The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution (39 page)

The initial approval had been quick and easy, but only because the company had avoided calling the drug a birth-control pill. Now, Searle was hoping to avoid controversy and gain another speedy victory by filing a supplemental application, essentially making the case that a new use for the drug had been discovered and asking for permission to advertise that use rather than starting over and applying as if this were a new drug. It was a standard procedure in the drug business, but there was nothing routine where Enovid was concerned. This was not a cure for a disease. It was not a treatment for a condition or pain. This was a drug designed to change the way women lived. What’s more, it was a drug that women might use for twenty years or more. No one had the slightest clue what kind of long-term side effects it might produce or what standards should apply in determining its safety.

Pincus continued to insist the pill was harmless, and Searle’s scientists agreed. Meanwhile, Jack Searle crunched the numbers. Contraception was an industry worth $200 million in the United States, with condoms accounting for $150 million of that amount and
diaphragms and jellies representing the next largest
category at about $20 million. That was $200 million going to inferior products. The pill had the potential to be bigger than anything currently on the market. But the big profits would come only if Searle got to the prize first. In 1958,
Fortune
reported that the Ortho Pharmaceutical Corporation, the industry leader in diaphragms and jellies, was shifting the majority of its research budget to the search for oral contraceptives, trying to catch up with Searle.

“
It is no news
, I am sure,” I. C. Winter wrote to Pincus on December 29, 1958, “that the powers that be are breathing down our neck in the hopes of speeding up our application.”

THIRTY-ONE

An Unlikely Pitch Man

I
N 1958, SEVENTEEN
states still had laws banning the sale, distribution, or advertisement of contraception. In Connecticut, it was a crime to “
use any drug, medicinal article, or instrument
for the purpose of preventing conception.” In Massachusetts, where so much of the pill work was being done, it was still a felony to “
exhibit, sell, prescribe, provide
, or give out information” about contraceptives.

But gradually, one state at a time, the laws were being overturned. Those in place were largely unenforced. It was clearer than ever that a majority of Americans favored some form of birth control, and there were no modern-day Comstocks raising hell about it. On the contrary, there were calls for the government not only to accept contraception but to step in and regulate it. Too many bootleggers were still selling worthless products, and too many quacks were still performing unsafe abortions.

Now it wasn’t only crusading sex advocates like Margaret Sanger angling for a birth-control pill; giant corporations and a growing number of politicians and religious leaders were pushing for its acceptance.

For Searle, that meant a market had emerged. Moral and legal issues mattered, but making money mattered, too. The company stepped up to meet the growing demand, confident that the law would find a way to keep pace with the rapid cultural changes taking place all over the country. In a sense, Searle may have been fortunate that Margaret Sanger was old and sick and perhaps somewhat shell-shocked from her encounter with Mike Wallace. Hers was not the face the drug company wanted to present as it prepared to market its newest product. Neither was Pincus’s, for that matter.

John Rock, on the other hand, was perfect. He was Catholic; he was tall, silver-haired, and handsome; and he was no one’s idea of a flamethrower. He was married with children and grandchildren, and he possessed one of the finest reputations in all of American medicine. Searle, a family-owned, Midwestern company, could not have hired a better spokesman if they had issued a Hollywood casting call and auditioned thousands. As the race for the birth-control pill came close to its finish, the company put him to use.

Rock was receiving about ten thousand dollars a year (eighty thousand by today’s standard) in grants from Searle, but it was not simply money that motivated him. He believed in Enovid. He believed in the birth-control pill. He believed it was safe. He believed it would be a great boon for women and a help to marriage. He believed the Catholic Church ought to embrace it, not only for the sake of women but also for the sake of the Church. For all of these reasons and others, he happily cooperated when Searle asked him in 1959 to help decide how the company ought to market the pill as a birth-control device—assuming, of course, that the FDA approved it.

In 1959, drugs came with labels and nothing more. There were no pamphlets in the packaging to tell patients how the drugs should be used or to warn them of possible side effects. If patients needed instructions beyond those printed on the bottle, they asked their doctors. For good reason, Searle was more worried than usual about how this drug would be received. For one thing, women would be taking it by choice rather than necessity. They would be trying it as a replacement for other forms of birth control, not to ease a pain or cure an illness. Searle officials recognized that it was important for doctors and patients to feel comfortable and informed as they tried the pill for the first time. They wanted to set the right tone, striking a balance between the pill’s medical uses and its social benefits, and they wanted to make sure the message about the drug’s effects was delivered in the plainest and least sensational way possible. That’s where Rock came in.

