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The Birth of the Pill:
How Four Pioneers Reinvented Sex and Launched a Revolution
by Jonathan Eig
EVERYONE knows that the pill was one of the transformative inventions of the 20th century. Far more obscure is the dramatic story told here of how it was created, by the most unlikely quartet of maverick midwives, in a extraordinary backstreet sort of scientific operation and in the teeth of massive social and institutional opposition.
Jonathan Eig is a former writer for The Wall Street Journal, and he offers a pacy narrative, full of sharp characterisation. His story begins with Margaret Sanger, a celebrated American campaigner for birth control, who opened her first contraception clinic in 1916, and who had radical views on female sexual pleasure (she wanted more of it), world population (less) and breeding (she thought the feeble-minded and degenerate should not be allowed to do it).
Distributing contraception - or even information about contraception - was a serious federal offence at the time. Sanger had already faced up to 40 years for 'obscenity' and briefly fled to Europe. Her husband had been jailed for 30 days for their 'scheme to prevent motherhood', and in the ensuing domestic mess their five-year-old daughter died of pneumonia.
Sanger, however, was unrelenting. She wanted to save women from sexual frustration, ceaseless pregnancies, dangerous abortions and the ineffective rubber pessaries her clinic supplied. Most were smuggled in from Canada, though in 1923 Sanger's stock was bolstered by 1,000 European diaphragms, sneaked through customs by her friend, the millionaire's wife and birth-control radical Katharine McCormick; she had them sewn into her designer dresses.
But diaphragms were old, poor technology. A woman, Sanger fervently believed, needed something she could 'swallow every morning with her orange juice or while brushing her teeth, with or without the consent of the man with whom she was sleeping'. She needed a pill.
Eig is vague about what Sanger knew about hormonal science, or when, but she came to believe that a biological solution was within reach. In 1921, an Austrian gynaecologist had rendered rabbits sterile by transplanting ovaries from pregnant animals into them. In 1937, Pennsylvania scientists had stopped rabbits ovulating by giving them progesterone, the hormone that prepares the uterus for implantation and shuts down egg-release. Few scientists, though, dared to extend this research into humans.
In 1950, Sanger sought the help of the reproductive researcher Gregory Pincus. He was an inspired choice. In 1934, he had been the first scientist to fertilise an ovum (a rabbit's) in a test tube. Soon after, he lost his Harvard post. Eig suggests that anti-semitism was in play, but the chief problem was his willingness to discuss the sexual nature of his work in the press.
Undeterred - this was a man who speed-read detective novels as a test of his powers of deduction - Pincus raised money door to door, and set up a foundation for experimental biology, economising by cleaning his own animal cages and identifying bottles of chemicals by smell to save on the cost of labels. He initially investigated how hormones might make soldiers less stressed and workers more productive. Sanger's achievement was to make him think about women as well. It helped that McCormick - who had been left one of the richest widows in America - agreed to fund the research.
Once Pincus had settled on a formulation - one called Enovid - what was needed next was testing. To lead this phase, he chose the physician John Rock, who in 1944 achieved the first test-tube fertilisation of a human egg. Strikingly, Rock was a faithful Catholic, but he was not an obedient one. He had argued that birth control was 'none of the Church's damn business', and earned the title of 'moral rapist' from a disapproving monsignor.
Rock tested Enovid on women visiting his fertility clinic. Eig, generally, is gentle on his subjects' ethics, but not on some of Pincus's tests - on women in the asylum of the Worcester State Hospital, for instance. These were performed without consent or permission.
In September 1956, Rock was ready to announce the results of the initial trials, at a conference of hormone scientists. His audience, however, saw straight through him, a voice shouting out 'it seems to me we have anti-ovulation'. By November, Science magazine had the news, and within months the company GD Searle (in which Rock, worryingly, had shares) had applied for approval to sell Enovid.
Remarkably, the application was merely for a drug to regulate 'menstrual disorders'. And when the Food and Drug Administration approved this use, it insisted that every bottle came with a label warning it prevented ovulation. Conservatism was still powerful in the 1950s, but women got the message. By 1959, some 500,000 were taking the pill for its 'off-label' contraceptive effect. By 1965, when the Supreme Court finally struck down state laws prohibiting contraception for married couples, this figure had risen to 6.5m.
On the life of the pill, postpartum, Eig enthusiastically notes the many advantages it has conferred on women. He reflects tellingly and poignantly on Sanger's own goals. She had wanted married couples to be happier - but divorce went up. She had wanted to diminish poverty - but the pill was adopted disproportionately by the affluent. Above all, she had strived for female sexual liberation - and it undoubtedly helped unleash that. If the launch of the pill was a 'birth', as Eig puts it, then it was a dramatic, difficult delivery in a somewhat disreputable clinic. But like so many biographies that begin with troubled births, this one ends with a feeling of triumph.
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