The Rebellious Roots Of The Birth Control Pill

It has been heralded as one of the most important inventions of the 20th century. More than 50 years ago, the Food and Drug Administration approved the birth control pill, ushering in a new era in which women and families can choose when — and if — they want to have children.

This election season, several Republican candidates have been pushing to make the pill available without a prescription while also supporting the rights of corporations not to cover the pill. But Democrats want to make sure that women have access and that it will remain fully covered by insurance under the Affordable Care Act.

Controversy is not new for the pill. It was created in Massachusetts as a result of the ardent efforts of four people: a researcher ousted from Harvard in the 1930s, a Catholic gynecologist in Boston, an MIT-trained millionaire and feminist Margaret Sanger.

WBUR's Sacha Pfeiffer speaks with the author of a new book about the history of the birth control pill.

Jonathan Eig, author of "The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution." He tweets @jonathaneig.

1. Women's lives were drastically different before the pill:
Jonathan Eig: "There really was no reliable form of contraception and the forms that were available were really all controlled by men — not just the condom, which is, you know, controlled by men during the act of sex but, to get a diaphragm, to get an IUD, you had to get the doctor's help in that process. So, women really needed something of their own and, because they didn't have that control over reproduction, they had, sometimes, seven, eight, nine kids when they didn't want to keep having them. The kids kept coming and that, of course, limited the things they could do with their lives. It affected their health — having that many children would wear women out, taking care of that many children would wear women out and the opportunities to go to college, to start careers were slim to none."

2. Margaret Sanger had always dreamed of the pill:
JE: "She began as a nurse in the tenements of New York City in the 1910s and saw how women were suffering. She saw her own mother die from having given birth to so many children, and she believed that there ought to be a way for women to get better help on birth control, to get a better education at least, and she also really thought that they should be allowed to enjoy sex and that it was something worth fighting for...She had this dream that she talked about for decades, that there ought to be a way for women to turn on and off their reproductive systems. She talked about the magical tablet, she called it. But it was fantasy stuff. Everybody she talked to about this said, 'Keep dreaming. It'll never happen'...She thought, it had to be something women could do on their own, they could hide from men, if necessary. They could keep it in their purses and not tell their spouses or their partners that they were taking this, and that when they stopped taking it they needed to be able to get pregnant again. This was her dream."

3. Birth control was illegal at the time:
JE: "The pill was approved [by the FDA] before the Supreme Court ruled that contraceptives [were] a right women had. So, Sanger of course got no interest. Doctors, scientists all told her there was no chance, no drug company would ever make such a thing. The government would never license such a thing."

4. One of the scientists involved, Gregory Goodwin Pincus, was not a feminist:
JE: "Pincus was, at first, attracted to the challenge...He did not come at this with a view of changing the world. He came at this because it was a challenge and the fact that no other scientists would take it on really piqued his interest. He was a supremely confident man, believed in his own genius, but he'd been fired from Harvard and couldn't get a job anywhere else in the country. He was considered too toxic. [He was fired for] in vitro fertilization in the 1930s and the press picked up on it and compared him to Frankenstein. They said he was trying to create babies in labs in test tubes — and that's exactly what he was trying to do, but it didn't go over that well in the 1930s. He was also Jewish at a time of a lot of anti-Semitism at Harvard. So, he was cut loose, unemployable, started his own laboratory in Worcester, literally went door-to-door in Worcester asking people to contribute money so we could have our own scientific institution right here in Worcester."

5. One of the founders of the pill was Catholic:
JE: "Dr. John Rock brings respectability to this band of misfits. He's a Harvard gynecologist, just one of the most respected OBGYNs in the country...He's got one of the largest practices for infertility in the country, in addition to delivering babies and helping women with their pregnancies. As a result of this, he really becomes passionate about women's rights and sees the importance of women being able to have sex for pleasure, that it's important to a family, it's also important for them not to have to have babies every time they have sex and, as a result of that, even though he's Catholic and attends Mass every day, he decides that the Church is wrong on this issue and he's willing to...team up with these other individuals to try to see if they can come up with this birth control pill...In fact, he went to Rome and lobbied the Vatican and tried to convince them that this was an important moment — that they had a chance here to view this pill as a natural form of birth control in line with the rhythm method and that they ought to embrace it and the Vatican came close to agreeing with him but then, of course, did not."

6. The pill began with dubious scientific ethics:
JE: "The standards today would definitely have stopped this thing cold. They were pushing the limits, by today's ethical standards, at the time they were pretty much well within the norms. But, to begin with, they couldn't test this thing in the United States because birth control was illegal. So, they didn't call it birth control. They began by taking some of Dr. Rock's patients who were seeking help with infertility and gave them the birth control pill and said this is going to make you really infertile for a little while. This is going to really shut down your reproductive system and maybe it'll give your system a rest and when you come off of this new medicine, you'll get pregnant. Who knows? It's worth a try. But that was an important test because they were able to give this — at that point it was still an injection — they were able to give this injection to women and see that it really did shut down their ovulation and see that it didn't cause them any harm except for some mild nausea and some headaches and some dizziness. But the male doctors were fine with ignoring all that, and they plowed ahead. They tested it in some mental health centers — insane asylums...The doctors I talked to who worked there said they would just walk up to women and say, 'Hey, Jane. I've got a shot for you today.' And nobody ever asked what it was, no forms were signed. But even then they'd only tested it on, you know, a handful of women. Dozens. And they needed hundreds if not thousands. I mean, think about it, this was the first pill in the world that you're going to give to healthy people every day."

7. The pill was approved by the FDA after the founders fudged the numbers:
JE: "They only had 130 women, they said they had something like 13,000 menstrual cycles. So, they fudged those numbers. And then they didn't ask for approval as birth control. They went to the FDA and asked for approval for a pill that would regulate women's cycles. So, women who had irregular cycles would take this pill and become more regular, and it was very clever because the threshold for approval was much lower for something like that — it didn't seem as controversial and these pills came with a warning on the bottle that said, 'Pregnancy will not occur while taking this pill.' And that became great advertising, because women realized that if they took this they wouldn't get pregnant and they began flocking to their doctors offices saying, 'I need that pill for the irregular cycle.'"

8. Societal changes happened almost overnight:
JE: "You see women staying in school longer, you see them delaying the decision to get married and have children until they're a little bit older. There are some negative consequences as well. You know, there's more promiscuity, there's more premarital sex. You can argue that it helps contribute to the sliding morals that we see during the sexual revolution. But overall, the effects both on health and on women's abilities to earn are just tremendous. And you can't overlook that issue of health because when women have fewer unplanned pregnancies, you get far fewer complications, you get far fewer deaths of infants, far fewer maternal deaths and far fewer abortions."

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