A complicated early '80s pregnancy test is seen in Netflix series Glow. Image Source: Netflix
Pregnancy tests have come a long way, baby. In ancient Egypt, women would pee on wheat and barley seeds to determine whether they were expecting. As a papyrus document from 1350 BCE explained: "If the barley grows, it means a male child. If the wheat grows, it means a female child. If both do not grow, she will not bear at all." In 1963, the wheat and barley theory was partially validated: in 70 percent of cases, the urine of pregnant women resulted in growth of either seed, while the urine of men or nonpregnant women did not. (There was no luck on the gender distinction.) Before we had to "pee on a stick" we could pee on a seed.
Moving Beyond Symptom Spotting
Unfortunately, science gave us few pregnancy test advancements from ancient times until relatively recently. The first home pregnancy test resembled a complex chemistry set and wouldn't come to market in the US until 1977. (You may have caught a glimpse of one version of it in the Netflix series Glow, set in 1985.) But it took a while even to get there. A historical timeline for pregnancy tests, put together by the National Institute of Health, shows that through the beginning of the 20th Century, the best method for diagnosing pregnancy remained looking out for symptoms, like a missed period or morning sickness. Considering not all women have symptoms — and implantation bleeding in early pregnancy can resemble a period — this was an imperfect way for women to determine whether they were actually pregnant.
In the 1920s, the only way to test for the pregnancy hormone was to inject a woman's urine into a young female rabbit or mouse.
In the 1890s, doctors identified chemical messengers and named them "hormones." By the 1920s, they identified human chorionic gonadotropin (hCG), a hormone that is found in pregnant women. (Today's home pregnancy tests still look for hCG.) But even once hCG was identified as the pregnancy hormone, it remained difficult to detect. The only way to test for hCG was to inject a woman's urine into a young female rabbit or mouse. No joke. If the woman was pregnant, the animal would go into heat. While this represented the first time we could scientifically prove or disprove a potential pregnancy, it clearly wasn't a practical DIY pregnancy test. It did, however, spawn development over the next few decades.
Once scientists determined how to detect hCG with a simple test-tube method in the 1960s, you could go to a doctor to confirm early pregnancy suspicions without harming rodents. A doctor would collect urine and send it to a lab for testing. The lab would then send the results back to the doctor, who would then inform the patient. "This could take a very long time and depended on a lot of factors, like could the woman afford the doctor or afford the test," points out Professor Emily Accampo, who studies the history of the family and feminism at the University of Southern California. "What if she didn't want anyone else to know, especially if she were not married? Doctors were not kind to unmarried pregnant women." Before home pregnancy tests, you had to broadcast your sexually active status to strangers if you wanted to gain private information about your body. Imagine what that would be like for teenagers or single women, considering the judgments of the time.
Bringing the Test Into the Home
A look at e.p.t.'s first pregnancy test for the US market. Image Source: Getty / Bettmann
By the 1970s, science and society began to change. With abortion rights affirmed in 1973's Roe v. Wade Supreme Court decision, there was more reason for women to want to know they were pregnant as soon as possible so they could safely act on that information. The technology was also catching up, and groundwork was laid for the first home pregnancy test. In 1970, doctors could conduct a successful "two-hour pregnancy test" four days after a missed period. The groundbreaking 1973 book and instant feminist classic Our Bodies, Ourselves advised women who were at least two weeks late for their periods to collect urine first thing in the morning and take it to a laboratory for testing. Control was gradually coming our way.
It was a woman, Margaret Crane, who realized the modern pregnancy test of the 1960s could be done in the home.
It was a woman, Margaret Crane, who realized the modern pregnancy test of the 1960s could be done in the home. As a 26-year-old freelance graphic designer working for pharmaceutical company Organon, Crane previously designed lipsticks. At Organon, she had seen pregnancy tests come in from doctors offices for interpretation, and she figured women could probably do it themselves. In 1967, she created the first home pregnancy test prototype — its design was inspired by the paper-clip holder on her desk. She called it "Predictor." Crane's name was on the patent, but she sold her rights to it for $1 and never saw any money when Organon licensed her design to the owners of e.p.t.
While a home test based on Crane's work was available in Canada in 1971, the FDA didn't approve the first home pregnancy test — e.p.t. — until 1976. The test hit the US market a year later. A 1978 advertisement in Vogue called it a "private little revolution any woman can easily buy at her drugstore." And a write-up in Mademoiselle noted that e.p.t. would "give you a chance, if pregnant, to start taking care of yourself . . . or to consider the possibility of an early abortion." The test was 97 percent accurate for positive results and 80 percent accurate for negative.
