The journey to accessible emergency contraception has been long and complicated. Like with many other medications, research started with animal studies before moving on to human use. Learn about the creation of the morning after pill, how it became approved, and when it became widely available for use. Some controversy around the use of emergency contraception still exists, particularly in some political sectors. The issue remains important for public health and women’s rights. 

When was the morning after pill invented?

Emergency contraception went through several iterations before the morning after pill became what it is today. In the 1960s, doctors would prescribe a high dose of estrogen to rape victims to prevent unwanted pregnancies. Severe side effects from the high levels of estrogen weren’t uncommon. The Yuzpe regime became an emergency contraceptive method in the early 1970s. Rather than containing high doses of estrogen, this method of emergency contraception used a combination of hormones. In the late 1970s, the copper IUD became the first nonhormonal method of emergency contraception. Emergency contraceptives continued to evolve and adapt to regulations around use. 

Who created Plan B?

Plan B evolved from an earlier method of emergency contraception. In 1977, Yuzpe and Lance developed a combination regimen of 0.1 mg ethinylestradiol and 0.5 mg levonorgestrel. This method came about due to research done in 1966 by John McLean Morris, MD. and Gertrude van Wagenen, Ph.D. Plan B only contains levonorgestrel. The Women’s Capital Corporation (WCC) owns the patent for Plan B. The FDA had requested new applications for dedicated emergency contraceptives; Plan B was a response to this call. Plan B was approved for sale in the United States in 1999. However, accessibility was lacking. At first, it wasn’t available over-the-counter, and there were age restrictions. 

When did Plan B become available over the counter?

It was a long and confusing journey to make Plan B widely available, so we’ll note some of the highlights. The FDA requested new drug applications specifically for emergency contraception in 1997. Plan B got created in response to the request, and the FDA approved its use in 1999. However, it took many years for Plan B to become a widely available OTC emergency contraceptive option. The first step to making Plan B more accessible included filing a citizen petition. Studies had to be reviewed by the FDA. However, controversy over the use of Plan B still existed. In 2004, the application to sell OTC Plan B got denied because of concerns about how it would impact teen health and sexual behavior. Revisions were made to the application to make Plan B available for those 16+. A ruling on the issue was delayed, keeping Plan B from being accessible to many who might have needed it. Politics seemed to overrule matters of public health in this process. In 2006, the petition for OTC Plan B got denied, and another revision was made to the application to make Plan B available OTC for those 18+ years of age. In 2009, those who were 17+ years could buy the medication. Plan B became accessible to women, regardless of age, in 2013, but the generic versions still had age restrictions. In 2014, more products became more accessible. Regardless of age, you could now buy generic versions of Plan B, as long as the product label claimed the product was for those who are 17+ years.   

When did the FDA approve birth control pills?

The history of the birth control pill stretches back to the 1950s. Margaret Sanger devoted her life to the research and development of birth control. Her goal was to find safe and effective methods of preventing pregnancy. She helped women in the United States gain the right to use contraception and contributed to the research and development of what became the birth control pill. Some may question whether the early tests would meet today's standards because of the number of people in the studies and the length of observation time. The FDA approved the pill in the 1960s, but this pill had the potential to cause severe side effects due to the high hormone levels, higher than necessary to reduce the chances of pregnancy. Due to an FDA ruling, informational packets are now included within every pill package to mitigate risks. This change occurred in the late 1970s. Over time, birth control pills have improved. Today there are fewer possible health risks and less severe side effects when you use them. The availability and accessibility of the birth control pill have helped reduce unwanted births and potentially unsafe pregnancies resulting in the need for abortion.

The intersection between public health and politics is challenging to navigate at the best of times. Awareness of history can provide evidence to make further improvements where necessary, though it’s a slow and complicated process.