At the beginning of her ambitious and compelling history of women, sex, and contraception over the past two hundred years, Hera Cook reminds us what was (and is) at stake: “the introduction of reliable contraception is one among many changes that increased the control of fear, and allowed a greater experience of pleasure and increased emotional aspirations” for women (8). It has only been relatively recently and often against considerable pressure in both public and private spheres that women have gained the ability to experience sex without the “real and substantial economic and social risk of pregnancy” (7). This is, therefore, one of the most important stories of twentieth-century Britain. Of course, there are, already, important texts by Jeffrey Weeks, Frank Mort, and Lesley Hall that trace the unfolding of sexual knowledge in the twentieth century and the structures of expertise and legislation that bounded such knowledge. These have helped our understanding of contraception. But Cook's work makes a unique and important contribution by providing a focused discussion of the relationship between women and contraception. This not only allows us to understand the intersection among knowledge, science, and bodies in the last two centuries but, more important, affords an appreciation of the relationship between the sexes over contraception, the struggles of individual men and women to open up questions of sexuality and make life better for others, and, finally, the impact of these changes upon women's lives.

Before the late twentieth century, sex for women was haunted by “constant self-discipline” and “vigilance” (143). The dominant culture of sex was one of restraint, with abstinence as the favored sexual technique. Cook begins her examination with the revolt by women against sex in the nineteenth century, a “rejection … of sexual pleasure” (110–11). This rejection was not, she argues, the result of a spreading Foucauldian regime of sexual control and repression. Rather, it was an act of agency from below, the rational response of women to the bleak conditions of their sexual lives. These included the possibility of contracting venereal disease from their husbands or facing the dangers (both physical and economic) of high fertility. Sexual activity was identified with male sexuality and viewed with considerable fear and suspicion. For these reasons, the rational response to such conditions was to seek protection in a “culture of abstinence” (121). This culture was pervasive across society and enduring through time. Ironically, it colored many women's view of birth control. More effective birth control might have addressed one aspect of women's anxieties, the problem of fertility, but it threatened to impair another, the ability to police male sexuality. Well into the 1930s, women were dubious about new methods of birth control, even if they were more effective, because this meant surrendering the security and control of sexual abstinence.

Cook takes seriously and treats respectfully this culture of restraint and abstinence. What emerges from her work is, first of all, the fear and anxiety surrounding sex for many, if not most women in Britain until the late twentieth century. But we also get a sense of the tensions between men and women over sexuality. There is little evidence of mutuality between British men and women over sex until the 1960s. Instead, sex was a recurring point of tension.

Change came slowly in the twentieth century. From the fin de siècle to the end of the First World War, “negative attitudes” (182) toward sexuality were broadly shared across society. Between the wars, these were worn away by the gradual spread of contraceptive practice and sexual knowledge through all classes. By the fifties, sexual mores had become more relaxed, with the further spread of contraceptive knowledge and an increasingly open approach to sexual questions. The culture of sexual abstinence was, by the sixties, becoming a culture of sexual activity.

Cook provides an acute reading of the last period. She avoids both an uncritical celebration of sexual liberalization and an overly skeptical assessment of permissiveness. Rather, she suggests that the spoils of the new world were shared unequally between the sexes: the separate sexual cultures of the nineteenth and early twentieth century persisted well into the 1960s. There was a disjuncture between the promise of a more open sexual climate and the efficacy of the contraception needed to support women. The postwar period witnessed the emergence of both a “libertine male sexual ethos” and a greater emphasis on female sexual pleasure (244), but it was women, rather than men, who continued to pay the “costs of relaxed sexual mores … in the form of rising rates of illegal abortions, illegitimate babies, and painful adoptions” (185). The bump in the birth rate after 1945 was not caused by the desire to have more children but by the failure of contraception to keep up with increased rates of coitus.

What changed this situation was the appearance of a reliable and convenient contraceptive method, the Pill. By the end of the twentieth century, fully three-quarters of adult women had used the Pill. The year 1967 is also a key date. In that year, the National Health Service Amendment (Family Planning) Act and the Abortion Act both widened and, perhaps more critically, legitimated the claims to birth control by a wide variety of women, whether married, single, middle or working class, young, or old. Against those who might see the state as invasive or restrictive, government, in this respect, immeasurably aided women's autonomy and emancipation.

The culture and experience of sexuality had changed in other ways by the 1970s. Cook provides a rich examination of the literature of English sexuality over the last century. This includes the work of well-known writers such as Marie Stopes and Alex Comfort and that of less familiar, but no less interesting figures such as Joan Malleson, Eustace Chesser, and Helena Wright. In many ways, they were the agents of sexual change, through birth control tracts, sex manuals, and guides to marriage that demystified sex. What is fascinating is the way that the body (and, in particular, the female body) changed in this literature from the “more porous, less mechanical … more emotional body” (125) of Stopes to the “transhistorical body as a source of empirical study” (255) of the Americans William Masters and Virginia Johnson. This shift allowed, Cook argues, a radical rearticulation of female sexuality. What we also glimpse through this literature is something else written on the body, the changing practice and experience of sex. Cook suggests that early in the century, sex amounted to short and infrequent bouts of coitus. As the century went on, there was a “widening out of acceptable physical activity beyond sexual intercourse” (206), based upon new views of genitalia and masturbation. The body was thus opened up to sex.

The Long Sexual Revolution deserves a wide readership. It is not only a major contribution to the history of sexuality but should become a standard text of twentieth-century social history.