Sunday, May 9, 2010

Contraceptive Confections—Happy Birthday Birth Control! I Made You a Cake

Disclaimer: This cake contains no contraceptive properties and does not prevent pregnancy

Ladies and gentlemen, let’s all give a big happy birthday to a very special someone today, THE PILL!  Today marks the birth control pill’s fiftieth birthday.  You’ve probably seen a lot of press coverage of this anniversary in important publications such as The New York Times and Time Magazine.  Well, I’d like to give oral contraceptives my own little commendation.

Birth control pills are certainly not perfect.  They are not 100% effective at preventing pregnancy and they require excellent compliance.  They put women at increased risk of blood clots, especially those who are older or who smoke.  They can cause high blood pressure.  They do not prevent sexually transmitted diseases or HIV. 

However, oral contraceptives are an incredible drug and we should celebrate them.  Not only have they revolutionized a woman’s ability to control her reproductive fate, but they also have peripheral benefits.  They are effective at resolving painful or heavy periods, they can help resolve acne, and they reduce a woman’s risk for ovarian cancer.  A recently released cohort study from the UK following 40,000 women over 40 years found that women who had ever taken the pill had lower mortality than those who had never taken the pill, controlling for age, smoking status, and socioeconomic status. [1]

When birth control pills were introduced on May 9, 1960, there was only one pill, called Enovid. Enovid contained very high levels of progestins which caused multiple undue side effects.  The dose was lowered fairly quickly as a lower amount of hormone was shown to be equally effective at suppressing ovulation.  Now there are over 30 different formulations of pills approved by the FDA, as well as shots, vaginal rings, patches and hormone laced intra-uterine devices which are all derivatives of the original birth control pills. 

It is impossible to dispute that the pill has had a tremendous impact on our society.  Analysis by political economists suggests that the Pill allowed women to pursue higher education and prolonged the average age of marriage [2].  Regardless of each woman’s individual contraceptive choices and intimate practices, I do think that we as women can at least indirectly thank birth control for our ability to realize our personal and professional dreams, whatever they might be, in this crazy, uncontrollable world. 

So, happy birthday The Pill.  I made you a birthday cake.  It was another baking disaster day, but the beauty about making cake with frosting is that frosting covers all scars.  I had to make the cake twice because I broke one half of it, and then when I re-baked it I took it out while it was still gooey so part of the cake is undercooked.  The white chocolate ganache, which I still can’t figure out for the life of me how to whip up right, got kind of grainy and then I put part of it on a hot cake so it melted everywhere.  But, the cake itself which I layered with kiwis and strawberries with a white chocolate filling, is delicious and I can only thank James Peterson’s Baking for his beautiful vanilla butter cake.  I made a simple buttercream frosting to coat the outside and cover the disaster, and I think it turned out beautifully.

Birth Control Cake (they're all sugar pills)

Vanilla Butter Cake from James Peterson’s Baking
2 9” by 1” round cake pans
Butter an flour for the cake pans
2 ½ cups cake flour (all purpose will work fine)
1 ½ cups sugar
½ tsp salt
1 tbsp plus 1 tsp baking powder
2 eggs
3 egg yolks
1 ½ cups milk
2 tsp vanilla
¾ cup plus 2 tbsp softened butter, sliced

Preheat oven to 350.  Butter and flour cake pans.  In a mixing bowl, whisk together flour, sugar, salt and baking powder.  Add 1 cup milk and butter.
In a second bowl, whisk together eggs, egg yolks, ½ cup of the milk, and vanilla.
In bowl with flour, mix with wooden spoon or mixer for about 2 minutes, until well combined.  Add ¼ egg mixture, work until smooth, then work in half of remaining egg mixture.  Add last of egg mixture.  Transfer to cake pans and bake until toothpick inserted in center comes out clean, about 25 minutes.  Remove from oven, let cool in cake pans for 5 minutes and then invert onto cake rack.

