FDA Approves the Birth Control Pill

Date June 23, 1960

After the Food and Drug Administration approved the oral contraceptive known as the pill, women’s lives and larger social structures changed dramatically.

Also known as The pill; progestin

Locale United States

Key Figures

• Min-Chueh Chang (1908-1991), Chinese-born American biologist
• Carl Djerassi (b. 1923), chemist who helped develop progestin
• Katharine Dexter McCormick (1875-1967), philanthropist who supported contraceptive research
• Gregory Goodwin Pincus (1903-1967), biologist considered the father of the birth control pill
• Edris Rice-Wray (b. 1904), responsible for the day-to-day testing of the pill in Puerto Rico
• Margaret Sanger (1879-1966), social activist who campaigned for birth control

Summary of Event

Attempts to prevent conception and the desire to control reproduction have existed for thousands of years. Prior to twentieth century developments in birth control technology, contraception was primarily the responsibility of the male. Use of the condom to prevent the spread of syphilis was first described in 1564. By the 1720’s, condoms were used for contraception in Europe.

Female contraception historically involved various violent acts, ingestion of potions or herbs, or the insertion of vaginal plugs and solutions, some with a spermicidal effect. Pessaries and sponges were among the oldest contraceptive devices for use by women. The cervical cap and diaphragm were developed during the nineteenth century as a result of social changes and attitude shifts in England, Germany, and France.

Other forces, such as industrialization, urbanization, and the democratization of contraceptive knowledge, resulted in the less privileged gaining knowledge that at times was only within the reach of the upper classes. The European influence spread to the United States, and an effort was mounted to educate the general population about contraception. Pioneers in birth control and women’s rights, such as Margaret Sanger, sought to establish a system of clinics where women could obtain reliable birth control devices and information.

Sanger was an ardent crusader for birth control and family planning. Having decided that a foolproof contraceptive was necessary, she arranged a meeting between a friend, biologist and wealthy socialite Katharine Dexter McCormick, and Gregory Goodwin Pincus, the head of the Worcester Institutes of Experimental Biology. With McCormick’s financial backing and Pincus’s technical know-how, work began on developing a pill to prevent pregnancy.

It was known that the female hormone progesterone could inhibit ovulation during pregnancy, and so it was thought that the same hormone might be used to prevent pregnancy as well. Laboratory studies, conducted under the direction of Min-Chueh Chang, investigated the manipulation of progesterone to inhibit ovulation. In 1937, inhibition of ovulation in rabbits was demonstrated by scientists from the University of Pennsylvania. In 1951, Carl Djerassi and other chemists devised inexpensive ways of producing a synthetic progesterone, called progestin, in the laboratory, thus clearing the way for the mass production of the substance that eventually would be used in a contraceptive pill.

Clinical tests were conducted by scientists who had been working with progesterone and progestin to treat female infertility. Hence, the first oral contraceptive was ironically developed in the context of increasing fertility. During the 1950’s the contraceptive pill was tested on a wide scale to determine its long-term effects on humans. The population chosen was Puerto Rico, because of a heightened need there for inexpensive contraception as well as legal problems in the United States. In 1956, 221 women volunteered for the first study, headed by Edris Rice-Wray, which was successful and resulted in minimal side effects. One death from congestive heart failure was deemed not to have been related to the contraceptive pill.

In 1960, the Food and Drug Administration (FDA) approved the oral contraceptive for distribution in the United States. Within two years, more than one million women were using “the pill,” as it came to be known. It would have both broad and long-range social, as well as physical, effects on the lives of women—many good, some less desirable.

Significance

Chief among the social and physical effects of the pill was the immediate freedom afforded to women to control their pregnancies, and their own bodies: No longer were women at the mercy of unplanned pregnancies, and the likelihood that children would be “unwanted” could now be lessened.

Second, the pill allowed women, and men, to become sexually active with more than one partner, prior to marriage. The so-called sexual revolution and changing ideas about premarital chastity followed, leading to a reevaluation of sexual morality and the acceptance or rejection of social and religious values.

Birth control was both a cause and an effect of a number of dramatic changes in society as well. Family size was reduced and life expectancy was increased. At the same time, increased opportunities for marriage and career caused a surge in the workforce; this, in turn, required control of reproduction, liberalization of abortion, and provision of reliable contraceptives. Women who valued childbearing, but in their chosen time frame, began to make the claim that abortion was a woman’s right, and one that was integrated into her right to equality. The pill also permitted spontaneity in sexual encounters.

