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[narrator] We're not sure why this shape
became the universal symbol of love.
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But one leading theory is that it came
from the silphium pod,
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so valuable
across the ancient Mediterranean,
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it was printed on the currency
of the only place they grew,
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the Greek colony Cyrene.
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It was exported around the region
for all kinds of medical uses
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and one in particular.
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Soranus of Ephesus,
the foremost gynecologist of his time,
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advised women to drink silphium juice
once a month,
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since it not only prevents conception,
but also destroys any already existing.
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Which means, our modern heart shape
may derive from an ancient kind
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of morning-after pill.
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But for most of human history,
birth control was a lot less refined.
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There were early condoms made
of animal intestines
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that were washed and reused.
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And diaphragms, early versions,
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were just women putting various things
up their vaginas:
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wool, silk, crushed plants or animal dung,
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depending on the available animal.
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In Egypt, it was crocodile dung.
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In India, dung of the elephant.
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We'll never know for sure
how well silphium worked,
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because it went extinct.
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But research into its likely relatives,
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like Queen Anne's lace
and devil's dung,
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suggest it probably manipulated
the hormone levels
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involved in getting pregnant.
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Scientists eventually figured out how
to do that in a lab in the 1950s.
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And it's how nearly every new type
of birth control has worked ever since.
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But this method isn't perfect.
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Weight gain, depression, acne...
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I was just bleeding and bleeding
at a low level for months.
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I would just, like, cry over, like,
things that didn't make any sense.
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Cutting a cucumber, and I was like, "Why?
Like, "Is this, like--?
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This is the worst, like, vegetable
I've ever, like, cut up before."
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[narrator] It's been over 60 years
since we invented hormonal birth control.
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Shouldn't it be better by now?
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[man 1] This little white tablet
is more explosive than dynamite.
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Sermons have been preached on it.
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Men and women have argued over it.
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[man 2] Mary
and her team merely explain the pill,
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and they nod back, but it's not consent,
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because it's their man
who decides yes or no.
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[woman 1] The doctors themselves
may not be well-informed
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about the side effects.
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[woman 2] It's hard to see what more
we could do without using women themselves
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as the experimental model.
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[narrator] If you have a pet cat,
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well, you may remember
when she started going into heat...
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[yowls]
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[narrator] ...as in,
when she started ovulating,
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producing eggs.
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And for those few days
when they're fertile,
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they really want to mate.
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Most female mammals look and act different
around the days they're ovulating,
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called "estrus,"
signaling that they want it,
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so come and get it.
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Female chimpanzees
get huge sexual swellings,
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goats wag their tails,
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and horses wink their vulvas.
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But higher primates, like humans,
are pretty unique.
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We don't show outward signs that
it's our fertile few days of the month,
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and we're continually receptive to sex,
whether we're fertile or not.
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Scientists call this concealed ovulation,
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and it took them into the 1900s
to figure out how it worked...
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and how to hack it.
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Ovulation mainly involves four hormones,
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which rise and fall
over the course of a month.
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Two of them are released from the brain,
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and two come from the ovaries:
estrogen and progesterone.
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To kick things off,
those two brain hormones
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send a signal to the ovaries,
where roughly a dozen follicles,
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each containing a single immature egg,
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have been patiently waiting
for this moment.
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It's winner takes all in the fight
over the limited hormone supply,
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and the loser follicles die off.
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Next, the winning follicle emits lots
of estrogen,
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which starts
to thicken the uterine lining
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and opens up the cervix,
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which is now coated
with a nutrient-filled fluid
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that protects any incoming sperm
on their journey up to the uterus.
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Then the follicle ruptures,
releasing the matured egg,
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which is snatched up
by the nearby Fallopian tube.
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The sperm has a short window of time
to get to the egg, or it dies off.
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But if one gets there,
that's fertilization.
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The egg keeps traveling down
the Fallopian tube to the uterus
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as progesterone levels rise,
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which close the cervix
and turns that fluid into a sticky shield,
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blocking any new sperm from getting in.
