Contraception is commonplace in many countries — but that wasn’t always the case. In today’s episode, author Laura Anthony and Mayo Clinic expert Dr. Paru David join us to explore Laura’s gripping historical novel The Women on Platform Two. Set against the backdrop of 1970s Ireland, the book explores the barriers women faced in accessing contraception and asserting bodily autonomy. We talk about the evolution of contraceptive access and the deeply personal and political dimensions of women’s health. It’s a tribute to the resilience of women past and present and a call to continue the conversation.
Contraception is commonplace in many countries — but that wasn’t always the case. In today’s episode, author Laura Anthony and Mayo Clinic expert Dr. Paru David join us to explore Laura’s gripping historical novel The Women on Platform Two. Set against the backdrop of 1970s Ireland, the book explores the barriers women faced in accessing contraception and asserting bodily autonomy. We talk about the evolution of contraceptive access and the deeply personal and political dimensions of women’s health. It’s a tribute to the resilience of women past and present and a call to continue the conversation.
We talked with:
Purchase “The Women on Platform Two.”
Got feedback?
Dr. Denise Millstine
Welcome to the “Read. Talk. Grow.” podcast, where we explore women’s health topics through books. Our topic is contraception and specifically its history and women's access to it. Our book is “The Women on Platform Two” by Laura Anthony. I'm your host, Dr. Denise Millstine. I'm an assistant professor of medicine at Mayo Clinic, where I practice women's health and integrative medicine.
I'm so excited about my guests today. Laura Anthony is a pseudonym for a published, internationally bestselling author of emotional women's fiction. She lives in Kildare, Ireland with her husband and children. “The Women on Platform Two” is her first book under this pen name. Laura, welcome to the show.
Laura Anthony
I'm so happy to be here. Thank you for having me.
Dr. Denise Millstine
Our expert guest today is a returning guest. Dr. Paru David is an assistant professor of medicine at Mayo Clinic, where she practices and is the vice chair of Women's Health Internal Medicine. She is a Menopause Society certified practitioner and has published research and gives lectures on women's health topics, including contraception. Paru, welcome back to the show.
Dr. Paru David
Thank you for having me. I'm excited to be here.
Dr. Denise Millstine
One of your favorite topics.
Dr. Paru David
Yes.
Dr. Denise Millstine
The “Women on Platform Two” is a historical fiction novel in which a modern conversation between two women leads the main character, Maura, to remember and reveal her role in fighting for women to have access to contraception in 1970s Ireland. Listeners should be aware that this book and conversation will include some challenging and potentially triggering subjects, such as pregnancy loss and domestic violence.
Okay, you both know how “Read. Talk. Grow.” works; we discuss books that portray health topics in an effort to better understand health experiences through story. And in this case, we're going to focus on contraception. Laura, tell us your inspiration for writing this book.
Laura Anthony
Honestly, it was an accident. Like you say, I, this Laura Anthony is a pseudonym. I normally write as Brooke Harris, emotional women's fiction. And I was researching a story idea I had. I generally tend to get a little bit lost in Wikipedia links and rabbit holes, and that is exactly what happened. I clicked a link, stumbled upon the events of May 22nd, 1971, when a small group of women boarded a train in Dublin, bound for Belfast, and snuck illegal contraception back over the border.
To say, my mind was blown would be an understatement. I had absolutely no idea that this event had ever happened. So straightaway I got on the phone and I was texting my millennial friends, and I was like, guys, have you any idea of how contraception actually came about? And they're like, yes, of course. I mean, we know how the pill was invented and how it works, and we know what condoms are. I was like, no, no, that's not what I'm asking you. I'm asking you if you know that the generation before us had no access to this.
And of course, none of my friends knew either. It was that instant spark of. Why aren’t we talking about this? This is so important. The women before us paved the way so our lives could be so much easier and we're not really celebrating them. I was just so drawn to it to just really celebrate what these women have done to make my life so much easier.
