A HISTORY OF EARLY INTERVENTIONS IN THE US
From early Colonial times through the mid-nineteenth century, people took herbs or drank special teas to “regulate,” “induce” or “bring down” late periods when they did not want to be pregnant. These efforts likely have a history thousands of years old; we know that in the US, such efforts were part of a traditional framework for thinking about early pregnancy and that they were both legal and culturally acceptable up until “quickening” (about 14-16 weeks after a last menstrual period) when a pregnant person could feel a fetus moving inside them and could confirm their pregnancy.
CHANGING IDEAS ABOUT BRINGING ON MENSTRUAL BLEEDING
Over time, several changes to culture and laws impacted this traditional way of thinking.
THE 19TH CENTURY: DOCTORS, MIDWIVES, AND MORAL AUTHORITY
In the mid-nineteenth century, mostly male physicians became the respected authorities on pregnancy and childbirth. They bolstered their moral authority by blaming midwives -- who were informally trained and mostly female -- for abortion, which physicians deemed unsafe and immoral. Midwives traditionally helped women give birth, regulate their menses, and end established pregnancies. For the first time, states began enacting laws regulating and banning abortion.
THE 20TH CENTURY: NEW WAYS OF TESTING FOR PREGNANCY
In the twentieth century, technological advances enabled people to confirm pregnancy at earlier and earlier dates. This continued to shift cultural frameworks away from uncertainty at the beginning of a potential pregnancy to one of supposed certainty -- where pregnancy was a yes/no question.
A HISTORY OF EARLY INTERVENTIONS IN THE US
From early Colonial times through the mid-nineteenth century, people sometimes took herbs or drank special teas to “regulate” their menses when their periods were late and they did not want to be pregnant. These efforts to induce menstrual bleeding likely have a history thousands of years old; we know that in the US, efforts to “bring down” a late period – or regulate menses [WS1] [CS2] were part of a traditional framework for thinking about early pregnancy. These actions were both legal and culturally acceptable when people thought they might be pregnant and did not want to be.
Bringing down late periods gave potentially pregnant people several months after their last menstrual period to try to ensure they were not pregnant. These actions to induce menstrual bleeding were legal up until the “quickening” (about 14-16 weeks after a last menstrual period) when a pregnant person could feel a fetus moving inside them and could confirm their pregnancy.
THE 21ST CENTURY: USING NEW TECHNOLOGIES TO REVIVE AN EMPOWERING TRADITION
The idea of taking action to bring down a period when someone doesn’t want to be pregnant is newly relevant today. Recent medical advances have shown us that many early pregnancies are lost naturally – so that a very early positive pregnancy test may well indicate that someone may have a lasting pregnancy, or a very early pregnancy that will soon pass.
And now, people with late periods can access safe, twenty-first century medications that will bring on menstrual bleeding and, if a person has an early pregnancy, that will end the pregnancy.”People with late periods have a new (yet traditional!) feasible, effective option for bringing down a late period.
A SAFE, TESTED OPTION
Medications that induce menstrual bleeding or early pregnancy loss have now been used safely and successfully around the world for more than thirty years. Research clearly shows that these medicines – misoprostol alone or with mifepristone – can be used when menses are just days late to induce cramping and bleeding, and to end any pregnancy that may be beginning. These medicines give people new options to ensure they aren’t pregnant when their periods are late – without needing to test for pregnancy first. Instead, people can choose – if they so desire – to be in a state of uncertainty, and to do something simple and at home to ensure a state of non-pregnancy.
ONE FINAL NOTE: A NOD TO FEMINISTS IN THE 1970s
Interestingly, this is not the only time that modern health advocates have explored the potential of very early interventions to ensure non-pregnancy when periods are late. In the early 1970s, some providers in the US offered “menstrual extraction” to restore bleeding when menses were late. Menstrual extraction – in which the uterus was evacuated using manual vacuum aspiration - was provided before pregnancy could be confirmed. However, most of this work mostly ended when Roe v. Wade legalized abortion in 1973.
WHAT’S DIFFERENT ABOUT THIS IDEA TODAY
Abortion is once again illegal in some parts of the US. But unlike in the years before Roe v. Wade, there are now safe and effective medications that cause uterine cramping and bleeding and can be taken to bring back a period when it is late.
We don’t know if conservative states will try to regulate period pills, since this option sits in a gray area between birth control and abortion. But this may be a moment in US history when we again embrace traditional ideas about bringing down periods to end early (possible) pregnancies. And period pills may be a way to empower everyone with another safe option for fertility control.