The Pill at 50: Sex, Freedom and Paradox

In May 1960, the FDA approved a new oral contraceptive. Somehow we are still fighting about it half a century later — whom it helped, whom it hurt, what it meant and why it mattered

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    Combined monophasic early contraception pill, 1960. Pink contraceptive pills (marked 'PD') in a circular blue plastic dispenser.

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    The Mothers of the Pill

    The driving force to change all this was a woman born in Corning, N.Y., in 1879 to a Catholic mother and a father who carved angels and saints out of marble. When her mother died at the age of 50 after 18 pregnancies, she confronted her father over her mother's coffin and charged, "You caused this. Mother is dead from having too many children."

    Margaret Sanger went on to train as a nurse and as early as 1912 was dreaming of a "magic pill" that would prevent pregnancy. She coined the phrase birth control in 1914, the year she was arrested for mailing her magazine the Woman Rebel , an outlaw tract with its discussions of contraceptive use. She jumped bail and fled to Europe but returned two years later and opened the nation's first family-planning clinic in a squalid tenement section of Brooklyn. Arrested again, she served 30 days. But she did not stop.

    In 1917, Sanger met a woman named Katharine Dexter McCormick at a lecture in Boston. Born into money, McCormick was the second woman to graduate from the Massachusetts Institute of Technology, with a degree in biology. She married the heir to the International Harvester Co. fortune — and soon learned that he suffered from schizophrenia. McCormick, like Sanger an ardent feminist, would devote her energy and money to finding a cure for her husband's illness. But she also set out to help women who did not want to have children be able to prevent pregnancy without their husbands' help, or even knowledge.

    In the years that followed, Sanger provided the ingenuity and energy to drive the birth control movement, and McCormick provided the capital. The movement gained momentum during the Depression, when limiting the size of families became practically a matter of survival. America went from 55 birth control clinics in 1930 to more than 800 in 1942, the year Sanger's Birth Control League changed its name to the Planned Parenthood Federation of America.

    In labs, research proceeded apace. The idea of a hormonal approach to birth control had been around for years, but going from a theory to a pill that women could take as easily as a vitamin required a collision of motivation, money, medicine and genius.

    The genius came in the form of a brash researcher named Gregory Pincus, whom Sanger met at a dinner party in 1951 and whom she persuaded McCormick to bankroll. Pincus had been a promising assistant professor of physiology at Harvard in the 1930s, when, at the age of 31, he succeeded in creating a rabbit embryo in a petri dish — the precursor to in vitro fertilization. It was lauded as a brilliant scientific breakthrough — until a 1937 profile in Collier's magazine suggested he was creating a world of Amazons in which men would be unnecessary. Harvard denied him tenure, and Pincus went off to form his own research lab.

    He learned from his work with animals that injections of progesterone, which chemists in Mexico had been able to synthesize from wild yams, could block ovulation. But testing a formula on humans would require someone with a clinical practice. Over the decades Pincus had followed the work of the country's pre-eminent infertility specialist, a Harvard-trained physician named John Rock, whom he ran into at a conference in 1952. A devout Catholic with five children and 19 grandchildren, Rock had made it his mission to help barren women have babies. When Pincus and Rock began to collaborate, Rock was experimenting with using hormones to help women conceive. The idea was to use progesterone to suppress ovulation for four months, then withdraw the drug and hope for a rebound effect; several of the women in his trials did get pregnant. Using hormones to prevent pregnancy followed the same logic: the progesterone prevented the release of a fertilizable egg, thus making it impossible for a woman to conceive.

    Testing hormonal pills on women for infertility was not illegal, but testing the pill as a contraceptive was, so in 1956 Rock and Pincus conducted clinical trials in Puerto Rico, where many women were desperate for some better means of birth control. The Pill proved effective at blocking ovulation and was approved for the treatment of "female disorders" in 1957. Thirty states still had laws against promoting birth control — so for its early life, the Pill existed only undercover. But there was a sudden epidemic of menstrual irregularity among women across the U.S.

    In 1959 the pharmaceutical firm G.D. Searle & Co. applied to the FDA for approval of the Pill, which would be marketed as Enovid. On May 9, 1960, the FDA gave its blessing. "Approval was based on the question of safety," said associate commissioner John Harvey, noting that "our own ideas of morality had nothing to do with the case."

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