Dr. Denise Millstine
Yeah. That's so beautiful. It's really incredible to think that our mothers didn't have access to contraception in the same way that we do. And yet, unfortunately, I think across the world, there are still women who don't have adequate access to contraception, which is why it's so important that you selected this topic and highlighted this story in addition to, as you say, celebrating the women who paved the way before us.
Paru, tell us your reaction to the book and also what it's like to work and focus in contraception as part of your clinical care.
Dr. Paru David
Yeah. So, you know, when I read this book, it was very powerful and brought up lots of emotions. Like you mentioned, there was so much to the story, you know, including the pregnancy loss that you talked about, the lack of access to hormonal contraception and, of course, the domestic violence that was within the book. And what I really liked about it was that it really highlighted various different points to why women may require contraception.
I think that some views are, you know, it's only one sided. But, you know, really some of the things that really stood out to me is that I think some of the lines and I'd have to like, really pull it up. But, you know, this is every woman, every woman has a voice in this. It is their body that they're talking about. And gosh, it was just very, very powerful on something that I just feel very, very passionate about.
Dr. Denise Millstine
And talk about some of the care that you provide to women for whom contraception is, is very important. It's important for all women. But there are certain populations that you work with who maybe have health related conditions that are exacerbated by hormones, or people who are going through transplant.
Dr. Paru David
Exactly. So of course, when people think about hormonal contraception, they think of preventing a pregnancy. But there may be times at which preventing a pregnancy is absolutely necessary to the health of the woman. For example, you mentioned transplant patients. So there are patients who undergo solid organ transplant, and there is a period of time where in which they are taking medications that if they were to get pregnant, it could cause severe birth defects.
And we also know that after an organ transplant, the body is healthier. And so the ability to ovulate comes back. And the return to that potential for pregnancy, that return to fertility comes back. And some patients are even unaware that it's even possible. You would have this devastating consequence where if they were to get pregnant, taking a drug that is teratogenic, meaning causing severe birth defects, and then possibly rejecting the organ that they waited so long to get, that all could happen. And so this could all be prevented by putting a patient on some sort of hormonal contraception. Absolutely necessary, you know. So yeah, there's many instances where I see patients where it's needed.
Dr. Denise Millstine
I love how you framed that. That we think of contraception is not getting pregnant. But it also can be about getting pregnant at the right time. And that could be for lots of different reasons, which we'll talk about a little bit.
Laura, the first line of a novel is always really important, and yours in “The Women on Platform Two” does not disappoint. For listeners who haven't read the book yet, it is. “I have pee on my fingers,” which of course is related to Saoirse taking a pregnancy test, which is an experience many women have had with heightened and probably mixed emotions. Was this your way of just pulling the reader right in?
Laura Anthony
Actually, it kind of comes from a personal place. Yeah, of course it was a literary tool. I wanted to hook the reader straight away, but I became a mother at 19 and was absolutely shocked by how messy the process was. I was very emotionally unprepared, as any teenager would be. But the very first start of it all was the pregnancy test that I took in a public bathroom because I was trying to hide from my mother, and I got pee on my fingers, and it was just the realization of, this is going to be messy. My life is never going to be the same. And it starts with something as simple as pee on your own hand.
Dr. Denise Millstine
It’s always incredible that people who write books are willing to incorporate their personal narrative, even if that's not clear in the fiction. But thank you for being willing to do that.
Laura Anthony
I did wash my hands.
Dr. Denise Millstine
Good to know, good to know. And listeners should take that as advice as well.
Saoirse’s test at the beginning of the book is negative and this is a huge disappointment for her partner. Miles, can you fill listeners in on why this raised so many conflicting feelings for her?
Laura Anthony
Saoirse is very close in age to myself. I put her kind of in her late 30s. You know, she's career focused. She loves her job. She's a pediatric nurse, and she really does love her fiancé. They're very close, and the only single thing she doesn't love about him is that just because he wants to be a dad, he is putting pressure on her to become a mother, and she doesn't feel it's fair. She doesn't feel she's ready and she's slightly concerned that she may never be ready. And she sort of feels like she's in a little bit of a boiling pot because, you know, while his colleagues would never say something like your biological clock is ticking to him, Saoirse's getting comments like this all the time, and she is aware that she only as a woman, only has a window. And when and if she wants children is a huge decision for any woman to make. And that was really kind of the basis for, obviously now Saoirse is a 30 something year old woman in 2023 when the book opens. My other characters were young women in the 1960s, and they didn't have the choices that they should have.