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The progesterone also keeps
building up the uterine lining
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into a warm, snuggly bed
where the egg can stick.
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But it's not that warm and snuggly.
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It's also a lethal testing ground
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that not every fertilized egg can survive.
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If a fertilized egg
does successfully implant,
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that's a pregnancy.
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Estrogen and progesterone levels
stay high,
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and the ovaries won't release more eggs.
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But if the fertilized egg is rejected
or there never was one,
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estrogen and progesterone plummet.
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And out comes that lining: your period.
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And the cycle reboots.
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Hormonal birth control's main cheat
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is altering the estrogen
and progesterone levels in the body,
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so it thinks you're already pregnant.
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So, no new eggs are released.
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The cervix stays plugged up,
and the uterine lining remains thin.
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"The pill," released in 1957,
was the first form of this hack.
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A daily dose of both synthetic estrogen
and progesterone,
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marketed as Enovid in the US
and Enavid in the UK,
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but only to treat menstrual problems,
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which an unusually large number of women
suddenly found they had.
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And when the pill hit the market
as birth control in the 1960s,
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it transformed the world.
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More women were able to stay in school
and have smaller families,
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helping to lift millions out of poverty.
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You can see that kind of profound impact
in rural Bangladesh,
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starting in the 1970s.
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Bangladesh had just become a country.
It was very poor.
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Religiously conservative.
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Most Bangladeshi women were practicing
female seclusion,
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where they would not even go in public.
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So, going to a clinic was a big ask
of these women.
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[narrator] But then in 1978,
health workers went door-to-door
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in 70 randomly selected villages
every two weeks
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with an array of birth control options,
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including injections,
the most popular choice,
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because they were discreet,
and one shot lasted for months.
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Two decades later,
the results were transformative.
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Compared to an otherwise
identical village...
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families in a birth control village
had more education,
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higher incomes, more valuable homes
and savings,
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and better access to running water.
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Those women also had
a higher body mass index,
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and as a result,
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they were 20% more likely to survive
into old age.
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But the progress hormonal birth control
brought women around the world
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didn't come without a cost.
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Starting with that very first pill.
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See, when you take the pill,
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it puts those synthetic hormones
in your bloodstream,
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so they travel all over the place.
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The changing hormone levels
can cause headaches and nausea,
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affect hair growth,
and increase water retention,
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so you can gain weight.
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And these hormones also play a role
in regulating sexual desire and emotions,
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so you can experience changes
to your very sense of self.
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And while the risk is extremely small,
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estrogen increases the chances
that your blood will thicken into a clot,
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which can travel to your lungs
and block blood flow,
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which can be lethal.
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And that first pill,
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it contained ten times the amount
of hormones needed to be effective.
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That high dose was primarily tested
in Puerto Rico in the '50s,
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chosen because it was poor,
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and the US government worried
about its overpopulation.
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The US-appointed governor endorsed
a sterilization program.
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By 1954,
sterilizations had nearly tripled,
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the women often coerced.
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So, when researchers arrived
with a reversible birth control option,
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these women took it.
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But they didn't know that they were a part
of an experiment
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until a documentary filmmaker told them
decades later.
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[interviewer, in Spanish]
The women who took those pills
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were the first in the world to try them.
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Did you know that, doña Maria?
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No.
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They were experimenting with us,
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without us knowing what they were doing.
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[narrator, in English]
Hundreds of women
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faced serious side effects.
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At least three died,
though it was never investigated.
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It took more than ten years,
several new formulations,
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and millions of women around the world
taking birth control pills
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for the US Congress to finally hold
a hearing on their side effects.
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It was called, after one senator
read the landmark book,
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The Doctors' Case Against the Pill,
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by the investigative journalist
Barbara Seaman,
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who reported women experiencing
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heart attacks, strokes, blood clots,
and cancer.
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Thousands had died or been injured
in the US alone.
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For the first five days of the hearing,
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the all-male panel only invited men
to testify.
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So, the women, they invited themselves.
