cycle. And what's happening during this phase is

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<v Speaker 2>that where the egg was released from in your ovary

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<v Speaker 2>develops into what's called the corpus ludium, and this secretes

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<v Speaker 2>yet another hormone, progesterone, and so now it's also going

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<v Speaker 2>to be secreting estrogen, but progesterone is going to rise

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<v Speaker 2>much more than it has up to this point in

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<v Speaker 2>the cycle. So now you have steadily high progesterone and estrogen.

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<v Speaker 2>This is going to prevent any further eggs from maturing.

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<v Speaker 2>It's going to stabilize the lining of your uterus, that endometrium,

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<v Speaker 2>so that if that egg is fertilized, it can implant

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<v Speaker 2>in the endometrial lining and a pregnancy can take place.

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<v Speaker 2>If that egg is not fertilized, then after fourteen days,

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<v Speaker 2>that corpus lutium degenerates, essentially drone drops and the menstrual

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<v Speaker 2>cycle starts over aka, you bleed from your vagina.

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<v Speaker 1>Okay, So can I start with the questions? Yes, instead

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<v Speaker 1>of asking how, even though I really want to ask how,

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<v Speaker 1>Like these things work on a molecular and like a

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<v Speaker 1>larger I guess level, can you tell me why we

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<v Speaker 1>have a menstrual cycle?

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<v Speaker 2>Oh Arin, I'm so glad that you asked that question.

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<v Speaker 1>You have some animals don't, like rabbits, will ovulate only

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<v Speaker 1>after like only after copulation, Aaron.

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<v Speaker 2>Not only do some animals don't, the vast majority of

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<v Speaker 2>other animals do not menstruate. You. Just if you think

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<v Speaker 2>I'm excited about birth control, you should not have asked

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<v Speaker 2>me this question. Let me tell you all about it. So, Okay,

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<v Speaker 2>that process that I said of building up the endometrial lining, okay,

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<v Speaker 2>that process where it gets thickened the blood supply increase,

0:15:00.960 --> 0:15:05.400
<v Speaker 2>That is called decidualization. Okay, that's what That process is called,

0:15:05.440 --> 0:15:09.360
<v Speaker 2>building up the thickening of that lining in preparation for

0:15:09.400 --> 0:15:15.200
<v Speaker 2>implantation of an embryo. In humans and a couple of

0:15:15.280 --> 0:15:20.360
<v Speaker 2>other primate species four species of bats, one species of

0:15:20.400 --> 0:15:27.680
<v Speaker 2>spiny mouse, and the elephant shrew. This process happens spontaneously.

0:15:28.320 --> 0:15:32.360
<v Speaker 2>So the question is not why do we menstruate? We

0:15:32.560 --> 0:15:38.040
<v Speaker 2>men stright because spontaneously every month, our uterus is like, hey,

0:15:38.320 --> 0:15:40.640
<v Speaker 2>gotta build up this real thick lining, gotta get things

0:15:40.680 --> 0:15:45.400
<v Speaker 2>ready before there's an egg that's been released, before there's

0:15:45.440 --> 0:15:49.080
<v Speaker 2>an embryo that's been created, Like we do that for

0:15:49.120 --> 0:15:51.840
<v Speaker 2>no reason, just ready to get it ready. And we

0:15:51.920 --> 0:15:54.800
<v Speaker 2>don't know exactly why that happens, but that is what

0:15:54.880 --> 0:15:58.960
<v Speaker 2>then leads to menstruation. Yeah, isn't that fascinating?

0:15:59.000 --> 0:16:01.080
<v Speaker 1>We don't, well, that's what I mean, Like, why does

0:16:01.120 --> 0:16:03.240
<v Speaker 1>this why does this build up happen? Like or why

0:16:03.320 --> 0:16:05.480
<v Speaker 1>is it? Like, oh, let's get ready, let's let's expend

0:16:05.520 --> 0:16:08.360
<v Speaker 1>all of this like energy and stuff into creating this lining,

0:16:08.520 --> 0:16:09.440
<v Speaker 1>and we shed it.

0:16:09.560 --> 0:16:11.560
<v Speaker 2>We don't even resorb it like a lot of other

0:16:11.600 --> 0:16:15.360
<v Speaker 2>species that have estras cycles, they'll resorb that lining if

0:16:15.400 --> 0:16:19.520
<v Speaker 2>implantation doesn't happen. It's a really, really good question. Some

0:16:19.640 --> 0:16:22.960
<v Speaker 2>of the evolutionary hypotheses have to do with like how

0:16:23.040 --> 0:16:27.400
<v Speaker 2>deeply the placenta invades into our endometrium, So having like

0:16:27.440 --> 0:16:33.360
<v Speaker 2>an extra thick lining can help prevent more invasive placentation. Okay,

0:16:33.760 --> 0:16:36.760
<v Speaker 2>but it's not entirely clear. We have right now, just hypotheses.

0:16:36.800 --> 0:16:40.560
<v Speaker 2>We don't have solid answers to that question, okay, but

0:16:40.680 --> 0:16:44.000
<v Speaker 2>it is all triggered by those specific hormones, right, So

0:16:44.040 --> 0:16:48.600
<v Speaker 2>it's all hormonally driven, and that whole cycle of menstruation

0:16:49.160 --> 0:16:52.680
<v Speaker 2>can last anywhere from like twenty five to thirty five days.

0:16:53.160 --> 0:16:55.400
<v Speaker 2>And one thing that I think is important about that

0:16:55.840 --> 0:17:01.280
<v Speaker 2>is that that variation in length occurs in follicular phase,

0:17:01.480 --> 0:17:05.040
<v Speaker 2>so that first phase when the follicle is developing, not

0:17:05.240 --> 0:17:09.280
<v Speaker 2>during the luteal phase. So the period from ovulation to

0:17:09.480 --> 0:17:14.000
<v Speaker 2>menstruation is almost always right about fourteen days, maybe twelve

0:17:14.040 --> 0:17:16.520
<v Speaker 2>to fifteen. It's a much narrower window.

0:17:17.040 --> 0:17:17.480
<v Speaker 1>Okay.

0:17:18.000 --> 0:17:21.639
<v Speaker 2>That's how a normal menstrual cycle pretty much functions. I'm

0:17:21.720 --> 0:17:23.479
<v Speaker 2>not going to touch on all the different ways that

0:17:23.480 --> 0:17:28.359
<v Speaker 2>that can go wonky, there's a lot. But how do

0:17:28.600 --> 0:17:33.600
<v Speaker 2>oral contraceptive pills the pill interact with this cycle and

0:17:33.640 --> 0:17:37.719
<v Speaker 2>how do they prevent pregnancy? Oh, it's so fun So

0:17:38.560 --> 0:17:41.600
<v Speaker 2>the oral contraceptive pill, the pill that most people are

0:17:41.640 --> 0:17:46.400
<v Speaker 2>familiar with, is a combination pill that includes both estrogen

0:17:46.760 --> 0:17:50.520
<v Speaker 2>and progesterone. Okay, and there's a lot of different forms

0:17:50.520 --> 0:17:55.679
<v Speaker 2>of synthetic progesterone. Ignore them all for now. Both of

0:17:55.720 --> 0:17:59.000
<v Speaker 2>these in combination are then going to be present when

0:17:59.000 --> 0:18:02.240
<v Speaker 2>you take this pill at higher levels than they would

0:18:02.240 --> 0:18:06.879
<v Speaker 2>be during a normal follicular phase of your cycle. So

0:18:07.000 --> 0:18:10.560
<v Speaker 2>what they do is, by the constant presence of a

0:18:10.720 --> 0:18:19.600
<v Speaker 2>higher level of especially progesterone, you inhibit ovulation from ever occurring, right,

0:18:20.160 --> 0:18:25.320
<v Speaker 2>because ovulation depends on a surge of estrogen, So a

0:18:25.560 --> 0:18:31.880
<v Speaker 2>rapid increase in estrogen, which triggers a rapid increase in LH.

0:18:32.960 --> 0:18:38.800
<v Speaker 2>By having relatively higher levels of progesterone and estrogen, your

0:18:38.800 --> 0:18:43.879
<v Speaker 2>body never sees that surge and therefore never ovulates.

0:18:44.640 --> 0:18:45.000
<v Speaker 1>Mm hm.

0:18:45.640 --> 0:18:47.000
<v Speaker 2>Isn't that incredible?

0:18:47.720 --> 0:18:51.960
<v Speaker 1>I mean the I guess, like simplicity may not be

0:18:52.000 --> 0:18:57.240
<v Speaker 1>the right word, but like it does seem beautifully like obvious.

0:18:57.480 --> 0:19:01.640
<v Speaker 2>Yeah, I mean relatively yeah. Yeah, yeah, And I'm simplifying

0:19:01.680 --> 0:19:03.639
<v Speaker 2>this cycle. But you know that's fine.

0:19:03.680 --> 0:19:06.080
<v Speaker 1>Well, but I know, I just mean, like the way

0:19:06.560 --> 0:19:10.360
<v Speaker 1>the mechanism of action of the birth control pill. Yes,

0:19:10.359 --> 0:19:12.760
<v Speaker 1>and it's just like, oh, we are going to just

0:19:13.000 --> 0:19:16.760
<v Speaker 1>use this trick that already exists, Like this is just

0:19:16.840 --> 0:19:19.959
<v Speaker 1>something that the body already does, and we're just going

0:19:20.040 --> 0:19:21.440
<v Speaker 1>to kind of lean into it a bit more.

0:19:21.600 --> 0:19:27.240
<v Speaker 2>Right, Yeah, and so in these combined oral contraceptive pills,

0:19:27.800 --> 0:19:31.720
<v Speaker 2>it's really the progestin, the progesterone, that's most effective at

0:19:31.760 --> 0:19:36.800
<v Speaker 2>inhibiting ovulation. The addition of estrogen does help to ensure

0:19:36.840 --> 0:19:41.520
<v Speaker 2>that ovulation doesn't occur, but it also helps to stabilize

0:19:41.560 --> 0:19:46.080
<v Speaker 2>that endometrium in a way that can prevent irregular bleeding,

0:19:46.200 --> 0:19:50.840
<v Speaker 2>so like breakthrough bleeding. And so it helps to regulate

0:19:51.040 --> 0:19:54.240
<v Speaker 2>menstrual cycles because you can have like this constant level

0:19:54.240 --> 0:19:56.679
<v Speaker 2>of estrogen and then you take it away for a

0:19:56.720 --> 0:19:59.040
<v Speaker 2>certain number of days and then boom, you're going to

0:19:59.119 --> 0:20:02.159
<v Speaker 2>shed that lining mm hm. And so that's kind of

0:20:02.200 --> 0:20:05.200
<v Speaker 2>the most In the United States, that's the most commonly

0:20:05.640 --> 0:20:10.360
<v Speaker 2>used form of contraception is the combined OCP. Now, these

0:20:10.400 --> 0:20:12.760
<v Speaker 2>pills also do a few other things that become more

0:20:12.800 --> 0:20:17.159
<v Speaker 2>important in other forms of contraception. The presence of progesterone

0:20:17.280 --> 0:20:20.920
<v Speaker 2>helps to thicken the cervical mucus. So remember the cervix

0:20:21.040 --> 0:20:23.600
<v Speaker 2>is the bottom portion of the uterus. It's the top

0:20:23.680 --> 0:20:27.760
<v Speaker 2>of the vaginal canal. So that's the entry way for

0:20:27.920 --> 0:20:31.440
<v Speaker 2>sperm to get in to the uterus. So by thickening

0:20:31.480 --> 0:20:34.480
<v Speaker 2>the mucus that's present there. It makes it really really

0:20:34.520 --> 0:20:38.120
<v Speaker 2>difficult for sperm to actually get into the uterine cavity,

0:20:38.320 --> 0:20:44.040
<v Speaker 2>and if sperm can't get in, then fertilization can't take place. Now, Aarin,

0:20:44.080 --> 0:20:47.240
<v Speaker 2>you said you've used the neuvera ring before. Have you

0:20:47.280 --> 0:20:48.200
<v Speaker 2>ever used the patch?

0:20:49.040 --> 0:20:50.679
<v Speaker 1>No, I haven't used the patch. I thought about it

0:20:50.680 --> 0:20:51.520
<v Speaker 1>for a bit, but no.

0:20:51.800 --> 0:20:55.120
<v Speaker 2>So the neeuver ring and the patch are basically the

0:20:55.160 --> 0:20:59.480
<v Speaker 2>same as combination oral contraceptives. They're estrogen and progesterone, so

0:20:59.520 --> 0:21:02.320
<v Speaker 2>they work the same way. Now, there are a lot

0:21:02.359 --> 0:21:04.760
<v Speaker 2>of other forms that I'll go through just really quickly

0:21:04.800 --> 0:21:07.359
<v Speaker 2>because I don't want to, like spend thousands of years,

0:21:07.359 --> 0:21:09.000
<v Speaker 2>even though I absolutely could.

0:21:10.520 --> 0:21:11.639
<v Speaker 1>We should do a mini series.

0:21:11.880 --> 0:21:16.320
<v Speaker 2>Yeah, so you mentioned Aaron progesterone only pills, and those

0:21:16.359 --> 0:21:19.560
<v Speaker 2>still exist today. It's often called the mini pill, which

0:21:19.560 --> 0:21:22.080
<v Speaker 2>I think is okay, silly because I think it's the

0:21:22.080 --> 0:21:22.920
<v Speaker 2>same size pill.

0:21:23.600 --> 0:21:25.720
<v Speaker 1>I mean, I assume so, yeah.

0:21:25.560 --> 0:21:30.480
<v Speaker 2>But it's only progesterone instead of progestine and estrogen. Now

0:21:30.560 --> 0:21:33.680
<v Speaker 2>a question is why would you want this as an option. Well,

0:21:34.320 --> 0:21:36.879
<v Speaker 2>it turns out that even though estrogen is great in

0:21:36.920 --> 0:21:39.840
<v Speaker 2>a lot of ways and does make like cycles more

0:21:39.880 --> 0:21:44.920
<v Speaker 2>regular and things. Estrogen of these two hormones, is associated

0:21:44.920 --> 0:21:50.879
<v Speaker 2>with higher risk of complications, especially a higher risk of

0:21:51.200 --> 0:21:56.359
<v Speaker 2>blood clots. Now, a caveat is that the increased risk

0:21:56.440 --> 0:22:01.119
<v Speaker 2>of blood clot by taking oral combined conscious reception is

0:22:01.760 --> 0:22:04.639
<v Speaker 2>far less than the increase in risk of blood clot

0:22:04.760 --> 0:22:09.719
<v Speaker 2>that you get by becoming pregnant, like right, way, way less, Okay.

0:22:09.800 --> 0:22:12.520
<v Speaker 1>Well, so that that's why blood clots kind of like

0:22:13.280 --> 0:22:15.719
<v Speaker 1>came to the mind first when people were looking at

0:22:15.720 --> 0:22:17.840
<v Speaker 1>potential side effects, because they were like, oh, if this

0:22:18.080 --> 0:22:21.399
<v Speaker 1>essentially mimics pregnancy in a way, then what are some

0:22:21.440 --> 0:22:23.560
<v Speaker 1>of the things that we see during pregnancy? Do we

0:22:23.640 --> 0:22:25.080
<v Speaker 1>see that during this pill?

0:22:25.200 --> 0:22:29.520
<v Speaker 2>Exactly right, So there is a small increase in risk

0:22:29.760 --> 0:22:34.880
<v Speaker 2>of blood clots with combination contraception. So the maneuver ring

0:22:34.960 --> 0:22:37.560
<v Speaker 2>the patch and the pill again, it's much less than

0:22:37.600 --> 0:22:42.240
<v Speaker 2>the risk of pregnancy. But for some people, actually myself included,

0:22:42.320 --> 0:22:45.240
<v Speaker 2>I started having migraines with aura, so I am now

0:22:45.600 --> 0:22:51.720
<v Speaker 2>and future contraindicated from combination therapy. But there are a

0:22:51.800 --> 0:22:54.680
<v Speaker 2>lot of other options that don't include estrogen, and they

0:22:54.720 --> 0:23:00.840
<v Speaker 2>are just as effective. Okay, So the mini pill is

0:23:01.119 --> 0:23:05.720
<v Speaker 2>just progestin. It usually is lower doses than the amount

0:23:05.760 --> 0:23:10.280
<v Speaker 2>of progestin in combination pills, which I think is interesting. So,

0:23:10.560 --> 0:23:14.520
<v Speaker 2>although they do help to inhibit ovulation, they do so

0:23:14.720 --> 0:23:20.120
<v Speaker 2>a little less consistently than combination pills do, but they

0:23:20.400 --> 0:23:25.200
<v Speaker 2>do a wonderful job of drastically changing the cervical mucus.

0:23:25.720 --> 0:23:29.119
<v Speaker 1>Oh okay, so much environment exactly.

0:23:29.240 --> 0:23:33.000
<v Speaker 2>So that the sperm are really unable to penetrate the

0:23:33.040 --> 0:23:37.360
<v Speaker 2>cervix and make it into the uterus. Okay, even if

0:23:37.400 --> 0:23:41.000
<v Speaker 2>sperm are able to get through this really thick, sticky

0:23:41.080 --> 0:23:46.760
<v Speaker 2>cervical mucus, their motility is absolutely ruined, so that even

0:23:46.800 --> 0:23:48.880
<v Speaker 2>if they make it into the uterus, like, they're never

0:23:48.920 --> 0:23:51.440
<v Speaker 2>going to be able to fertilize an egg, even if

0:23:51.440 --> 0:23:52.480
<v Speaker 2>you happen to ovulate.

