The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution (32 page)

It was ironic that the great American sexual burning came as Sanger had all but completely remade her crusade. A mission that had originally been built around the joy of sex and the desire for more of it was now constructed around respectable themes such as population control and sound parenthood. If that approach tended to induce yawns rather than gasps, Planned Parenthood wanted it that way, and Sanger had gone along grudgingly. It wasn’t that Sanger or Planned Parenthood had lost interest in sex. On the contrary, the Planned Parenthood Federation of America was one of the only organizations in the world that made a woman’s sexual fulfillment part of its official program, offering sex counseling that was often disguised as marriage counseling and working with doctors, social workers, and mental health services
to promote sex education
.

Sanger was able to get grants from wealthy friends and arrange meetings with world leaders now in large part because she had taken the birth-control movement mainstream, arguing that contraception was a tool for economic growth and political stability. By 1956, that transformation was nearly complete, but Sanger and the organization’s other leaders believed there was one important faction they needed to win over before birth control would truly gain widespread acceptance.

The message was summed up in a memo from 1954 that continued to circulate in 1955 and 1956 among leaders of the International Planned Parenthood Federation. It mentioned rumors that the Catholic Church might soon be pressured by its followers “to accept some of the new forms for the rational control of fertility, if and when they are developed.” The report continued: “The Church is far from monolithic; it contains many different points of view, and the Pope, like many other authoritarians, can only move a certain distance ahead of the different elements who support him.” Planned Parenthood had two choices, according to the memo, which was sent to Sanger among other leaders: The organization could harass the Church and stir controversy as it had done consistently through the years, or it could “avoid controversy, trying to show them the effects of world population . . . and to work with those elements in the Church
who want to see a change
.” Catholics comprised a quarter of the American population. Winning them over, or at least gaining some allies within their ranks, would be a coup for Planned Parenthood.

The Vatican could not have been any clearer at the time in its attitude toward birth control. In 1951, Pope Pius XII spoke to the Italian Catholic Society of Midwives and reaffirmed what his predecessor, Pius XI, had said on the subject: that Catholicism would not sanction any attempt to impede the creation of life during the conjugal act. “This precept is as valid today as it was yesterday,” the pope declared, “and it will be the same tomorrow and always, because it does not imply a precept of the human law, but is the expression of a
law which is natural and divine
.”

Anyone disobeying such a strong and clear declaration, theologians said, would be sinning against the faith. But, as John T. Noonan wrote in his definitive account of contraception and Catholicism, the pope did sanction the rhythm method, which he deemed “natural” because it didn’t kill sperm the way a spermicide did; it didn’t impede the normal processes of creation in the manner of a diaphragm; and it didn’t mutilate the body’s organs as sterilization did. That led some theologians to contemplate other loopholes, including the one presented by the research of Pincus and Rock: What if a drug allowed women to control or extend their safe periods? And what if this drug were built with or based on ingredients occurring naturally in the body? Would that be natural? Would that be enough like the rhythm method? Would that satisfy the pope?

Some thought it might. The human body secreted progesterone during pregnancy to protect an unborn child in the mother’s womb. If science made it possible with natural compounds, why shouldn’t a woman have the power to prevent a pregnancy that might endanger her health or harm the well-being of her existing offspring? Could she take a drug during the first six months after the birth of a child, while she was nursing, to make sure she would not get pregnant again? Wouldn’t that be useful? And wouldn’t that be just as morally acceptable as the rhythm method?

It was a question neither the Church nor anyone else had been forced to answer, but one the Vatican would soon confront. Not only were Pincus, Rock, and Planned Parenthood pressing the issue, Catholic women were, too. American women were having children at never-before-seen rates in the 1950s. While the average American woman in 1957 would give birth to a record-setting 3.7 children over the course of her lifetime, for Catholic women the
average was about 20 percent higher
.