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An outburst
by a group of young women today
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temporarily halted the Senate hearing
on the safety of the birth control pill.
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I'd like to know why is it that scientists
and drug companies are perfectly willing
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to use women as guinea pigs
and experiment testing the high estrogen,
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low estrogen content of the pill.
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[narrator] The doses of hormones
in the pills were lowered
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in the following years,
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reducing the chance
of side effects like headaches, nausea,
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excess hair growth and weight gain.
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And some new pills were better
at reducing cramps and acne,
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thanks to new synthetic forms
of progesterone.
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A lot of potential side effects
still remain.
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But for hundreds of millions of women
around the world,
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not getting pregnant is worth
making yourself a little sicker.
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And just like with those early versions,
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women, and sometimes even their doctors,
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don't actually know
how much sicker they'll get,
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because you can't always know
until a lot of people start taking a drug.
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One of those synthetic forms
of progesterone, DRSP,
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was a key component
in a pill called Yaz,
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which was heavily marketed in the 2000s
as way more than just birth control.
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[announcer on TV]
Yaz is the only birth control
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proven to treat the emotional
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and physical premenstrual symptoms
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that are severe enough
to impact your life.
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It can also help keep your skin clear.
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Yaz contains a different kind of hormone
that may increase potassium.
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[narrator] The ad campaign worked.
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For two years, Yaz
was the most popular birth control pill
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00:11:06,207 --> 00:11:07,583
in the United States.
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And many young women
who didn't need birth control
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bought it on its own claims
that it made PMS symptoms disappear.
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Then reports of side effects started
to spread.
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From blood clots to organ failure
to stroke,
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thousands of women say they got sick
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after taking a birth control pill
called Yaz.
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Now under scrutiny
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for possibly causing
serious health problems.
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Using it can increase the risk
of dangerous side effects
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that may even cause death.
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[narrator] Birth control pills roughly
triple the risk of getting blood clots...
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but studies later found that DRSP
can as much as triple that risk.
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And while the risk is still small,
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it adds up to thousands of women
if millions are taking that pill.
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As of 2015, the maker of Yaz,
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Bayer Pharmaceuticals,
has settled nearly 10,000 claims
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from women who got blood clots,
totaling around $2 billion.
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But by that time,
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a different type of birth control
was growing in popularity: the IUD.
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This is the hormonal version.
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There's also a different kind,
made of copper.
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Both types are inserted
into the uterus by a doctor,
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where it can stay for three to ten years,
depending on the brand.
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We don't totally know how they work,
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but we do know they turn the uterus
into a no-sperm zone.
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As a foreign object in the uterus,
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the IUD causes inflammation,
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00:12:29,540 --> 00:12:32,585
triggering white blood cells
to rush in and eat the sperm.
243
00:12:33,043 --> 00:12:36,964
The hormonal IUD
also continuously releases a tiny amount
244
00:12:37,047 --> 00:12:40,801
of synthetic progesterone, so it has a lot
of the same effects of the pill,
245
00:12:40,885 --> 00:12:42,470
but with fewer side effects.
246
00:12:43,220 --> 00:12:45,806
The copper IUD doesn't use hormones
at all.
247
00:12:45,890 --> 00:12:48,559
Its trick is that copper
is sperm kryptonite,
248
00:12:48,976 --> 00:12:51,061
for reasons scientists don't understand.
249
00:12:51,645 --> 00:12:52,605
I love having an IUD.
250
00:12:52,688 --> 00:12:55,316
I don't worry that I forgot
to take my pill.
251
00:12:55,399 --> 00:12:58,068
I don't spot. I don't get a period.
252
00:12:58,152 --> 00:13:01,155
I think I've used two tampons
in the last seven years.
253
00:13:01,238 --> 00:13:04,867
I decided to get the copper IUD
because both my mother and her sister
254
00:13:04,950 --> 00:13:06,994
had estrogen-related breast cancer.
255
00:13:07,077 --> 00:13:09,789
So, I was advised by doctors
256
00:13:09,872 --> 00:13:12,416
to get
on a non-hormonal birth control option.