0:23:52.720 --> 0:23:53.480
<v Speaker 1>That's really cool.

0:23:53.600 --> 0:23:57.639
<v Speaker 2>Yeah, one downside with progestin only pills, because we always

0:23:57.680 --> 0:24:01.199
<v Speaker 2>have to talk about downsides, is that it's a narrow

0:24:01.760 --> 0:24:05.840
<v Speaker 2>window of effectiveness compared to estrogen containing pills.

0:24:05.960 --> 0:24:09.680
<v Speaker 1>Right, So, like the exact hour exactly is really important

0:24:10.119 --> 0:24:11.080
<v Speaker 1>that you take the pill.

0:24:10.960 --> 0:24:13.399
<v Speaker 2>Right, So with a combination pill, like you need to

0:24:13.440 --> 0:24:15.760
<v Speaker 2>take it every day, but if you don't take it

0:24:15.800 --> 0:24:19.000
<v Speaker 2>at the exact same time every day, that's Okay. With

0:24:19.200 --> 0:24:23.480
<v Speaker 2>progestin pills, they really are effective for about twenty three hours,

0:24:24.000 --> 0:24:26.320
<v Speaker 2>so you need to take it at the same time

0:24:26.640 --> 0:24:29.200
<v Speaker 2>every day, so that can be a lot harder to remember.

0:24:29.680 --> 0:24:33.600
<v Speaker 1>And are you going to later talk about like what

0:24:33.760 --> 0:24:37.880
<v Speaker 1>effective means like proper use and effectiveness and blah blah blah,

0:24:37.960 --> 0:24:40.399
<v Speaker 1>bus break those things down in all different forms of

0:24:40.440 --> 0:24:44.120
<v Speaker 1>contraceptional yeah, absolutely, okay, perfect.

0:24:44.240 --> 0:24:47.159
<v Speaker 2>Okay, So there's like kind of three other forms of

0:24:47.160 --> 0:24:49.280
<v Speaker 2>contraception I want to touch on really briefly, and then

0:24:49.280 --> 0:24:52.480
<v Speaker 2>we'll go through the effectiveness of all these types. Okay, excellent.

0:24:53.119 --> 0:24:56.600
<v Speaker 2>So the next one is called depo Privera. It's probably

0:24:56.640 --> 0:24:58.160
<v Speaker 2>a brand name, and I wish I would have said

0:24:58.160 --> 0:25:02.960
<v Speaker 2>the generic, but whatever. This is a long acting injectable

0:25:03.240 --> 0:25:07.600
<v Speaker 2>form of progestin progesterone. So it does exactly the same

0:25:07.680 --> 0:25:12.360
<v Speaker 2>things that the progestin only pills do. It's better at

0:25:12.440 --> 0:25:18.680
<v Speaker 2>inhibiting ovulation than progestin only pills, So deepot shots are

0:25:18.760 --> 0:25:21.960
<v Speaker 2>really good at blocking ovulation so you're not going to ovulate.

0:25:22.320 --> 0:25:25.879
<v Speaker 2>They're really great at changing the cervical mucus so that

0:25:25.920 --> 0:25:31.720
<v Speaker 2>sperm can't get in, and deepo privera also remember that

0:25:32.119 --> 0:25:36.359
<v Speaker 2>estrogen in the combined pill helps to stabilize the lining

0:25:36.359 --> 0:25:38.560
<v Speaker 2>of the uterus so that you, you know, don't have

0:25:38.600 --> 0:25:41.000
<v Speaker 2>breakthrough bleeding and you have like that kind of a thing.

0:25:42.119 --> 0:25:46.440
<v Speaker 2>With deepo privera and a lot of the progestin only contraceptives,

0:25:46.800 --> 0:25:50.720
<v Speaker 2>it diminishes the proliferation of that uterus so that you're

0:25:50.760 --> 0:25:54.960
<v Speaker 2>just not building up a lining to begin with. Yeah.

0:25:55.080 --> 0:25:59.439
<v Speaker 2>The only downside with the deepot privera is that, unlike

0:25:59.560 --> 0:26:03.720
<v Speaker 2>pretty much which every other form of contraception, fertility takes

0:26:03.840 --> 0:26:07.240
<v Speaker 2>longer to increase back to baseline after you stop using it.

0:26:07.320 --> 0:26:09.720
<v Speaker 2>And that's because it's so long acting, so it inhibits

0:26:09.720 --> 0:26:13.800
<v Speaker 2>ovulation for a lot longer than the twelve to thirteen

0:26:13.840 --> 0:26:18.840
<v Speaker 2>weeks in which you should get your shots regularly. Okay, gotcha, Okay,

0:26:18.880 --> 0:26:22.480
<v Speaker 2>And then we have my favorite. But these are all

0:26:22.480 --> 0:26:28.440
<v Speaker 2>great options, and those are the long acting reversible contraceptions, Larks.

0:26:28.800 --> 0:26:34.760
<v Speaker 2>There's two kinds. There's the IUD and there's the implant. Okay, gotcha,

0:26:34.920 --> 0:26:36.480
<v Speaker 2>you know this already, erin.

0:26:36.600 --> 0:26:37.000
<v Speaker 3>I know this.

0:26:37.640 --> 0:26:43.080
<v Speaker 2>So the IUD is a little T shaped plastic device

0:26:43.600 --> 0:26:47.120
<v Speaker 2>that is inserted through the cervix into the uterus. There

0:26:47.200 --> 0:26:49.840
<v Speaker 2>are several different brands on the market right now, Aarin,

0:26:49.880 --> 0:26:51.880
<v Speaker 2>we have two different brands in our bodies.

0:26:52.359 --> 0:26:52.720
<v Speaker 4>We do.

0:26:53.760 --> 0:26:58.960
<v Speaker 2>Some of them contain progestin. So again, just progesterone, which

0:26:59.000 --> 0:27:01.400
<v Speaker 2>is going to act too thicken your cerviro cole mucus,

0:27:01.720 --> 0:27:05.960
<v Speaker 2>inhibit sperm motility, not let them get in. It's gonna

0:27:06.280 --> 0:27:09.760
<v Speaker 2>thin the lining of the uterus. Okay. These ones can

0:27:09.840 --> 0:27:14.399
<v Speaker 2>also help to suppress ovulation. These ones in the US

0:27:14.560 --> 0:27:17.119
<v Speaker 2>are approved for either three or five years, so you

0:27:17.200 --> 0:27:19.159
<v Speaker 2>put it in and then three or five years go by,

0:27:19.240 --> 0:27:20.719
<v Speaker 2>you don't have to think about your birth control.

0:27:21.040 --> 0:27:23.760
<v Speaker 1>What Yes, it's like a slow cocker. Set it and

0:27:23.840 --> 0:27:24.240
<v Speaker 1>forget it.

0:27:25.480 --> 0:27:28.040
<v Speaker 2>And then there's the implant, which in the US is

0:27:28.080 --> 0:27:29.840
<v Speaker 2>like the next spleanon I think is the only one

0:27:29.840 --> 0:27:33.000
<v Speaker 2>we have. It's the same exact thing. It's a little

0:27:33.000 --> 0:27:35.240
<v Speaker 2>piece of plastic. It's just shaped like a rod and

0:27:35.320 --> 0:27:37.679
<v Speaker 2>it goes right underneath the skin of your arm. It

0:27:37.760 --> 0:27:41.520
<v Speaker 2>works literally the exact same way. It releases progestin over time,

0:27:41.840 --> 0:27:45.959
<v Speaker 2>it does all the same things to your cervix. And

0:27:46.000 --> 0:27:48.639
<v Speaker 2>then finally there's the copper IUD, which is the only

0:27:48.920 --> 0:27:51.720
<v Speaker 2>non hormonal form of birth control that I've talked about

0:27:51.760 --> 0:27:57.000
<v Speaker 2>thus far, and that is a plastic T shaped little thing,

0:27:57.680 --> 0:28:00.880
<v Speaker 2>but it's covered in coils of copper white. I don't

0:28:00.920 --> 0:28:04.919
<v Speaker 2>know who thought of this, it's incredible, But copper ions

0:28:05.200 --> 0:28:09.440
<v Speaker 2>happen to cause inflammatory changes in the lining of your uterus,

0:28:09.440 --> 0:28:14.880
<v Speaker 2>the endometrium that have spermicidal activity, so it kills the

0:28:14.920 --> 0:28:18.800
<v Speaker 2>sperm if they make it into the uterus, and if

0:28:18.800 --> 0:28:22.680
<v Speaker 2>that's not enough, if not all sperm die. These ions

0:28:22.720 --> 0:28:27.119
<v Speaker 2>also block the activation of enzymes in the heads of

0:28:27.160 --> 0:28:31.360
<v Speaker 2>sperm that are necessary for fertilization to take place.

0:28:32.320 --> 0:28:35.320
<v Speaker 1>It blew my mind that just like a little bit

0:28:35.359 --> 0:28:37.040
<v Speaker 1>of copper can do all.

0:28:36.880 --> 0:28:40.800
<v Speaker 2>That, just a little bit of copper I clue my mind. Yeah,

0:28:40.840 --> 0:28:44.320
<v Speaker 2>it's really incredible. So, because the copper id doesn't have

0:28:44.360 --> 0:28:46.640
<v Speaker 2>these hormonal effects, it's not going to have a big

0:28:46.680 --> 0:28:49.360
<v Speaker 2>effect on your cervical mucus, it doesn't have an effect

0:28:49.480 --> 0:28:53.000
<v Speaker 2>on your ovulation cycles, it doesn't have an effect on

0:28:54.120 --> 0:28:57.240
<v Speaker 2>you building up an endometrial lining because it's not interfering

0:28:57.240 --> 0:29:00.640
<v Speaker 2>with your hormones whatsoever. So the biggest side for a

0:29:00.640 --> 0:29:04.080
<v Speaker 2>lot of people with copper IUDs is that they because

0:29:04.120 --> 0:29:06.959
<v Speaker 2>you have this kind of constant inflammation in your uterus.

0:29:07.000 --> 0:29:09.360
<v Speaker 2>It can lead to more bleeding. So if you already

0:29:09.440 --> 0:29:12.240
<v Speaker 2>have really heavy periods, some people don't like the copper

0:29:12.280 --> 0:29:17.120
<v Speaker 2>id because then they have heavier periods potentially. Okay, I

0:29:17.160 --> 0:29:18.440
<v Speaker 2>want to sum it up a little bit and then

0:29:18.480 --> 0:29:21.960
<v Speaker 2>we'll talk about the effectiveness of all these different ones. Okay, Yeah,

0:29:22.000 --> 0:29:25.000
<v Speaker 2>And actually I want to post this really great graphic

0:29:25.080 --> 0:29:28.440
<v Speaker 2>that's from Reproductive access dot org that has all these

0:29:28.440 --> 0:29:32.240
<v Speaker 2>different forms of contraception and their effectiveness with typical use.

0:29:33.240 --> 0:29:37.720
<v Speaker 2>So in summary, we have the pills as well as

0:29:37.880 --> 0:29:43.040
<v Speaker 2>the maneuvera ring and the patch. With perfect use, those

0:29:43.080 --> 0:29:47.440
<v Speaker 2>options are actually like ninety eight ninety nine percent effective.

0:29:47.480 --> 0:29:49.080
<v Speaker 2>They're super effective.

0:29:49.680 --> 0:29:51.440
<v Speaker 1>That's amazing. Well, I mean perfect use.

0:29:51.320 --> 0:29:55.400
<v Speaker 2>Though perfect use, Okay, So with typical use they're about

0:29:55.520 --> 0:29:59.560
<v Speaker 2>ninety to ninety three percent effective. So that's still pretty

0:29:59.640 --> 0:30:03.800
<v Speaker 2>dang especially if you compare that to the condom, which

0:30:03.880 --> 0:30:07.440
<v Speaker 2>with typical use is about eighty five to eighty seven

0:30:07.480 --> 0:30:12.080
<v Speaker 2>percent effective. So you're getting an additional you know, three

0:30:12.160 --> 0:30:15.760
<v Speaker 2>to six percentage points of effectiveness, which is pretty great

0:30:16.080 --> 0:30:21.200
<v Speaker 2>important boost. Yep. Now, the deepot privera, so the shot

0:30:21.880 --> 0:30:25.920
<v Speaker 2>is about ninety six percent effective with typical use. Again,

0:30:25.960 --> 0:30:28.960
<v Speaker 2>we're reaching over ninety eight ninety nine with perfect use,

0:30:29.000 --> 0:30:31.280
<v Speaker 2>So that's if you got it exactly on time every time.

0:30:31.960 --> 0:30:36.840
<v Speaker 2>The larks so iud's explan on these are over ninety

0:30:36.920 --> 0:30:42.720
<v Speaker 2>nine percent effective. Wow, they are equivalent to a tubal ligation,

0:30:43.040 --> 0:30:47.360
<v Speaker 2>so having your tubes tied in forms of effectiveness. And

0:30:47.520 --> 0:30:51.800
<v Speaker 2>they are reversible and don't require surgery, and in the

0:30:51.800 --> 0:30:54.800
<v Speaker 2>case of the implant it doesn't even require a pelvic exam.

0:30:55.120 --> 0:30:55.640
<v Speaker 1>Huh.

0:30:55.680 --> 0:30:58.400
<v Speaker 2>And another thing that I want to really point out

0:30:58.440 --> 0:31:01.800
<v Speaker 2>and highlight here is that every one of these birth

0:31:01.840 --> 0:31:08.200
<v Speaker 2>control options that I mentioned are contraceptives, so they are

0:31:08.440 --> 0:31:14.880
<v Speaker 2>preventing pregnancy from ever happening. These do not serve as

0:31:15.000 --> 0:31:19.280
<v Speaker 2>a bard of fashions, which means they do not prevent implantation.

0:31:20.000 --> 0:31:25.600
<v Speaker 2>You can still get pregnant even with an IUD in place. Okay.

0:31:27.480 --> 0:31:30.920
<v Speaker 2>And there is a lot of misinformation out there right now,

0:31:31.520 --> 0:31:37.160
<v Speaker 2>especially about IUDs, saying that they kill embryos, which is

0:31:37.200 --> 0:31:42.400
<v Speaker 2>not true. No, So an abortifatient is something that we

0:31:42.480 --> 0:31:48.120
<v Speaker 2>can use to induce an abortion, So terminate a pregnancy

0:31:48.240 --> 0:31:52.720
<v Speaker 2>after the point of implantation, right. Implantation in the wall

0:31:52.760 --> 0:31:56.800
<v Speaker 2>of the uterus is the scientific and the legal definition

0:31:56.920 --> 0:31:58.200
<v Speaker 2>of the start of pregnancy.

0:31:58.880 --> 0:32:01.520
<v Speaker 1>So the egg has been released and fertilized and implants

0:32:01.640 --> 0:32:03.360
<v Speaker 1>in implants.

0:32:02.600 --> 0:32:11.200
<v Speaker 2>Exactly, IUDs do not block implantation period, which is why

0:32:11.280 --> 0:32:14.960
<v Speaker 2>you can still in theory, though it's very rare get

0:32:15.120 --> 0:32:18.760
<v Speaker 2>pregnant while using an IUD while having an IUD in place.

0:32:19.920 --> 0:32:23.480
<v Speaker 2>All of the IUDs block fertilization from taking place.

0:32:23.800 --> 0:32:26.640
<v Speaker 1>Right, and so it's right just preventing the sperm from

0:32:26.640 --> 0:32:28.200
<v Speaker 1>ever meeting exactly.

0:32:28.280 --> 0:32:32.160
<v Speaker 2>That's what all of these contraceptive options are doing. Whether

0:32:32.240 --> 0:32:35.800
<v Speaker 2>they do that by preventing ovulation so there's no egg there,

0:32:36.320 --> 0:32:40.240
<v Speaker 2>whether they do that by blocking by changing the cervical

0:32:40.360 --> 0:32:43.920
<v Speaker 2>mucus in a way that makes it impossible for sperm

0:32:44.080 --> 0:32:47.840
<v Speaker 2>to penetrate the uterus, or whether they do it by

0:32:47.960 --> 0:32:52.160
<v Speaker 2>changing the environment of the uterus such that the sperm

0:32:52.360 --> 0:32:56.400
<v Speaker 2>can then they basically either die or are so adversely

0:32:56.400 --> 0:32:59.320
<v Speaker 2>affected that they're unable to fertilize the egg.

0:33:00.160 --> 0:33:02.680
<v Speaker 1>Okay, gotcha, Okay, I think yeah, I think that's a

0:33:02.720 --> 0:33:04.920
<v Speaker 1>really important point to make.

0:33:05.040 --> 0:33:08.479
<v Speaker 2>It is and clarify it is, and that is also

0:33:08.600 --> 0:33:11.440
<v Speaker 2>true for the last form of contraception I haven't touched

0:33:11.480 --> 0:33:15.880
<v Speaker 2>on and that is emergency contraception. So this is essentially

0:33:15.960 --> 0:33:18.800
<v Speaker 2>just a pill that is a high dose of progesterone.

0:33:19.400 --> 0:33:23.000
<v Speaker 2>It's fifty eight to ninety four percent effective. That's a

0:33:23.120 --> 0:33:28.280
<v Speaker 2>huge range. And the reason is because it functions to

0:33:28.680 --> 0:33:30.240
<v Speaker 2>block ovulation.

