The pill that changed everything

It has now been 40 years since the Food and Drug Administration approved the first oral contraceptive and changed history.

The Pill. It was, from the very start, wildly popular. It meant women could, for the first time, decide whether and when to get pregnant -- and make this decision their own. No need, anymore, for guesswork. Or for persuading a reluctant partner to wear a condom. Or for a major operation that would, back then, put you out of commission for weeks -- and so who would take care of the kids?

''Women control it themselves,'' says Richard Blackburn, a researcher at Johns Hopkins University School of Public Health.

The power of it.

From the beginning, it was marketed directly to women. It came in a small, round dial pack made to look -- even then -- like a makeup compact. Just slip it into your purse.

The privacy was unbeatable. The effectiveness, remarkable. Within just five years of its introduction, the Pill was the leading contraceptive in the United States.

Now, 80 percent of American women born since 1945 have used the Pill at some point in their lives. Worldwide there are 100 million users, according to Johns Hopkins. More than half the married women in countries from Bangladesh to Brazil, from Nicaragua to Botswana, have used the Pill.

There have been pharmaceutical advances with greater medical impact. But no drug, ever, has upended society like this.

''Nothing has changed the gender power balance more,'' said Gloria Feldt, president of Planned Parenthood Federation of America.

The Pill had the power to change the old deal.

The old deal was that the man would get educated, gain work skills and have a life -- social and economic -- that wasn't tied to his reproductive function. The woman's economic life would be determined by her reproductive life.

The Pill split them apart. It broke the deal.

''Financial support in exchange for domestic services is no longer valid,'' Feldt said.

Now women don't usually get married as young as Feldt did. She was a teen bride, who became a teen mother, who had three children by 20. When her doctor told her about the Pill, Feldt said, her response was quick.

''I asked no questions,'' she recalled. ''I said, Give it to me now!' ''

Today that young woman might be a college student, thinking about what she will do with her life, rather than whom she will marry. And, when she does marry, both she and her husband are likely to have very different expectations about what that union will be like. They may, one day, get divorced.

And so there are people who say the Pill destroyed the institution of marriage. Ruined the American family. Hurt kids. And harmed their mothers, too.

They see in those dial packs a feminist plot, a sexual revolution that subverted all that was good and true and dependable. They do not see, in this perversion they discern in the Pill, that 91 percent of American adults still choose to marry -- down 3 percent since 1960. They do not see the kids who overflow the schools now, proof their Pill-popping mothers really do want families. They cannot explain why the women in remote villages of Africa and Asia and Latin America line up to get this Pill that they believe, with all good reason, will make things better and not worse.

The Pill's antagonists see the choices and do not like them. But the importance is that there are choices at all. That is why this is a very happy anniversary.