In this August 1974 file photo, a woman holds a birth control pill dispenser in New York. [Agencies]

CHICAGO: A world without "the pill" is unimaginable to many young women who now use it to treat acne, skip periods, improve mood and, of course, prevent pregnancy. They might be surprised to learn that US officials announcing approval of the world's first oral contraceptive were uncomfortable.

"Our own ideas of morality had nothing to do with the case," said John Harvey of the Food and Drug Administration in 1960.

The pill was safe, in other words. Don't blame us if you think it's wicked.

Sunday, Mother's Day, is the 50th anniversary of that provocative announcement that introduced to the world what is now widely acknowledged as one of the most important inventions of the last century.

The world has changed, but it's debatable what part the birth control pill played. Some experts think it gets too much credit or blame for the sexual revolution. After all, sex outside of marriage wasn't new in 1960.

The pill definitely changed sex though, giving women more control over their fertility than they'd ever had before and permanently putting doctors -- who previously didn't see contraceptives as part of their job -- in the birth control picture.

But some things haven't changed. Now as then, a male birth control pill is still on the drawing board.

"There's a joke in this field that a male pill is always five to seven years away from the market, and that's what people have been saying since 1960," said Andrea Tone, a history professor at Montreal's McGill University and author of "Devices and Desires: A History of Contraception in America."

The pill is America's favorite form of reversible birth control. (Sterilization is the leader overall.) Nearly a third of women who want to prevent unwanted pregnancies use it. "In 2008, Americans spent more than $3.5 billion on birth control pills," Tone said, "and we've gone from the one pill to 40 different brands."

There are Yaz, Yasmin, Seasonale, Seasonique and Lybrel -- all with slightly different packaging, formulations and selling points. Lybrel is the first pill designed to eliminate menstrual periods entirely, although gynecologists say any generic can do the same thing if you skip the placebo and take the active pill every day.

In the 1960s, anthropologist Ashley Montagu thought the birth control pill was as important as the discovery of fire. It turns out it wasn't the answer to overpopulation, war and poverty, as some of its early advocates had hoped. Nor did it universally save marriages.

"Married couples could have happier sex with more freedom and less fear. The divorce rate might go down and there would be no more unwanted pregnancies," said Elaine Tyler May, 62, a University of Minnesota history professor who wrote "America and the Pill.

"None of those things happened, not the optimistic hopes or the pessimistic fears of sexual anarchy," she said.

And it didn't eliminate all unwanted pregnancies either. Nearly half of all pregnancies to US women are unintended and nearly half of those end in abortion, according to the Guttmacher Institute, which has gathered data on abortions for years.

The pill is often associated with the women's movement of the 1970s. But the two feminists behind the pill, the ones who provided the intellectual spark and the financial backing, were born a century earlier, in the 1870s.

As suffragists worked for the vote, renowned birth control pioneer Margaret Sanger distributed pamphlets with contraceptive advice and dreamed of a magic pill to prevent pregnancy.

Her grandson, Alex Sanger, 62, now chair of the International Planned Parenthood Council, remembers playing catch as a boy with his famous grandmother and eating her firehouse-spicy food.

"My grandmother had the idea for the pill back in 1912 when she was working on the lower East Side of New York," Alex Sanger said. "She saw women resorting to back alley, illegal abortions. One too many of these women died in her arms and she said 'Enough.'

Katharine McCormick, a philanthropist with a science degree from the Massachusetts Institute of Technology, bankrolled the work of Gregory Pincus, the man Sanger convinced to develop the pill. "It was my grandmother's idea and Katharine McCormick's money," Alex Sanger said.

Ironically, when health hazards of the early pill arose — high levels of hormones caused blood clots in some women — young feminists protested that men had invented it and turned women into unwitting guinea pigs.

The FDA's response to the hazards of the pill led to greater access to safety information for patients, another less-appreciated part of the pill's legacy.

Today's pill, with much lower doses of hormones, is much safer than the pill of 50 years ago. And it may even be good for you.

"The health benefits are tremendous," said Dr. Melissa Gilliam, chief of family planning contraceptive research at the University of Chicago Medical Center. "It decreases the risk of ovarian cancer and uterine cancer. If we called it 'the cancer-preventing pill,' it would have far better traction. It's a real success story."