0:33:30.960 --> 0:33:31.240
<v Speaker 3>Huh.

0:33:31.400 --> 0:33:34.840
<v Speaker 2>So if you have already ovulated by the time you

0:33:35.040 --> 0:33:39.200
<v Speaker 2>take that contraception, it's not going to be effective. It

0:33:39.240 --> 0:33:43.120
<v Speaker 2>has no effect on fertilization and no effect on implantation,

0:33:43.600 --> 0:33:47.200
<v Speaker 2>which is so important because there was so much misinformation

0:33:48.000 --> 0:33:53.560
<v Speaker 2>about this out there, and that's why the emergency contraceptive

0:33:53.600 --> 0:33:57.000
<v Speaker 2>pills that, by the way, legally should be available over

0:33:57.040 --> 0:34:01.800
<v Speaker 2>the counter to anyone over I think age thirteen in

0:34:01.880 --> 0:34:06.080
<v Speaker 2>the United States without a prescription, male or female. By

0:34:06.120 --> 0:34:10.319
<v Speaker 2>the way, they are most effective if they're taken as

0:34:10.440 --> 0:34:14.680
<v Speaker 2>soon after an unprotected sexual encounter as possible, right.

0:34:14.680 --> 0:34:18.280
<v Speaker 1>Right, rather than like having to get signed parental permission

0:34:18.440 --> 0:34:20.719
<v Speaker 1>or prescription from the doctor or whatever else.

0:34:20.840 --> 0:34:21.680
<v Speaker 2>Yeah, exactly.

0:34:22.280 --> 0:34:23.000
<v Speaker 1>Yeah.

0:34:23.080 --> 0:34:27.640
<v Speaker 2>So that's it, Aaron, That is contraception and how it works.

0:34:28.080 --> 0:34:31.279
<v Speaker 2>Does that answer your questions? Do you have more?

0:34:31.440 --> 0:34:37.360
<v Speaker 1>I mean, yeah, I probably have more in there, but

0:34:38.239 --> 0:34:42.480
<v Speaker 1>I'm I'm just processing. Now. Do you want to hear

0:34:42.520 --> 0:34:45.400
<v Speaker 1>about the history of birth.

0:34:45.120 --> 0:34:47.520
<v Speaker 2>Control, Yes, I do. How did we come up with it?

0:34:47.640 --> 0:34:49.440
<v Speaker 2>How long have we even had access to it? I

0:34:49.440 --> 0:34:51.120
<v Speaker 2>don't know the answer to that question.

0:34:52.120 --> 0:34:55.400
<v Speaker 1>Okay, let's take a quick break first.

0:34:55.800 --> 0:35:04.520
<v Speaker 2>Okay.

0:35:23.680 --> 0:35:28.000
<v Speaker 1>The history of birth control or reproductive control is massive,

0:35:28.520 --> 0:35:32.319
<v Speaker 1>as you might expect, like absolutely massive and enormously complicated.

0:35:33.840 --> 0:35:38.200
<v Speaker 1>And the motivation behind the fight for reproductive rights hasn't

0:35:38.200 --> 0:35:41.840
<v Speaker 1>always been the same, and nor have its opponents always

0:35:41.880 --> 0:35:46.000
<v Speaker 1>had their same justifications. So what I want to do.

0:35:46.280 --> 0:35:49.799
<v Speaker 1>My goal for this section is to try to understand

0:35:50.040 --> 0:35:53.080
<v Speaker 1>how we got to where we are today by examining

0:35:53.120 --> 0:35:56.480
<v Speaker 1>some of the past struggles for reproductive rights, particularly in

0:35:56.560 --> 0:36:00.160
<v Speaker 1>terms of birth control, and then focusing more narrowly on

0:36:00.200 --> 0:36:04.239
<v Speaker 1>the development of the hormonal birth control pill. Awesome, and

0:36:04.320 --> 0:36:06.799
<v Speaker 1>a quick caveat before I begin. There are a million

0:36:06.880 --> 0:36:09.080
<v Speaker 1>different ways to tell this story, but no one wants

0:36:09.120 --> 0:36:11.040
<v Speaker 1>to sit here for a million years, and so I'm

0:36:11.040 --> 0:36:15.280
<v Speaker 1>going to focus primarily on the US for birth control history.

0:36:16.480 --> 0:36:19.000
<v Speaker 1>And I would love to talk about the global history

0:36:19.000 --> 0:36:21.800
<v Speaker 1>of each and every contraceptive, but nobody wants an episode

0:36:21.840 --> 0:36:26.760
<v Speaker 1>that long. Nobody, Okay, So I think there's this common

0:36:26.800 --> 0:36:30.320
<v Speaker 1>misconception that birth control methods emerged out of the twentieth

0:36:30.400 --> 0:36:34.040
<v Speaker 1>century as a result of an increase in scientific technology

0:36:34.200 --> 0:36:37.920
<v Speaker 1>and a loosening of the puritanical morals that had shaped

0:36:37.960 --> 0:36:40.200
<v Speaker 1>many of our earlier policies and laws.

0:36:41.040 --> 0:36:43.839
<v Speaker 2>But not so, really, not so not so.

0:36:44.400 --> 0:36:48.000
<v Speaker 1>In fact, up until the nineteen fifties, the most common

0:36:48.040 --> 0:36:51.840
<v Speaker 1>methods of birth control had been with us for hundreds,

0:36:51.960 --> 0:36:54.040
<v Speaker 1>if not thousands of years.

0:36:54.600 --> 0:36:55.719
<v Speaker 2>Is it like pulling out?

0:36:56.280 --> 0:36:58.279
<v Speaker 1>Well, okay, that is one of them, but there are

0:36:58.320 --> 0:37:03.120
<v Speaker 1>other ones too. Vaginal sponges, condoms, withdrawal methods, diaphragms, even

0:37:03.200 --> 0:37:06.680
<v Speaker 1>like early forms of IUDs had all been in use

0:37:07.080 --> 0:37:09.000
<v Speaker 1>like it since the ancient world.

0:37:09.200 --> 0:37:11.759
<v Speaker 2>Oh. Also, fertility tracking is another.

0:37:11.680 --> 0:37:14.520
<v Speaker 1>Yeptive exactly, although it took a really long time for

0:37:14.560 --> 0:37:17.680
<v Speaker 1>that to emerge in medicine because doctors never wanted to

0:37:17.680 --> 0:37:19.720
<v Speaker 1>study women's periods because they were yaki.

0:37:20.160 --> 0:37:22.480
<v Speaker 2>They're so yaki mighty.

0:37:25.120 --> 0:37:29.279
<v Speaker 1>There's a famous quote by Heinlen Robert Heinland, which is

0:37:29.320 --> 0:37:33.040
<v Speaker 1>that every generation thinks it invented sex. Each generation is

0:37:33.080 --> 0:37:35.879
<v Speaker 1>totally mistaken. And I think the same could be said

0:37:35.920 --> 0:37:40.359
<v Speaker 1>for birth control. And I think the other thing that's

0:37:40.400 --> 0:37:43.839
<v Speaker 1>really important is that the sheer variety of all these

0:37:43.840 --> 0:37:47.400
<v Speaker 1>different methods and the ingenuity the creativity that went into

0:37:47.480 --> 0:37:51.600
<v Speaker 1>making them shows just how important birth control has always

0:37:51.680 --> 0:37:55.440
<v Speaker 1>been to humans. Yeah, birth control was not invented by

0:37:55.440 --> 0:37:58.160
<v Speaker 1>the scientists and doctors of the twentieth century. It was

0:37:58.239 --> 0:38:01.200
<v Speaker 1>tested and practiced by women who passed their knowledge of

0:38:01.239 --> 0:38:06.400
<v Speaker 1>folk medicine from generation to generation. Early in human history,

0:38:06.480 --> 0:38:10.320
<v Speaker 1>when humans lived primarily in small nomadic groups, family size

0:38:10.400 --> 0:38:13.120
<v Speaker 1>was really important because it was much easier to feed

0:38:13.440 --> 0:38:15.640
<v Speaker 1>and pack up and move a small family compared to

0:38:15.680 --> 0:38:18.359
<v Speaker 1>a large one, and so it's not surprising that these

0:38:18.400 --> 0:38:23.759
<v Speaker 1>groups regularly practiced various forms of contraception and abortion. And then,

0:38:23.960 --> 0:38:27.000
<v Speaker 1>with the agricultural Revolution one of our favorite themes to

0:38:27.000 --> 0:38:30.960
<v Speaker 1>discuss on the podcast, larger family sizes were not only

0:38:31.080 --> 0:38:36.080
<v Speaker 1>more possible to support, but they were even economically advantageous

0:38:36.640 --> 0:38:39.720
<v Speaker 1>because more people then could work the land.

0:38:39.920 --> 0:38:41.040
<v Speaker 2>Yeah.

0:38:41.080 --> 0:38:43.960
<v Speaker 1>And then, combined with the high infant mortality due to

0:38:43.960 --> 0:38:47.640
<v Speaker 1>the increase in infectious diseases that the agricultural revolution brought on,

0:38:48.080 --> 0:38:53.960
<v Speaker 1>this led to many of these agricultural societies producing ideologies

0:38:54.000 --> 0:38:58.360
<v Speaker 1>that banned birth control entirely. Wow, isn't that interesting? I

0:38:58.400 --> 0:38:59.600
<v Speaker 1>never really thought about it that way.

0:39:00.000 --> 0:39:03.040
<v Speaker 2>Absolutely fascinating, yeah, and horrifying and horrifying.

0:39:03.480 --> 0:39:06.600
<v Speaker 1>In the last five hundred years or so, the growth

0:39:06.640 --> 0:39:10.840
<v Speaker 1>of cities and industrialization meant that in many places, large

0:39:10.840 --> 0:39:14.640
<v Speaker 1>families no longer held the same economic advantage as they

0:39:14.680 --> 0:39:19.040
<v Speaker 1>had in early farming societies. Children started to cost more

0:39:19.239 --> 0:39:21.680
<v Speaker 1>than they contributed, which I know is like a horrible

0:39:22.080 --> 0:39:23.719
<v Speaker 1>like it sounds like a very horrible way to look

0:39:23.760 --> 0:39:25.960
<v Speaker 1>at it, But this is just sort of like sociologically,

0:39:26.840 --> 0:39:28.120
<v Speaker 1>sort of the trend in what happened.

0:39:28.200 --> 0:39:29.840
<v Speaker 2>Also, they're very expensive.

0:39:29.920 --> 0:39:35.600
<v Speaker 1>Children are expensive. They're very expensive. And this shift, this,

0:39:35.800 --> 0:39:38.800
<v Speaker 1>you know, the increase in cost of children is reflected

0:39:38.840 --> 0:39:41.719
<v Speaker 1>in a slow decline of the birth rate, particularly in

0:39:41.880 --> 0:39:46.480
<v Speaker 1>urbanized areas. But this drop in the birth rate did

0:39:46.520 --> 0:39:51.840
<v Speaker 1>not correspond to a loosening of those ideological standards. If anything,

0:39:52.160 --> 0:39:56.400
<v Speaker 1>things became even stricter during the Victorian era, which sharply

0:39:56.440 --> 0:40:01.120
<v Speaker 1>defined how proper women should behave, and there were moralistic

0:40:01.200 --> 0:40:05.160
<v Speaker 1>policies such as the Comstock Law enacted in eighteen seventy three,

0:40:05.719 --> 0:40:10.160
<v Speaker 1>which forbade sending obscene matter through US mail, including but

0:40:10.239 --> 0:40:14.120
<v Speaker 1>not limited to birth control devices or even information about

0:40:14.160 --> 0:40:18.120
<v Speaker 1>birth control. What side note, And I know that like,

0:40:18.200 --> 0:40:20.759
<v Speaker 1>this episode is long and I should probably just cut this,

0:40:20.840 --> 0:40:23.480
<v Speaker 1>but I really wanted to tell you that the namesake

0:40:23.520 --> 0:40:27.880
<v Speaker 1>of the law, Anthony Comstock, as a teenager, masturbated so

0:40:28.080 --> 0:40:31.400
<v Speaker 1>obsessively that he thought he might be driven to suicide

0:40:31.400 --> 0:40:35.400
<v Speaker 1>by it. And he blamed it on the magazines and postcards,

0:40:35.440 --> 0:40:38.560
<v Speaker 1>the sexy magazines and postcards, and so he made it

0:40:38.680 --> 0:40:40.880
<v Speaker 1>his life's mission to prevent their distribution.

0:40:41.480 --> 0:40:45.680
<v Speaker 2>Oh my god, just because he couldn't stop masturbating.

0:40:45.800 --> 0:40:48.719
<v Speaker 1>Yeah, Jesus well, and was probably told that it was

0:40:48.800 --> 0:40:49.840
<v Speaker 1>wrong to masturbate.

0:40:50.040 --> 0:40:53.480
<v Speaker 2>Yes, right, and it's immoral and blah blah.

0:40:53.320 --> 0:40:57.319
<v Speaker 1>Blah, oh right. That is so awful, I know. But

0:40:57.480 --> 0:41:01.680
<v Speaker 1>these types of policies, like the Comstock Law, they weren't

0:41:01.719 --> 0:41:04.920
<v Speaker 1>just a relic of the times. They were a response

0:41:04.960 --> 0:41:08.560
<v Speaker 1>to a growing rebellion against this type of thought, and

0:41:08.600 --> 0:41:12.759
<v Speaker 1>they were fighting a losing battle. So the roots of

0:41:12.880 --> 0:41:17.320
<v Speaker 1>the modern birth control movement really began in voluntary motherhood,

0:41:17.400 --> 0:41:20.359
<v Speaker 1>which is a concept and movement that originated out of

0:41:20.400 --> 0:41:24.960
<v Speaker 1>the woman's suffrage movement of the late nineteenth century, and

0:41:25.000 --> 0:41:29.120
<v Speaker 1>at its outset, it opposed all methods of birth control. Devices,

0:41:29.680 --> 0:41:34.120
<v Speaker 1>behavior and restraint were the only approved proper methods. But

0:41:34.200 --> 0:41:37.440
<v Speaker 1>this movement also dared to suggest that women could be

0:41:37.520 --> 0:41:41.080
<v Speaker 1>sexual subjects rather than objects, that women were capable of

0:41:41.120 --> 0:41:44.800
<v Speaker 1>sexual desire for pleasure itself, not just to become pregnant.

0:41:45.760 --> 0:41:49.000
<v Speaker 1>At the heart of it, the voluntary motherhood movement was

0:41:49.040 --> 0:41:52.840
<v Speaker 1>about a woman's right to say no, to refuse her husband,

0:41:52.920 --> 0:41:58.520
<v Speaker 1>her wifely duty. And this movement, I know. And this

0:41:58.600 --> 0:42:02.080
<v Speaker 1>movement was preceded by and already existing drop in birth

0:42:02.120 --> 0:42:04.880
<v Speaker 1>rates in the US. So in the late seventeen hundreds,

0:42:04.920 --> 0:42:11.239
<v Speaker 1>American women had on average eight live births one hundred. Yeah.

0:42:11.560 --> 0:42:15.160
<v Speaker 2>Oh I'm sorry, my face just like, oh no, it's

0:42:15.200 --> 0:42:15.560
<v Speaker 2>a lot.

0:42:15.680 --> 0:42:18.439
<v Speaker 1>That's a lot of pregnancies to go through.

0:42:18.719 --> 0:42:21.920
<v Speaker 2>Yes, squeezing my vagina.

0:42:22.680 --> 0:42:26.360
<v Speaker 1>One hundred years later that number was three. It was

0:42:26.400 --> 0:42:27.200
<v Speaker 1>down to three.

0:42:27.440 --> 0:42:27.840
<v Speaker 2>Wow.

0:42:28.040 --> 0:42:33.360
<v Speaker 1>So what can explain this? It's not restraint. The answer

0:42:33.640 --> 0:42:38.520
<v Speaker 1>is birth control, its contraception, its abortion. Yeah, and sure

0:42:38.600 --> 0:42:41.560
<v Speaker 1>some methods or devices were improved during that time, but

0:42:41.600 --> 0:42:44.279
<v Speaker 1>it was not really about a lack of technology, but

0:42:44.400 --> 0:42:49.000
<v Speaker 1>rather a suppression of that technology. Nevertheless, people found a

0:42:49.000 --> 0:42:54.520
<v Speaker 1>way around that, for instance, euphemistic advertisements that warned Portuguese

0:42:54.520 --> 0:42:57.400
<v Speaker 1>female pills not to be used during pregnancy, for they

0:42:57.400 --> 0:43:02.440
<v Speaker 1>will cause miscarriage or stimulates menstruation when late or irregular.

0:43:03.440 --> 0:43:08.440
<v Speaker 1>Those were hidden messages to those in the know. Yep, okay. So,

0:43:08.600 --> 0:43:13.279
<v Speaker 1>rolling into the nineteen hundreds, morality ruled over medicine, at

0:43:13.400 --> 0:43:17.399
<v Speaker 1>least in the US, physicians saw themselves as guardians over

0:43:17.400 --> 0:43:21.920
<v Speaker 1>the sexual purity of their patients. Gross, absolutely disgusting.

0:43:22.160 --> 0:43:24.040
<v Speaker 2>I am infuriated.

0:43:24.560 --> 0:43:27.200
<v Speaker 1>M I mean yep, that.

0:43:27.400 --> 0:43:30.360
<v Speaker 2>Sentence, Aaron is one of the most gross.