257
00:13:13,042 --> 00:13:15,336
[narrator] The IUD is 99% effective,
258
00:13:15,753 --> 00:13:18,339
in part,
because you can just set it and forget it.
259
00:13:18,714 --> 00:13:21,091
In general,
birth control gets less effective
260
00:13:21,175 --> 00:13:24,428
the more humans have to remember
to do something to make it work,
261
00:13:24,678 --> 00:13:26,555
especially if it's during sex.
262
00:13:27,014 --> 00:13:30,893
Which is why another of the most
effective methods is sterilization.
263
00:13:32,019 --> 00:13:34,730
For men, "the snip" is a minor procedure
264
00:13:34,814 --> 00:13:38,567
to cut or clamp the tubes
that carry sperm out of the testicles.
265
00:13:39,068 --> 00:13:43,030
For women, "getting your tubes tied"
is a more invasive procedure,
266
00:13:43,197 --> 00:13:45,366
which blocks or cuts the Fallopian tubes.
267
00:13:46,158 --> 00:13:49,036
That's actually the most popular form
of birth control in the world.
268
00:13:49,537 --> 00:13:52,706
But women usually only get it
when they've already had kids.
269
00:13:53,415 --> 00:13:57,461
Meanwhile, the IUD is as effective
and can be taken out,
270
00:13:58,003 --> 00:14:01,549
but only 12% of American women
using birth control have one.
271
00:14:02,216 --> 00:14:05,511
And that's largely
because of a huge class action lawsuit
272
00:14:05,594 --> 00:14:08,222
against one IUD, the Dalkon Shield.
273
00:14:08,806 --> 00:14:12,101
Such a disaster,
it was a joke on Saturday Night Live.
274
00:14:12,351 --> 00:14:15,688
If you don't agree
that the Dalkon Shield trout lure
275
00:14:15,771 --> 00:14:19,233
is the most amazing trout catching
phenomenon you've ever tried,
276
00:14:19,525 --> 00:14:20,651
well, sue us!
277
00:14:21,402 --> 00:14:23,320
[narrator]
But it wasn't the fish-bait shape
278
00:14:23,404 --> 00:14:25,781
that caused problems
for people who got the Dalkon Shield,
279
00:14:26,448 --> 00:14:27,449
like Loretta Ross.
280
00:14:27,533 --> 00:14:30,119
My first two or three years
with it were fine.
281
00:14:30,202 --> 00:14:33,914
But then, I started developing
very low-grade infections.
282
00:14:34,456 --> 00:14:37,751
[narrator] She went to an ob-gyn,
who said she had an STD.
283
00:14:38,294 --> 00:14:41,338
If I was black and female presenting
with an infection,
284
00:14:41,422 --> 00:14:43,841
it had to be an STD, in his opinion.
285
00:14:44,133 --> 00:14:46,927
Even though all the tests
were showing up negative.
286
00:14:47,136 --> 00:14:51,515
He just kept searching for something
more exotic, more exotic, more exotic.
287
00:14:51,599 --> 00:14:54,768
[narrator] None of the treatments worked,
and six months later...
288
00:14:55,436 --> 00:14:57,563
I lapsed into a coma one night.
289
00:14:57,646 --> 00:15:00,482
When I woke up,
I had a total hysterectomy.
290
00:15:01,191 --> 00:15:02,985
The first thing that doctor
should have done
291
00:15:03,068 --> 00:15:04,403
was remove the Dalkon Shield.
292
00:15:04,987 --> 00:15:08,282
[narrator] It turned out
the Dalkon Shield had a design flaw.
293
00:15:08,365 --> 00:15:10,576
Its braided string was too thick,
294
00:15:10,659 --> 00:15:14,330
and it acted like a ladder
for bacteria to climb into the uterus.
295
00:15:14,830 --> 00:15:17,917
Within four years
of the Dalkon Shield's release,
296
00:15:18,000 --> 00:15:19,460
it was taken off the market.