Dr. Denise Millstine
Yeah, it's a nice comparison of how times have changed for women, and women can choose to be mothers, career women, mothers and career women. All of the above is available for them.
Paru, you started talking about this, but I wonder if you'll elaborate on why women use contraception, the different reasons that women will use contraception and how many pregnancies are actually planned.
Dr. Paru David
That's a great question. So you know, here in the United States, I realized that the book was taking place in Ireland. But you know, if you were just to talk about here in the United States, still half of pregnancies are unintended. And that's a pretty shocking number as advanced as our country is.
When I started my career, and I'll age myself here, 25 years ago, I was tasked to give a talk on contraception. And I knew about contraception, but I really had to do a deep dive into contraception to give this talk. And I learned so much. And one of the things that really surprised me was, of course, that half of pregnancies are unplanned and at that time, a quarter of all pregnancies. So half of those unintended pregnancies ended in abortion, which really, really, I don't know, it did something to me. And I just thought, oh my gosh, how is this still happening?
At that time, the statistics was 40% of all women have had at least one abortion. And just these numbers were so staggering to me. And I thought, well, there is obviously a gap here because there are women who are not using effective contraception. I really feel strongly about this need for contraception. I think that we've made some advances. I believe now that the unintended pregnancies are still there, but I believe that the percentage of abortions over the years have decreased, which is great, which means that hopefully that means that we are getting the message out.
But I still feel so strongly that women should have access to contraception. Like I said, that all of the reasons that people use contraception are varied. It could mean that they simply just don't want to have a pregnancy right now. And when we talk about those unplanned pregnancies, the ones that when women do keep those pregnancies, that those are mistimed. And so, you know, it may not be the right time in their life. Maybe they're trying to accelerate their career and they're or school or whatever it is, and this just isn't the right time.
Or like Saoirse, she just doesn't want to be a mother. And that is not a requirement of being a woman. And I think he made that so clear. And I loved it because you know, I am a mother. I love my children dearly. But I also realize that I come into contact with patients who, after we have the discussion about reproductive life planning and when is the optimal time for a healthy pregnancy. And I tell them, you know, go ahead and think about it. Talk about it. Is this something that you desire? Is this something that your partner desires?
You also highlighted that there are couples who are discordant in their desire for starting a family. And this is a valid discussion. And I liked the fact that through this story, she kind of came and was at the end was more clear about her feelings about her desire for pregnancy in the future and what this meant for her relationship, right. Because it wasn't right for her to continue the relationship. If Miles really, really wanted this to be a father and would be an incredible father. Was it her right to kind of take that away from him? And so I really love that you brought up these things.
But, you know, there could be other reasons why women may not want to have a pregnancy at that particular time. It could be related to their health. It could be related to relationships, status or finances. There are so many things that you need to have an ideal, healthy pregnancy, and for the child to be in an environment where they are thriving and loved and have access to the things that they need. You know, it's not fair to a child to come into the world where the parents may not have the finances to care for them appropriately. The list is endless, right, for why I think knowing when it is an appropriate time to become pregnant and to have a child is so important.
You also highlighted the number of pregnancies, right? The people who had large families, and these women that were absolutely exhausted and tired and couldn't think about having another pregnancy. You also highlighted Bernie, which I know we haven't talked about yet, but Bernie's story, which I thought was great, you know, she had three children, healthy, beautiful children. They had a fourth on the way. And I, of course, being a doctor, I knew I'm like, oh no, she's got preeclampsia on the way. It's happening.
Laura Anthony
And I'm so glad to hear you say that, because I think it means that I might have got it accurate. I guess because I was just so concerned.