0:43:31.719 --> 0:43:33.680
<v Speaker 1>Is it worse than the female organism?

0:43:34.040 --> 0:43:36.120
<v Speaker 2>I don't know if it's worse than the female organism,

0:43:36.239 --> 0:43:38.800
<v Speaker 2>but it's up there. It might be worse.

0:43:39.160 --> 0:43:40.520
<v Speaker 1>Oh my gosh.

0:43:40.800 --> 0:43:41.120
<v Speaker 2>Okay.

0:43:41.280 --> 0:43:45.520
<v Speaker 1>Well, and this inflated self importance of theirs led them

0:43:45.520 --> 0:43:48.440
<v Speaker 1>to make decisions for their patients not just based on

0:43:48.520 --> 0:43:53.680
<v Speaker 1>medical reasoning, but also morals. A break from the dominant

0:43:53.719 --> 0:43:58.120
<v Speaker 1>stance on birth control is bad came in nineteen twelve

0:43:58.280 --> 0:44:02.200
<v Speaker 1>from the president of the American Medical Association, Abraham Jacoby.

0:44:02.800 --> 0:44:06.600
<v Speaker 1>He advocated for a campaign for industrial health access to

0:44:06.640 --> 0:44:10.279
<v Speaker 1>birth control, and requiring STI testing before marriage, which is

0:44:12.000 --> 0:44:16.800
<v Speaker 1>problematic very There had been growing support for birth control

0:44:16.800 --> 0:44:20.160
<v Speaker 1>throughout the US, including from the medical community, but the

0:44:20.239 --> 0:44:24.120
<v Speaker 1>fact that the president of this moral respected institution was

0:44:24.239 --> 0:44:27.960
<v Speaker 1>calling for the separation of sex and reproduction. Was both

0:44:28.200 --> 0:44:32.600
<v Speaker 1>sort of this culmination of decades of debate as well

0:44:32.640 --> 0:44:36.200
<v Speaker 1>as a revitalization of the birth control movement or what

0:44:36.239 --> 0:44:40.560
<v Speaker 1>would become the birth control movement. Okay, people were also

0:44:40.600 --> 0:44:44.239
<v Speaker 1>simply talking about sex. More Ford's concept that sex was

0:44:44.280 --> 0:44:47.239
<v Speaker 1>good and repression was bad had reached the US and

0:44:47.280 --> 0:44:50.879
<v Speaker 1>had led people to question their assumptions about sex, and

0:44:51.200 --> 0:44:54.600
<v Speaker 1>a new set of beliefs, unfortunately housed in the objective

0:44:54.680 --> 0:45:02.359
<v Speaker 1>terminology of biology, began to take hold. Eugenics. Yeah, yeah, yeah,

0:45:02.440 --> 0:45:05.160
<v Speaker 1>real quick, just in case people haven't heard of eugenics

0:45:05.239 --> 0:45:06.680
<v Speaker 1>or have heard of it but don't know what it is.

0:45:07.400 --> 0:45:10.400
<v Speaker 1>It has really old roots, but the modern eugenics movement

0:45:10.480 --> 0:45:13.160
<v Speaker 1>began around the late eighteen hundreds and was a set

0:45:13.160 --> 0:45:15.960
<v Speaker 1>of beliefs or policies which stated that people can be

0:45:16.000 --> 0:45:22.440
<v Speaker 1>classified as having either superior or inferior genetics like just

0:45:22.600 --> 0:45:26.520
<v Speaker 1>incredibly subjectively, and that those deemed inferior should not be

0:45:26.560 --> 0:45:30.919
<v Speaker 1>allowed to reproduce. If it sounds like Nazi talk, it's

0:45:30.960 --> 0:45:34.560
<v Speaker 1>because it is. Nazis got many of their ideas from

0:45:34.760 --> 0:45:36.200
<v Speaker 1>US eugenics policies.

0:45:36.920 --> 0:45:37.200
<v Speaker 2>Cool.

0:45:38.400 --> 0:45:41.800
<v Speaker 1>Eugenics became popular when it did because with the incredible

0:45:41.840 --> 0:45:45.560
<v Speaker 1>advancements in medical science and technology, people were living much

0:45:45.680 --> 0:45:49.960
<v Speaker 1>longer and the global population had greatly expanded, and so

0:45:50.040 --> 0:45:52.239
<v Speaker 1>this led to a lot of fears and talk of

0:45:52.320 --> 0:45:57.040
<v Speaker 1>overpopulation and discussion about what to do with it. Okay,

0:45:57.440 --> 0:46:01.040
<v Speaker 1>back to birth control. Eugenics had a commonplicated relationship with

0:46:01.080 --> 0:46:04.520
<v Speaker 1>birth control. It was pro in some cases and anti

0:46:04.719 --> 0:46:08.080
<v Speaker 1>in others. Essentially, who should be able to use birth

0:46:08.080 --> 0:46:11.080
<v Speaker 1>control was a concern of the whole society and not

0:46:11.200 --> 0:46:13.200
<v Speaker 1>for an individual to decide.

0:46:14.160 --> 0:46:16.040
<v Speaker 2>Oh dear God.

0:46:16.000 --> 0:46:20.000
<v Speaker 1>Uh huh so. Teddy Roosevelt was a huge eugenicist and

0:46:20.280 --> 0:46:25.440
<v Speaker 1>very anti birth control. Great He said that smaller families

0:46:25.840 --> 0:46:29.239
<v Speaker 1>were a sign of moral disease and that women who

0:46:29.320 --> 0:46:34.040
<v Speaker 1>avoided having children were criminal against the race, the object

0:46:34.080 --> 0:46:36.280
<v Speaker 1>of contemptuous abhorrence by healthy people.

0:46:36.880 --> 0:46:42.759
<v Speaker 2>I I have aaron, I have so many feelings right now,

0:46:42.840 --> 0:46:45.959
<v Speaker 2>I honestly can't deal with them.

0:46:46.080 --> 0:46:50.160
<v Speaker 1>I know, just sit back, let it wash all over you,

0:46:50.920 --> 0:46:52.480
<v Speaker 1>and then take a nap.

0:46:53.280 --> 0:46:56.920
<v Speaker 2>Oh God, well.

0:46:56.800 --> 0:46:57.680
<v Speaker 1>It's gonna get worse.

0:46:58.239 --> 0:47:00.840
<v Speaker 2>I know, it always does with you, always does.

0:47:02.760 --> 0:47:06.359
<v Speaker 1>Race suicide quote unquote became a talking point and a

0:47:06.400 --> 0:47:09.640
<v Speaker 1>passion of his for the next five or so years.

0:47:10.600 --> 0:47:13.640
<v Speaker 1>Which race was the one committing suicide wasn't specified, but

0:47:13.840 --> 0:47:17.760
<v Speaker 1>it's pretty implied that Roosevelt and others wanted wealthy, educated

0:47:17.800 --> 0:47:20.840
<v Speaker 1>white people to have more children and poorer people, especially

0:47:20.920 --> 0:47:26.080
<v Speaker 1>people of color, to have fewer. This is eugenics. Falling

0:47:26.120 --> 0:47:29.200
<v Speaker 1>birth rates, particularly among the wealthier and more educated, was

0:47:29.239 --> 0:47:33.359
<v Speaker 1>attributable to birth control because the most effective methods were

0:47:33.480 --> 0:47:37.480
<v Speaker 1>the most expensive and required seeing a doctor, and so

0:47:37.920 --> 0:47:41.960
<v Speaker 1>women using birth control were specifically condemned as selfish or

0:47:41.960 --> 0:47:46.719
<v Speaker 1>displaying unladylike ambition, denying their true purpose in life, which

0:47:46.760 --> 0:47:54.840
<v Speaker 1>was motherhood. I know, rage noises, but this didn't result

0:47:54.880 --> 0:47:57.799
<v Speaker 1>in the proponents of the birth control movement championing it

0:47:57.920 --> 0:48:00.640
<v Speaker 1>as an inherent right of women to have agecies over

0:48:00.719 --> 0:48:05.120
<v Speaker 1>their own bodies, nor were they shamed into giving it up. Rather,

0:48:05.680 --> 0:48:09.720
<v Speaker 1>this resulted in an unfortunate alliance between the birth control

0:48:09.760 --> 0:48:11.240
<v Speaker 1>movement and the eugenics movement.

0:48:11.600 --> 0:48:14.840
<v Speaker 2>Oh no, yeah, oh yes God.

0:48:15.920 --> 0:48:18.880
<v Speaker 1>The answer to quote race suicide, they said, was greater

0:48:19.040 --> 0:48:22.760
<v Speaker 1>access to birth control by the poorer classes. This provided

0:48:22.840 --> 0:48:27.640
<v Speaker 1>a more palatable reason for people, particularly people in power,

0:48:28.160 --> 0:48:32.319
<v Speaker 1>to support birth control rather than hey, women like sex

0:48:32.360 --> 0:48:35.320
<v Speaker 1>two and may not want to be continuously pregnant, but honestly,

0:48:35.360 --> 0:48:36.880
<v Speaker 1>it's none of your business, so I'm going to do

0:48:36.920 --> 0:48:39.200
<v Speaker 1>what I want to do. That was not the reason.

0:48:39.239 --> 0:48:41.600
<v Speaker 1>That was not what they wanted to hear, right, they

0:48:41.640 --> 0:48:43.840
<v Speaker 1>wanted to hear here's a solution to the problem that

0:48:43.880 --> 0:48:48.560
<v Speaker 1>you see. And it's important to note that the eugenics

0:48:48.640 --> 0:48:51.279
<v Speaker 1>movement in the early nineteen hundreds in the US was

0:48:51.360 --> 0:48:54.600
<v Speaker 1>not some fringe group. Was also global, like a lot

0:48:54.640 --> 0:48:58.960
<v Speaker 1>of countries had eugenics you know movements. It was huge

0:48:59.000 --> 0:49:03.240
<v Speaker 1>and it greatly acted policy. For instance, by nineteen fifteen,

0:49:03.600 --> 0:49:08.399
<v Speaker 1>thirteen states had compulsory sterilization laws. By nineteen thirty two,

0:49:08.680 --> 0:49:10.520
<v Speaker 1>twenty seven states had them.

0:49:11.000 --> 0:49:14.040
<v Speaker 2>I mean, Aarin, this just sounds like you're talking about

0:49:14.040 --> 0:49:16.920
<v Speaker 2>twenty twenty quite honestly, Like it doesn't sound any different,

0:49:16.960 --> 0:49:18.200
<v Speaker 2>and I'm getting really.

0:49:18.360 --> 0:49:23.120
<v Speaker 1>Oh absolutely, I mean, like forest or coer. Sterilizations have

0:49:23.200 --> 0:49:28.560
<v Speaker 1>been happening for as long as the first person was

0:49:28.600 --> 0:49:32.640
<v Speaker 1>able to figure out how to remove sterilized, yeah, to

0:49:32.640 --> 0:49:39.080
<v Speaker 1>figure out how to sterilize. And these policies were by

0:49:39.120 --> 0:49:42.000
<v Speaker 1>no means limited to the US. There were plenty of

0:49:42.000 --> 0:49:46.120
<v Speaker 1>international organizations seeking to reduce birth rates in other countries,

0:49:46.160 --> 0:49:50.839
<v Speaker 1>particularly developing ones. During this time the rise of eugenics,

0:49:51.080 --> 0:49:56.080
<v Speaker 1>the birth control movement gained an outspoken leader, enter Margaret Sanger.

0:49:57.040 --> 0:49:59.919
<v Speaker 1>Growing up, Sanger had been taught to speak her mind,

0:50:00.120 --> 0:50:02.040
<v Speaker 1>and when she moved to New York City after finishing

0:50:02.160 --> 0:50:05.879
<v Speaker 1>nursing school, she met people whose radical ideas at least

0:50:05.960 --> 0:50:09.480
<v Speaker 1>radical during the time, would completely change her life, in

0:50:09.520 --> 0:50:12.880
<v Speaker 1>particular the socialist leader Eugene Debs and the famous feminist

0:50:12.920 --> 0:50:15.920
<v Speaker 1>Emma Goldman, who became her mentor and from whom she

0:50:15.920 --> 0:50:19.240
<v Speaker 1>would learn so much more about the voluntary motherhood movement.

0:50:20.239 --> 0:50:22.520
<v Speaker 1>As a nurse in New York City, Sanger spent much

0:50:22.560 --> 0:50:26.080
<v Speaker 1>of her time serving poverty stricken regions where there was

0:50:26.120 --> 0:50:29.040
<v Speaker 1>a lot of overcrowding, there were high rates of infectious disease,

0:50:29.600 --> 0:50:33.439
<v Speaker 1>and like no one was getting adequate nutrition, and one

0:50:33.480 --> 0:50:37.319
<v Speaker 1>experience in particular made a huge impact on Saanger. There

0:50:37.360 --> 0:50:39.960
<v Speaker 1>was a woman named Sadie who had been told by

0:50:40.000 --> 0:50:42.880
<v Speaker 1>her doctor that she shouldn't get pregnant again because she

0:50:42.920 --> 0:50:46.720
<v Speaker 1>would likely die, and so as a solution, her doctor

0:50:46.840 --> 0:50:49.680
<v Speaker 1>recommended that she sleep on the roof so her husband

0:50:49.719 --> 0:50:54.759
<v Speaker 1>wouldn't bother her Sadie got pregnant because who's going to

0:50:54.800 --> 0:50:58.359
<v Speaker 1>sleep on a roof for your whole life, and then

0:50:58.560 --> 0:51:00.759
<v Speaker 1>died after an abortion attempt.

0:51:00.920 --> 0:51:01.400
<v Speaker 3>Jesus.

0:51:01.800 --> 0:51:05.200
<v Speaker 1>This death was a pivotal moment for Sanger. She vowed

0:51:05.239 --> 0:51:07.880
<v Speaker 1>that she would do whatever she could to ensure that

0:51:07.960 --> 0:51:11.759
<v Speaker 1>women had the right to contraception. The next year, in

0:51:11.840 --> 0:51:15.280
<v Speaker 1>nineteen thirteen, she began writing a series of educational articles

0:51:15.320 --> 0:51:18.400
<v Speaker 1>about sex and reproduction titled What Every Girl Should Know.

0:51:19.239 --> 0:51:22.839
<v Speaker 1>Of course, the Comstock Act prevented the distribution of many

0:51:22.880 --> 0:51:25.920
<v Speaker 1>of these articles, and Sanger was arrested for her involvement,

0:51:26.920 --> 0:51:30.399
<v Speaker 1>but instead of showing up to court, she skipped town

0:51:30.960 --> 0:51:35.000
<v Speaker 1>went to Europe for a couple of years, where her

0:51:35.080 --> 0:51:38.719
<v Speaker 1>radical education continued, and her time there also led to

0:51:38.760 --> 0:51:43.600
<v Speaker 1>her narrowing her focus on contraceptives rather than women's liberation overall,

0:51:43.680 --> 0:51:46.120
<v Speaker 1>which is sort of At the beginning, she was much

0:51:46.160 --> 0:51:49.880
<v Speaker 1>more about equality in the workplace and equal rights, and

0:51:49.920 --> 0:51:54.279
<v Speaker 1>then she was persuaded to just focus on contraception. In

0:51:54.320 --> 0:51:57.600
<v Speaker 1>the books I read for this, Sanger is described as

0:51:57.640 --> 0:51:59.759
<v Speaker 1>being kind of in the right place at the right

0:51:59.800 --> 0:52:03.480
<v Speaker 1>time time. She was a huge fighter. She was very outspoken,

0:52:03.719 --> 0:52:07.120
<v Speaker 1>but this fight. The fight for access to contraceptive seemed

0:52:07.160 --> 0:52:11.759
<v Speaker 1>to be simply waiting for a leader to head the charge.

0:52:12.560 --> 0:52:16.279
<v Speaker 1>Sanger coined the term birth control in nineteen fifteen, and

0:52:16.480 --> 0:52:20.040
<v Speaker 1>in nineteen sixteen she opened the first birth control clinic

0:52:20.120 --> 0:52:24.239
<v Speaker 1>in Brooklyn Wow. There, she and her sister and a

0:52:24.280 --> 0:52:27.680
<v Speaker 1>team of nurses handed out condoms and what were essentially

0:52:27.880 --> 0:52:32.040
<v Speaker 1>early diaphragms, and the clinic was under constant threat of

0:52:32.080 --> 0:52:34.840
<v Speaker 1>closure because it was illegal, and it did get closed

0:52:34.840 --> 0:52:38.560
<v Speaker 1>a few times. But Sanger wasn't discouraged easily, and for

0:52:38.600 --> 0:52:41.120
<v Speaker 1>a few years she continued the operation of her birth

0:52:41.160 --> 0:52:44.160
<v Speaker 1>control clinics and the grassroots movement to increase awareness of

0:52:44.200 --> 0:52:47.480
<v Speaker 1>birth control. But beginning in the nineteen twenties, she began

0:52:47.560 --> 0:52:54.480
<v Speaker 1>to form some powerful allies with physicians, politicians, and eugenicists.

0:52:54.640 --> 0:52:55.680
<v Speaker 2>Oh gosh.

0:52:56.200 --> 0:53:00.879
<v Speaker 1>Sanger is painted alternatively as being a eugenicist herself, or

0:53:01.000 --> 0:53:03.680
<v Speaker 1>just someone who saw the value in this powerful alliance.

0:53:04.360 --> 0:53:08.320
<v Speaker 1>Based on her own writings, I'm inclined to believe the former.

