- The Morning After: A History of Emergency Contraception in the United States
Heather Munro Prescott provides an engrossing and many-angled account of the origins and development of emergency contraception in the United States through to 2010. This study, chronologically organized and eschewing simplistic categories of friends and foes of emergency contraception, contextualizes the growth of popular and legal approval for emergency contraception within the fluid political history of the nonemergency birth control pill, changing feminist perspectives on hormonally based contraceptives, the anti-abortion backlash to Roe v. Wade, and the complex evolution of U.S. drugs' oversight and regulation. Charting shifts and continuities in public attitudes regarding unwanted pregnancy, Prescott observes how oral contraceptives were promoted to cure the unwanted pregnancy "disease," then reframed as attention expanded to societal causes of unwanted pregnancy; for example, taking into account sexual violence and social inequality, and in the later 1960s counting reproductive self-control as essential to a woman's power to over her own body. Relying on diverse documentation such as congressional hearings, Federal Drug Administration transcripts, National Institute of Health minutes, Planned Parenthood papers, television broadcasts, unpublished individual papers in numerous archives, professional, political and popular journals as well as relevant print and internet scholarship, Prescott builds the case that the consensus that emerged in support of emergency contraception—radical feminist groups antagonistic to decades of male medical and pharmaceutical callousness over women's interests; women of color rightfully suspicious of population control agendas; population and family planners; pharmaceutical and medical professionals—did not come easily. It entailed diligent and creative collaborative outreach and organization even among groups internally divided. It reflected constant medical, feminist, and non feminist reassessment of the risks of emergency contraception relative to the risks of alternative postcoital methods of preventing birth. Crucial to consensus building were conservative successes: Women of diverse races rose up against the stalling of FDA approval for RU 486, against pharmaceutical companies concealing the fact that the regular birth control pill could also be used as a postcoital contraceptive, and against judicial restrictions of access to abortion. Throughout her account Prescott stresses the key role of countless women from the 1960s to the present day who demanded ready access to emergency contraception, ultimately through over-the-counter purchase. She argues that "recent activism on emergency contraception demonstrates how women have continued to use personal histories of their bodies to transform reproductive health research and healthcare policy" (p. 127).
Prescott is fully aware that emergency contraception is not a panacea for a woman's well-being. Written from a feminist pro-contraceptive persuasion, her study joins others critical of shallow advocacy of emergency contraception and calls for reproductive justice. She concludes her study by stating that the feminist [End Page 296] health movement and consumer economic initiatives "have thus far been unable to resolve the economic inequalities in the United States that continue to pose an insurmountable barrier to those unable to afford the products of this self-care revolution" (p. 128). Prescott might add that even if this barrier were surmounted, eased availability of emergency contraceptives may well compound female vulnerability to unwanted male sexual overtures if concurrent female sexual autonomy and self-confidence did not also ensue.
Prescott's excellent account is not without its limitations, as when she cursorily turns to global developments. Why, for example, did thirty-eight countries provide emergency contraception ahead of the United States? We need fuller understanding of national variables in health care provision and feminist activism as well as greater knowledge of international exchanges and collaborations, since for decades the United States imported much of its contraceptive technology from Europe. Disappointing, too, is Prescott's weak discussion of Supreme Court rulings on privacy rights, especially the three pivotal decisions during the 1970s that involved Bill Baird, no mere "contraceptive salesman" (p. 16). Since Prescott places substantial emphasis on female...