297
00:15:19,543 --> 00:15:24,715
By that point, it had been inserted
into 3.3 million women around the world.
298
00:15:24,965 --> 00:15:26,592
At least 18 died.
299
00:15:27,635 --> 00:15:29,553
Hundreds of thousands of women
300
00:15:29,637 --> 00:15:33,390
sued the maker of the Dalkon Shield,
A.H. Robins,
301
00:15:33,474 --> 00:15:34,850
bankrupting the company.
302
00:15:35,142 --> 00:15:39,229
It later came out that Robins officials
knew about the wicking problem
303
00:15:39,313 --> 00:15:41,815
six months before the shield went
to market.
304
00:15:43,776 --> 00:15:46,862
The IUDs on the market now
are extremely safe.
305
00:15:47,112 --> 00:15:48,614
The most common drawback?
306
00:15:48,697 --> 00:15:50,157
Horrible to get put in.
307
00:15:50,240 --> 00:15:51,700
Excruciating pain.
308
00:15:51,784 --> 00:15:54,203
[narrator] Every birth control option
has a drawback,
309
00:15:54,286 --> 00:15:58,666
which is why a third of American women
have tried five or more kinds.
310
00:15:59,333 --> 00:16:02,586
I started with the pill,
and then I went to the ring.
311
00:16:02,670 --> 00:16:04,046
And then I went back to the pill.
312
00:16:04,129 --> 00:16:05,214
Two forms of the pill,
313
00:16:05,297 --> 00:16:08,425
the Nuvaring, um, which was interesting,
314
00:16:08,509 --> 00:16:10,302
but that would come out during sex.
315
00:16:10,386 --> 00:16:13,138
I've been on three different types
of the pill.
316
00:16:13,222 --> 00:16:17,059
I tried an IUD.
And now I'm getting an arm implant.
317
00:16:17,685 --> 00:16:20,062
[narrator] And a lot of women
don't use birth control at all,
318
00:16:20,562 --> 00:16:22,481
even though they don't want
to get pregnant.
319
00:16:23,065 --> 00:16:25,109
In one survey of developing countries,
320
00:16:25,192 --> 00:16:29,655
just 5% of women not on birth control
said the reason was access.
321
00:16:30,114 --> 00:16:33,409
26% said the reason was side effects.
322
00:16:34,243 --> 00:16:38,455
There is actually a birth control pill
that doesn't use hormones.
323
00:16:38,664 --> 00:16:40,290
It was launched as Saheli,
324
00:16:40,374 --> 00:16:43,168
and it's been on the market
for almost 30 years.
325
00:16:43,627 --> 00:16:45,963
Its active ingredient is what's called
326
00:16:46,046 --> 00:16:48,841
a "selective estrogen receptor modulator."
327
00:16:49,258 --> 00:16:50,384
Not estrogen,
328
00:16:50,467 --> 00:16:53,971
but a compound that acts
on estrogen receptors in the uterus.
329
00:16:54,263 --> 00:16:56,473
So, the estrogen there can't do its job,
330
00:16:56,557 --> 00:17:00,978
building up that warm uterine lining
so no fertilized eggs can snuggle in.
331
00:17:01,478 --> 00:17:04,356
Since it doesn't actually affect
estrogen levels,
332
00:17:04,648 --> 00:17:07,359
the balance of hormones
in your body stays the same.
333
00:17:07,484 --> 00:17:09,987
So there are fewer side effects
than hormonal pills.
334
00:17:10,237 --> 00:17:12,322
And you only have to take it once a week.
335
00:17:13,490 --> 00:17:15,743
But good luck getting Saheli
outside of India.
336
00:17:15,826 --> 00:17:17,119
That's where it was invented
337
00:17:17,202 --> 00:17:21,540
and went through the large human trials
most countries require to market a drug.
338
00:17:22,249 --> 00:17:24,168
And it was one of the lucky ones.