0:53:08.800 --> 0:53:12.680
<v Speaker 1>She had written that certain people should be sterilized and

0:53:12.760 --> 0:53:15.960
<v Speaker 1>that criminals, illiterate sex workers, and drug addicts should be

0:53:16.000 --> 0:53:17.640
<v Speaker 1>separated from the rest of society.

0:53:17.960 --> 0:53:18.560
<v Speaker 2>Oh Dear.

0:53:20.840 --> 0:53:23.760
<v Speaker 1>Throughout the nineteen twenties and thirties, the birth control movement

0:53:23.800 --> 0:53:26.719
<v Speaker 1>gained a lot of momentum. More clinics were opened, and

0:53:26.760 --> 0:53:29.560
<v Speaker 1>more people got behind the idea that perhaps women should

0:53:29.600 --> 0:53:33.239
<v Speaker 1>have some control over their family size. The Great Depression

0:53:33.360 --> 0:53:37.040
<v Speaker 1>also played a role in this. Women were increasingly seeking

0:53:37.080 --> 0:53:39.759
<v Speaker 1>out employment to help support their family, and for many

0:53:39.840 --> 0:53:41.960
<v Speaker 1>of them this meant moving out of the home and

0:53:42.040 --> 0:53:47.240
<v Speaker 1>into big cities, becoming financially independent. The idea of hey,

0:53:47.520 --> 0:53:50.960
<v Speaker 1>maybe I don't want kids right now and that's okay

0:53:51.320 --> 0:53:55.280
<v Speaker 1>was becoming more and more common, and during this time

0:53:55.400 --> 0:53:58.400
<v Speaker 1>eugenics fell out of favor in the US as it

0:53:58.480 --> 0:54:02.640
<v Speaker 1>rose to prominence in Nazi German. It was replaced or

0:54:02.880 --> 0:54:08.319
<v Speaker 1>maybe just repackaged as population control, with both international and

0:54:08.400 --> 0:54:11.640
<v Speaker 1>national programs offering incentives for those willing to have an

0:54:11.640 --> 0:54:15.560
<v Speaker 1>IUD put in or to be sterilized, and finder's fees

0:54:15.600 --> 0:54:17.919
<v Speaker 1>for those who could find someone willing to have either

0:54:17.960 --> 0:54:24.439
<v Speaker 1>procedure done. But generally speaking, at least privately, people were

0:54:24.560 --> 0:54:27.520
<v Speaker 1>finding that they didn't need as much of a justification

0:54:27.640 --> 0:54:31.040
<v Speaker 1>for birth control for themselves. World War Two and then

0:54:31.080 --> 0:54:34.359
<v Speaker 1>the threat of nuclear holocaust during the Cold war lent

0:54:34.560 --> 0:54:37.160
<v Speaker 1>a sort of you know, get it while getting's good

0:54:37.360 --> 0:54:41.880
<v Speaker 1>vibe to the times, and Alfred Kinsey's titillating research began

0:54:42.000 --> 0:54:45.240
<v Speaker 1>making headlines and got people talking even more about sex,

0:54:45.719 --> 0:54:48.360
<v Speaker 1>even though his findings were super flawed and biased, but

0:54:48.440 --> 0:54:51.880
<v Speaker 1>they were a crucial step forward in chipping away some

0:54:52.160 --> 0:54:55.960
<v Speaker 1>of the shame associated with sex in the US, and

0:54:56.080 --> 0:54:58.960
<v Speaker 1>during these decades, Sanger was still hard at work on

0:54:59.000 --> 0:55:02.520
<v Speaker 1>her goal of making birth control accessible to women. The

0:55:02.560 --> 0:55:05.520
<v Speaker 1>first clinic from nineteen sixteen had grown into many more

0:55:05.560 --> 0:55:09.960
<v Speaker 1>across the country, organized first as the American Birth Control League,

0:55:09.960 --> 0:55:13.160
<v Speaker 1>which later became the Birth Control Federation of America, which

0:55:13.200 --> 0:55:15.920
<v Speaker 1>then changed its name to the Planned Parenthood Federation of

0:55:15.960 --> 0:55:17.480
<v Speaker 1>America in nineteen forty two.

0:55:18.200 --> 0:55:20.560
<v Speaker 2>Huh, there you go. Wow.

0:55:20.719 --> 0:55:24.000
<v Speaker 1>Though Planned Parenthood began as a place where contraceptives or

0:55:24.000 --> 0:55:28.040
<v Speaker 1>info about contraceptives could be obtained, it gradually turned into

0:55:28.120 --> 0:55:32.200
<v Speaker 1>a medical facility that provided much much more counseling, family planning,

0:55:32.239 --> 0:55:36.759
<v Speaker 1>medical procedures, et cetera. And by making contraception more accessible,

0:55:36.800 --> 0:55:39.680
<v Speaker 1>it basically paved the way for the feminist movement of

0:55:39.719 --> 0:55:42.719
<v Speaker 1>the nineteen sixties, which is kind of I also think

0:55:42.719 --> 0:55:45.400
<v Speaker 1>it's ironic because at the beginning they would only provide

0:55:45.440 --> 0:55:47.120
<v Speaker 1>contraceptives to married women.

0:55:47.200 --> 0:55:47.520
<v Speaker 2>Married.

0:55:48.480 --> 0:55:52.280
<v Speaker 1>Yeah, but this brings me to one of the biggest

0:55:52.280 --> 0:55:55.160
<v Speaker 1>developments in birth control history and the main focus of

0:55:55.160 --> 0:56:00.239
<v Speaker 1>this episode, the birth control pill. The Pill. Aaron talked

0:56:00.280 --> 0:56:03.560
<v Speaker 1>a bit about different classifications of birth control based on

0:56:03.640 --> 0:56:07.000
<v Speaker 1>how they work, but there's another way that you could

0:56:07.000 --> 0:56:12.000
<v Speaker 1>group them. Which person in a sexual relationship was responsible

0:56:12.040 --> 0:56:15.080
<v Speaker 1>for its use? Oh yeah, and whether using it is

0:56:15.200 --> 0:56:18.120
<v Speaker 1>obvious to the other person or if its use could

0:56:18.160 --> 0:56:19.759
<v Speaker 1>be concealed if necessary.

0:56:20.120 --> 0:56:23.800
<v Speaker 2>Oh my gosh, yeah huh.

0:56:24.440 --> 0:56:28.400
<v Speaker 1>A magic bullet contraceptive had been dreamt about by Margaret

0:56:28.480 --> 0:56:32.560
<v Speaker 1>Sanger for decades. Something one hundred percent effective with minimal

0:56:32.600 --> 0:56:36.400
<v Speaker 1>side effects, that could be easily obtainable, affordable, and allowed

0:56:36.400 --> 0:56:39.440
<v Speaker 1>a woman to be completely in control of her body.

0:56:40.480 --> 0:56:43.480
<v Speaker 1>She had also listed the help of a philanthropist and

0:56:43.560 --> 0:56:48.280
<v Speaker 1>feminist named Catherine McCormick, who graduated from MIT in nineteen

0:56:48.320 --> 0:56:51.480
<v Speaker 1>oh four with a biology degree, the second woman ever,

0:56:51.719 --> 0:56:55.680
<v Speaker 1>I think, to graduate from MIT, and McCormick would essentially

0:56:55.719 --> 0:56:59.239
<v Speaker 1>fund the entire creation of the pill, like it was

0:56:59.440 --> 0:57:04.160
<v Speaker 1>basically all from her Wow. Sanger had approached researchers to

0:57:04.160 --> 0:57:07.120
<v Speaker 1>try to realize her dream, but she was repeatedly turned

0:57:07.160 --> 0:57:09.440
<v Speaker 1>down because it was disreputable work.

0:57:10.760 --> 0:57:13.439
<v Speaker 2>Disreputable, that is.

0:57:13.520 --> 0:57:18.640
<v Speaker 1>Until she met Gregory Pinkis in winter nineteen fifty. Pinkus

0:57:18.880 --> 0:57:22.360
<v Speaker 1>was a bit of I don't know if iconoclast is

0:57:22.400 --> 0:57:25.080
<v Speaker 1>the right word. He was a brilliant scientist with a

0:57:25.080 --> 0:57:29.480
<v Speaker 1>bad reputation. His work on in vitro fertilization in rabbits

0:57:29.600 --> 0:57:33.200
<v Speaker 1>had led to him being compared to Victor Frankenstein, and

0:57:33.400 --> 0:57:38.240
<v Speaker 1>basically any reputable research institution refused to hire him, so

0:57:38.280 --> 0:57:41.400
<v Speaker 1>he started his own research center like you do, the

0:57:41.480 --> 0:57:47.160
<v Speaker 1>Worcester Foundation for Experimental Biology. After his meeting with Sanger,

0:57:47.200 --> 0:57:49.640
<v Speaker 1>he realized that creating a birth control pill could not

0:57:49.680 --> 0:57:52.480
<v Speaker 1>only get him the scientific respect he felt he deserved,

0:57:52.800 --> 0:57:55.280
<v Speaker 1>but it would also earn him fame for tackling what

0:57:55.360 --> 0:58:00.680
<v Speaker 1>he felt was a pressing global issue overpopulation. Agreed to

0:58:00.680 --> 0:58:03.240
<v Speaker 1>look into the possibility of a birth control pill, and

0:58:03.280 --> 0:58:06.320
<v Speaker 1>he even knew where to start. Back in nineteen thirty seven,

0:58:06.640 --> 0:58:09.600
<v Speaker 1>a few researchers from the University of Pennsylvania had published

0:58:09.600 --> 0:58:13.240
<v Speaker 1>a paper titled The Effect of Progesterine and Progesterone on

0:58:13.320 --> 0:58:17.760
<v Speaker 1>Ovulation in the rabbit, which described how progesterone injections could

0:58:17.800 --> 0:58:23.320
<v Speaker 1>prevent ovulation. Pinkus and another researcher at the lab named M. C.

0:58:23.560 --> 0:58:26.600
<v Speaker 1>Chang set out by first repeating the experiment described in

0:58:26.640 --> 0:58:29.280
<v Speaker 1>the paper. Things went as expected, so then they started

0:58:29.280 --> 0:58:32.160
<v Speaker 1>to play around a bit. What if a progesterone pellet

0:58:32.240 --> 0:58:34.480
<v Speaker 1>was lodged under the skin of the rabbit, And does

0:58:34.480 --> 0:58:38.480
<v Speaker 1>this also work in rats who ovulate spontaneously like humans,

0:58:38.480 --> 0:58:43.120
<v Speaker 1>as opposed to rabbits who ovulate after copulation? Yes, it does. Indeed,

0:58:44.560 --> 0:58:48.200
<v Speaker 1>all told, things were looking very promising for Pinkus and Chang.

0:58:48.640 --> 0:58:51.080
<v Speaker 1>The next step was simply to test out the procedure

0:58:51.160 --> 0:58:54.160
<v Speaker 1>on humans, so Pinkus teamed up with a doctor who

0:58:54.200 --> 0:58:58.439
<v Speaker 1>specialized in infertility named John Rock. Together, they sought out

0:58:58.520 --> 0:59:02.280
<v Speaker 1>dozens of women seeking help for difficulty in conceiving. They

0:59:02.280 --> 0:59:04.040
<v Speaker 1>didn't tell them about the study that they were to

0:59:04.080 --> 0:59:07.400
<v Speaker 1>be a part of, which was not required by US

0:59:07.560 --> 0:59:10.360
<v Speaker 1>law at the time, nor did they ask for any

0:59:10.440 --> 0:59:12.520
<v Speaker 1>kind of consent, nor did they pay the women.

0:59:12.960 --> 0:59:13.760
<v Speaker 2>Oh my god.

0:59:14.080 --> 0:59:16.479
<v Speaker 1>They just told them to take pills, take their temperature daily,

0:59:16.560 --> 0:59:18.760
<v Speaker 1>collect their urine, and take some vaginal smears.

0:59:19.240 --> 0:59:22.160
<v Speaker 2>So they took women who were actively wanting to become

0:59:22.200 --> 0:59:24.960
<v Speaker 2>pregnant and having difficulty, and they made it to make

0:59:25.000 --> 0:59:27.360
<v Speaker 2>sure that they were not going to become pregnant.

0:59:27.880 --> 0:59:31.320
<v Speaker 1>So it was they were told that the pills that

0:59:31.360 --> 0:59:33.920
<v Speaker 1>they were taking would prevent them from becoming pregnant, but

0:59:33.960 --> 0:59:37.800
<v Speaker 1>what it might do afterwards was regulate their ovulation such

0:59:37.840 --> 0:59:41.680
<v Speaker 1>that their likelihood of getting pregnant is increased following the

0:59:41.800 --> 0:59:42.440
<v Speaker 1>end of the study.

0:59:42.800 --> 0:59:44.200
<v Speaker 2>Some tiny relief.

0:59:44.800 --> 0:59:48.640
<v Speaker 1>Yeah yeah, oh well, okay, scratched that relief because they

0:59:48.680 --> 0:59:52.880
<v Speaker 1>also went to asylums to bump up their studies.

0:59:53.000 --> 0:59:54.680
<v Speaker 2>Cool yeah, yep, yep, yep, yep yep.

0:59:54.720 --> 0:59:57.120
<v Speaker 1>Sounds about right, mm hmm, like lots of them, and

0:59:57.160 --> 1:00:00.760
<v Speaker 1>it was just not no one was informed outside of

1:00:00.760 --> 1:00:02.480
<v Speaker 1>like the head of the of course.

1:00:02.560 --> 1:00:04.480
<v Speaker 2>Cool yeah cool cool.

1:00:04.800 --> 1:00:08.560
<v Speaker 1>And so Pinkus loaded up these women with extremely high

1:00:08.560 --> 1:00:11.960
<v Speaker 1>doses of progesterone. So I don't think you mentioned the

1:00:12.440 --> 1:00:15.760
<v Speaker 1>like what a pill is what they do now, but

1:00:15.920 --> 1:00:20.120
<v Speaker 1>this is between two hundred and fifty and three hundred milligrams.

1:00:19.600 --> 1:00:22.800
<v Speaker 2>Daily and that's a lot.

1:00:23.200 --> 1:00:25.800
<v Speaker 1>Is what's in a like a pill today.

1:00:25.600 --> 1:00:28.800
<v Speaker 2>They vary a lot depending on the synthetic progesterone used,

1:00:28.800 --> 1:00:33.120
<v Speaker 2>but it's like, I don't know, one, maybe two, depending

1:00:33.160 --> 1:00:36.840
<v Speaker 2>on the type. Ye yep, yeah. Yeah.

1:00:37.640 --> 1:00:40.160
<v Speaker 1>Of the sixty women who were enrolled in the study

1:00:40.200 --> 1:00:43.360
<v Speaker 1>without their knowledge, about half dropped out due to the

1:00:43.360 --> 1:00:47.080
<v Speaker 1>demanding requirements or because the side effects were just too much.

1:00:47.560 --> 1:00:47.920
<v Speaker 2>Yeah.

1:00:47.960 --> 1:00:50.480
<v Speaker 1>The results of the study were mixed, so four women

1:00:50.640 --> 1:00:53.919
<v Speaker 1>became pregnant after it was over, suggesting that it might

1:00:54.080 --> 1:00:57.840
<v Speaker 1>help people who have difficulty in conceiving. But about fifteen

1:00:57.880 --> 1:01:01.479
<v Speaker 1>percent of the participants continued to during the study, which

1:01:01.600 --> 1:01:04.360
<v Speaker 1>was too high to be an effective method of contraception

1:01:04.800 --> 1:01:08.920
<v Speaker 1>in Pinkus's eyes. More research needed to be done to

1:01:08.960 --> 1:01:12.000
<v Speaker 1>bring down that number to make it more effective. But

1:01:12.120 --> 1:01:14.320
<v Speaker 1>where were they going to get the sample sizes that

1:01:14.360 --> 1:01:15.960
<v Speaker 1>they needed to do these studies?

1:01:16.240 --> 1:01:18.680
<v Speaker 2>Oh, some more terrible aaron For.

1:01:18.880 --> 1:01:23.240
<v Speaker 1>Pincus, The answer was Puerto Rico. So Puerto Rico had

1:01:23.360 --> 1:01:27.360
<v Speaker 1>already been subjected to extensive medicalized torture from the US.

1:01:27.480 --> 1:01:31.320
<v Speaker 1>In the post World War two years, thousands upon thousands

1:01:31.400 --> 1:01:35.520
<v Speaker 1>upon thousands of sterilizations were performed, both with and without consent.

1:01:35.680 --> 1:01:37.280
<v Speaker 1>It was, in fact, like the one of the most

1:01:37.280 --> 1:01:42.360
<v Speaker 1>common procedures after a delivery was sterilization.

1:01:42.200 --> 1:01:44.200
<v Speaker 2>Without probably without ever consent yeah.

1:01:44.200 --> 1:01:45.680
<v Speaker 1>So it was like the most common form of birth

1:01:45.680 --> 1:01:48.840
<v Speaker 1>control essentially of like yeah.

1:01:48.400 --> 1:01:51.160
<v Speaker 2>Oh well you had a baby, you're done. Clip clip, yeah.

