Selling American Women on the First At-Home Pregnancy Tests

In Depth

In 2015, there’s a pretty standard process for what happens if you miss a period or two. You buy a pregnancy test, and you piss on a stick, and you wait. Whatever the results—whether they’re what you want or not—you typically get them in private. Thanks to online shopping, you might not even have to face a cashier anymore.

Until very recently, that was not the case.

The modern test began with the 1927 discovery that various animals would go into heat when injected with a pregnant woman’s urine, as The Atlantic recounts in their history. Hence the old expression that if you got a positive test, “the rabbit died,” which you might recognize from the M.A.S.H. episode. (Though finding out the result required dissecting the animal so the rabbit died regardless—sorry.) Even as the sexual revolution kicked into high gear and Roe v. Wade legalized abortion, you still had to go to the doctor to find out whether you were knocked up, before you could figure out your next step.

That began to change in 1972, when Judith Vaitukaitis and Glenn Braunstein, a pair of researchers at the National Institutes of Health, developed a way to measure levels of hGC, the protein all pregnancy tests are looking for. That made it possible to test for pregnancy earlier, easier, and with greater accuracy. Pharmaceutical companies quickly spotted an opportunity for a consumer-facing product.

In 1976, the FDA approved the first at-home pregnancy test—Warner-Chilcott’s e.p.t. It was essentially the same test as the doctors were using, but simplified for at-home users. 1978 brought a burst of full-page ads in major women’s magazines, including this one, which appeared in the March issue of Ladies Home Journal, which put an overtly feminist spin on the product, declaring it “a private little revolution any woman can easily buy at her drugstore.”

“Very easily” is, of course, a relative term. That kit looks like something you’d use to adjust the chlorine in a swimming pool. Notice there’s a whole hell of a lot of text, too. You can sell tampons without too much more than a picture of a carefree teenager in a white bikini, but an at-home urine test takes some more coaxing—not to mention more instruction. Frankly, it seems like it would’ve been easier just to go to the damn doctor. As you can see from the diagram, on the ad, it required sucking some urine up into a dipper, then combining it with something else in a plastic vial, then letting it sit, then looking at a mirror underneath the vial to see whether a brown circle appeared. You had to use your “first morning urine.” It wouldn’t work until nine days after your period was supposed to start. It took two hours to get the results, and it was all too easy to introduce errors.

Of course, competitors quickly piled onto the market. July 1979, from McCall’s:

Meanwhile e.p.t. got more personal, adding color and women’s happy faces to their advertisements.

This late-’70s commercial emphasized that it was the very same thing as the lab test you’d get if you went to the doctor, and many, many women have used it. “The hospital and lab method already used by over a million women.”

As with any advance in women’s health, though, there was some hesitancy. One 1979 Washington Post piece (filed to the styles section, according to Lexis Nexis) captures some of the hemming and hawing:

“But the privacy of an in-home test can be counterproductive,” added [Irene] Wolcott [project director of the Washington-based Women and Health Roundtable], who noted that pregnancy tests are free at most abortion clinics and $5 at Planned Parenthood. “The people most likely to utilize these tests are teen-agers who may be fearful of going to a physician, and these same people have the greatest need of counseling that goes along with tests done in clinics. Ads always show women thrilled at being pregnant, while the whole population out there may not be thrilled.”
“We neither condemn nor applaud the tests,” says Dr. Ervin Nichols, director of practice activities for the American College of Obstetrics and Gynecology. “There is no harm in the patient doing the test, but we do have concern for false results.”
In the case of a false positive a woman might run to a storefront abortionist, says Dr. Nichols. A false negative result could hinder early detection of an ectopic (tubal) pregnancy which, if untreated, could result in death.

And you’ll notice that while at least one of those e.p.t. ads featuring smiling faces includes a woman for whom “no” was a relief—and when was the last time you saw a pregnancy test commercial featuring a negative result, much less the admission that sometimes negative is the answer you want?—neither includes a woman thankful she could discover an unwanted pregnancy in private before scheduling an appointment at the abortion clinic, even though presumably, that’s one of the use cases where women are most thankful for the at-home option.

The concerns about accuracy and other risks took a long time dissipate, too, even as more women tried them and pharmaceutical companies rolled out new technologies. In 1987, the L.A. Times published a report headlined, “Doctors Warn Women: Don’t Rely on Home Pregnancy Test.” “The problem with using at-home tests is that most women are far too unaware of the potential risk of relying on those tests,” warned Dr. Louise Tyrer, VP for medical affairs at Planned Parenthood. One woman I spoke to having babies in the early ‘80s (who never used one) said she figured if you were actively trying for a baby, why not just go ahead and make the doctor’s appointment, rather than bothering with a fiddly test you weren’t entirely sure would be accurate? Many just didn’t see the point.

Maybe that’s why it took another ten years for the option to really catch on. The New York Times says it was only with late-‘80s advent of the simple, streamlined “wand” that at-home tests became truly ubiquitous, permanently transforming the experience of learning about a pregnancy. Ironic, considering it’s easier to pee into a cup that onto a stick:

In 1988, Unilever introduced the first “one step” test, Clearblue Easy, so named for the blue stripe that slowly materialized to indicate pregnancy.
According to the Food and Drug Administration, one-third of all American women have used a home pregnancy test. And Leavitt says it was the wand that transformed how we define pregnancy. “Eventually, of course, you’ll know you’re pregnant,” she says. But the home test has “shifted that knowledge earlier” so that pregnancy starts with a moment in the bathroom, watching a little plastic window and waiting for a sign.

Your reaction can be your own—though of course, it promptly became a joint affair all over again.

Contact the author at [email protected].

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