Abby Norman
Jun 27, 2016 · 8 min read

or the vast majority of human history, women were at the mercy of biology and the limitations of their own creativity when it came to family planning. It wasn’t until The Pill hit the market as a means of preventing pregnancy in 1960 that women gained a semblance of control over how many children they bore (though, three years prior it had been introduced as a treatment for menstrual disorders).

The decade before, chemists were competing with each other to see who could develop the contraceptive pill first. Early attempts included synthesizing hormones from Mexican yams, testing progesterone in rats and eventually conducting human trials in Puerto Rico in the mid-1950s, where there were no laws restricting the use of birth control.

Within the first two years The Pill was on the market, 1.2 million women were using it. By the following year, that number had doubled. These figures steadily grew in spite of the fact that The Pill was illegal in 8 states. It was a tumultuous decade for women’s rights, and while The Pill offered control and empowerment over reproductive health, it also became the center of an ethical controversy.

By the 1970s, some physicians were beginning to speak up about the side effects their patients were experiencing while taking The Pill; some of which turned out to be fatal. Barbara Seaman published The Doctors’ Case Against The Pill in 1969 which prompted a Senate hearing on its safety. The result of that hearing was that The Pill was required to include warnings about risk for stroke, blood clots and other adverse outcomes which had not previously been discussed.

the fifty-some years that have elapsed since the original birth control pill went on the market, a slew of brand-name and generic options have come and gone. The science of contraceptives continues to evolve: some pills, like Seasonale, reduce a woman’s periods to just four a year. Newer products like Lybrel, can suppress menstruation indefinitely.

Almost all contraceptives on the market today are also FDA approved for use combating acne, menstrual disorders and/or irregular bleeding. Of course, birth control can also cause a deluge of side-effects, too. But with so many options available, many women find, though trial-and-error, a pill that works for them if they so choose.

If the pills don’t work as well as they should, women can also use patches, injections, intrauterine devices, female condoms, diaphragms or implants as birth control — that is, assuming they have access to these options.

he issue of access existed for women long before birth control pills were even on the market. With so many choices available today you’d think that any women wanting to prevent pregnancy, treat a hormonal disorder or at least have the option to do either, would be able to get her hands on any or all of the aforementioned methods fairly easily.

Not so; at least not in many parts of the world. Whether it be that the products simply aren’t available, or the vast majority of women can’t afford them — or, as is the case in the United States, that the disparity in access has more to do with the politicization of women’s health than a lack of available products — access to birth control is a worldwide public health issue.

This goes hand-in-hand with access to menstrual hygiene products, which incur a luxury tax in many developed nations and are flat-out unvailable in many developing or third-world countries. New York City just passed legislature that mandates free menstrual hygiene products in schools, churches and shelters. It remains to be seen if other cities will follow their lead.

When it comes to accessing birth control, at least, there’s one project in particular that has found a way to circumvent the politics with a wide enough berth to provide women with contraceptives for just $20 a month, requiring no prescription from a doctor, and conducted completely online.

hen Peter Ax engaged his two teenage daughters, Meryl Ruby and Sophie, in a conversation about birth control, the two young women shared their observations from a recent trip abroad. While traveling throughout Asia and Africa, they were startled by the plight of women in other parts of the world who did not have birth control or, in many cases, menstrual hygiene products.

In the United States, where Ax’s daughters are coming of age, there exists an obvious disparity in access to birth control — either because of politics, economics or often a combination of the two. Generally, birth control can’t be obtained without a prescription from a doctor. Then, when the prescription is filled, whether or not an individual’s insurance will cover it has been wildly volatile — mainly due to religious exemptions as exemplified by the Hobby Lobby supreme court case. Still, the Obama administration mandated that women be able to obtain birth control despite their employer’s objections; and in theory, that’s a good thing.

practice, it can a more complex undertaking. Prjkt Ruby, which operates entirely online, understands this. Part of the challenge for women to obtain birth control is getting the necessary prescription. The debate about making the pill or the patch available over the counter has been ongoing for decades.

Prjkt Ruby seems to have found a way to operate on the periphery of that debate. “The state and federal environments are complicated,” explains Ax via email, “and we’ve had the benefit of 15 years of experience in this legal and regulatory environment.”