Dr. Paru David
You did, and I was so nervous. It kind of kept me on my toes. And I was like, what's going to happen to Bernie? And of course, you know, we I mean, I don't want any spoilers here, but like, Bernie wasn't alive when Maura was telling the story to Saoirse
And so, of course, there was a lot of fear when I was reading this story. But fortunately, she did make it through the pregnancy. But the baby did not have a good outcome.
And so, you know, you have a situation where then she is told by the physician, you cannot have any more pregnancies. And it was true because it would have put her and her future babies in danger. But then that created a rift between her and her husband for a normal marriage. And I thought, oh my gosh, how sad, how sad is that? And I love the fact that you brought up so many different points for why contraception may be necessary to prevent a pregnancy, or to have a pregnancy at the correct time in one's life.
Laura Anthony
Oh, I'm so glad that that's what you got from Bernie’s story, because that was 100% my intention when I was writing it. It wasn't necessarily that Bernie didn't want any more children. She adored the three children that she had. She loved her husband so very much, but another pregnancy would have possibly cost her her life. And something that I really wanted to highlight was I wanted to make sure that Bernie and her husband, Dan, had a wonderful relationship because I think in their instance, and I think in every instance, contraception is not necessarily just a woman's concern, especially with a loving couple. It is very much the concern of their unit. And I think that had Bernie had access to contraception, their relationship could have been so different. Their only option in the late 1960s was abstinence, which took a huge emotional toll on them and also had they had Bernie become pregnant again, she could have potentially left three small children without a mother and Dan without a wife. So the complications were so far reaching for her just by the lack of access to contraception.
Dr. Paru David
Right. I really thought that you brought up some great points as to why someone may need contraception, because I think that sometimes a viewpoint is, oh, you know, it's if you have an unwanted pregnancy from, say, like rape or something like that, but that may not be the situation. And you did certainly highlight the story of Maura and her domestic violence that she went through, and her not wanting to bring a baby into that situation, which I thought was another great point.
Laura Anthony
Thank you.
Dr. Denise Millstine
All right. Hold on. We have to introduce our listeners to all these characters. So you've given them a taste Paru, of all of these situations. But let's break them down and take each one in their case.
So Laura, at the beginning of “The Women on Platform Two,” we meet the other, or who I would call the main character of the whole story, who is Maura. Because much of the book is set really in her memory as being a young woman in the 70s. We meet her, at least in this memory of her. We meet her in the train, of course. But then she goes back to this time where she's working in this very posh department store in Dublin. She meets a man who seems like a prince. He's a doctor, he's wealthy, he's handsome. He sweeps her off her feet and very quickly their relationship turns dark. Literally immediately after their wedding.
So she is trying to get pregnant. This is the expectation for her at this time. And she does. But then she has several miscarriages and eventually she decides that she just can't bring a child into this situation, as Paru has just alluded to. What else do you want our listeners to know about Maura before we go into the other aspects.
Laura Anthony
I think it was really important that Maura was in very difficult circumstances. She actually, really truly wanted to be a mother. But she started to fear that if she couldn't keep yourself safe, how was she possibly going to keep a baby safe? And that was my main. I wanted more a story to be very heartbreaking and a real eye opener for why you could have a woman who desperately wants a baby but needs contraception for her own safety, and to prevent bringing a child into an environment that would be very dangerous.
Dr. Denise Millstine
And I know we're talking about contraception, but I think it's important to highlight what happens to Maura, where she is very much in love and she is truly believing that she's about to start this almost princess like part of her life, and how difficult it is to be in a relationship where there's domestic abuse, where her husband is a respected member of the community, and lots of excuses for how she has injuries even ends up in the hospital. So I also want to congratulate you, Laura, for not shying away from the topic of domestic abuse, which is quite prevalent and such an important one for us to see and in its multitude of faces. I'm sure that was important while you were writing.
Laura Anthony
It was very important for me. There were some scenes that were quite difficult, and it was quite hard to decide the level of detail that I was going to include, but I think Maura’s story ultimately, you know, she's a woman who overcame so incredibly much and had to really find her inner strength. And so I did make the creative decision to be quite descriptive in her scenes. And I'm sure some readers may find that very difficult, especially anybody who may have any sort of experience in that area themselves. But yeah, I think it to be to be true to her situation. It is quite descriptive.