339
00:17:24,752 --> 00:17:28,213
Out of every 5,000 compounds developed
in a lab,
340
00:17:28,297 --> 00:17:32,551
only five make it to human trials,
and only one of those gets to market.
341
00:17:33,343 --> 00:17:37,347
So finding new ways to deliver
the same hormones we already know work
342
00:17:37,431 --> 00:17:40,726
is faster, cheaper, and less risky.
343
00:17:41,518 --> 00:17:44,188
Birth control has sparked
thousands of lawsuits,
344
00:17:44,271 --> 00:17:47,274
because mostly healthy women
are taking these drugs,
345
00:17:47,649 --> 00:17:51,570
so they're more likely to notice
and sue over serious side effects.
346
00:17:52,321 --> 00:17:54,615
There's also little incentive to innovate
347
00:17:54,698 --> 00:17:56,742
since women are
buying their products anyway.
348
00:17:57,242 --> 00:17:59,161
The mood swings have been bad.
349
00:17:59,703 --> 00:18:04,792
The nausea has been bad initially,
but then you just get used to it, I guess.
350
00:18:04,875 --> 00:18:08,587
Years worth of drama in my life,
years worth of medical bills,
351
00:18:08,670 --> 00:18:10,339
drama while I'm traveling,
352
00:18:10,422 --> 00:18:12,800
drama that I have to think about
every time I have sex,
353
00:18:12,883 --> 00:18:14,343
every time I get my period.
354
00:18:14,426 --> 00:18:18,180
Why go through that?
I guess 'cause condoms suck, but...
355
00:18:18,764 --> 00:18:20,766
[narrator] And there's
a huge potential market
356
00:18:20,849 --> 00:18:24,144
the birth control industry
has left almost entirely untapped.
357
00:18:24,686 --> 00:18:26,980
I'm not at all satisfied
with the options of birth control
358
00:18:27,064 --> 00:18:31,693
for myself as a man
because I feel like there aren't enough.
359
00:18:31,777 --> 00:18:34,279
My only option
as a guy is to use condoms, uh...
360
00:18:34,363 --> 00:18:36,031
[laughs] ...or to-- or to pull out.
361
00:18:36,115 --> 00:18:38,158
So, really,
my only option is to use condoms.
362
00:18:38,283 --> 00:18:42,496
If there was a commercially available
male birth control pill,
363
00:18:42,579 --> 00:18:46,792
I would definitely, definitely,
at the very least, try it.
364
00:18:47,376 --> 00:18:50,587
[narrator] Scientists figured out
how to hack the male reproductive system
365
00:18:50,671 --> 00:18:52,047
decades ago.
366
00:18:52,131 --> 00:18:55,008
And large trials
in the 1970s showed some promise.
367
00:18:55,092 --> 00:18:57,678
The perfection of male birth control
368
00:18:57,761 --> 00:18:59,972
seemed right around the corner
for decades.
369
00:19:00,055 --> 00:19:02,349
The Chinese have developed what they say
370
00:19:02,432 --> 00:19:05,519
is a safe and effective birth control pill
for men.
371
00:19:05,602 --> 00:19:07,521
Medical researchers reported today
372
00:19:07,604 --> 00:19:09,648
they have found a chemical
that may hold the key
373
00:19:09,731 --> 00:19:11,150
to a male birth control pill.
374
00:19:11,233 --> 00:19:14,027
International research teams are working
on an injectable...
375
00:19:14,111 --> 00:19:15,279
...birth control pill for...
376
00:19:15,362 --> 00:19:19,283
...men are taking part in the first trials
of a new form of birth control.
377
00:19:19,366 --> 00:19:21,034
-For men...
-Birth control for men...
378
00:19:21,118 --> 00:19:22,870
-Male birth control...
-Male birth control pill.
379
00:19:22,953 --> 00:19:26,915
Male birth control may be one step closer
to becoming a reality.
380
00:19:26,999 --> 00:19:31,086
[narrator] But it never arrived,
since trials were often cut short
381
00:19:31,378 --> 00:19:33,630
because men faced too many side effects.
