8 Mar 2017

A history of contraception in good ol’ Aotearoa

4:31 pm on 8 March 2017

Be glad that birth control has moved on from the 1870s.

 

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Photo: Illustration: Holly Davies

Long before Europeans showed up to educate Māori on the correct number of petticoats to wear in hot weather (many), Māori women had been using hormonal birth control for centuries. A native plant, poroporo, naturally produces a steroidal hormone used in making contraceptive pills. Māori women would brew the leaves in a broth to keep their menses on schedule. (NB I wouldn’t recommend doing this at home because the broth is also poisonous).  It was grown in Taranaki up to the ‘80s, when cheaper sources of steroids became available.

As well as petticoats and rib-cracking corsets, European settlers also brought their own kinds of birth control (even if they didn’t work very well).

Condoms in various forms had been used in Europe since the 16th century, but they had several significant drawbacks. They were:

1.     Made from animal intestines (eww)

2.     Prone to tearing (unfortunate)

3.     “Reusable” (eww again)

4.     Much too expensive for everyday folk (damn)

In 1844, Charles Goodyear invented the rubber vulcanisation process and by 1855 the first rubber condoms were on the market. (For context, this was more than 30 years before the first rubber bicycle tire). These were still too expensive for most people and were also thicker and more uncomfortable than their sheep entrails predecessors. And, as they were designed for “repeated use”, they had to be washed thoroughly after each use, something that made the rubber more likely to perish. Add on a sea voyage to the Antipodes and only the thickest and most unpleasant rubber condoms made it all the way to New Zealand in one piece.

More sea-worthy types of 19th century birth control included early IUDs and contraceptive sponges. Intrauterine devices (if we use the term loosely) have been around for thousands of years but have only fairly recently become the effective and safe devices that we have today; European medical device manufacturers made crude IUDs out of bone, silk-thread, and even gold and silver, but they had the tendency to fall out or cause dangerous infections. Contraceptive sponges had the advantage of not being pushed through your cervix and could be made more effective by using them with spermicides – but even under the best conditions they still could let sperm through.

That left settler ladies with two choices: the rhythm method or coitus interruptus (AKA the withdrawal method), both of which require a decent knowledge of reproductive biology and a lot of luck. I don’t recommend either of these methods if you aren’t at least mostly OK with an “oops” baby coming along. No one’s ovulation schedule runs like clockwork and two recent studies have found that pre-cum contains healthy little swimmers capable of getting you in the family way – plus a lot of guys seem to overestimate their staying power.

Māori women would brew Poroporo leaves in a broth to keep their menses on schedule.

Māori women would brew Poroporo leaves in a broth to keep their menses on schedule. Photo: Illustration: Holly Davies

Given the options available to them were not great, it’s not surprising to know that the average Kiwi lady of the 1870s had seven kids and very little say in the matter. By the time the Great Depression rolled around, that number had dropped to two. I don’t know if people got more careful or if the economic situation was a bit of a downer in the bedroom, but either way people were having fewer kids.

The Family Planning Association (then called the Sex Hygiene and Birth Regulation Society) set up shop in New Zealand in 1936, just in time to make a submission to the McMillan Abortion Inquiry. Led by Elsie Locke, good old Family Planning pointed out that poorer women had extremely little control over their reproductive tracts and that a lot of people were turning to unsafe abortions in the absence of effective birth control options. The McMillan Inquiry ultimately discovered that one in five pregnancies in New Zealand were ending in unsafe, illegal abortions – meaning that several thousand risky, back-alley procedures were going on each year.

New Zealanders that found themselves “in trouble” could go to their local pharmacist and pick up a box of pills, often sold under euphemisms like “female pills” or “woman’s friend”, although these pills were far from friendly. While the death toll from that era is hard to calculate due to the intense stigma around illegal abortion, there is a fairly recent study from Uruguay, where abortion was decriminalised only in 2008.

Conducted by the poison control centre, the study investigated 86 poisoning cases brought to their attention that resulted from attempts to terminate a pregnancy using the sort of “herbal remedies” our grandparents and great-grandparents would have used: the results are not pretty. In the poisoning cases explored in the study, 16 percent resulted in multiple organ system failures, 20 percent required emergency curettage at a hospital, 10 percent required emergency hysterectomies to save their lives, and 6 percent died. Only a quarter of the poisoning cases were “successful” in terminating a pregnancy.

An unlucky casualty of reproduction in the days before reliable birth control and legal abortion was Wellington’s Phyllis Symons, a 17-year-old girl who left her family to live with a 29-year-old widower and single dad of two. In July 1931 her beau, George Coats, bashed her in the head with a shovel and buried her in the excavated earth from what would soon be the Mount Victoria Tunnel. The pathologist testified that there were signs that Miss Symons had tried her hand at a DIY abortion and that she’d still been alive when Coats buried her. Coats hanged, the tunnel was opened ahead of schedule, and poor little Phyllis Symons lies in a lonely grave in Karori Cemetery

While the rubber condoms hardy enough to survive the voyage to New Zealand were thick and off-putting, diaphragms reached their peak in the 1940s just before the baby boom took off. Used in conjunction with spermicidal gel like the sponges mentioned earlier, the diaphragm was a rubber cap that was supposed to fit snugly over the cervix to prevent little swimmers getting through. Unlike the condom, they had to be put in place an hour or so before sex, so spontaneous bursts of passion were out of the question. Worse still, doctors weren’t always great at getting them fitted correctly, meaning they could slip out of place allowing a horde of sperm to storm the keep.

