The Pill’s Guinea Pigs

Ann Friedman reviews Jonathan Eig’s The Birth of the Pill. The book doesn’t shy away from the ethically dubious parts of the pill’s development:

Initially, [fertility expert John Rock and researcher Goody Pincus] sought out healthy American women for the hormone trials but didn’t tell them they were testing a possible contraceptive, or what the risks were. (At the time, there were no rules governing medical testing.) Nurses at the city hospital refused to participate. Inmates at a women’s prison refused.

Rock and Pincus finally found a couple of takerswomen who hoped their participation would contribute to fertility researchbut due to side effects like nausea, dizziness, and breast tenderness, as well as a demanding schedule of invasive checkups, most of those women dropped out of the study. And so Pincus and Rock decided to take their trials to Puerto Rico, where contraception was entirely legal and abortion readily available (wealthy American women with unwanted pregnancies would fly there for a “San Juan weekend”), due in large part to concerns about overpopulation on the island. McCormick worried that Puerto Ricans couldn’t be trusted to follow the testing regimen, and Rock was concerned he wouldn’t find “ovulating intelligent” women there. But, the researchers assumed, women there would be more compliant test subjects.

Their racist paternalism had real consequences, arguably hindering the development of the pill. Women in Puerto Rico dropped out of the study, too, and so they started looking for women they could force to participate, both at home and in Puerto Rico. Women locked up at a Massachusetts mental asylum were signed up. Women enrolled in medical school in San Juan were told they had to take part in the medical test or face expulsion. Many dropped out rather than comply.

Eig explains how the researchers got FDA approval:

This is the first pill ever created for healthy women to take every day. There’s never been anything like this and the idea of seeking FDA approval for something women are going to take every day without studying it for years and years and checking out the long-term side effects, this is scary stuff! But Pincus also feels like he’s racing the clock, that if the word gets out about this and the Catholic Church and the federal government realize what they’re doing, the opposition will mount and he’ll have no chance of getting it through. …

In 1955, when they’ve really only tested the pill on maybe 60 women for more than say, six months or a year, Pincus goes to a conference and declares victory. He declares that we’ve invented the pill. The media picks up on this and it becomes this huge story. … Thousands of women are writing to their doctors and writing directly to [Pincus and Rock] saying, “I’ve heard about this pill and I need it, I need it now!” … There was this huge outpouring and it had a huge effect on Pincus and on the other scientist working on this because they began to see there was an enormous demand for this and they began to see they had to push harder, they had to go fast.