382
00:19:33,714 --> 00:19:35,841
Side effects that might sound familiar,
383
00:19:35,924 --> 00:19:39,303
like mood swings, acne,
and a loss of libido.
384
00:19:39,928 --> 00:19:42,723
When approving a drug,
the FDA weighs its risks
385
00:19:42,806 --> 00:19:45,684
against the risks of not taking that drug.
386
00:19:45,767 --> 00:19:48,645
And men, unlike women,
don't personally face
387
00:19:48,729 --> 00:19:51,398
the risks that come
with pregnancy and childbirth,
388
00:19:51,481 --> 00:19:52,858
like blood clots.
389
00:19:53,525 --> 00:19:57,237
Hormonal birth control might triple
a person's risk of blood clots,
390
00:19:57,362 --> 00:20:00,407
but during pregnancy,
the risk is double that,
391
00:20:00,741 --> 00:20:03,744
and in the weeks after childbirth,
quadruple.
392
00:20:03,827 --> 00:20:06,413
And that was part of Bayer's defense
in court documents
393
00:20:06,496 --> 00:20:08,207
in the wake of all those lawsuits.
394
00:20:08,290 --> 00:20:10,792
And it's why Yaz is still on the market,
395
00:20:10,876 --> 00:20:13,837
as are a bunch of other pills
using DRSP.
396
00:20:14,796 --> 00:20:17,674
Male birth control just has
to meet a higher bar,
397
00:20:17,758 --> 00:20:21,345
so the kind that has the best shot
at approval right now
398
00:20:21,428 --> 00:20:22,804
doesn't use hormones.
399
00:20:22,888 --> 00:20:25,349
It's a non-surgical vasectomy.
400
00:20:25,891 --> 00:20:29,561
It works by injecting a gel
into that sperm carrying tube,
401
00:20:29,645 --> 00:20:33,232
where it stays, killing sperm
as they leave the testicles.
402
00:20:33,649 --> 00:20:36,735
A second shot is in development
that would break down the gel.
403
00:20:37,444 --> 00:20:39,196
It's awaiting approval in India...
404
00:20:40,030 --> 00:20:43,575
where early trials have shown
it's 98% effective,
405
00:20:43,867 --> 00:20:45,285
has no major side effects
406
00:20:45,369 --> 00:20:46,995
and can last over a decade.
407
00:20:47,955 --> 00:20:50,499
But it hasn't gone through human trials
anywhere else,
408
00:20:50,749 --> 00:20:52,501
and drug companies aren't sure
409
00:20:52,584 --> 00:20:55,545
male birth control has a market
to make that worth it.
410
00:20:55,963 --> 00:20:57,297
I'll be open to it.
411
00:20:57,381 --> 00:20:58,966
Does that make me less of a man?
412
00:20:59,049 --> 00:21:01,093
I don't know,
but I'm open to anything, honestly.
413
00:21:01,176 --> 00:21:04,513
If guys had the option to sort of take
that level of responsibility,
414
00:21:05,180 --> 00:21:08,517
like, leveling up
from just using a condom,
415
00:21:08,600 --> 00:21:10,227
I think that would make it
a fairer conversation.
416
00:21:10,310 --> 00:21:13,855
It takes two people
to accidentally get pregnant.
417
00:21:14,439 --> 00:21:18,402
[narrator] A 2002 survey found that 55%
of men would be willing
418
00:21:18,527 --> 00:21:21,488
to try even a hormonal male birth control.
419
00:21:21,780 --> 00:21:23,323
But everywhere in the world,
420
00:21:23,407 --> 00:21:26,994
women get their tubes tied
more often than men get the snip.
421
00:21:27,327 --> 00:21:29,579
They don't think
it's their responsibility.
422
00:21:29,663 --> 00:21:32,124
I would probably personally always want
to protect myself.
423
00:21:32,207 --> 00:21:34,918
I have to be responsible for my own shit.
