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The story of how the birth control pill was invented and tested

Transcript

As the FDA considers whether to make birth control pills available over the counter, some are looking back at the controversial history of the development of "the pill."

LEILA FADEL, HOST:

The Food and Drug Administration is now considering whether to make birth control pills available over the counter. The origins of the pill go back to an infertility clinic in the 1950s. Since then, it's been used by hundreds of millions of women around the world. Gabrielle Emanuel of member station WBUR reports on the pill's controversial beginnings.

GABRIELLE EMANUEL, BYLINE: It all started with 80 women who wanted a baby.

MARGARET MARSH: It was the baby boom. And they wanted desperately to be pregnant.

EMANUEL: Margaret Marsh is a historian of medicine at Rutgers University. She says these women had all gone to an infertility clinic in Massachusetts. It was run by a devout Catholic named John Rock. He thought the women might be struggling.

MARSH: Because their reproductive systems were, as he called them, underdeveloped.

EMANUEL: His plan was to give them hormones that would let their system rest and then reboot. Back then, there was little in the way of research ethics. And often patients had no idea they were part of an experiment. But Marsh says Rock did things differently.

MARSH: He was a real unicorn. He never asked women to be part of a research study unless he explained to them everything that was going on.

EMANUEL: At the same time, there was a biologist named Gregory Pincus. He was looking for a birth control pill with backing from prominent feminists, including Margaret Sanger, the founder of Planned Parenthood. He experimented at a state mental hospital. He was more typical of his time and didn't tell patients. Pincus and Rock differed on ethics, but they were working with the exact same hormones and teamed up. They looked at uterine tissue from Rock's patients and realized none of the women were ovulating. This was birth control. Marsh says there was just one problem.

MARSH: In Massachusetts during this time, birth control was prohibited. It was against the law.

EMANUEL: Pincus and Rock scrambled to figure out where to conduct a bigger trial. They considered Japan and Hawaii, but ended up flying south to Puerto Rico, which was already a U.S. territory.

MARSH: In Puerto Rico, birth control was legal.

EMANUEL: Legal, but the trial was still controversial. Starting in 1956, Dr. Edris Rice-Wray ran Pincus' and Rock's Research in Puerto Rico. In an oral history recorded before her death, she remembered Catholic clergy spoke out against the trial. But that helped recruit participants.

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EDRIS RICE-WRAY: The priests would denounce the methods we were using in the pulpit. And then women would run in the next day and say, what is it the priest said we couldn't have?

EMANUEL: About 800 women enrolled. Many were poor and from a nearby housing project.

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RICE-WRAY: We couldn't get enough pills because as soon as we got started, everybody wanted to get on it.

EMANUEL: It's not clear whether the women were told this was an experiment. What we do know is that three women died and the dose was many times what it is now, causing some severe nausea, dizziness and headaches.

MARSH: They even say, you know, that many of the effects were psychological because we Puerto Rican women are, you know, hyperactive emotionally.

EMANUEL: Lourdes Lugo-Ortiz is a professor at the University of Puerto Rico. She says Pincus dismissed the side effects because he didn't want anything to come in the way of his drug succeeding. But Puerto Rican politicians, newspaper columnists and others took a stand against the trial.

LOURDES LUGO-ORTIZ: The claim was that Puerto Rico was used as the testing site, that we were guinea pigs, that our women, you know, were women who are abused by the U.S. imperialism.

EMANUEL: Still, the trial went forward and the data gathered in Puerto Rico was a game changer for women around the world, Marsh says. The pill was approved by the Food and Drug Administration in 1960.

MARSH: There was considerable controversy here because the pill is essentially what they would call back then a lifestyle drug.

EMANUEL: Meaning a medication that doesn't treat a medical condition. That was a first for the FDA. Yet in many states, the birth control pill remained illegal until the U.S. Supreme Court gave married couples the right to use contraceptives in 1965. Today, the pill is available without a prescription in over a hundred countries, but not in the U.S. The Food and Drug Administration is expected to decide whether to change that this summer.

For NPR News, I'm Gabrielle Emanuel.