1:01:51.240 --> 1:01:53.960
<v Speaker 1>I mean, and these were like, these were policies implemented

1:01:54.000 --> 1:01:55.800
<v Speaker 1>by the US, and there was like it was an

1:01:55.840 --> 1:02:00.600
<v Speaker 1>active program to try to oh yeah yeah, but it

1:02:00.720 --> 1:02:03.280
<v Speaker 1>wasn't just an annoying amount of urine collecting that the

1:02:03.320 --> 1:02:06.720
<v Speaker 1>women would have to face. In their preliminary study, only

1:02:06.800 --> 1:02:10.640
<v Speaker 1>five of the seventy women involved reported no side effects.

1:02:11.280 --> 1:02:14.760
<v Speaker 1>The rest experienced things ranging from breast soreness, change in

1:02:14.840 --> 1:02:18.440
<v Speaker 1>pigment or size of nipples, nausea, vomiting, vaginal discharge, increased

1:02:18.480 --> 1:02:20.800
<v Speaker 1>or decrease libidos lactation, et cetera.

1:02:21.240 --> 1:02:23.960
<v Speaker 2>These are all pregnancy complications.

1:02:25.440 --> 1:02:28.800
<v Speaker 1>Shocker, No one involved in the research seemed to really

1:02:28.840 --> 1:02:32.240
<v Speaker 1>care about these side effects, so he proceeded with the studies,

1:02:32.680 --> 1:02:35.760
<v Speaker 1>also beginning to experiment with synthetic progestines, which were more

1:02:35.800 --> 1:02:40.000
<v Speaker 1>powerful than natural progesterone and worked better than progesterone when

1:02:40.040 --> 1:02:44.120
<v Speaker 1>taken orally. But despite the initial promising results of the pill,

1:02:44.240 --> 1:02:47.920
<v Speaker 1>Pinkus was still facing difficulties in retaining people in the study,

1:02:48.320 --> 1:02:51.520
<v Speaker 1>so he decided to change things up a bit maybe

1:02:51.880 --> 1:02:54.320
<v Speaker 1>instead of just like keeping people in the dark and

1:02:54.400 --> 1:02:56.600
<v Speaker 1>not telling them anything about what they are involved with.

1:02:57.000 --> 1:03:01.000
<v Speaker 1>What if we actually recruit women who want to try

1:03:01.040 --> 1:03:04.080
<v Speaker 1>out a contraceptive pill. What a concept?

1:03:04.280 --> 1:03:07.600
<v Speaker 2>What if we try informed consent? Is that about the

1:03:07.640 --> 1:03:08.760
<v Speaker 2>conclusion he came to.

1:03:09.120 --> 1:03:11.480
<v Speaker 1>Yeah, And it turned out that that was like a

1:03:11.520 --> 1:03:13.760
<v Speaker 1>way to get people involved. People were like, oh, yeah,

1:03:13.800 --> 1:03:15.840
<v Speaker 1>actually I am interested in this and not having to

1:03:15.880 --> 1:03:20.000
<v Speaker 1>be sterilized after I give birth Jesus. But still the

1:03:20.040 --> 1:03:23.720
<v Speaker 1>participants experienced unpleasant or severe side effects, which caused many

1:03:23.720 --> 1:03:26.960
<v Speaker 1>to drop out. And even though Pinkus was convinced that

1:03:27.000 --> 1:03:29.680
<v Speaker 1>the side effects were mostly in the women's heads, they

1:03:29.720 --> 1:03:33.640
<v Speaker 1>were severe enough to be costing him a good sample size.

1:03:33.840 --> 1:03:36.880
<v Speaker 1>So he started to play around with combinations. So first

1:03:36.880 --> 1:03:40.000
<v Speaker 1>he added an antacid or changed the dose, but it

1:03:40.080 --> 1:03:42.800
<v Speaker 1>didn't really make a difference. And then he and Chang

1:03:42.840 --> 1:03:46.840
<v Speaker 1>made a discovery the progestin that the company, the pharmacocal

1:03:46.880 --> 1:03:51.360
<v Speaker 1>company Cyril had provided was actually contaminated by a small

1:03:51.480 --> 1:03:54.880
<v Speaker 1>amount of estrogen and it had just slipped under the cracks,

1:03:55.040 --> 1:03:57.720
<v Speaker 1>So that must be causing the side effects, right, So

1:03:57.840 --> 1:04:00.840
<v Speaker 1>then when he gave women the pure progest in, nausea

1:04:00.880 --> 1:04:03.880
<v Speaker 1>and breakthrough bleeding became even worse. Okay, let's add a

1:04:03.920 --> 1:04:06.080
<v Speaker 1>little bit of that estrogen back in. Too much and

1:04:06.080 --> 1:04:08.280
<v Speaker 1>there'd be breast tenderness and nausea, too little on your

1:04:08.280 --> 1:04:11.400
<v Speaker 1>back to breakthrough bleeding. Eventually he found a sweet spot.

1:04:12.120 --> 1:04:15.880
<v Speaker 1>They were back on track to getting this pill to market. Cyril,

1:04:16.000 --> 1:04:20.480
<v Speaker 1>the company that had produced the synthetic progestin, applied for

1:04:20.640 --> 1:04:24.240
<v Speaker 1>FDA approval to market this birth control pill that they

1:04:24.240 --> 1:04:29.200
<v Speaker 1>were calling Navid, but not for contraception, for infertility and

1:04:29.240 --> 1:04:34.919
<v Speaker 1>menstrual irregularities. Interesting mm hmm, And in July nineteen fifty seven,

1:04:35.120 --> 1:04:38.560
<v Speaker 1>the first packs of Navid or a Novid I'm not

1:04:38.600 --> 1:04:41.720
<v Speaker 1>really sure, were prescribed to women for those purposes, but

1:04:41.840 --> 1:04:45.439
<v Speaker 1>also for whatever the doctor wanted to give them for. Yeah,

1:04:45.800 --> 1:04:48.480
<v Speaker 1>that's how flabile use. Yeah, that's how it works, and

1:04:48.520 --> 1:04:53.600
<v Speaker 1>so that included contraception. In nineteen fifty eight, there were

1:04:53.640 --> 1:04:56.480
<v Speaker 1>still seventeen states in the US that had laws banning

1:04:56.480 --> 1:04:59.920
<v Speaker 1>the sale, distribution, or advertisement of any kind of contraception.

1:05:00.640 --> 1:05:03.280
<v Speaker 1>In Massachusetts, where the pill was developed, it was a

1:05:03.360 --> 1:05:07.440
<v Speaker 1>felony to sell or prescribe, or hand out or provide

1:05:07.640 --> 1:05:13.960
<v Speaker 1>information about contraceptives. What uh huh oh, my gracious, but

1:05:14.240 --> 1:05:16.840
<v Speaker 1>things were changing, and part of that change was not

1:05:16.960 --> 1:05:19.840
<v Speaker 1>just the early signs of the sexual revolution, which I

1:05:19.880 --> 1:05:22.400
<v Speaker 1>talked a little bit about in the Herpes episode. It

1:05:22.480 --> 1:05:26.360
<v Speaker 1>was politicians realizing that their voters wanted access to birth control.

1:05:26.560 --> 1:05:31.160
<v Speaker 1>It was also corporations like Cyril realizing how much profit

1:05:31.200 --> 1:05:33.960
<v Speaker 1>they could make through the legal sale of contraceptives. It

1:05:34.000 --> 1:05:38.640
<v Speaker 1>was an untapped market, and socially, what had in previous

1:05:38.640 --> 1:05:42.400
<v Speaker 1>decades been a moral majority had decreased to a small

1:05:42.520 --> 1:05:45.959
<v Speaker 1>but vocal minority, largely made up of the Catholic Church.

1:05:47.000 --> 1:05:49.960
<v Speaker 1>When articles published in popular magazines such as Time or

1:05:50.040 --> 1:05:54.080
<v Speaker 1>Life highlighted the drug, there wasn't the roaring backlash that

1:05:54.120 --> 1:05:57.600
<v Speaker 1>they had expected to accompany this news. They merely presented

1:05:57.600 --> 1:06:01.640
<v Speaker 1>this drug as almost a welcome innovation. Of course, these

1:06:01.760 --> 1:06:04.440
<v Speaker 1>articles barely mention the side effects or long term safety,

1:06:05.120 --> 1:06:08.000
<v Speaker 1>but following their publication, there was a rush for the pill.

1:06:08.200 --> 1:06:11.800
<v Speaker 1>So by nineteen fifty nine, which is when anovid or

1:06:11.920 --> 1:06:14.280
<v Speaker 1>novid is on the market only as a treatment for

1:06:14.320 --> 1:06:19.200
<v Speaker 1>infertility or irregular periods, and estimated five hundred thousand women

1:06:19.240 --> 1:06:22.400
<v Speaker 1>were taking the drug. Wow, so word it had gotten out.

1:06:23.800 --> 1:06:25.400
<v Speaker 1>Though there may not have been a lot of outcry

1:06:25.440 --> 1:06:28.160
<v Speaker 1>directly on the pill's release, there was still plenty of

1:06:28.200 --> 1:06:32.080
<v Speaker 1>debate about contraception in politics. Some advocated for funds to

1:06:32.080 --> 1:06:35.600
<v Speaker 1>be used in international aid programs to supply contraception, which

1:06:35.680 --> 1:06:40.160
<v Speaker 1>of course smacks of eugenics, particularly because in one proposal,

1:06:40.240 --> 1:06:43.800
<v Speaker 1>for instance, the reasoning was that otherwise we face quote

1:06:43.840 --> 1:06:49.760
<v Speaker 1>communist political and economic domination. Oh my god, what gross. Meanwhile,

1:06:49.840 --> 1:06:52.600
<v Speaker 1>the pill was up for approval at the FDA, not

1:06:52.720 --> 1:06:55.200
<v Speaker 1>for its sale, which it already had, but to be

1:06:55.240 --> 1:06:58.840
<v Speaker 1>able to advertise for it as a contraceptive pill as

1:06:58.840 --> 1:07:02.200
<v Speaker 1>a birth control pill. This was a totally different process,

1:07:02.760 --> 1:07:05.720
<v Speaker 1>and a very new one, because rather than the pill

1:07:05.760 --> 1:07:08.240
<v Speaker 1>being used to treat a condition, it was being taken

1:07:08.360 --> 1:07:12.400
<v Speaker 1>by healthy people, and so its safety standards were totally different.

1:07:13.280 --> 1:07:16.280
<v Speaker 1>The FDA agent handling their application took his time with it,

1:07:16.400 --> 1:07:19.480
<v Speaker 1>a Lla Francis Kelsey. He wanted to know whether there

1:07:19.560 --> 1:07:22.320
<v Speaker 1>was an elevated risk of cancer or blood clots associated

1:07:22.360 --> 1:07:25.439
<v Speaker 1>with long term use, and so he decided to send

1:07:25.480 --> 1:07:28.240
<v Speaker 1>out a questionnaire to sixty one doctors that had experienced

1:07:28.240 --> 1:07:31.760
<v Speaker 1>prescribing the drug. Ultimately, even though some doctors said, I

1:07:31.800 --> 1:07:33.200
<v Speaker 1>don't think it's ready. I think they are to many

1:07:33.240 --> 1:07:37.280
<v Speaker 1>side effects. The decision that most doctors came to was

1:07:37.320 --> 1:07:40.720
<v Speaker 1>that the pill had far fewer side effects and was

1:07:40.840 --> 1:07:43.640
<v Speaker 1>much safer than an unwanted pregnancy.

1:07:44.040 --> 1:07:48.760
<v Speaker 2>Than any pregnancy, than any especially an unwanted pregnancy or

1:07:48.800 --> 1:07:50.080
<v Speaker 2>an unplanned pregnancy.

1:07:50.280 --> 1:07:53.920
<v Speaker 1>And also, the FDA was not there to decide whether

1:07:54.000 --> 1:07:57.960
<v Speaker 1>a drug should be approved or rejected based on moral, religious,

1:07:58.040 --> 1:08:01.840
<v Speaker 1>or political grounds. Their job was simply to decide whether

1:08:01.920 --> 1:08:03.959
<v Speaker 1>it did what it was supposed to do and whether

1:08:04.040 --> 1:08:06.960
<v Speaker 1>it was safe while it was doing it. And so

1:08:07.360 --> 1:08:11.800
<v Speaker 1>for this, Enevid was approved as the first oral contraceptive

1:08:11.960 --> 1:08:16.760
<v Speaker 1>on May ninth, nineteen sixty Wow. Its use grew steadily,

1:08:16.920 --> 1:08:19.320
<v Speaker 1>and within a few years it was not known as

1:08:19.560 --> 1:08:23.479
<v Speaker 1>enevid but just the pill, which, with that simple name

1:08:23.800 --> 1:08:29.280
<v Speaker 1>highlighting just how incredibly important it had become like the pill,

1:08:29.680 --> 1:08:31.360
<v Speaker 1>the pill. I mean, everyone knows.

1:08:31.240 --> 1:08:33.759
<v Speaker 2>When you say the pill. Yeah.

1:08:34.000 --> 1:08:36.880
<v Speaker 1>By nineteen sixty five, so five years after its release

1:08:36.920 --> 1:08:41.800
<v Speaker 1>as a contraceptive, and estimated six point five million American

1:08:41.840 --> 1:08:45.520
<v Speaker 1>women were using it, and lower dose pills became available

1:08:45.760 --> 1:08:49.800
<v Speaker 1>and more affordable. The pill didn't start a movement, but

1:08:49.880 --> 1:08:53.200
<v Speaker 1>it surely played a role. Women were able to have

1:08:53.280 --> 1:08:56.120
<v Speaker 1>greater agency over their own bodies than they ever had before.

1:08:56.439 --> 1:09:00.800
<v Speaker 1>They were free to pursue a greater variety of career opportunities,

1:09:00.920 --> 1:09:03.599
<v Speaker 1>and they were also free to not do those things.

1:09:04.080 --> 1:09:08.360
<v Speaker 1>The pill simply gave them the choice. In nineteen seventy,

1:09:08.400 --> 1:09:11.120
<v Speaker 1>women made up ten percent of first year law students

1:09:11.120 --> 1:09:14.160
<v Speaker 1>and four percent of first year business students. In nineteen eighty,

1:09:14.280 --> 1:09:16.759
<v Speaker 1>those numbers jumped up to thirty six percent and twenty

1:09:16.760 --> 1:09:17.320
<v Speaker 1>eight percent.

1:09:17.800 --> 1:09:18.280
<v Speaker 2>Wow.

1:09:18.320 --> 1:09:21.439
<v Speaker 1>In large part a lot of people reason is because.

1:09:21.240 --> 1:09:21.679
<v Speaker 2>Of the pill.

1:09:22.120 --> 1:09:25.639
<v Speaker 1>Yeah, and also overall like the second wave feminist movement.

1:09:25.720 --> 1:09:30.600
<v Speaker 1>But okay, a quick note about the timing of our episodes.

1:09:30.640 --> 1:09:33.200
<v Speaker 1>I just wanted to say, in nineteen fifty nine, to

1:09:33.240 --> 1:09:35.479
<v Speaker 1>the same year that the birth control pill was up

1:09:35.560 --> 1:09:39.759
<v Speaker 1>for approval to be advertised as a contraception, the litamide

1:09:39.840 --> 1:09:42.400
<v Speaker 1>was also up for approval, and it made me think

1:09:42.439 --> 1:09:45.000
<v Speaker 1>about whether the birth control pill would have been approved

1:09:45.000 --> 1:09:47.679
<v Speaker 1>so quickly if it had happened a year after the litamide,

1:09:47.680 --> 1:09:48.240
<v Speaker 1>for instance.

1:09:48.800 --> 1:09:49.600
<v Speaker 2>Very interesting.

1:09:49.800 --> 1:09:50.280
<v Speaker 4>Yeah.

1:09:50.760 --> 1:09:54.719
<v Speaker 1>Also, a listener commented on one of our Instagram posts

1:09:55.040 --> 1:09:58.040
<v Speaker 1>that she's doing a thesis in which she talks about

1:09:58.040 --> 1:10:00.920
<v Speaker 1>how apparently in the Soviet Union this time. They tried

1:10:00.920 --> 1:10:03.639
<v Speaker 1>to recreate the birth control pill there, but they didn't

1:10:03.640 --> 1:10:07.080
<v Speaker 1>put enough resources into its development, and so there were

1:10:07.160 --> 1:10:10.160
<v Speaker 1>some horrible side effects associated with it, and a lot

1:10:10.200 --> 1:10:14.200
<v Speaker 1>of women confused that birth control pill with polidamide, and

1:10:14.240 --> 1:10:16.120
<v Speaker 1>so they assumed that they were the same, and so

1:10:16.200 --> 1:10:19.280
<v Speaker 1>the use of hormonal birth control pill like really dropped

1:10:19.680 --> 1:10:23.040
<v Speaker 1>and emotion became the main form of birth control. Oh wow,

1:10:23.120 --> 1:10:25.519
<v Speaker 1>So she's still writing the thesis, but she said she's

1:10:25.560 --> 1:10:27.280
<v Speaker 1>going to send it to us when she's done.

1:10:27.479 --> 1:10:29.479
<v Speaker 2>Oh my gosh, I'll be so interested to read that.

1:10:29.479 --> 1:10:29.680
<v Speaker 3>I know.

