Facts I Learned From My Copy of The Birth of the Pill

Margaret Sanger, the founder of Planned Parenthood, had a complicated relationship with her father. She grew up in a loving household. Her father, a freethinker, once invited agnostic activist Robert Ingersoll to speak at their town. As a result, Sanger’s father lost his job as a stonecarver for the Catholic church, and Sanger was bullied. Still, it taught her to always stand up for her beliefs.

However, Sanger’s mother had eleven children and died young. Sanger couldn't help but feel resentful of her father for, in a very real sense, causing the death of her mother.

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Margaret Sanger had many sexual affairs. When her first husband objected, she encouraged him to have affairs as well. He didn't want them, though.

Her lovers included H. G. Wells and Havelock Ellis. Wells wrote a novel that was a thinly veiled version of their romance; Ellis convinced Sanger that she should focus solely on contraception and not do broad attacks against capitalism, marriage, and religion.

With her second husband, Sanger avoided all this monogamy drama by simply requiring, in writing, that she and her husband live in separate apartments and that he never drop by without an invitation.

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When her birth control clinic was raided by the police, Sanger refused to be fingerprinted because she was a political prisoner and not a criminal. She fought off three guards to avoid being fingerprinted.

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Margaret Sanger found condoms to be an inadequate form of birth control, on the grounds that men seemed happy to have seven children, half of whom would die and all of whom would be raised in horrific conditions, as long as they got sex whenever they wanted.

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Katharine Dexter McCormick was one of the richest women in the world. She was an ardent feminist and one of the first women to graduate with a science degree from MIT. McCormick liked working so much that she once complained about Christmas because no one works then.

McCormick married the son of the inventor of the mechanized reaper. Her husband, unfortunately, was schizophrenic—a fact that McCormick only discovered after the wedding. She refused to institutionalize him or divorce him and funded research into cures for schizophrenia. Soon after their marriage, he became afraid of women to the point of violence, so McCormick could only see him through binoculars. She cared for him for over forty years, spending $2.3 million a year in today’s money on his well-being.

After her husband died, McCormick took up philanthropy. Though her primary interest was the birth control pill, she also funded the creation of MIT’s first woman-only dorm. After the dorm was built in 1964, McCormick held weekly afternoon teas, with required hats and optional gloves. The students wore fancy hats, baseball gloves and oven mitts. McCormick was delighted.

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McCormick once illegally smuggled a thousand diaphragms into the United States, sewn into the linings of the latest fashions from Paris and London.

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McCormick caused the birth control pill. At the time, Planned Parenthood, as an institution, thought birth control research was a waste of money. Condoms were fine. They didn’t want something speculative like a new pill; they just wanted to give more women access to what already existed. They worried that a pill with bad side effects would set back the entire cause of birth control.

No one else wanted the pill, either, except Margaret Sanger, who by this time was an elderly, chronically ill drug addict. Even the inventors of the pill mostly worked for the money. McCormick alone caused it to happen.

She was willing to throw arbitrary amounts of money at the problem. When John Rock, one of the inventors of the pill, retired, she literally bought the building across the street from the Harvard hospital, so he could still conveniently see patients. The other inventor, Gregory Goodwin Pincus, would charge his wife's shopping to her account; she didn’t seem to care, as long as the pill was being studied.

And it is very, very lucky that the pill was approved when it was. It squeaked in just before the thalidomide crisis of 1961. While no one can know the counterfactual for certain, after thalidomide, it seems very unlikely that the FDA would have approved a pill that millions of women would use for over twenty years—at least, not without decades of study.

Bain, Public domain, via Wikimedia Commons

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Gregory Goodwin Pincus was a highly charismatic man with a gift for marketing his ideas to funders and the public. But he had less of a gift for marketing his ideas for universities.

In fact, he was fired from his first academic job, at Harvard, because he gave an interview saying that in vitro fertilization would end reproduction via sex and lead to a glorious future of reproduction with SCIENCE. This caused a storm of backlash. He was criticized, by the same article, for ruining women and for creating a world of Amazons with no need for men. One critic said that pregnancy made women more beautiful and "improved [their] nervous system[s]."

Harvard University was not amused.

Pincus wound up at Clark, a university so poor that he couldn't afford labels for his chemicals and had to tell which was which by smell. He continued to court controversy, including one case where the Associated Press dropped a key "not" and wound up informing everyone that Pincus was planning to grow human babies in test tubes.

