Birth control pill

The invention: An orally administered drug that inhibits ovulation
in women, thereby greatly reducing the chance of pregnancy.
The people behind the invention:
Gregory Pincus (1903-1967), an American biologist
Min-Chueh Chang (1908-1991), a Chinese-born reproductive
biologist
John Rock (1890-1984), an American gynecologist
Celso-Ramon Garcia (1921- ), a physician
Edris Rice-Wray (1904- ), a physician
Katherine Dexter McCormick (1875-1967), an American
millionaire
Margaret Sanger (1879-1966), an American activist

An Ardent Crusader
Margaret Sanger was an ardent crusader for birth control and
family planning. Having decided that a foolproof contraceptive was
necessary, Sanger met with her friend, the wealthy socialite Katherine
Dexter McCormick. A1904 graduate in biology from the Massachusetts
Institute of Technology, McCormick had the knowledge
and the vision to invest in biological research. Sanger arranged a
meeting between McCormick and Gregory Pincus, head of the
Worcester Institutes of Experimental Biology. After listening to Sanger’s
pleas for an effective contraceptive and McCormick’s offer of financial
backing, Pincus agreed to focus his energies on finding a pill
that would prevent pregnancy.
Pincus organized a team to conduct research on both laboratory
animals and humans. The laboratory studies were conducted under
the direction of Min-Chueh Chang, a Chinese-born scientist who
had been studying sperm biology, artificial insemination, and in vitro
fertilization. The goal of his research was to see whether pregnancy
might be prevented by manipulation of the hormones usually
found in a woman.It was already known that there was one time when a woman
could not become pregnant—when she was already pregnant. In
1921, Ludwig Haberlandt, an Austrian physiologist, had transplanted
the ovaries from a pregnant rabbit into a nonpregnant one.
The latter failed to produce ripe eggs, showing that some substance
from the ovaries of a pregnant female prevents ovulation. This substance
was later identified as the hormone progesterone by George
W. Corner, Jr., and Willard M. Allen in 1928.
If progesterone could inhibit ovulation during pregnancy, maybe
progesterone treatment could prevent ovulation in nonpregnant females
as well. In 1937, this was shown to be the case by scientists
from the University of Pennsylvania, who prevented ovulation in
rabbits with injections of progesterone. It was not until 1951, however,
when Carl Djerassi and other chemists devised inexpensive
ways of producing progesterone in the laboratory, that serious consideration
was given to the medical use of progesterone. The synthetic
version of progesterone was called “progestin.”
Testing the Pill
In the laboratory, Chang tried more than two hundred different
progesterone and progestin compounds, searching for one that
would inhibit ovulation in rabbits and rats. Finally, two compounds
were chosen: progestins derived from the root of a wild Mexican
yam. Pincus arranged for clinical tests to be carried out by Celso-
Ramon Garcia, a physician, and John Rock, a gynecologist.
Rock had already been conducting experiments with progesterone
as a treatment for infertility. The treatment was effective in some
women but required that large doses of expensive progesterone be
injected daily. Rock was hopeful that the synthetic progestin that
Chang had found effective in animals would be helpful in infertile
women as well. With Garcia and Pincus, Rock treated another
group of fifty infertile women with the synthetic progestin. After
treatment ended, seven of these previously infertile women became
pregnant within half a year. Garcia, Pincus, and Rock also took several
physiological measurements of the women while they were
taking the progestin and were able to conclude that ovulation did
not occur while the women were taking the progestin pill.Having shown that the hormone could effectively prevent ovulation
in both animals and humans, the investigators turned their attention
back to birth control. They were faced with several problems:
whether side effects might occur in women using progestins for a
long time, and whether women would remember to take the pill day
after day, for months or even years. To solve these problems, the birth
control pill was tested on a large scale. Because of legal problems in
the United States, Pincus decided to conduct the test in Puerto Rico.
The test started in April of 1956. Edris Rice-Wray, a physician,
was responsible for the day-to-day management of the project. As
director of the Puerto Rico Family Planning Association, she had
seen firsthand the need for a cheap, reliable contraceptive. The
women she recruited for the study were married women from a
low-income population living in a housing development in Río
Piedras, a suburb of San Juan. Word spread quickly, and soon
women were volunteering to take the pill that would prevent pregnancy.
In the first study, 221 women took a pill containing 10 milligrams
of progestin and 0.15 milligrams of estrogen. (The estrogen
was added to help control breakthrough bleeding.)
Results of the test were reported in 1957. Overall, the pill proved
highly effective in preventing conception. None of the women
who took the pill according to directions became pregnant, and
most women who wanted to get pregnant after stopping the pill
had no difficulty. Nevertheless, 17 percent of the women had some
unpleasant reactions, such as nausea or dizziness. The scientists
believed that these mild side effects, as well as one death from congestive
heart failure, were unrelated to the use of the pill.
Even before the final results were announced, additional field
tests were begun. In 1960, the U.S. Food and Drug Administration
(FDA) approved the use of the pill developed by Pincus and his collaborators
as an oral contraceptive.Consequences
Within two years of approval by the FDA, more than a million
women in the United States were using the birth control pill. New
contraceptives were developed in the 1960’s and 1970’s, but the
birth control pill remains the most widely used method of preventing pregnancy. More than 60
million women use the pill
worldwide.
The greatest impact of the
pill has been in the social and
political world. Before Sanger
began the push for the pill,
birth control was regarded often
as socially immoral and
often illegal as well. Women
in those post-World War II
years were expected to have
a lifelong career as a mother
to their many children.
With the advent of the pill,
a radical change occurred
in society’s attitude toward
women’s work.Women had increased
freedom to work and enter careers previously closed to them
because of fears that they might get pregnant. Women could control
more precisely when they would get pregnant and how many children
they would have. The women’s movement of the 1960’s—with its
change to more liberal social and sexual values—gained much of its
strength from the success of the birth control pill.