For white chocolate Ganache
From James Patterson’s Baking
8 oz white chocolate chopped
1 cup heavy cream

Place the chocolate in a heatproof bowl.  Bring cream to simmer and pour it over chocolate.  Let mixture sit for about 10 minutes.  To whip, put the bowl in a bowl of ice water to cool it and beat until fluffy and stiff, like beaten egg whites.

For buttercream frosting
From Betty Crocker Cookbook
2/3 cup butter softened
3 cups powdered sugar
1 tsp vanilla
1 tbsp milk

With mixer, beat butter and sugar until a paste, add vanilla and milk slowly and whip until desired consistency. 

For cake assembly
1 kiwi thinly sliced
5 strawberries, thinly sliced
2 packs Giant Smarties for pills

Put first layer of cake down, cover with layer of ganache and fruit.  Add other layer of cake, if ganache remains put on top.  Coat with frosting and arrange smarties to look like pills.

Update: A special thanks to Dr. Charles of the blog The Examining Room of Dr. Charles.  He hosted Grand Rounds this week, a carnival of medical blog posts, and the birth control cake post was the editors choice.

1. Hannaford, PC., et al. “Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners' Oral Contraception Study.” BMJ: British Medical Journal, v. 340, 2010, p. c927
2. Claudia Goldin and Lawrence F. Katz. The Power of the Pill: Oral Contraceptives and Women's Career and Marriage Decisions.  The Journal of Political Economy, Vol. 110, No. 4 (Aug., 2002), pp. 730-770.


  1. qué linda la torta pa' nuestras pastillitas mágicas!!!!
    te quiero, amigaaaaaaaa!!!

  2. Happy Birthday BCP! I am still a fan of you, even though you did contribute to my bilateral pulmonary embolisms. But you did make my life easier for 5 years! Now I'm having an affair with your nemesis IUD.

  3. I'll give you an interesting story about the original OCPS.

    The first OCPs in the US were made by a group at Harvard. The researchers were put in a strange position in this development, as a good deal of their research budget came from the Catholic Church, who was a major funding agent for Harvard's group of hospitals. Understanding that their work might be discouraged by their patron, they sought to sell it as a medicine for regulation of menses and for prevention of ovarian cancer, downplaying the real goal of contraception.

    At the same time they realized that they might get found out, and so they had a plan B - a secondary lab in Mexico.

    The original pill was a progestin only pill. They produced this pill in Cambridge and also in their lab in Mexico. They then ran two randomized trials with women, with the primary outcome being pregnancy.

    After the data was analyzed, the group was surprised by the results! In Mexico the pregnancy rate for the treatment group was only 1-2%, while in Cambridge the pregnancy rate was more like 10%.

    They were puzzled by this difference, so they sent their pills to an independent lab for analysis.

    The pills made in Cambridge were exactly what they thought - 100% progestin. The pills in Mexico, on the other hand, turned out to have been made a little sloppily, and were filled with contaminants. And what was the contaminant? Estrogen!

    As thus, it was found that a combination estrogen-progestin pill was more effective for birth control than progestin alone.

    From moldy bread to birth control, many medical discoveries are serendipitous indeed.

  4. @Emily oh you just wait--IUD cookies are the next post! The IUD is fantastic

    @Dr. Fogelson--good bless Mexico. Probably one of the only times that having your drugs be laced is a GOOD thing!

  5. So funny; I only took the pill for 3 month's 34 years ago and was told it would be perfectly okay for my nursing baby..I read other wise and never took it again! But Happy Birthday anyway you sure did make a statement!!

  6. its a great fun. now no procedure is for permanent birth doctors introduces new surgery tubal reversal,by this method a woman can repair her tied tubes again

  7. WOw..That cake is awesome.. as is the post!!

    And reading the comments section, was another story!

    Love your blog!

  8. i googled birth control cake and found this and was no disappointed. very fun!

  9. I love this! I did this recently for a Valentine's party with cupcakes.