The Pill has questionable legacy

Knowing history behind its development may serve repro rights advocates well

The Pill revolutionized sexual expression and practice when it was introduced in the 1950s. But questionable testing practices and side effects associated with it have lingered over its development since its inception. That has led to a distrust of organizations like Planned Parenthood and Margaret Sanger, who was instrumental to its introduction to America.

This has particularly been true within the Black community, which reacted to it with articles penned by African-American writers where they speculated if it was part of an effort to perpetrate genocide against black people. That belief in part came from the widespread sterilization of Black women within the southern hospital system before that.

PPFA President Alexis McGill Johnson addressed the pill’s development within her NY Times editorial that conceded some of the more problematic parts of Sanger’s legacy. It may be of use for women to understand and review some of the historical aspects of Enovid and the research behind it.  

Paul Vaughn’s 1970 book The Pill on Trial begins with an explanation of how research commenced. Sanger had dreamed of an oral contraceptive for years, but she couldn’t find someone to develop it. It wasn’t until she met Gregory Pincus, a physiologist based in Massachusetts, that the aspiration became reality. Pincus along with another experimentalist John Rock were the primary researchers who developed the pill. Sanger had doubts about regarding Rock because of his Catholicism, which was something that she distrusted throughout her life.

Sanger secured funding for the project through wealthy patroness Katherine Dexter McCormick.

Pincus and Rock couldn’t get human testing approved within the United States, and so they looked for alternative locations to do it. They eventually selected Puerto Rico because of the island’s intense poverty and corresponding desperation among women to control their fertility. They would have many test subjects willing to participate as a result, according to Annette B. Ramirez de Arellano’s book Colonialism, Catholicism and Contraception: A History of Birth Control in Puerto Rico.

While Pincus and Rock knew some of the negative side effects, they didn’t inform the women properly before the subjects gave consent. That violated a basic principle of human testing for medical advancements. Three women died during the tests, but no autopsies were done. So it’s unclear whether it was caused by the birth control research or not. Mortality was high in Puerto Rico as a result of the squalid living conditions. So other causes may have been the reason.

When Enovid got approved by the FDA in 1957, it liberated women to have sex as much as they wanted. Prior to that, society expected women to go from complete abstinence to married sex that could be enjoyable or not, according to the PBS documentary The Pill. No one wanted them to develop their skills as lovers beforehand and correspondingly didn’t care whether they had good sex after finding a husband.

While the Pill led to the sexual revolution, it soon became apparent that terrible side effects came for some women as a result of the excessively high dosage within the first round of vials. Barbara Seaman, a journalist at the time, investigated and revealed the problems associated with it in her 1969 work The Doctor’s Case Against the Pill, which led to congressional hearings and changes within birth control care and treatment.