Dr. Denise Millstine
Well, but it's authentic and I think we need that in story in order to talk about difficult things.
Dr. Denise Millstine
Hey listeners, we hope you're enjoying this episode of “Read. Talk. Grow.” If you find our discussions helpful and insightful, please take a moment to subscribe to and rate “Read. Talk. Grow.” on your preferred podcast platform and don't forget to tell your friends to listen. Your support will help us reach more readers and those eager to learn about health through books. As always, feel free to drop us a line at readtalkgrow@mayo.edu with suggestions for books, topics or any comments. Thanks for listening.
Dr. Denise Millstine
Okay, Paru, I'm going to have you talk about Bernie. So Bernie is this wonderful character. She has a loving marriage. She has these three lovely little girls and when we meet her, she's pregnant. And like you said, as doctors, we could see that she likely had preeclampsia. And as is also true to form unfortunately, when Bernie brought this up to her doctor, who happened to be Maura's husband. But she was told that she was completely fine and she needed to stop complaining and just go home and put her feet up.
Meanwhile, she has, nearly life threatening pregnancy complication that does end the life of her son. And Dr. Davenport, Maura's husband, comes in and tells her, no more babies. It's dangerous. This can and will happen again. Can you talk a little bit about how important it is to know about these things coming in for future pregnancies in order to have, safe and healthy pregnancies?
Dr. Paru David
Yeah. So, well, there's many things that came up as I was reading this portion with the way that Dr. Davenport responded to Bernie's symptoms. Number one, was this minimizing of her symptoms, which I hate, you know and we see that. And then that has happened historically is that women's symptoms have been minimized. And even she knew something wasn't right. She had had other pregnancies that went well and she said, there's something wrong. This isn't right. There's something going on. And she kept trying to ask him, why am I having swelling in my feet? Why am I having these headaches? I still feel nauseous. I shouldn't feel nauseous this far into my pregnancy.
And he just simply, you know, shooed away the symptoms, would tell her to take some medications for the headache and then, oh, go home and, you know, keep your feet up and read the paper. And she's like, well, first of all, I don't even get the paper. You know, like, that was something that was part of her household because they had to pinch pennies.
And the other was that she has three children. She had an infant, a toddler who she was potty training, by the way, and then she had a six-year-old, and there was no way that she was going to be able to keep her feet up and comply with these orders. That was the first issue that I had with this, with the response that he had.
But then also identifying number one, what could be going on. Then she presented with the true preeclampsia. It was an emergency. It sounds like an emergency C-section had to happen. And then he just simply said, no more babies. This is it. End of story. There wasn't any further discussion.
Nowadays, we do know that potentially having another pregnancy with preeclampsia again could happen and could cost her life. We also know that just having preeclampsia in pregnancy is a risk factor for diseases down the line. And so one of the things that I'm so passionate about is having women be educated on this.
As a provider, I will sometimes see patients for other indications, but I happen to be taking an obstetric history and I ask them about these disorders. And, you know, did you have any complications doing your pregnancy, such as high blood pressure, preeclampsia, gestational diabetes? And when they tell me that, I will tell them that I don't know if you know this, but having preeclampsia in a pregnancy can put you at risk for high blood pressure in the future, but also heart disease and heart failure in the future. And so you need to know about this. Meaning you need to bring this up to your providers because I can just, you can just see this happening, right. If she's in her 30s and she comes to the doctor and she has high blood pressure and they're like, oh, you're too young to have high blood pressure. No, she could have high blood pressure and it needs to be treated.
So those are some of the things that I really work with my patients to educate them so that if they were to see another provider say no, actually, I was told that there could be a potential problem with my health. I was glad that you brought that up and that I could speak about it in this forum.
Dr. Denise Millstine
Yes, that's really important because it is not an uncommon complication of pregnancy.