Fed up with the poverty, if not the cancellations, he founded his own organization, the Worcester Foundation for Experimental Biology. The Worcester Foundation primarily fundraised from individuals. So scientists working at the Worcester Foundation had put up with constant Rotary clubs and church groups doing tours before they donated.

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Pincus had a bad habit of immediately spending all donated money on research, instead of allocating any to useless overhead like “buying chairs” or “having cages in which to put animals.” It got so bad that his business partner went behind his back and got McCormick to make a $50,000 ($590,000 in today’s money) grant, earmarked to buy a new animal building, so Pincus couldn't spend it on something else.

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Pincus’s mother had longed to receive the same education as her brothers, but her father forced her to drop out of school at fourteen. She fell in love with a teacher at the local high school and they married. Their romance ended approximately nine months after their wedding, when she gave birth to the first of their six kids.

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Pincus originally studied agricultural sciences specializing in fruit. When he was twenty, he met Elizabeth Notkin, a social worker, flapper, and intellectual. He fell in love and decided to win her over by telling her he was a sexologist. They married; he did not, in fact, become a sexologist, but he did invent the pill, which is almost as good.

Pincus and Elizabeth were deeply in love. Pincus left love poetry on Elizabeth's pillow on mornings in which he felt particularly inspired. Nevertheless, Elizabeth was very frustrated by her marital life, which involved nothing but child-rearing. She took up a habit of telling Pincus, in detail, which rooms she vacuumed each day.

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Pincus regularly credited everyone else who was involved in the creation of the pill, in spite of attempts to call him the "inventor.” He refused to patent the pill, because he didn’t invent anything; he was drawing on others’ research and on the natural functions of the human body.

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John Rock, the other inventor of the birth control pill, was Catholic. As a teenager, he had been so concerned about sex that he kept a journal of his every erection and sexual urge so he could confess them. (His priest eventually told him to chill.)

Rock loved his wife dearly and would make public speeches about how wonderful she was. But he also fell in love with a man as a teenager, making him an official Bisexual Legend (TM).

As a gynecologist, he was so devoted to his patients that he would sometimes pay for buses or taxis for them if they would have trouble paying for one themselves. He also performed the first successful human in vitro fertilization.

Rock believed that a woman's career ought to be motherhood and anything that delayed that was wrong. Nevertheless, he supported contraception for child spacing and for women whose bodies were exhausted by pregnancy. He ran the first free clinic in Massachusetts that offered birth-control advice, mostly teaching the rhythm method. He sometimes performed hysterectomies as a form of birth control, when women's situations were desperate. One woman who received a hysterectomy was dumped by her husband because she'd "lost her 'nature.'"

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Rock made a habit of injecting himself with any new preparation of estrogen and progesterone before giving it to a patient.

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Someone confronted Rock and said the Catholic Church would never approve of birth control:

"I can still see Rock standing there," I. C. Winter recalled of the encounter, "his face composed, his eyes riveted... and then, in a voice that would congeal your soul, he said, 'Young man, don't you sell my church short.'"

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Pincus suggested that Rock tell women to skip their progesterone pills for five days out of the month. They would have a withdrawal bleed, or "period.”

Searle, one of the pharmaceutical companies Pincus worked with, said they wouldn't sell a birth control pill that interfered with the menstrual cycle because it would be "interfering with Nature." Pincus hoped that withdrawal bleeds would appear to be periods and so would appeal to the pharmaceutical companies.

You can take birth control pills continuously and so avoid having a period.

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Administering birth control was illegal in Massachusetts, where Pincus first attempted to study the pill. Pincus explained that he wasn't trying to develop a birth control pill, he was trying to study the biology of progesterone in a purely academic way. If this happened to later lead to a birth control pill, was that his fault? And if his initial formulation turned out to be exactly what was needed from a birth control pill, would that be his fault?

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Pincus and Rock had a very low participant compliance rate for their birth-control pill, until they realized that they should test it on women who actually wanted birth control.

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But even once that had been figured out, it wasn’t straightforward:

At least one patient went home and took all the pills at once. Others shared them with friends. The doctor, nurses, and social workers tried handing out calendars. They tried giving the women beads on a string to help them count. Nothing worked.

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In some cases, women who had not yet heard about the new contraceptive learned about it in church. They would listen on Sunday as their priests made fiery sermons about a forbidden pill, and on Monday they would arrive at [the study offices] asking what exactly was forbidden and how they could get it.

