The history of the Pill is a history interwoven with capitalism, exploitation, racism and classism. In that this is a historical look at oral contraception, this section will proceed in chronological order through the development, testing and present day situation of “the Pill. ” This historical look will also discuss the effects of capitalism, exploitation, racism and classism, with a careful look at how the effects of oral contraception were felt in vastly different ways by white women and black women.
Development of the Pill was partly facilitated by Katherine McCormic, multi-million dollar widow and friend of Margaret Sanger, who contributed over three million dollars for scientific research into the development of oral contraception (Chesler 432), but was primarily funded by pharmaceutical companies and every major international institution for population control (Petchesky 171). The first oral progestin was synthesized in 1951 by Carl Djerassi and other chemists at the University of Mexico (Chesler 432).
Built on Djerassis work and funded greatly by McCormic, Gregory Pincus, M. C. Chang and John Rock, a Catholic pro-birth control gynecologist, collaborated to further develop the Pill and experiment with the drug on Boston patients (McLaren 240). Large-scale clinical trials in Puerto Rico and Mexico were undertaken in 1956 (McLaren 240). The dosages used in the original clinical trials on poor Puerto Rican and Haitian women are now know to be extremely dangerous (Petchesky 171). It was decided to manufacture a pill with high levels of estrogen, despite the fact that clinical literature since the 1940s showed a positive correlation between estrogen and cancer (Petchesky 171).
Enovid-10, a combination estrogen/progestin ovulation inhibitor, was approved by the Food and Drug Administration (FDA) in 1960 (Reynolds 114 and McLaren 240). This oral contraceptive was built on the exploitation of women of color through their use as laboratory subjects as well as the image projected to greater society of birth control to limit further propagation of the black and brown peoples of the United Sates and of the world. Margaret Sangers contribution to the journal of the American Birth Control League (ABCL) makes the original intent of birth control clear.
Much of the birth control movement was aimed at, as Sanger wrote in the ABCL journal, having “more children from the fit, less from the unfit” (Davis 20). Control of black and brown populations was not limited to the United States, and was liberally extended to aggressive global population control programs. Proponents of national and international aggressive population control programs included the Ford and Rockefeller foundations as well as the United States Agency for International Development, known as US AID (Alexander 53).
In international programs to aid what is (under a very broad definition of the word) termed development, ” . there is the widespread use of the Pill, IUDs and other aggressive contraceptive devices that were either banned or were in the experimental phases in countries like the US” (Alexander 53-54). Not only were population programs targeted at limiting reproduction of women of color, but they were used to test contraceptives, and subsequently “dump” products that had had been banned in the US on developing neighbors. Americas relationship to Puerto Rico during the testing phase of the Pill is possibly the greatest insult to human dignity in all of the history of birth control.
US AID, the agency responsible for population programs carried out on Puerto Rico, increased its spending on birth control measures by one hundred million dollars and decreased spending on health care by that same amount (La Operacion). Helen Rodrigues, M. D. notes in La Operacion, that birth control is a right where people are given information to make a choice, population control is a program by which certain people are targeted to have no or very few children. The inseparability of capitalism, population control and birth control is exemplified by the conditions in which the Pill was developed and tested.
In 1898 North American troops landed in Puerto Rico, and by 1930 corporations owned more than half of the land (La Operacion). By 1937, Puerto Rico was experiencing a 37% unemployment rate, and the many landless and jobless people were deemed excess population by the overseers in the North (La Operacion). That same year sterilization was legalized and cumulated in 35% of women of childbearing age being sterilized (La Operacion). A combination of sterilization and birth control were used to limit Puerto Ricos population to 1/3 its original size.
People decried the population explosion in Puerto Rico, and ads of the time showed black and brown faces crowding over and choking out the world (Petchesky 118-119). This was in spite of the fact that, as frank Bonilla, MD notes, population in Puerto Rico was 654 people per square mile compared to 90,000 in New York City (La Operacion). Operation Bootstrap had many effects on population control programs in Puerto Rico. A model for industrialization, Operation Bootstrap provided tax free cheap labor and profits for US companies (La Operacion).
Although it was an ambitious program, it was known that Bootstrap would not provide enough jobs, and that coupled with concerns of revolution lead to intensive birth control, sterilization and population control programs (La Operacion). The Pill originally tested on Puerto Rican women, the first humans to ever take the Pill, was thirty times stronger than that used today (La Operacion ). The Family Planning Association of Puerto Rico, financed by pharmaceutical mogul Joseph Sunin, funded sterilizations for 11 thousand women, and also was used to test Sunnins new contraceptive foam (La Operacion).
In 1997, Dr. Richard T. Ravenholt, the population officer of US AID said that “. . . if US goals were met, one fourth of the worlds women would be sterilized to prevent revolutions that would interfere with the interests of multi national corporations” (La Operacion). This blatant eugenic, genocidal attitude of US officials was reflected in their race suicide arguments for white women to have children. White women have had a unique experience with birth control. Unlike their colored sisters who were originally fighting for the right to bear children in economically and environmentally suitable conditions, white women were fighting for the right to limit family size.