Although it initially was regarded as a panacea, the pill’s effectiveness depended largely on conscientious use. From the time it was developed, it generated controversy in scientific circles, with the public becoming involved shortly thereafter. The increase in sexual activity and multiple partners spawned by the pill increased the number of sexually transmitted diseases (STDs) in the North American population but, more important, created an expectation among a generation of baby boomers and their children that sexual freedom and increased sexual activity was a right of consenting adults that had fewer serious consequences (such as pregnancy) than it had had in the past. This freedom had its consequences, giving way, in the 1980’s, to a growing concern over STDs, including HIV-AIDS and other viral and less-preventable diseases such as human papillomavirus, a major cause of cervical cancers, not to mention the rise of teenage pregnancies—since the attitudes engendered by the pill were not limited to its users. The pill therefore invited a reexamination of moral proscriptions previously cast aside.

Many people believe that, on balance, the pill’s benefits have far outweighed its potential risks and negative social impacts. Proponents point out that, while the pill poses risks to women’s health, it poses fewer risks than does pregnancy and it constitutes an easy, workable method for women to control their own fertility. They argue that the intent of scientists who developed the pill was not to harm women, but to free them, and that STDs are not caused by the pill but by irresponsible behaviors on the part of people.

Nevertheless, some feminists see the pill as an outrage perpetrated against women by the predominantly male medical and scientific community. These critics point out that other methods exist to prevent pregnancy and that too few tests were conducted to ascertain the pill’s safety. They argue that the pill was released prematurely, proving that the prevailing culture considers women to be expendable commodities, subject to experimentation. Critics believe that the pill’s side effects—increased risks for blood clots, breast cancer, pulmonary emboli, heart attack, stroke, hypertension, gall bladder disease, birth abnormalities, benign tumors, and depression—are unacceptable.

Studies of fertility control practices in North America reveal that there has been a steady increase in sterilization since the 1970’s, because many people see it as a safe alternative to the risks associated with other methods of contraception. While oral contraceptives generally are preferred by women under the age of thirty, voluntary surgical sterilization is the option of choice for many older couples because it is safe, reliable, and permanent. Sophisticated research and technologies, including an oral contraceptive for men, continue to revolutionize the reproductive arena, simultaneously challenging traditional values and creating new opportunities.

Bibliography

Asbell, Bernard. The Pill: A Biography of the Drug That Changed the World. New York: Random House, 1995. Readable history of the origins and development of the pill in its social and political context. Discusses the pill’s worldwide impact.

Blank, Robert, and Janna C. Merrick. Human Reproduction, Emerging Technologies, and Conflicting Rights. Washington, D.C.: Congressional Quarterly, 1995. Examines the complex issues surrounding reproduction from a public policy perspective.

Djerassi, Carl. This Man’s Pill: Reflections on the Fiftieth Birthday of the Pill. New York: Oxford University Press, 2001. Although the title is somewhat misleading, this work nevertheless provides an insider’s look at the development of a synthetic progesterone called progestin, a major component of the pill, by chemist Carl Djerassi and colleagues in 1951.

Fields, Armond. Katharine Dexter McCormick: Pioneer for Women’s Rights. Westport, Conn.: Praeger, 2003. A biography of Katharine Dexter McCormick, the driving, yet often forgotten, force behind the development of the birth control pill. Well researched, and recommended.

Guillebaud, John. The Pill and Other Hormonal Contraception: The Facts. 6th ed. New York: Oxford University Press, 2005. Explains the basic facts about the pill and other forms of contraception. Written for general readers with little or no scientific knowledge of contraception.

Knight, James W., and Joan C. Callahan. Preventing Birth: Contemporary Methods and Related Moral Controversies. Salt Lake City: University of Utah Press, 1989. Political and philosophical aspects of contraception, including the moral debate and social policy concerns surrounding elective abortion.

McLaren, Angus. A History of Contraception: From Antiquity to the Present Day. Cambridge, Mass.: Basil Blackwell, 1990. Traces the concept of fertility control in various cultures.

Maguire, Daniel C., ed. Sacred Rights: The Case for Contraception and Abortion in World Religions. New York: Oxford University Press, 2003. Examines the issue of birth control among the world’s religions. Bibliography and index.

Marks, Lara V. Sexual Chemistry: A History of the Contraceptive Pill. New Haven, Conn.: Yale University Press, 2001. A medical historian explores, among other related topics, the significance of advances in chemistry that helped in the development of the pill. A well-researched, well-written, and highly recommended work.