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AMERICA’S FIRST BIRTH CONTROL PILL
After a successful preliminary trial in Boston in 1954-1955, OB/GYN John Rock and biologist Gregory Pincus wanted to have a large-scale clinical trial to gain FDA approval of the birth control drug, Enovid. Given religious sentiment in the states at the time, Pincus went to Puerto Rico and found it to be the ideal place for a trial. Puerto was chosen for large-scale clinical trials due to religious sentiments in the United States and the government's cooperation.
The government of Puerto Rico—an island that already had a large population density—also believed the trials could help with population control and allowed the island’s many, already established, birth control clinics to provide the pill to the women of the island for the study.
Up until 1964, Enovid was supplied to the birth control clinics to maintain the trials in Puerto Rico. Delia Mestre, a subject in the trial, recalls hospital social workers telling the island’s women of a medication that prevented them from having children they couldn’t support; women actively sought out the pill as there were no anti-birth control laws. Prior to, the pill the only form of contraceptive for women in Puerto Rico was sterilization, which was known as “la operacion”. Pincus wanted to prove if the poor, uneducated women in Puerto Rico could maintain the contraceptive regimen, then women in the US could as well.
High doses of synthetic progesterone and estrogen supplied by pharmaceutical company G.D. Searle yielded significant results in the trials overseen by Dr. Edris Rice-Wray. However, Rice-Wray told Pincus and Rock that the dose was too high and that 17% of women experienced negative side effects, such as nausea, headaches, and stomach pains and effects as severe as unwanted sterilizations. Additionally, three of the women involved in the study had died within the span of the trial, but no investigation was conducted to see if the pill had been the cause of death.
Within the first year of the trial, 25% of the women quit because they found the pill to be undesirable. Despite this, the FDA cleared this birth control pill in May of 1960, but the trials in Puerto Rico didn’t end, as adjustments were still being made to the dosages and tested on this population. Many lawsuits arose, from women in the U.S. against G.D. Searle; however, lawsuits were never started against those who oversaw the trials nor did they come from Puerto Rican women who were experimented on. Years after the trials, Pincus and Rock's team was accused of exploitation of poor women of color, as the women were only told they were being provided a pill, and not participating in a clinical trial. Today, the pill is widely used in America and is promoted to women with the idea of sexual freedom, never advertising the history behind its creation.
Sources:
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Vargas, Theresa. “Guinea Pigs or Pioneers? How Puerto Rican Women Were Used to Test the Birth Control Pill.” The Washington Post, WP Company, 9 May 2017, www.washingtonpost.com/news/retropolis/wp/2017/05/09/guinea-pigs-or-pioneers-how-puerto-rican-women-were-used-to-test-the-birth-control-pill/
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Case Western Reserve University. (1960). Early Enovid Pill Bottle. Retrieved from https://case.edu/affil/skuyhistcontraception/online-2012/pill.html
Andrea Tone, "Contraceptive Pill" in The Oxford Companion to United States History, ed. Paul S. Boyer (New York: Oxford University Press, 2001), 132. (book)
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Edris Rice-Wray, "Contraception in the Tropics," in Obstetrics and Gynecology, vol. 18, no. 2 (August 1961), 238-245.(book)
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"The Pill in Puerto Rico: The History of Experimentation," PBS American Experience, accessed February 28, 2024,