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Pincus was worried there weren't enough women in his study to impress the FDA, so he started writing about "menstrual cycles" rather than "women":

Simply put, 1,279 menstrual cycles sounded more impressive than 130 women.

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The drug company Searle sold the first birth-control pill. According to legend, its founder dyed aspirin colors and prescribed different colors for different diseases (one for headaches, one for stomachaches…)

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Searle originally marketed the birth control pill as a drug that would help women become pregnant by giving their ovaries a break.

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In typical Pincus fashion, he said that he knew very little about side effects or long-term effects, so he urged doctors to prescribe it as widely as possible so data could be collected.

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When the birth-control pill was first approved for birth control, instead of as a galaxy-brained fertility drug, the New York Times covered this fact on page 75 in only 136 words.

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Searle's promotion strategies included telling doctors that they could earn more money by making women visit them once a month for an exam before prescribing another month of the pill. They also distributed a paperweight of a naked woman breaking free from chains.

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The first birth control pill was very high-dose-- nearly 250 times the dose of present-date progestin-only contraceptives. Pincus wanted it to get approved, and that meant a dose high enough that it would definitely work no matter what.

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The FDA required every bottle of the birth control pill to have a warning that it prevented ovulation, which wound up being a free advertisement.

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When anti-birth-control advocate Anthony Comstock was a teenager, he masturbated so often he thought he would commit suicide. When he got older, he decided it was porn's fault, and decided to devote his life to fighting pornography, a term which here includes medical information about birth control.

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The rhythm method had been practiced throughout the early twentieth century, but it was only in the 1930s that people realized that the safe period wasn't two weeks after your last period. Oops.

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I read this paragraph and had murder fantasies about the editors of Ladies’ Home Journal:

In 1949, Ladies' Home Journal ran a feature on the poet Edna St. Vincent Millay, along with a photo of her recently remodeled kitchen. "Now I expect to hear no more about the housework's being done," the magazine said. "For if one of the greatest poets of our day, and any day, can find beauty in simple household tasks, this is the end of the old controversy."

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Then there was Mrs. Richard Petry, a mother of four from Levittown, Pennsylvania, who insisted that her husband let her work once or twice a week. Why? "To see some people and talk to people-- just to see what is going on in the world," she said. Mrs. Petry found a job at a department store, working between six and nine hours a week, but after three weeks of covering for her over a span of hours that added up to only one day, her husband couldn't take it anymore. "I wouldn't have your job for anything," he told her.

One woman was asked if she'd ever had a vacation from housework. "Just in the hospital, having my babies," she said, adding, 'if you call that a vacation."

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One woman in 1890s New York was told by a doctor that another pregnancy would kill her, but the doctor's only advice was to sleep on the roof so her husband couldn't get at her. The woman died of a botched abortion.

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In the 1950s, Puerto Ricans loved sterilizations. It was a routine procedure. The more that the Catholic Church told them it was a sin, the more aware they were it was possible, and the more sterilizations they got.

Men and women both complained that condoms were not always handy when needed. Many men refused to use condoms because they didn't like the way they felt, and some women rejected them because they had heard rumors that they might cause cancer or hemorrhages. Men said they were unconcerned about birth control because it was the wife's responsibility to raise the children no matter how many were born. One man told Stycos that when he felt his wife had too many children, "I will have her sterilized."

Some women deliberately married men who were believed to be sterile, in the hopes of not having children. One Puerto Rican man cheated on his wife so she wouldn’t have more kids. A Puerto Rican woman, fearing conception, refused sex even after her husband threatened to kill her.

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Julia Garcia was thirty years old and had ten children between the ages of sixteen years and ten months. Her husband was sick and he drank heavily, forcing Garcia to perform odd jobs to support her family. Her husband refused to be sterilized or to let her undergo sterilization. Her husband had never allowed her to use any form of contraception and insisted on having sex with her every day. She signed up for trials of the pill because it was the first form of contraception she'd encountered that she could use without her husband's knowledge.

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"I absolutely need your help," wrote a thirty-year-old woman in Canada who was pregnant at the time with her fifth child. "I do not think that I am fitted to raise 10 or more children-- it costs too much and my husband is not giving me much help to educate my [here she crossed out "our"] children... Please help me!"

The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution. By Jonathan Eig. Published 2015.