“We have been long term investors in telemedicine and online pharmacies and understood the regulatory framework we would need to comply with,” Ax continues — the we being himself and Dan Snyder, Prjkt Ruby’s Chief Marketing Officer. Both men have backgrounds in telemedicine and pharmaceuticals. Prjkt Ruby operates at the apex of these two fields.

If you log on to, you can sign up for their service, which includes obtaining birth control for just $20/month without needing a prescription. When you’ve registered, you can view several generic birth control options. If you don’t know what pill is the best option for you, answering a few quick questions will help you choose.

rjkt Ruby’s dedication to due diligence regarding informed consent is more thorough than you’d find in some doctor’s offices and hospitals. They’ve crossed their t’s and dotted their i’s, so to speak—and expect the same of those who want to use their services. Birth control, while generally safe, is still a medication with possible side effects, contraindications and adverse outcomes. Being honest with Prjkt Ruby’s questions would be no different than the honesty you would need to bring with you to a doctor’s office or clinic.

The difference being that Prjkt Ruby lives online, accessible 24/7; therefore, you can complete these questions when it’s convenient for you. No appointment scheduling necessary. And it’s done privately; no one here to pass judgment. If, at any time, you have questions (like whether or not a medication you currently take could adversely interact with a birth control pill) you can consult one of the pharmacists that works with the project.

here’s another side to Prjkt Ruby that sets it apart from your typical birth control obtaining experience: you’re not just getting birth control for you, you’re donating to help make birth control more widely available in underserved countries.

The project got its name from Ax’s daughter, and works together with a co-formed 501(c)(3) that provides contraceptives to third-world nations. “The 501(c)(3) is a separate and distinct entity from the operating business of Project Ruby,” Ax explains, “This structure allows us to isolate donations so that we can contribute 100% of all contributions to for their monitoring and deployment in the developing world.”

Each month, 25-cents of every purchase made through Prjkt Ruby goes directly to PSI.

This side of Prjkt Ruby is called TAKE1GIVE1, which not only provides birth control to women developing nations, but also helps them get counseling and education regarding their reproductive health, empowering them to make the right choices for themselves. And when it comes to getting the products abroad? Well, Prjkt Ruby has it covered. All administrative costs are absorbed by Project Ruby,” assures Dan Snyder, Chief Marketing Officer, via email.

he project acquires its contraceptive wares through a partnership with Afaxys Pharmaceuticals. The company was the first of its kind, established in 2008, with a focus of providing access to high quality, FDA- approved, but still low cost pharmaceuticals; particularly oral contraceptives and emergency contraception.

While the majority of the products listed on Prjkt Ruby are birth control, they also offer FDA-approved emergency contraception, which is around $67. Emergency contraception, like Plan B, is available in many pharmacies over-the-counter or through Planned Parenthood if the need is immediate, through Prjkt Ruby you could purchase some to have on hand.

Prjkt Ruby has operated somewhat below the radar since 2014, but as of late has received much press attention as it challenges cultural expectations about access. While it’s not infrequent that we see start-ups fold after receiving such attention, because they just can’t meet the demand, Ax and Snyder aren’t the least bit worried.

“Prjkt Ruby has been operating since April 2014 and have been growing every month so we are well prepared to absorb the added volume caused by recent press and attention,” says Ax, “We were one of the very first firms focused on the online delivery of healthcare and have significant operations to absorb growth.”

Which is great news for women — well —everywhere.

Find out more about Prjkt Ruby here.

About the Artist

Rebecca Stuart is a visual artist based in Brookyln.

About the Author

Abby Norman is a writer based in New England. She’s currently writing a memoir for Nation Books. She’s represented by Tisse Takagi in New York City. Follow her on Twitter @notabbynormal.

Ask Me About My Uterus

Essays, interviews, and research about reproduction health, menstruation, endometriosis, PCOS, PMDD, menopause, miscarriage, identity, infertility and more.

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Ask Me About My Uterus

Essays, interviews, and research about reproduction health, menstruation, endometriosis, PCOS, PMDD, menopause, miscarriage, identity, infertility and more.