All right, Laura, do you want to talk about contraception black market. So I love this scene where Maura and Bernie go out to a pub, which in and of itself is pretty scandalous. Again, those listening this is 1970 Dublin, so it's a different time. But yeah, very scandalous. And already this has happened where Bernie and Dan are sleeping separately. It's causing a lot of tension. It's very sad for both of them because they would like to be intimate with each other, and their friend has a connection to something called French letters. What's that?
Laura Anthony
At the time, Ireland was a very conservative country, but we were very aware that the UK were not, America were not. There was an awful lot that they had access to that we didn't. But like everything, if you know a guy, who knows a guy, who knows a guy, you just might be able to get what you needed. And there was most definitely a black market. There was a black market for things as simple as magazines that may have had articles that the government here didn't necessarily want people reading, and that would have included articles about birth control. Yeah. So Maura is very concerned about the toll that not being able to be intimate is taking on Bernie and Dan's relationship. And so she finds a way to get what were, well, condoms, but were referred to as French letters because the word condom was considered to be completely blasphemous in 1970s Dublin.
Dr. Denise Millstine
I had not heard that term before. Had you heard it, Paru?
Dr. Paru David
No. I was surprised to even know that it was even referred to French letters.
Laura Anthony
Really?
Dr. Paru David
Yeah. And I kind of was curious as to where that terminology, like the history of the terminology, you know. So I thought that was interesting. And I did like how you had one of your characters who had such a hard time saying the word condom, you know.
Laura Anthony
It would have been extremely shocking in society. You didn't use words like that. Even though, I think the book does cover the topic as well between Maura and her mother before she gets married, and Maura asks what she can expect on her wedding night, and her mother shoots the conversation down straight away. Because, quite simply, you didn't talk about stuff like that. Her mother is even shocked that she would dare to ask. And that actually comes from a very real place. When my agent first read the book and we were chatting about it and what we were going to edit and chop and change, we got into conversation about our grandmothers.
We got into discussing how both of them had a really similar experience when they started their first period. So they would have been, you know maybe 12 or 13 in the 1940s. They both thought that they were dying because no one had ever told them what happens when a young girl starts to menstruate. So initially, if you think for a 12-year-old who has no idea what's happening, if she's bleeding for three, four, five days, she's going to start to get very concerned. Then thankfully, it stopped, but the next month it comes back again. We were just fascinated that both of our grandmothers had had that exact same experience, and it had stuck with them. They had that little scar of, oh, the fear of genuinely not knowing what was happening to their bodies because nobody talked about it.
Dr. Denise Millstine
Yeah, it will be a wonderful time when women are in touch and knowledgeable about their bodies. I think we've come a long way, and yet we have such a long way to go. So these conversations are so important.
Paru, you alluded to your early work in talking about contraception, as really being shocked by not only the number of unintended pregnancies, but the number of pregnancies that were then ended. And so there's a character in the book who actually is taking this approach. We meet Mrs. Stitch, that's not her real name, but she is a seamstress, and she has a morning role where she's helping young distressed girls. Can you talk about her role in the book and your impression of her?
Dr. Paru David
Yeah. So, you know, we get introduced to Mrs. Stitch because she is the seamstress for Bernie. But then we find out that she's only works from noon onward as a seamstress and she is never, ever to that Bernie is never, ever to come before that time. But you know, Bernie, is there a little bit early and she and that is how she finds out that these young, what I'm assuming are unmarried women are coming to her because she is known as someone who can give them a…I can just say it's probably some sort of potion or concoction of something that they have to drink, and then they would potentially lose the pregnancy, which of course, my heart sank. Because knowing about termination of pregnancy and what has happened historically is that these poor women who are desperate have gone to providers who are many of them have not been trained physicians and are performing either procedures or giving patients whatever they think may work, but could potentially cause significant harm. And so my heart just sank as we saw one of the characters drinking down, which they even said it, it smelled like bleach.
And I thought, oh my gosh, that can't be good on their stomach. It just broke my heart because like with what was alluded to in the story, is that this all could have been prevented with accessible contraception to women. And of course, the one character, you know, she was being abused sexually by somebody and that is how she got pregnant. That was all out of her control. Her parents, when they found out about the pregnancy, blamed it on her. And I just my heart just went out to that poor little girl.