Church officials lectured the faithful not to give in to the temptation to use birth control. “You need to think about heaven and hell,” one cleric wrote. “You need to think about death, and how God can call you in the very midst of your planning for
a comfortable future on earth
.”

But even worshipful Catholics were conflicted. When a
Catholic Digest
survey in 1952 found that more than half of all Catholics did not regard “mechanical birth control” as inherently sinful, Paul Bussard, the priest who ran the magazine, was so disturbed he
decided not to publish the results
. By 1955, 30 percent of Catholic women admitted using a form of birth control other than abstinence or rhythm. A growing minority within the Church began to overlook its teachings on this subject, and many Catholics stopped regularly attending the
sacraments of confession and communion
. In letters to the editors of Catholic publications and in discussions with their priests, Catholic women expressed their dissatisfaction.

“I have had seven children within eight years,
despite frantic and distressing efforts
to follow rhythm,” one woman wrote. “It seems unjust that we who have accepted the responsibilities of marriage should have to practice continence.”

In response, priests prescribed prayer and the sacraments. The women, feeling as if their religious leaders were out of touch, responded bluntly: With eight children, who had time for the sacraments? Then there were other priests who told the young women in their flock that the Church might be mistaken in this instance, an approach that had equally devastating effects over time.

“
I was taught by the Church
that if you used birth control the faces of your unborn children would haunt you on your deathbed,” recalled Loretta McLaughlin, who grew up in Boston and went on to become a journalist and the biographer of John Rock. “When I was nineteen years old I confronted my priest. I said, ‘I don’t believe it.’ The priest said to me, ‘I wouldn’t worry about it,’ and he walked away.” McLaughlin was so infuriated by the priest’s “
high-handedness
” and casual dismissal of her concerns that she never went to confession again and soon stopped attending Mass.

In 1956, Vatican leaders recognized the deepening chasm between the Church’s leaders and its followers. They heard about it from priests and read about it in newspapers and magazines. They also knew that a new birth-control pill was in development, with a Catholic doctor involved in its creation. If the pill reached the market, it would compel the Vatican to make a choice—whether to continue to hold the line against contraception or to moderate its position. John Rock was hoping he might persuade the leaders of his faith to choose the latter. In the meantime, he had found a way to solve, at least temporarily and in his own mind, the moral problem of whether he might be violating the doctrines of his faith by testing an oral contraceptive in the heavily Catholic communities of Puerto Rico. While it was true that the Church forbade contraception through chemical means, there was no explicit ban on experimentation. Technically, he wasn’t giving pills to prevent conception; he was giving them
to find out if they worked
.

Once, another Catholic doctor confronted Rock, telling him he was being naive, that the Church would never accept a birth-control pill no matter how well it worked, how closely it resembled the rhythm method, or how hard Rock lobbied for it. Rock, who towered over the younger doctor, stared him down before speaking.

“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.
’”

TWENTY-FOUR

Trials

I
N FEBRUARY 1956,
Pincus flew to Puerto Rico to see if he could salvage the trials. The university students and nurses had all quit. Threatening them hadn’t worked, and Pincus saw no point in trying to get them back.
He needed a new approach
.

Arriving in San Juan, he met with Edris Rice-Wray. Rice-Wray then held two posts: She was the medical director of the Family Planning Association and director of the training center for nurses at the Department of Health’s public health unit in Rio Piedras (meaning “river of stones”), a poverty-stricken district of San Juan. These dual roles made her an ideal guide to Puerto Rico for Pincus and Rock. She knew her way around the communities where the field trials would be taking place. She knew the doctors and social workers in those communities. What’s more, she had pull with local officials who might offer protection if the work stirred controversy. Rice-Wray—or Edie, as her friends called her—also had something in common with Pincus, Rock, Sanger, and McCormick: she was a rebel. She’d given up a comfortable medical practice in Chicago because she believed women should have access to contraception. She believed birth control would help women overcome some of the fundamental inequalities of being women, that it would free them to seek more education, pursue better jobs, and raise healthier and better-educated children. She liked the idea of a scientific form of birth control, and she was excited that Pincus was working on one. But she was nevertheless hesitant to test new drugs on patients.

