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Roux Alexandra

PhD student in Sociology, EHESS 

Contact: aroux(at)ens-cachan.fr 

PhD Subject: the diffusion of oral contraception in France : how the pill came to be obvious

Supervisors: Ilana Löwy and Nathalie Bajos (Inserm-Cesp)

Following many years of debate around legalizing birth control methods in France (Neuwirth Law, 1967), the contraceptive pill massively spread in the 1970s and 1980s. At the end of the 1980s, the pill became central in the contraceptive practices and in doctors’ prescriptions and representations. Oral contraceptives are prescribed as a first-line method, whereas other methods (such as IUDs or other hormonal methods) are only prescribed when the pill is contraindicated. This centrality can come as a surprise when one looks at its questioning in the media, and by comparison with other birth control systems in Europe. Apart from Germany whose use of the pill is quite similar to what is observed in France, most of the other countries consider this method as one among many, and consequently resort less to the pill. In France, the pill appears as the obvious choice for prescribers when they recommend a method to users in need of contraception.

This work examines the development of this contraceptive evidence, leading to identify the pill with contraception itself.

First, my analysis focuses on prescribers and contraceptive experts, and on how their socio-demographic profiles evolve between the 1960s and the 2000s. Based on biographical interviews with practitioners that are linked to the contraceptive field of expertise or identified as experts in the media, and using some of these experts’ personal archives, I try to understand how the idea that the pill is the only method worth recommending arises, and how a consensus slowly emerges around this medical representation. I also focus on how such a belief is transmitted from experts to the whole body of practitioners. Part of my work tries to understand the tensions between different medical specialties, and how those different types of doctors came to further oral contraception.

My work also takes into account the links and interactions between doctors and other types of actors concurring to the emergence of the pill as the main contraceptive in France. A second axis of my analysis highlights the links between doctors and pharmaceutical firms, and how their interactions result in the promotion of certain types of contraceptives, marketed towards specific parts of the population. Using interviews, pharmaceutical advertisement in the medical press, and other archives, I study the firms’ role in shaping medical beliefs.

Last, I emphasize how the links and tensions between feminist activists, contraceptive experts and prescribers contributed to fostering specific representations of the contraceptive pill, and of the difficult access to other methods. Based on interviews which such activists, feminist archives funds and a certain amount of research focusing on the feminists’ claim for access to contraception, I lay the stress on how actors with diverging interests contributed to the rise of this contraceptive evidence.