Dr. Denise Millstine
Yeah, that was a really tough portion of the book. I really appreciated how Maura thought that Mrs. Stitch could help her. She wasn't pregnant, but she had decided she never wanted to have a baby with her abusive husband. And when she went to Mrs. Stitch and said, I just want you to help me never get pregnant, and she says, what do you think I am, a wizard? If I could stop women from getting pregnant, I'd be a millionaire.
Laura, I think that's brilliant, because she knew that she didn't want to be doing what she was doing, but that these women were so desperate and in such need that somebody had to help them. The devastation there, though, is that contraception existed at that time. They just didn't have access to it, right? I mean, the pill, Paru, was the pill, was released publicly in the 60s, I think. So almost ten years before this story takes place, right?
Laura Anthony
It was available in Ireland, technically. You could go to your general practitioner, and if you could prove that you had very heavy periods or you had some serious discomfort, they may prescribe it for you, which really translates to, you know, they absolutely would not. It was almost impossible to get it, and they certainly would not prescribe it as a contraceptive.
So again, I really wanted these scenes to highlight how little information women actually had. So Maura going to Mrs. Stitch and thinking, well, you know, if you can help girls try to lose a pregnancy, maybe you could help me try to not get pregnant. Because she genuinely had no idea how any of it worked because she was so ill informed.
And I think that was my, my main thing in creating Mrs. Stitch was I wanted to leave it up to reader interpretation, whether she was a bad person or a good person. There is a conversation at the end of the book. I won't spoil it, but it is a conversation at the very at the very end chapters between Maura and Mrs. Stitch. And in the reading guide at the back of the book, there is the question, at the end, has your opinion of Mrs. Stitch changed? I really wanted readers to really have to kind of think about, would I have been a Mrs. Stitch? What would I have done?
Dr. Paru David
Exactly. I mean, I think that her intent was to help because these women did not have good options. You know, it was either going out onto the street or going to, I think at that time they were they were going to these laundries and having the baby there. That's a whole other story too, which was really tragic.
Laura Anthony
The spoiler for my second book.
Dr. Paru David
Oh, okay. Well, good, I can't wait. I want to read about that.
But it really sounds like it was a very difficult time for women. I think that if you think about it historically, I mean, the United States is probably in the same boat a decade earlier. It just said at that time it just was not even available. I mean, the pill did come out, I believe, in 1960. And so then you know, this book takes place in 1970. And so it wasn't like it was that far off for Americans either.
Laura Anthony
Yeah. And I think it was the knowing that other countries had access to what was being denied to you in circumstances where you may desperately have needed, was what drove the real women on the contraceptive train to take action.
Dr. Denise Millstine
Well, tell listeners a little bit about the contraceptive train, without ruining the book, so that they'll be excited to listen in and hear. How did this ragtag group of, collection of women come to be going to Northern Ireland on that day?
Laura Anthony
I think so, the real women on the contraceptive train, they had a little bit more advantage than my characters because they were actually journalists. So they had access to information that your average everyday housewife may not have. They also had a platform to get their voices heard. They had contacts in radio and television, but they were also still at the mercy of the state.
There was one woman in particular, a real woman. She passed recently. Her name is Nell McCafferty, if anybody would like to google her. She is an amazing powerhouse. And she actually was a lesbian. So she said, I actually have no need for contraception myself, but I just think that it is disgraceful that anybody who does, doesn't have it, and I'm not standing for it anymore. And so she, it took obviously it took a very long time, in the book, it's all a little bit simplified but it did take a very long time, but they eventually did get a little bit of traction, as simple as boarding a train. And they went up to Belfast and were a little bit shocked when they got there that you couldn't, again back to having very little information even as journalists. They didn't realize that you couldn't just walk into a pharmacy and buy the pill over the counter. They didn't know that you needed a prescription.
Being the clever woman that she was and determined not to be defeated, she asked what it looked like. And the pharmacist told her. This is all in the book, but it's also true. The pharmacist told her, well, it just looks like any pill. It's a little small white pill. And she said, okay, great, does it look like paracetamol? He said, yeah, sure looks like paracetamol. Okay, give me 20 packets of paracetamol. So they took all the paracetamol and they filled it into clear packaging. And that's actually what they returned with. But nobody knew.