Like condoms, diaphragms have a long history. In his memoirs, Casanova wrote about using half-a-lemon as a cervical cap – although I have to say I would be less than thrilled to have lemon juice introduced to intimate parts of my anatomy, even the person doing it had legendary powers of seduction. By the 1830s the first rubber cervical caps were being custom made by German gynaecologist Friedrich Wilde for his wealthy patients; but uncured rubber perishes quickly, meaning this is yet another contraceptive device we can thank Mr Goodyear for! By the 1880s another German gynaecologist, Wilhelm Mensinga, had added a spring to the rim which allowed “womb veils” to snap into place and stay there. They have fallen out of favour as more reliable methods of contraception have come along – the failure rate with typical use is about 12 percent.

1951 saw the first national Family Planning conference in Lower Hutt; the attendees called upon the government to open birth control clinics and to improve the quality of contraception training medical students received. The government said “no”.  

Instead, we got a ministerial inquiry that in 1954 resulted in a document called the Report of the Special Committee on Moral Delinquency in Children and Adolescents (popularly referred to as the Mazengarb Report) which recommended that the best way to deal with teenagers having sex was to make it a crime to give them the means to do so safely.

Only the thickest and most unpleasant rubber condoms survived the voyage  to New Zealand in one piece.

Only the thickest and most unpleasant rubber condoms survived the voyage to New Zealand in one piece. Photo: Illustration: Holly Davies

In spite of all this nonsense, the first Family Planning opened in Auckland in 1953. There, doctors and nurses were able to educate men and women on how to use condoms, diaphragms, or chart their menstrual cycles. The 1960s brought the pill and the first plastic IUDs just as the boomer generation started developing their carnal urges. Unfortunately, even though the sexual revolution was in full swing, contraception was still reserved for couples whose sex lives were state-sanctioned; teens and people cohabiting without the benefit of a marriage license were out of luck.

By the ‘70s, the safe sex brigade had had enough of being patient agitators for change from within and decided to just get on with things. Dr Margaret Sparrow was working in the student health clinic at Victoria University early that decade when she decided to start handing out contraceptives to free-range fornicators as well as married ones. She earned the ire of the clinic director, an MBE, and the title of Dame Margaret for “meritorious service to the Crown”.  Her extensive collection of contraceptive devices was the centrepiece of an exhibition on contraception at Te Papa earlier this year.

Dr Sparrow was one of the first proponents of “the snip”, working with Family Planning to set up the first low-cost vasectomy clinic in New Zealand. She estimates that she performed over 7000 vasectomies during her career and that at one point the snip was so popular it was the second most widely used method in New Zealand. If you still have a copy of the November 13th, 1972 issue of Woman’s Weekly lying around the house, you’d also know she was an early proponent of the morning after pill – the perfect back-up for when you have an “oops” moment with your regular birth control.

Unfortunately, just when New Zealanders were granted unprecedented control over their sexual health, two new threats arrived in the ‘80s. The first was the Dalkon Shield, a popular kind of IUD with a dangerous secret; the manufacturer decided to exchange the tried and tested string attached to the device with a cheaper alternative to save money. Unlike the string that had been used on the devices during the clinical trials, the new string wicked bacteria up into the uterus where they caused devastating infections. Although no New Zealanders are thought to be among those who were killed by the device, many were maimed and left unable to have children.

The second dark cloud came when the Human Immunodeficiency Virus (HIV) first hit our shores. Until then condoms hadn’t taken off in New Zealand like they had in other countries, but a life-threatening infection with no treatment forced a sudden change in habits. As part of the effort to stop the virus from spreading, condoms finally came out of the pharmacy and into the local supermarket. We also had our first ad for condoms on TV. I’m not old enough to have seen it but I’m told that it involved a parachute metaphor, but no actual condoms. I am old enough to remember the “If you don’t got the rubba there’ll be no hubba hubba” ads where the government tried cringingly hard to relate to young people.

The condoms of today are nothing like the mood-killers our grandparents refused to wear; they are now both thinner and safer than ever, and you can even get them in different colours and flavours (I recommend the orange flavoured Durex ones). Even though we have made huge progress at getting HIV and AIDS under control in New Zealand, it’s still a real possibility so you and your partner need to protect yourselves until you both get a clean bill of health. Most other STIs can be cleared up with antibiotics, but herpes, HPV, and hepatitis are life-long companions that can put your health in jeopardy. You can get 144 condoms for $5 on prescription (even flavoured ones), so there are no excuses to avoid getting your raincoat on.

A decade-and-a-half into the 21st century, it’s time to take full advantage of the new, super-effective contraceptives available to us. Instead of taking a pill everyday, you can get regular injections or have a hormonal IUD or implant inserted by a doctor; all of these approaches bring your chances of getting pregnant as close as possible to zero. For example, I have the implant in my arm and - as well as being able to freak people out by making the little sticks move around under my skin - my chances of getting pregnant are one-in-2000 (by comparison if I was using just condoms my chance of getting pregnant would be one-in-five – yikes!)

If you have concerns about talking to your regular doctor about birth control, I really recommend talking to the staff at Family Planning; they are the best at this sort of thing and they will take the time to talk through any questions and worries you have about the different options available to you. Don’t get discouraged if the first method you try doesn’t work out; no method is without its downsides, but with so many different kinds on offer you are sure to find an approach that works for you.