424
00:21:35,002 --> 00:21:37,546
At the end of the day,
if something did happen,
425
00:21:37,629 --> 00:21:39,715
the consequences would lay on me.
426
00:21:40,048 --> 00:21:42,634
[narrator] And most women
around the world see the consequences
427
00:21:42,718 --> 00:21:46,972
of an unplanned pregnancy as so serious,
that the choice is easy.
428
00:21:47,055 --> 00:21:49,433
Which is why in the United States,
429
00:21:49,516 --> 00:21:52,853
more than two-thirds of partnered women
use birth control.
430
00:21:53,437 --> 00:21:55,605
It's 68% in El Salvador,
431
00:21:56,189 --> 00:21:57,733
58% in Kenya,
432
00:21:58,358 --> 00:22:00,277
and 80% in China.
433
00:22:01,737 --> 00:22:03,697
But not everyone gets the same choices.
434
00:22:04,656 --> 00:22:08,160
In 1999, it was included
in the Congressional Record.
435
00:22:08,243 --> 00:22:11,997
that A. H. Robins had "conspired
in the early 1970s
436
00:22:12,164 --> 00:22:13,957
to dump hundreds of thousands
437
00:22:14,041 --> 00:22:17,377
of dangerous,
unsterilized contraceptive devices--
438
00:22:17,586 --> 00:22:21,006
unmarketable in the United States--
into the developing world."
439
00:22:21,423 --> 00:22:23,842
Those devices "were Dalkon Shields."
440
00:22:24,634 --> 00:22:26,845
Loretta Ross traveled
to one of those places,
441
00:22:27,179 --> 00:22:29,848
apartheid South Africa,
and shared her story.
442
00:22:30,098 --> 00:22:32,142
But many women still chose to get one.
443
00:22:32,768 --> 00:22:36,104
There were so few contraceptive options
available to them,
444
00:22:36,188 --> 00:22:41,401
they thought that they needed
to accept the IUD
445
00:22:41,485 --> 00:22:43,278
because it's what freed them up
446
00:22:43,362 --> 00:22:46,531
for educational
and economic opportunities.
447
00:22:46,615 --> 00:22:49,076
And I felt it was tragic.
448
00:22:49,659 --> 00:22:54,081
[narrator] Having a variety of options
is just as important as knowing the risks.
449
00:22:54,164 --> 00:22:57,250
That's what made the Bangladesh program
so successful.
450
00:22:57,334 --> 00:23:00,796
[Shareen Joshi] What you see in Bangladesh
is the commitment
451
00:23:00,879 --> 00:23:04,591
to offer them a full range of services.
452
00:23:04,674 --> 00:23:07,594
Getting a cold storage supply chain
for injectables
453
00:23:07,677 --> 00:23:10,639
in a place where there are no roads
or fridges, or electricity,
454
00:23:10,722 --> 00:23:14,393
that was a very big deal at that time.
455
00:23:14,476 --> 00:23:17,979
And, you know,
the task of recruiting local women
456
00:23:18,063 --> 00:23:21,108
to talk to women about their lives,
457
00:23:21,191 --> 00:23:24,611
their needs, their desires,
their aspirations,
458
00:23:24,861 --> 00:23:27,406
was a pretty big commitment.
459
00:23:27,489 --> 00:23:29,324
One thing we
in the women's health movement
460
00:23:29,408 --> 00:23:30,951
have never insisted upon
461
00:23:31,034 --> 00:23:33,912
is a perfect contraceptive with no risk.
462
00:23:34,121 --> 00:23:36,289
because every time you put something
in your body,
463
00:23:36,373 --> 00:23:38,375
you're changing something.
464
00:23:38,959 --> 00:23:42,754
What we ask is fully informed consent.
465
00:23:43,255 --> 00:23:46,341
We need to determine for ourselves
466
00:23:46,425 --> 00:23:50,095
what risk we're willing to undertake
or not.
467
00:23:50,429 --> 00:23:54,683
Not have someone determine that for us,
regardless of risk.
468
00:23:56,852 --> 00:23:58,687
[theme music playing]