Saturday marks the 60th anniversary of the birth control pill, which on May 9, 1960, became the first oral contraception to be approved by the U.S. Food and Drug Administration.

But even as more than 100 different reproductive health, rights, and justice organizations across the country mark the occasion with the annual #FreeThePill day—an effort demanding the birth control pill be available over the counter and without a prescription—new barriers to contraception continue to appear.

Case in point: This week’s U.S. Supreme Court case that found conservatives once again arguing that most employers and universities should be able to deny you health insurance coverage for birth control.

To gain a deeper understanding of just how far we have—and haven’t—come in securing access to birth control during the last six decades, I talked on video with Alexis McGill Johnson, the acting president and CEO of Planned Parenthood Federation of America and the Planned Parenthood Action Fund, and a mother of two daughters, ages 8 and 11. In between commiserating about the challenges of working from home and the growing desperation for a decent haircut, we talked about the past, present, and future of birth control, a conversation that has been lightly edited and condensed below.

Rewire News Group: As you think about the 60th anniversary of the pill, do you feel a sense of celebration?

Alexis McGill Johnson: It just feels surreal. I’m 47, so I’m as old as Roe [v. Wade, the landmark abortion rights case], and it’s just striking to me to think that I grew up in a world where I was fortunate to have parents who talked to me about contraception, and went to a college where there was contraception flying off the shelves!

And then I got to make choices—I could go to graduate school, and keep living my life. By the time I met my husband, I was able to be in a position to consciously make a decision about having kids and say, “You know, it’s time—we’re ready. Let’s do this.”

But then I’m also thinking back to ten years ago and the fight we went through to have contraception covered in the Affordable Care Act, so that we would be able to have birth control without a co-payment. The fact that we’re still litigating it after all this time? It feels so retro!

You’ve shared how landmark court decisions and policies positively affected your own life. What are some of the broader impacts the pill has had on women’s lives? 

AMJ: It’s a big deal to know that you are regulating your own cycle—that it’s in your own control. Knowing that you can come off it and within a month start trying to have a child? That’s the essence of family planning. The pill is first about, I plan to have a great, fabulous sex life. And then, when I’m ready, I can plan to have a great, fabulous family life.

I talk about the pill a lot in terms of self-determination, which is what it means to control your own journey, the freedom to imagine our own lives. Just think about wage-earning: We know that a third of the wage gains for women have been largely because women have been able to control when they start a family.

Do you think it’s this level of freedom the pill delivers that makes it such a target?

AMJ: Whenever you start talking about freedom, people start finding ways to control. What’s really striking to me is that nearly nine out of ten women use birth control in their lifetime, so what we’re looking at [in cases like Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania] is just another case of having a vocal minority of conscientious objectors, or other objectors, who have access to the levers of power.

It’s completely out of step and out of touch with what women say they want. And what it’s saying is that it’s OK to change the dreams of some hundred thousand women because you have an objection.

I worry that there’s a younger generation that’s never known a world in which affordable access to birth control wasn’t a given. How do we make them more aware of the kinds of controls they’ll have to fight against? 

AMJ: My girls are 8 and 11, and they’re just now asking more questions about bodies and things that are happening. We’ve always grounded these conversations in how they can maintain their own protection of their bodies, and how they keep themselves safe.

For example, my 8-year-old is a hugger, but sometimes she hugs someone who doesn’t want a hug! So we talk about what it means to have somebody come into your space in a way that you can’t control your own body. That’s the basis for understanding how to be very intentional about taking care of yourself and your body.

And now thinking about when I talk to my friends with tweens and teens and college students, that’s the perfect time to be showing all these layers of restrictions. Because it’s a coordinated strategy—like building a conservative judiciary, including appointing a judge who doesn’t believe in IVF, and a Supreme Court that’s hearing cases about whether insurance companies should have to cover birth control.

Would we ever let an employer say, “I object to hearts being treated so therefore you can’t have your heart medication?” So talking about what’s really happening here—and then giving them the call to action of, If you want to live a free life, you have to fight for this right.

What are some actions people can take to protect reproductive and sexual health and rights?

AMJ: I honestly think that our job continues to be how we export imagination. Look: We live in a tale of different states. We have states like California, where our affiliate there has opened up health clinics called “well-being centers” inside of high schools. You can leave algebra class to go talk to a nurse practitioner about your birth control options—and it’s paid for by [the state Medicaid program] Medi-Cal. Or you can go to Missouri and have the health commissioner track your period.

How do you export the imagination from these places like California, where we’re laying an infrastructure of freedom, to a place like Missouri where that’s consistently being denied?

Social media helps with this, as does demonstrating what we’re fighting and advocating for. That’s the work we have to do: Collectively educate our families, our legislators.

We’re also encouraging people to vote on these issues—and this election is critical! So we need to get young people involved in understanding these issues, so they can begin to make demands.

Talk to me about where we’re heading—do you think we’re going to be having this same conversation in the next 60 months? 

AMJ: Hopefully in November a lot of things will change. But even if the election doesn’t change things, we know we have a lot of work to do with our judiciary and really understanding the impact of having an incredibly conservative judiciary, and people on the bench for life. How do we think through strategies for that?

I also think technology is going to be a really important way to connect. Just look at how access to telehealth has fundamentally transformed this moment—people have been talking about telehealth for a long time and now we’re here, “Zoom-ing” in to see our doctors. The more people have the convenience of that experience, the more it will shift the demand, including around policies regarding women’s health. And if women’s health isn’t part of this shift, people will really see the hypocrisy.

What keeps you up at night? 

AMJ: It’s been hard over the last few weeks not being able to focus on the stories we’ve heard about people having to drive through dozens of states, across thousands of miles, stopping on the side of the road to sleep, having to arrange child care—all so they can go to a state where they don’t know anyone so they can basically get two pills to have an abortion.

At a time—during a pandemic!—when we should really be fully understanding and embracing humanity, and instead it’s being used to push a political agenda? Or that workers can be both deemed “essential” and asked to come in to perform jobs to keep the basic economy going—while at the same time being told that you still can’t have control over your body, your freedom?

That’s what keeps me up at night because we have to figure out how we’re going to marshal the incredible support we have into energy that can actually transform the system.

What’s an empowering message that you’d like people to think about on #FreeThePill day?

AMJ: I think that it’s just so important to recognize that our ability to control our bodies and our reproduction is one of the most important indicators of our ability to control the rest of our lives. It’s an economic issue, a sociological issue, and we need to think inclusively, so that we make sure we all have the same equality when it comes to resources like birth control.

We have made so much progress over the years—just look at the recent slate of [presidential] candidates. Women are really stepping up and leading, and birth control is what helps to power that. So it’s unconscionable to think our bosses, our employers, our universities are going to be the ones to say, “We’re not going to give you that power.” They’re finding levers of control while we’re fighting for freedom.