Institutional factors have intervened to promote the standard of the white mother since the 19th century. Decreasing rates of childbirth accompanied the 19th century shift from rural agricultural to urban industrial society and method of production. These decreasing rates of childbirth were pathologized and evinced cries of “race suicide” (Davis 19). Concerns of racial suicide were echoed at the highest levels of government. President Theodore Roosevelt concluded his 1905 Thanksgiving Dinner Speech with a warning that “racial purity must be maintained” (Davis 19).
Concerns about race preservation were only directed at white women, who had and continue to be pushed into childbearing and to a lesser extent, rearing. By 1906, Roosevelts concern over racial purity had been elevated as birth rates among native-born whites continued to fall, and he evoked the ethos of racial suicide in his State of the Union address where he chastised white women who engaged in “willful sterilitythe one sin for which the penalty is national death, race suicide” (Davis 19).
It is no wonder that reproduction in America is grossly stratified, especially when our great leaders reflect and reinforce the racist, eugenic, classist notions of acceptable reproduction. Interestingly enough, Roosevelts race suicide arguments drew more people to support the birth control movement, as well as exposed the racial divisions within the movement (Davis 19). The birth control movement reflected and reinforced some of the racial divisions surrounding reproductive rights. Angela Davis explains that birth control. . . a fundamental prerequisite for the emancipation of women.
Since the right of birth control is onvisonols advantageous to women of all classes and races, it would appear that even vastly dissimilar womens groups would have attempted to unite around this issue. In reality, however, the birth control movement has seldom succeeded in uniting women of different social backgrounds, and rarely have the movements leaders popularized the genuine concerns of working-class women. Moreover, arguments advanced by birth control advocates have sometimes been based blatantly on racist premises.
The progressive potential of birth control remains indisputable. But in actuality, the historical record of this movement leaves much to be desired in the realm of challenges to racism and class exploitation (15). The abortion rights campaign was hindered by racial barriers that can be linked back to issues surrounding birth control. White women failed to grasp their black sisters concerns about genocide, and black women failed to recognize the urgency of both abortion and birth control campaigns (Davis16).
Women of color were further separated from their white sisters by the popular practice of white reproductive rights leaders advocating programs that were directly aimed at limiting the reproductive rights, and human rights of black and colored women. Many women in the abortion movement advocated sterilization as a form of birth control for women of color (Davis 16). Davis further elucidates how issues around birth control split what could have been a cohesive movement for reproductive rights.
The voluntary motherhood slogan under which the birth control movement was organized “. was rigidly bound to the lifestyle enjoyed by the middle class and the bourgeois. The aspirations underlying the demand for voluntary motherhood did not reflect the conditions of working-class women, engaged as they were in a far more fundamental fight for economic survival. Since this first call for birth control was associated with goals that could only be achieved by women possessing material wealth, vast numbers of poor and working-class women would find it rather difficult to identify with the embryonic birth control movement” (Davis 18).
Current birth control issues do not present as devastating problems as original testing and eugenic practices, though current problems surrounding birth control are extremely important to many women, especially poor women. As stated before, poor in America generally equates black, or other minority status, and discussion of poor women is a discussion of colored women. Poor women of color, even though they bore the original burden of hazardous contraceptive tests, were denied, through various measures, access to oral contraception when it became available to the general public.
Costs of producing and further developing the Pill were inflated by the unprecedented [and unnecessary] multi-tier testing requirements imposed on female contraception by the Food and Drug Administration (Djerassi The Pill 133). Expensive testing requirements coupled with sensational press coverage of the Nelson Hearings, held in 1970 to investigate whether people were properly informed of the Pills alleged hazards, lead pharmaceutical companies to cut spending on contraceptive research and development (Djerassi The Politics 100) thus thwarting improvement of the Pill and further inflated oral contraceptive costs.
Although a monthly cycle of contraceptives costs $0. 15 to produce, consumer prices range from $15-35, and with the medical examinations requisite for securing contraceptive prescriptions, minimum annual costs of oral contraception is $250 to $640 (Brown). Added to the financial burden, is that while 97% of large-group insurance plans provide prescription drug coverage, only 33% pay for birth control pills (Guttmacher), and for women on Medicaid, contraceptives are harder to obtain, as only 50% of gynecologists accept Medicaid reimbursement for contraceptive visits (Samara and Forrest).
Women of color are at a distinct disadvantage in securing viable birth control options. Some access to reproductive health services is offered to young and/or low income women through Title X. Title X, part of the Public Health Service Act of 1970, was designed to increase accessibility of family planing services to women who are not eligible for Medicaid and has been defunded access (NFPRHA 6/24/1997). Title X clinics are also facing face ever increasing governmental regulations expressly designed to limit access to contraception and abortion (NFPRHA 6/24/1997).
Financial burdens are intensified with the increasing Catholicization of public hospitals. With restriction or elimination of family planing services following increased mergers and acquisitions between Catholic and non-Catholic hospitals, many poor women are denied access to contraception because they cannot find a provider, nor can they afford to travel to an area where they can receive these integral services.