Dr. Paru David
I know I thought that was a great story. I loved it.
Laura Anthony
And 100% true.
Dr. Denise Millstine
It is a really great story. And I'm glad that your novel will keep it fresh in the modern mind.
Paru, maybe this is a good point to talk about some of the really exciting changes and contraception in the current era. You just heard that women have needed a prescription for birth control pills forever. But what's going on now?
Dr. Paru David
Yeah, that is true. Up until just a few years ago, I think it was like last year, actually, or in 2023 the only way in which you could get hormonal contraception was through a prescription. And so just to kind of give a little bit of background, most hormonal contraception has both estrogen and progesterone. And for some women estrogen can be contraindicated or it can pose some risks so that you do have to have some medical background to understand whether or not this patient is safe enough to take this type of hormonal contraception.
What is available, though, is that there is a hormonal contraception which only has progesterone in it, which is effective in preventing pregnancy. And it is very, very safe now. It has been available through a prescription for many years, since the 70s, but in other countries it has been available over the counter. And so for the longest time we have been saying, well, why isn't it over the counter here? And thankfully it went through the FDA and now it is available, known as Opill, and it is available over the counter here in the United States. And, you know, some medications are over the counter, meaning you don't need a prescription, but you do need to speak with the pharmacist because it's being held behind the counter or something. This one isn't even like that. I mean, you can go to any pharmacy. You can just pick it up off the shelf. You don't even need to go to talk to the pharmacist. You just can just go buy it, just like you would buy anything else. Any other medication from a pharmacy that is truly over-the-counter and and go ahead and start it and it works to prevent pregnancy. And I thought, wow, this is amazing. This is truly amazing for women.
Laura Anthony
Wow. It's like 1971 again, because I am an Irishwoman and slightly jealous of how easy it is to access contraception in America.
Dr. Denise Millstine
Yeah, it's really mind bending. Although listeners who are interested in hormonal contraception should know that if they were to talk to a health care team, healthcare professional, the number of options available by prescription is wide. And there are there are so many, you can barely keep track of them. But there are many, many that it's likely that they can find a safe and a good fit for you if that's what you're interested in.
Let's just wrap up by talking about how important it is for the health of women to have access to contraception. And I wonder if you both will comment on whether this is considered a true human right for women to be able to access contraception.
Laura Anthony
Yes, very much so. I think that everybody has a right to govern their own bodies and their own lives. I should never tell you how to live your life or what is best for you, and you should offer me the same respect.
Dr. Paru David
That is exactly my sentiments. I think that for someone else to dictate what I do with my body is not acceptable. As a woman, I know what's best for me. Within my body, I know how I feel, but I also know my unique circumstances of what's happening in my life. And so I do think that it is a right, it is a human right to have control and agency over what I decide to do with my body.
Laura Anthony
Could not agree more.
Dr. Denise Millstine
Well, I love that we are ending on that, and I love that we're all inspired by these actual women who were on the contraception train. And listeners should go out and buy “The Women on Platform Two” by Laura Anthony and learn more about this story. Thank you both for being here with me.
Laura Anthony
Thank you so much.
Dr. Paru David
Thank you
Dr. Denise Millstine
“Read. Talk. Grow.” is a product of the Women's Health Center at Mayo Clinic. This episode was made possible by the generous support of Ken Stevens. Our producer is Lisa Speckhard Pasque and our recording engineer is Rick Andresen.
Visit our show notes to see the books discussed today and for links to other health education materials. Follow us on social media like Instagram and Facebook, or reach out directly to our email readtalkgrow@mayo.edu with suggestions for books or topic ideas. We'd love to hear from you.
This podcast is for informational purposes only and is not designed to replace a physician's medical assessment and judgment. Information presented should not be relied on as medical advice. Please contact a health care professional for medical assistance if needed for questions pertaining to your own health. Keep reading everyone!