1:10:30.400 --> 1:10:36.599
<v Speaker 1>Okay. So, despite wrapping up here, despite the open arms

1:10:36.640 --> 1:10:39.320
<v Speaker 1>with which many people welcomed the birth control pill, it

1:10:39.400 --> 1:10:42.960
<v Speaker 1>did not stop being controversial. Long term health risks such

1:10:42.960 --> 1:10:45.639
<v Speaker 1>as blood clots, heart attacks, strokes, and cancer were found

1:10:45.640 --> 1:10:48.000
<v Speaker 1>to be associated with the high doses of estrogen in

1:10:48.080 --> 1:10:51.519
<v Speaker 1>early versions of the pill, and people advocated for safer

1:10:51.560 --> 1:10:54.639
<v Speaker 1>doses and pointed out that these side effects would never

1:10:54.680 --> 1:10:57.599
<v Speaker 1>have been deemed acceptable in a version of male birth control.

1:10:58.080 --> 1:10:59.760
<v Speaker 2>Oh, we can talk more about that if you want.

1:11:00.560 --> 1:11:05.560
<v Speaker 1>Oh good. And then there was the enormously racist practices

1:11:05.600 --> 1:11:08.280
<v Speaker 1>that emerged from the development of family planning clinics in

1:11:08.360 --> 1:11:14.040
<v Speaker 1>predominantly black neighborhoods, for instance, incentivizing these long acting reversible

1:11:14.040 --> 1:11:18.639
<v Speaker 1>contraceptive implants or shots or the iud's, so a lot

1:11:18.640 --> 1:11:23.280
<v Speaker 1>of those were preferentially given to black women than they

1:11:23.280 --> 1:11:26.880
<v Speaker 1>were to white women. Later analysis showed that there was

1:11:27.040 --> 1:11:31.439
<v Speaker 1>disproportionate prescription of those forms of birth control pill between

1:11:31.520 --> 1:11:33.600
<v Speaker 1>black people and white people, or people of color and

1:11:33.640 --> 1:11:37.240
<v Speaker 1>white people. You know, like, that's and that's not even

1:11:37.280 --> 1:11:41.519
<v Speaker 1>to mention the force sterilization of thousands upon thousands of

1:11:41.600 --> 1:11:46.120
<v Speaker 1>black and Native American women. Yes, and then there's some

1:11:46.160 --> 1:11:49.280
<v Speaker 1>more bad news, so like the Dalkon Shield IUD scandal,

1:11:49.520 --> 1:11:52.280
<v Speaker 1>in which many women were hospitalized or died due to

1:11:52.320 --> 1:11:55.880
<v Speaker 1>infections related to that IUD, and it was pulled from

1:11:55.920 --> 1:11:58.000
<v Speaker 1>the market. That Dalkon Shield was pulled from the market

1:11:58.160 --> 1:12:02.720
<v Speaker 1>much much like, way too long after it should have been,

1:12:03.560 --> 1:12:06.040
<v Speaker 1>And this led to an enormous decline in other IUDs

1:12:06.080 --> 1:12:08.200
<v Speaker 1>as well, out of fear of lawsuits and out of

1:12:08.360 --> 1:12:09.960
<v Speaker 1>fear of the women who were like, well if I

1:12:10.080 --> 1:12:12.640
<v Speaker 1>put this in here, am I gonna like is this

1:12:12.680 --> 1:12:16.760
<v Speaker 1>going to hurt me? But throughout the nineteen seventies, there

1:12:16.800 --> 1:12:20.599
<v Speaker 1>were some positive developments. In nineteen seventy two, the Supreme

1:12:20.640 --> 1:12:25.360
<v Speaker 1>Court legalizes birth control for unmarried people Loretta lynbs I

1:12:25.400 --> 1:12:30.639
<v Speaker 1>know Loretta Lyn's song. The pill is released in nineteen

1:12:30.680 --> 1:12:36.439
<v Speaker 1>seventy five, and sterilization procedures become stricter, requiring informed consent

1:12:36.600 --> 1:12:37.519
<v Speaker 1>and a waiting period.

1:12:38.040 --> 1:12:41.720
<v Speaker 2>Oh, nineteen seventy five, except in twenty twenty if you're

1:12:42.040 --> 1:12:43.200
<v Speaker 2>in Georgia.

1:12:43.080 --> 1:12:47.960
<v Speaker 1>I mean, at least okay, nowadays it's it's illegal. Then

1:12:48.120 --> 1:12:51.800
<v Speaker 1>it wouldn't have been, right, Yeah, which is so depressing.

1:12:51.880 --> 1:12:54.519
<v Speaker 1>I mean, it's depressing. It's layers of depressing upon depressing,

1:12:54.600 --> 1:12:59.720
<v Speaker 1>upon rage, and nihilism. Since the release of the first

1:13:00.160 --> 1:13:04.479
<v Speaker 1>control pill, there has been overall incredible progress made, both

1:13:04.520 --> 1:13:08.880
<v Speaker 1>in terms of technology like better IUDs and emergency contraceptives,

1:13:09.160 --> 1:13:11.680
<v Speaker 1>as well as in social perspectives on the right to

1:13:11.800 --> 1:13:15.880
<v Speaker 1>access contraceptives. The birth control movement became more about the

1:13:15.880 --> 1:13:18.839
<v Speaker 1>individual rights of a woman to have agency over her body,

1:13:19.000 --> 1:13:22.840
<v Speaker 1>rather than a tool for eugenics or population control. That's

1:13:22.880 --> 1:13:25.439
<v Speaker 1>not to say that those perspectives are gone, nor should

1:13:25.439 --> 1:13:28.240
<v Speaker 1>the origin story of the birth control movement be forgotten,

1:13:28.840 --> 1:13:31.960
<v Speaker 1>but even more important to remember or pay attention to

1:13:32.360 --> 1:13:36.200
<v Speaker 1>is the justifications that people use to restrict access to

1:13:36.240 --> 1:13:40.880
<v Speaker 1>birth control. Only when birth control became a representation of

1:13:40.960 --> 1:13:44.040
<v Speaker 1>women's liberation and a woman's right to decide for herself

1:13:44.120 --> 1:13:46.679
<v Speaker 1>what to do with her life and was no longer

1:13:46.760 --> 1:13:51.320
<v Speaker 1>a justification for racist population control programs, did the outcry

1:13:51.360 --> 1:13:55.040
<v Speaker 1>against it begin to grow. Think there's a very unusual

1:13:55.080 --> 1:13:59.040
<v Speaker 1>timing there. Birth control doesn't go against nature. We have

1:13:59.120 --> 1:14:03.720
<v Speaker 1>been practicing it four thousands upon thousands of years. Hormonal

1:14:03.760 --> 1:14:06.880
<v Speaker 1>birth control pills mimic what our bodies do during pregnancy.

1:14:07.760 --> 1:14:11.280
<v Speaker 1>Why not a similar outcry against condoms? If there was

1:14:11.320 --> 1:14:13.280
<v Speaker 1>a male birth control pill, would there be as much

1:14:13.320 --> 1:14:16.880
<v Speaker 1>debate over whether it was natural or moral? I highly

1:14:16.920 --> 1:14:20.879
<v Speaker 1>doubt it. Restriction of reproductive rights isn't about what's natural

1:14:21.000 --> 1:14:24.200
<v Speaker 1>or healthy. It's about control. It's about putting people in

1:14:24.280 --> 1:14:28.799
<v Speaker 1>boxes narrowly defined by those in charge. This pushback against

1:14:28.800 --> 1:14:32.600
<v Speaker 1>reproductive rights has picked up a terrifying amount of momentum

1:14:32.680 --> 1:14:36.360
<v Speaker 1>in these past few years. Aaron, why don't you bring

1:14:36.439 --> 1:14:38.519
<v Speaker 1>us up to speed on birth control today?

1:14:39.400 --> 1:14:42.639
<v Speaker 2>Okay, I think I'm gonna need a quick break first.

1:14:42.800 --> 1:15:20.639
<v Speaker 2>Same so we can touch briefly on male contraception if

1:15:20.640 --> 1:15:22.280
<v Speaker 2>you like, just to kind of get started.

1:15:22.479 --> 1:15:24.240
<v Speaker 1>Yeah, I'm very curious about this.

1:15:24.840 --> 1:15:30.120
<v Speaker 2>Yeah, there are currently two forms of contraception available that

1:15:30.240 --> 1:15:35.680
<v Speaker 2>target males, and that is the condom and of eseectomy.

1:15:36.280 --> 1:15:40.200
<v Speaker 2>That's it. Cool cool condoms I mentioned briefly earlier. They're

1:15:40.280 --> 1:15:44.280
<v Speaker 2>about eighty seven percent effective with typical use. The biggest

1:15:44.280 --> 1:15:48.680
<v Speaker 2>benefit of condoms is that they protect against other STIs

1:15:48.720 --> 1:15:53.559
<v Speaker 2>as well, which the vast majority of other contraception options don't.

1:15:53.720 --> 1:15:56.439
<v Speaker 2>So that's a real huge benefit of condoms.

1:15:56.120 --> 1:15:57.439
<v Speaker 1>Right, important thing to remember.

1:15:57.479 --> 1:16:03.600
<v Speaker 2>Also, yes, definitely vasectomy. It's very effective, but it's a

1:16:03.640 --> 1:16:06.880
<v Speaker 2>little bit invasive and for the most part at this

1:16:07.000 --> 1:16:10.040
<v Speaker 2>point at least, it's not reversible, at least not reliably.

1:16:10.160 --> 1:16:14.200
<v Speaker 1>So okay, so there's not like the snip snap snip

1:16:14.240 --> 1:16:15.800
<v Speaker 1>snap from the office.

1:16:16.040 --> 1:16:19.719
<v Speaker 2>Yeah, not quite. There has been a lot of research

1:16:19.800 --> 1:16:23.920
<v Speaker 2>to try and develop like gels, injectible gels that would

1:16:24.000 --> 1:16:26.280
<v Speaker 2>then be able to be reversible, like you inject a

1:16:26.320 --> 1:16:29.560
<v Speaker 2>gel that causes occlusion of the vast deference which is

1:16:29.560 --> 1:16:32.439
<v Speaker 2>where the sperm would exit, and then be able to

1:16:32.439 --> 1:16:36.760
<v Speaker 2>inject something else to like dissolve that essentially. But they

1:16:36.760 --> 1:16:39.120
<v Speaker 2>are they're not like on the market at this point,

1:16:39.120 --> 1:16:44.280
<v Speaker 2>are okaying. There aren't a lot of non hormonal male

1:16:44.360 --> 1:16:49.439
<v Speaker 2>contraceptive options that have really been under that advanced level

1:16:49.439 --> 1:16:53.080
<v Speaker 2>of clinical investigation, so not large scale studies of those

1:16:53.160 --> 1:16:54.959
<v Speaker 2>yet they're mostly in animal models.

1:16:55.080 --> 1:16:55.439
<v Speaker 1>Okay.

1:16:56.160 --> 1:17:01.840
<v Speaker 2>Now, Hormonal mail contraception methods include being androgen, so testosterone

1:17:01.880 --> 1:17:06.479
<v Speaker 2>administration with or without the addition of a progestin in

1:17:06.600 --> 1:17:11.240
<v Speaker 2>various forms so like short acting injectibles, long acting injectibles,

1:17:11.680 --> 1:17:15.479
<v Speaker 2>little subcutaneous implants kind of like an explanon, as well

1:17:15.520 --> 1:17:20.680
<v Speaker 2>as pill forms have all been studied. They are in

1:17:20.800 --> 1:17:23.080
<v Speaker 2>fact very effective.

1:17:25.720 --> 1:17:27.280
<v Speaker 1>Soever, what's the hold up?

1:17:27.360 --> 1:17:34.320
<v Speaker 2>Yeah, they have the risk of certain side effects. There

1:17:34.360 --> 1:17:36.840
<v Speaker 2>was actually, I think one of the largest studies of this,

1:17:37.680 --> 1:17:40.439
<v Speaker 2>and I will link to a review article that kind

1:17:40.479 --> 1:17:44.639
<v Speaker 2>of updates all of the research on male contraception. That's

1:17:44.640 --> 1:17:47.120
<v Speaker 2>from twenty nineteen, so it's a really comprehensive, up to

1:17:47.200 --> 1:17:51.200
<v Speaker 2>date article. But in two thousand and eight to twenty twelve,

1:17:51.240 --> 1:17:53.960
<v Speaker 2>there was a really long term phase two clinical trial

1:17:54.320 --> 1:17:58.439
<v Speaker 2>of an injectible combination of testosterone and progestine, so a

1:17:58.479 --> 1:18:02.479
<v Speaker 2>four year study that was to be very effective, and

1:18:02.880 --> 1:18:06.439
<v Speaker 2>seventy four percent of male participants and eighty percent of

1:18:06.479 --> 1:18:09.800
<v Speaker 2>their female partners said that they were satisfied or very

1:18:09.840 --> 1:18:14.559
<v Speaker 2>satisfied with their birth control method, so this injectable, and

1:18:14.680 --> 1:18:17.360
<v Speaker 2>eighty five and eighty eight percent, respectively said that they

1:18:17.360 --> 1:18:21.160
<v Speaker 2>would use this method of contraception if it was available. Now,

1:18:21.200 --> 1:18:26.440
<v Speaker 2>the side effect profile included weight gain, changes in libido

1:18:26.560 --> 1:18:31.679
<v Speaker 2>either increased or decreased, an increase in acne, an increased

1:18:31.760 --> 1:18:36.400
<v Speaker 2>risk of hypertension so high blood pressure, and increases in

1:18:36.520 --> 1:18:41.040
<v Speaker 2>abnormal liver function tests, as well as a slight increase

1:18:41.120 --> 1:18:45.599
<v Speaker 2>in moderate to severe depression. Now, one thing to point

1:18:45.600 --> 1:18:50.840
<v Speaker 2>out is that those are essentially exactly the same side

1:18:50.840 --> 1:18:59.519
<v Speaker 2>effects as female targeted combination oral contraceptive pills. Okay, Another

1:18:59.600 --> 1:19:02.639
<v Speaker 2>thing to point out is that in this study only

1:19:02.760 --> 1:19:08.160
<v Speaker 2>six percent of participants discontinued the study due to these

1:19:08.200 --> 1:19:09.360
<v Speaker 2>side effects.

1:19:09.560 --> 1:19:11.720
<v Speaker 1>Which is a far cry from at least in the

1:19:11.760 --> 1:19:16.000
<v Speaker 1>early years of birth control studies like fifty percent or more. Yeah.

1:19:16.160 --> 1:19:20.280
<v Speaker 2>Yeah, But especially because of the increase of moderate to

1:19:20.320 --> 1:19:23.120
<v Speaker 2>severe depression, this study was ended a bit early and

1:19:23.160 --> 1:19:27.360
<v Speaker 2>it was not approved. Now, one big difference that I

1:19:27.520 --> 1:19:33.760
<v Speaker 2>do have to mention is that in females, because contraceptives

1:19:34.120 --> 1:19:39.840
<v Speaker 2>are actively preventing pregnancy and pregnancy itself is an extremely

1:19:40.040 --> 1:19:44.240
<v Speaker 2>risky state of being, not just during pregnancy, but childbirth

1:19:44.520 --> 1:19:49.000
<v Speaker 2>and postpartum. There are so many increased risk that increases

1:19:49.000 --> 1:19:54.639
<v Speaker 2>your risk of hypertension, preclanthia, stroke, Gosh, you can die

1:19:54.640 --> 1:19:56.840
<v Speaker 2>by hemorrhage. There are so many ways that you can die,

1:19:57.160 --> 1:20:03.280
<v Speaker 2>blood clots, everything, Right, So in preventing pregnancy, you have

1:20:03.360 --> 1:20:06.320
<v Speaker 2>a bit more risk that you might be willing to

1:20:06.400 --> 1:20:09.760
<v Speaker 2>take before you exceed the benefit, if that makes sense.

1:20:09.800 --> 1:20:12.599
<v Speaker 2>So your risk benefit profile is different when you are

1:20:12.640 --> 1:20:17.839
<v Speaker 2>targeting females preventing pregnancy versus preventing males from getting somebody

1:20:17.840 --> 1:20:20.600
<v Speaker 2>pregnant because they are not directly affected by pregnancy.

1:20:20.760 --> 1:20:23.960
<v Speaker 1>That's interesting. Yeah, I didn't really consider that, right.

1:20:24.040 --> 1:20:25.880
<v Speaker 2>I think that that's really important to keep in mind.

1:20:26.160 --> 1:20:30.519
<v Speaker 2>But in terms of what people want, males are very

1:20:30.520 --> 1:20:33.599
<v Speaker 2>interested in contraceptive methods that they would be able to take,

1:20:33.800 --> 1:20:38.439
<v Speaker 2>like overwhelmingly. Yeah, So I think that that's important too. Okay,

1:20:38.479 --> 1:20:43.719
<v Speaker 2>So that's that globally, IUDs are by far the most

1:20:43.720 --> 1:20:48.879
<v Speaker 2>common method of contraception, reversible female contraception in the globe.