“
I was kind of scared
of it at first, really,” she told one interviewer. Rice-Wray didn’t want to offer her patients a drug that didn’t work, and she certainly didn’t want to offer them anything that might do harm. But Pincus was
so charming and self-assured
that Rice-Wray was won over.

A few weeks after Rice-Wray’s meeting with Pincus, John Rock flew to Puerto Rico to talk to doctors and nurses there about how the trials were to be run. Rice-Wray was unsure what to make of Rock at first. He was a pipe-smoking Bostonian, the picture of sophistication, and a Catholic, to boot. Yet here he was in San Juan, wearing an ascot or tie even in the tropical heat, standing erect and proud, eager to go to work in the slums.

“I understand you’re very Catholic,” she said, “and yet you’re in favor of birth control.”

“Do you want to know what I think?” Rock told her. “I think it’s
none of the Church’s damn business
.”

Rice-Wray liked him. She told Rock the same thing she’d told Pincus: that they’d been going about their work all wrong in Puerto Rico. They’d been trying to shove their experimental pills down the throats of women who didn’t want or need birth control. But Rice-Wray knew where to find women who would be eager to go along with the experiment, women who were desperate for more effective birth control. In Rio Piedras, where ramshackle slums had recently given way to government-funded housing developments, young women were fighting to escape poverty. Rice-Wray felt certain that many of the women she had met in Rio Piedras would be willing to try a new form of birth control. What’s more, the new housing developments offered an ideal laboratory. There would be no “wading in the mud” for the doctors and nurses visiting the community, she said, and because so much of the housing was new and highly desirable, the population would remain
stable over months of work
. Her efforts there so far, mostly funded by Planned Parenthood and Clarence Gamble, had shown that women visiting clinics in Rio Piedras didn’t need to be strong-armed. Rice-Wray was certain that if the pill worked, word would spread quickly and demand for the new drug would be strong.

Rice-Wray began by visiting the superintendent of the Rio Piedras housing development, a man who saw firsthand the effects of overpopulation and the burdens it placed on young mothers. He turned over a detailed list of all the community’s residents and promised that his staff would help Rice-Wray recruit subjects. Next, she enlisted a nurse named Iris Rodriguez. Rodriguez was a strong, smart, ebullient woman who knew everyone in Rio Piedras by name. She would make a survey of young couples who had children (to establish that the women in the study were indeed fertile) and wanted to have more. They would screen out women who were over the age of forty or sterilized, as well as women who were making plans to leave the community within the year.

Puerto Rican government officials approved the study but asked that Pincus and his team avoid publicity. As they recruited women, Rice-Wray and Rodriguez were careful to explain that this was a private, scientific study, not affiliated with the government. They compared themselves to the Cancer League or National Foundation for Infantile Paralysis, emphasizing that they were doing research to improve health and help parents
manage their family’s size
.

“It was
very easy to talk to mothers
about the contraceptive program in neighborhood gatherings or in the health centers,” Rice-Wray recalled years later in a speech to the Royal Swedish Endocrine Society, “but very difficult to get fathers to attend such meetings.” To find out what fathers thought about birth control, Rice-Wray went to the city jail in San Juan and interviewed prisoners, and she came away with the impression that the men, while reluctant to admit it, were every bit as interested as women in limiting family size.

By the end of March 1956, Rodriguez and Rice-Wray had selected a group of 100 women, as a well as a control group of another 125. Though almost all the residents of Rio Piedras were Catholic, Rice-Wray encountered only one woman who said her
religion prohibited her from enrolling
in the study. The subjects receiving the birth-control pill were told that they were taking an experimental new contraceptive. The women in the control group were told they were part of a survey on family size. In April, the researchers began dispensing pills.