Accampo believes the home pregnancy test fit into the feminist movement of the 1960s and early '70s, which emphasized a woman's ability to have control over her own body. "This largely meant, but not exclusively, control over her own sexuality and reproductive process. But it also meant, in general, appropriating the power of the medical profession over one's own body." Home pregnancy tests were tools to do just that. "Being able to perform a pregnancy test in one's own home was cheaper than going to a doctor, much faster, and far more private," Accampo points out.
A 1978 advertisement called it a "private little revolution any woman can easily buy at her drugstore."
Unsurprisingly, the home test also had its detractors. In a 1976 letter to the editor of American Journal of Public Health, one concerned "chief technologist" based in the UK wrote that he was becoming increasingly worried by the escalating use of such kits by nontechnical staff, especially "by the patient herself." Tests had come out earlier in the UK, and the technologists wrote that: "It is my experience that such users do not in general have sufficient training to detect malfunctions in these materials, and not understanding the complex nature of the reactions involved, often try to modify the products to suit themselves, with predictably catastrophic results." In a response, the editor noted that a falsely reported temperature could be more dangerous than a falsely interpreted pregnancy test and concluded "not everyone needs carpenters to hammer in their nails."
Alison Brie's character navigates a chemistry set to find out if she's pregnant in Glow, set in 1985. Image Source: Netflix
Early pregnancy tests may have incensed mansplainers, but they were a huge advancement for women. That doesn't mean they were easy, though. In the episode "Maybe It's the Disco," Netflix series Glow puts this reality on full display. The show is about 1980s women wrestlers, and Alison Brie's character Ruth Wilder undertakes a home science experiment to figure out whether she's pregnant. She pees in a plastic tray, navigates a series of test tubes, liquids, and eyedroppers, and then waits . . . forever . . . for the liquid to possibly change colors. She has time to trim her bangs, scrub the shower, and attempt to read. As the show makes clear, the mess of pregnancy tests and the wait for results in that era were painful, but it still beat going to a doctor's office or waiting longer for lab results.
The "Pee on a Stick" Era
The stick was introduced in 1988 and still dominates today. Image Source: Flickr user Johannes Jander
Things were about to get easier for women like Wilder. In 1986, e.p.t's new test promised results within 10 minutes and as soon as one day after a missed period. Then, in 1988, the "stick" was introduced, making it possible to pee on one side and get the results on the other. By 2003, the FDA approved a new generation of tests, including the Clearblue Easy, which would tell you in simple English: "pregnant" or "not pregnant." Modern tests come at various price points and levels of early detection — and with sites like Amazon, you don't even have to face a drugstore cashier to buy one. First Response Early Results Pregnancy Test (FRER) costs about $17 for two, but can possibly tell you as early as five days before your missed period. On the other hand, you can go for cheap and get 50 Wondfo pregnancy strips for $19, but they only promise accuracy one day after your missed period. Unlike in the '60s, there's no doubt that women can navigate the instructions and implications, and "peeing on a stick" is now the standard way women find out they're pregnant — or not.
The evolution of home pregnancy tests has resulted in very real and positive changes for women and family planning. If a woman is pregnant and planning to keep the baby, she can stop drinking or smoking and make other lifestyle changes. Serious neural tube birth defects occur within one month of conception, but the risk can be reduced with folic acid. Thanks to home pregnancy tests, a woman can start taking prenatal vitamins with folic acid early in pregnancy, action that has contributed to a significant drop in such birth defects.
If a woman does not intend to follow through on the pregnancy, she can make a decision early. This means more options, like the abortion pill, will be available. Today, two-thirds of abortions occur at eight weeks of pregnancy or earlier. These tests also improves things for women who get disappointing negative test results. Thanks to home pregnancy tests, these women can process that disappointment in private and perhaps with their partners.
"Home tests allow a woman either immediate relief or disappointment unmediated by a doctor's office."
"Some women aren't very much in touch with their bodies," acknowledges Accampo. We may mistake pregnancy symptoms for something else or simply not want to admit we're pregnant, especially if we think we're using birth control effectively. "If suddenly a woman realizes she's been in denial, or she hasn't been paying attention to symptoms that have been going on for a while, a pregnancy test can be absolutely key, especially if she's several weeks or even months into it and needs to know immediately. For various reasons, she may want to be the first to find out rather than being told by a doctor."
While a woman experiences the physical burden of pregnancy, she isn't afforded much privacy as it progresses. Accampo rightly notes that a pregnancy may involve a partner, families, the medical profession, and a host of social mores about unborn children, childbearing, and child-rearing. "Home tests allow a woman either immediate relief or disappointment unmediated by a doctor's office, or the opportunity to figure out how she feels before sharing the information with anyone else." explains Accampo. "Women in the past never had such control or choice."