1:20:49.400 --> 1:20:52.680
<v Speaker 2>Over one hundred and sixty eight million people worldwide, use

1:20:52.720 --> 1:20:56.479
<v Speaker 2>an IUD as their form of contraception. In the US,

1:20:57.320 --> 1:21:01.759
<v Speaker 2>that's not the case. Combination oral contraception is the most

1:21:02.360 --> 1:21:05.680
<v Speaker 2>common by far, and for a really long time, like

1:21:05.720 --> 1:21:10.120
<v Speaker 2>you mentioned, especially after those lawsuits in the eighties, iud's

1:21:10.160 --> 1:21:13.240
<v Speaker 2>got a really bad rap in the United States. But

1:21:14.200 --> 1:21:18.400
<v Speaker 2>in the last few years, the rates of long acting

1:21:18.520 --> 1:21:23.000
<v Speaker 2>reversible contraception use has been steadily increasing. So in two

1:21:23.080 --> 1:21:27.559
<v Speaker 2>thousand and eight, the overall LARK use was about six percent,

1:21:28.360 --> 1:21:31.759
<v Speaker 2>and in twenty fourteen that had increased to fourteen percent,

1:21:31.880 --> 1:21:35.120
<v Speaker 2>which is really incredible because again these are much more

1:21:35.200 --> 1:21:44.040
<v Speaker 2>effective forms of contraception. Okay, and over roughly that same

1:21:44.200 --> 1:21:47.519
<v Speaker 2>time period, So from two thousand and eight to twenty eleven,

1:21:47.600 --> 1:21:51.200
<v Speaker 2>when we saw this increase in long acting reversible contraception use,

1:21:51.479 --> 1:21:57.280
<v Speaker 2>that is the first time in recent decades that the

1:21:57.920 --> 1:22:04.880
<v Speaker 2>unintended pregnancy rate actually declined. Really, in twenty eleven, it

1:22:04.920 --> 1:22:08.559
<v Speaker 2>had declined to forty five percent from fifty one percent

1:22:08.720 --> 1:22:11.840
<v Speaker 2>in two thousand and eight. Huh, and twenty eleven is

1:22:11.840 --> 1:22:14.519
<v Speaker 2>the most recent data I could find on this. So

1:22:15.160 --> 1:22:19.880
<v Speaker 2>that also means that forty five percent of pregnancies in

1:22:19.920 --> 1:22:25.639
<v Speaker 2>this country are unintended, which either means unwanted or wanted later,

1:22:25.880 --> 1:22:27.120
<v Speaker 2>like not wanted right now.

1:22:27.360 --> 1:22:29.759
<v Speaker 1>That is a higher number than I thought.

1:22:30.200 --> 1:22:34.880
<v Speaker 2>Uh huh, and forty percent of unintended pregnancies and in

1:22:35.000 --> 1:22:40.480
<v Speaker 2>abortion in this country. So in twenty fourteen, the availability

1:22:40.600 --> 1:22:47.000
<v Speaker 2>of family planning services, including contraceptive coverage, helped to avoid

1:22:47.080 --> 1:22:50.840
<v Speaker 2>over two million unintended pregnancies that would have occurred without

1:22:50.920 --> 1:22:58.120
<v Speaker 2>access to contraceptive coverage. Additionally, public funding for contraception in

1:22:58.200 --> 1:23:02.920
<v Speaker 2>twenty ten results in ten point five billion dollars of

1:23:03.080 --> 1:23:08.479
<v Speaker 2>cost savings. That's nearly six dollars of savings per dollar

1:23:08.600 --> 1:23:13.560
<v Speaker 2>spent on contraceptive coverage. And if you take into account

1:23:13.760 --> 1:23:19.599
<v Speaker 2>additional family planning services like STI screenings, HIV screenings, cervical

1:23:19.640 --> 1:23:23.840
<v Speaker 2>cancer screenings, it's like thirteen billion dollars of saving by

1:23:23.920 --> 1:23:26.960
<v Speaker 2>investing in family planning services.

1:23:27.439 --> 1:23:27.799
<v Speaker 1>Wow.

1:23:28.560 --> 1:23:34.760
<v Speaker 2>Yeah. Contraceptive use is linked to increases in educational attainment

1:23:35.000 --> 1:23:40.000
<v Speaker 2>and wage earning, and coverage of this contraception like buy

1:23:40.080 --> 1:23:44.080
<v Speaker 2>insurance companies, saves women over a billion dollars a year

1:23:44.120 --> 1:23:45.200
<v Speaker 2>in out of pocket spending.

1:23:45.600 --> 1:23:47.000
<v Speaker 1>That's a lot of money.

1:23:47.560 --> 1:23:54.160
<v Speaker 2>Yeah. Yeah. And so even though we've seen some improvements

1:23:54.240 --> 1:23:58.120
<v Speaker 2>in terms of the uptake of long acting reversible contraceptive use,

1:23:58.760 --> 1:24:01.280
<v Speaker 2>and in two thousand and eleven a reduction in the

1:24:01.360 --> 1:24:07.200
<v Speaker 2>rate of unplanned pregnancies. Reproductive rights in this country are

1:24:07.240 --> 1:24:11.280
<v Speaker 2>not just on the ballot, they're being actively stripped away.

1:24:12.080 --> 1:24:12.479
<v Speaker 1>Oh yeah.

1:24:12.720 --> 1:24:17.360
<v Speaker 2>So in twenty ten is when Obama signed the Affordable

1:24:17.360 --> 1:24:22.479
<v Speaker 2>Care Act, which required coverage of preventable health services and

1:24:22.520 --> 1:24:26.400
<v Speaker 2>screenings like SDI screenings and cervical cancer screening. And then

1:24:26.439 --> 1:24:29.680
<v Speaker 2>the next year it also required that employers and insurers

1:24:30.000 --> 1:24:36.080
<v Speaker 2>provided women with coverage at no cost for all FDA

1:24:36.280 --> 1:24:40.200
<v Speaker 2>approved contraception, all of those ones that we talked about.

1:24:40.320 --> 1:24:43.720
<v Speaker 2>So the first time that this law was challenged, it

1:24:43.760 --> 1:24:46.360
<v Speaker 2>went up to the Supreme Court in twenty fourteen. You

1:24:46.479 --> 1:24:51.240
<v Speaker 2>probably remember everyone the Hobby Lobby case. Oh God, okay.

1:24:51.600 --> 1:24:54.880
<v Speaker 2>In that case, the Supreme Court ruled in favor of

1:24:54.960 --> 1:24:58.080
<v Speaker 2>Hobby Lobby in a five to four decision, saying that

1:24:58.520 --> 1:25:05.200
<v Speaker 2>in a family owned company with particular religious beliefs, they

1:25:05.439 --> 1:25:12.240
<v Speaker 2>could deny coverage of their employees' contraception. Then in twenty eighteen,

1:25:12.640 --> 1:25:18.120
<v Speaker 2>Trump issued an even broader ruling saying that almost any organization,

1:25:18.520 --> 1:25:23.919
<v Speaker 2>including nonprofits, private companies, non governmental institutions, anyone who claims

1:25:24.000 --> 1:25:29.600
<v Speaker 2>a religious or moral objection to birth control is not

1:25:29.720 --> 1:25:34.559
<v Speaker 2>required to provide it to their employees. And here's what

1:25:34.600 --> 1:25:39.759
<v Speaker 2>I think is really important two things. First of all,

1:25:40.360 --> 1:25:45.280
<v Speaker 2>under the original ACA, the original Affordable Care Act, religious

1:25:45.479 --> 1:25:50.400
<v Speaker 2>entities like churches or mosques were already exempt from having

1:25:50.479 --> 1:25:58.520
<v Speaker 2>to provide contraceptive coverage. So religiously affiliated nonprofit institutions like universities, hospitals,

1:25:58.560 --> 1:26:03.120
<v Speaker 2>and charities were not exacts empt. But under the original ACA,

1:26:03.280 --> 1:26:06.760
<v Speaker 2>they could issue a formal request for exemption to the

1:26:06.800 --> 1:26:10.360
<v Speaker 2>government or their insurance provider, so that it would be

1:26:10.439 --> 1:26:13.280
<v Speaker 2>the insurance company itself that would have to front the

1:26:13.320 --> 1:26:17.519
<v Speaker 2>cost and cover the contraceptives for employees. Okay, so like

1:26:17.560 --> 1:26:21.800
<v Speaker 2>a religious university or hospital wouldn't have to pay for

1:26:21.880 --> 1:26:24.800
<v Speaker 2>its employees to have birth control, but those employees could

1:26:24.840 --> 1:26:30.200
<v Speaker 2>still be covered directly from the insurance provider. But somehow

1:26:30.320 --> 1:26:36.400
<v Speaker 2>that was considered unacceptable, and so this new Trump ruling

1:26:36.800 --> 1:26:41.600
<v Speaker 2>insisted that these organizations had the right, based on religious

1:26:41.760 --> 1:26:47.000
<v Speaker 2>or moral grounds, to completely deny access to contraceptive coverage

1:26:47.120 --> 1:26:52.840
<v Speaker 2>for their employees. And in July of this year, the

1:26:52.880 --> 1:26:56.240
<v Speaker 2>Supreme Court ruled essentially in favor and punted it back

1:26:56.280 --> 1:27:02.519
<v Speaker 2>to lower courts. Of this extremely broad base restriction. There

1:27:02.520 --> 1:27:09.080
<v Speaker 2>were only two voices in dissent, and guess what they were,

1:27:09.080 --> 1:27:16.599
<v Speaker 2>both women, shocking the late Justice, the late Justice Ruth

1:27:16.640 --> 1:27:22.680
<v Speaker 2>Bader Ginsburg and Justice Sonya Sodamayor. And what's very frustrating

1:27:22.840 --> 1:27:27.719
<v Speaker 2>is not, I think just that this happened, but also

1:27:28.000 --> 1:27:31.280
<v Speaker 2>that these companies were allowed to cite blatantly untrue statements

1:27:31.320 --> 1:27:34.840
<v Speaker 2>as their reasoning for objecting to birth control, not only

1:27:34.880 --> 1:27:39.800
<v Speaker 2>claiming that birth control itself is against their particular religious beliefs,

1:27:40.120 --> 1:27:43.280
<v Speaker 2>but claiming that the forms of birth control they were

1:27:43.320 --> 1:27:48.520
<v Speaker 2>objecting to are capable of destroying embryos and causing abortions,

1:27:48.560 --> 1:27:50.320
<v Speaker 2>which is simply not true.

1:27:50.600 --> 1:27:51.719
<v Speaker 1>How was that allowed?

1:27:52.800 --> 1:27:57.719
<v Speaker 2>I truly don't know. Erin Again, there has been extensive

1:27:57.760 --> 1:28:00.559
<v Speaker 2>research on this and nothing to support the idea that

1:28:00.640 --> 1:28:07.839
<v Speaker 2>emergency contraceptives, oral contraceptive pills, hormonal IUDs or implants ever

1:28:08.120 --> 1:28:12.599
<v Speaker 2>act as an abortive fashion. And the only circumstances under

1:28:12.640 --> 1:28:17.120
<v Speaker 2>which copper IUDs may is if they are used in

1:28:17.160 --> 1:28:22.040
<v Speaker 2>the context of emergency contraception, and even then they act

1:28:22.080 --> 1:28:27.480
<v Speaker 2>to prevent implantation, which is the scientific and legal definition

1:28:27.640 --> 1:28:32.439
<v Speaker 2>of the start of pregnancy. So yeah, not only are

1:28:33.040 --> 1:28:38.080
<v Speaker 2>contraceptives not acting as abortive fashions, but access to contraceptive

1:28:38.080 --> 1:28:41.000
<v Speaker 2>coverage reduces the rates of abortions.

1:28:41.720 --> 1:28:44.839
<v Speaker 1>All of these rulings, all of the quote unquote logic

1:28:45.360 --> 1:28:49.759
<v Speaker 1>just reveals one thing that it's only ever been about

1:28:49.920 --> 1:28:52.920
<v Speaker 1>control over people's bodies.

1:28:53.320 --> 1:28:57.400
<v Speaker 2>Yeah, period, because the thing is that allowing people to

1:28:57.560 --> 1:29:02.679
<v Speaker 2>choose when and if to have children, and this doesn't

1:29:02.680 --> 1:29:06.640
<v Speaker 2>get enough coverage, but how far apart to space their pregnancies,

1:29:06.840 --> 1:29:11.760
<v Speaker 2>which is really important, and what form of contraception they

1:29:11.800 --> 1:29:16.880
<v Speaker 2>want to use. Allowing people to have these options, it

1:29:16.920 --> 1:29:20.920
<v Speaker 2>has benefits for moms, it has benefits for babies, It

1:29:20.960 --> 1:29:26.680
<v Speaker 2>has benefits for families. It has helped to further women's equality,

1:29:27.040 --> 1:29:32.559
<v Speaker 2>educational attainment, wage earning, It results in better pregnancy and

1:29:32.880 --> 1:29:37.639
<v Speaker 2>neonatal outcomes, and again it reduces abortion rates. So there

1:29:37.760 --> 1:29:42.960
<v Speaker 2>truly is no reason to hinder or block access to

1:29:43.000 --> 1:29:47.439
<v Speaker 2>safe and effective, comprehensive Comprehensive that means all the options

1:29:47.439 --> 1:29:52.479
<v Speaker 2>that are available contraceptive coverage. So one of the things

1:29:52.520 --> 1:29:54.840
<v Speaker 2>that we hoped to do in this episode was to

1:29:54.960 --> 1:29:59.639
<v Speaker 2>provide you all with information about how these birth control

1:29:59.680 --> 1:30:03.920
<v Speaker 2>options work because I think that that it's hard to

1:30:04.080 --> 1:30:08.880
<v Speaker 2>know that information sometimes you know so because I know

1:30:08.960 --> 1:30:11.559
<v Speaker 2>you care about the people in your life that can

1:30:11.600 --> 1:30:17.360
<v Speaker 2>benefit from access to contraceptives and comprehensive reproductive healthcare. I

1:30:17.360 --> 1:30:20.240
<v Speaker 2>think the most important thing that we all need to

1:30:20.280 --> 1:30:24.840
<v Speaker 2>do is please vote.

1:30:25.080 --> 1:30:25.439
<v Speaker 1>Vote.

1:30:26.280 --> 1:30:29.040
<v Speaker 2>This is a long episode to ask you to vote.

1:30:29.880 --> 1:30:34.400
<v Speaker 1>It's the most important thing right now is to vote.

1:30:35.200 --> 1:30:38.960
<v Speaker 2>Anyways, that's all I got erin.

1:30:39.680 --> 1:30:41.519
<v Speaker 1>I mean, we got a lot erin.

1:30:42.320 --> 1:30:46.799
<v Speaker 2>We sure do? Oh you do sources?

1:30:47.000 --> 1:30:50.679
<v Speaker 1>Man, Yes, I do have a couple of sources. So

1:30:51.040 --> 1:30:53.519
<v Speaker 1>I've read a couple of books. One is The Moral

1:30:53.600 --> 1:30:56.559
<v Speaker 1>Property of Women, A History of birth control Politics in

1:30:56.600 --> 1:31:00.559
<v Speaker 1>America by Linda Gordon, and that has gone through several

1:31:00.760 --> 1:31:03.400
<v Speaker 1>revisions and iterations. And I read the one from two

1:31:03.400 --> 1:31:07.720
<v Speaker 1>thousand and two, and then by Jonathan Iig. I think

1:31:07.760 --> 1:31:11.120
<v Speaker 1>it's ig The Birth of the Pill, How four pioneers

1:31:11.240 --> 1:31:15.040
<v Speaker 1>reinvented sex and launched a revolution. That's from twenty sixteen.

1:31:15.520 --> 1:31:20.320
<v Speaker 1>And then finally, Our Bodies Ourselves dot org website has

1:31:20.960 --> 1:31:24.240
<v Speaker 1>a brief history, a brief timeline of birth control, and

1:31:24.280 --> 1:31:28.040
<v Speaker 1>so I extracted especially some of the later points from there.

1:31:28.439 --> 1:31:32.360
<v Speaker 2>Awesome I have a number of articles about the mechanism

1:31:32.360 --> 1:31:36.479
<v Speaker 2>of action of contraception, as well as that review article

1:31:36.600 --> 1:31:39.920
<v Speaker 2>on developments in mail contraception which was from twenty nineteen,

1:31:40.280 --> 1:31:44.240
<v Speaker 2>and also on the Gutmacher Institute website. That is an

1:31:44.400 --> 1:31:47.360
<v Speaker 2>organization that does a lot of research on reproductive rights

1:31:47.400 --> 1:31:49.439
<v Speaker 2>and they have some great stats, so I have a

1:31:49.479 --> 1:31:52.479
<v Speaker 2>link to a couple of their articles as well. You

1:31:52.520 --> 1:31:55.360
<v Speaker 2>can find all of our sources from this episode and

1:31:55.479 --> 1:31:59.040
<v Speaker 2>every single one of our episodes from all three seasons,

1:31:59.040 --> 1:32:02.680
<v Speaker 2>that's sixty episodes on our website this podcast will kill

1:32:02.720 --> 1:32:03.439
<v Speaker 2>You dot com.

1:32:04.920 --> 1:32:08.000
<v Speaker 1>Thank you to Bloodmobile for providing the music for this

1:32:08.080 --> 1:32:11.280
<v Speaker 1>episode and all of our sixty episodes.

1:32:12.680 --> 1:32:15.120
<v Speaker 2>And thank you to you listeners. This has been a

1:32:15.160 --> 1:32:18.240
<v Speaker 2>fun three seasons. We will be coming back with season

1:32:18.320 --> 1:32:22.840
<v Speaker 2>four in a few weeks. We don't have a particular date,

1:32:22.920 --> 1:32:25.679
<v Speaker 2>so make sure that you're subscribed so that you don't

1:32:25.840 --> 1:32:28.080
<v Speaker 2>miss it when we dress a new season.

1:32:28.880 --> 1:32:34.719
<v Speaker 1>Absolutely well until next season, wash.

1:32:34.640 --> 1:32:58.840
<v Speaker 4>Your hands, you fill the animals and vote and vote

1:33:03.520 --> 1:33:03.560
<v Speaker 2>U