“I’m not experienced in this kind of promotional work,” Rock wrote to an executive at Searle, adding, “
I don’t know if you will approve
” of the results. But he agreed to try. He suggested the company use phrases such as “child spacing,” “postponement of pregnancy,” and “suppression of ovulation” in its literature rather than “contraception” or “birth control.” Searle would settle eventually on “family planning” as its euphemism of choice.

In a brochure prepared for doctors, Rock spent a page and a half describing the menstrual cycle for general practitioners who were perhaps not as familiar with it as gynecologists were. Enovid, he wrote, “completely mimics” the action of natural progesterone in suppressing ovulation. In a separate brochure for patients, he wrote even more plainly: “
Enovid is an artificially made hormone
that is chemically quite similar to the two hormones,
estrogen
and
progesterone
, naturally produced in the human ovary.” Although the pill was ten times more powerful than progesterone, he wrote, its action was “quite like that of the natural hormone.” He never used the words “contraception” or “birth control,” but he did repeatedly use the word “natural,” in part because he was writing not only for women but for the Catholic Church officials who might be reading the same materials. Once women embraced the pill, as Rock believed they would, he hoped the Church might follow.

In Rock’s mind, the pill served as an extension of nature, and he was not the only one who thought so. James Balog, a researcher at Merck and Company, said that Searle and Rock were on to an important idea.

“I felt that the
pill might be the theological way out
,” Balog told the writer Bernard Asbell. “It’s not abortive because there’s no ovum, you’re not interfering with the will of God by putting a spermicidal jelly on that poor little sperm who’s trying to find this wonderful little ovum to do his thing. . . . If you believe the soul is created when the sperm unites with the ovum, there is no fertilized ovum, therefore no soul.”

There was a real sense that the pill might so thoroughly reinvent the notion of birth control that even the Church would find it impossible not to go along with it. In that regard, John Rock never saw himself as a radical; he believed his objective was a realistic one. He wasn’t trying to attack the Church. He was merely hoping to lead it in the direction that he so strongly believed would prove to be the right way.

In 1959, transatlantic jet service became widely available to commercial passengers. Americans also greeted the first astronauts, a group of fit and handsome U.S. test pilots known as the Mercury Seven. At the age of forty-two, John F. Kennedy emerged as the undeclared Democratic frontrunner in the next presidential election. Barney Rosset, owner of Grove Press, sued the government to overturn censorship and obscenity laws in order to publish D. H. Lawrence’s
Lady Chatterley’s Lover
. Philip Roth published
Goodbye, Columbus
, a novel in which the plot turned on a young woman’s decision to visit the Margaret Sanger Clinic and get a diaphragm—and her mother’s subsequent discovery of the device. As the pain of World War II and the Korean War faded and a wave of prosperity swept across the country, Americans began to push for all kinds of change, pressing the limits of what had previously been possible socially, economically, and morally.

In
Thy Neighbor’s Wife
, Gay Talese reported that, in 1959, “
after a Chicago vice squad
had arrested 55 independent news vendors for selling girlie magazines, a jury of five women and seven men—uninfluenced by a church group that sat in the courtroom holding rosary beads and silently praying—voted to acquit the defendants. After the verdict had been announced, the judge seemed stunned, then slumped forward from the bench and had to be rushed to a hospital. He had had a heart attack.”

The times were changing. Katharine McCormick found out firsthand when, in the summer of 1959, she stepped into a drugstore in Santa Barbara, California, and handed the pharmacist
a prescription for Enovid
. She was merely picking up the pills for a friend, but it didn’t matter. She had waited many years and spent great sums of money in the hope that such a simple transaction might one day be possible, and that day had come.

Yet for all the dramatic cultural and political change, G. D. Searle & Co. still wasn’t certain that women would feel comfortable talking to their friends about birth-control options and asking their doctors for Enovid. In an attempt to find out, the company’s top public relations man, James W. Irwin, phoned a few magazine writers and editors he knew, encouraging them to produce stories about his company’s new pill and the big changes for family planning it might deliver.

He warned the editors that
they might catch heat
for the stories. The Catholic Church might protest their magazines. Subscribers might cancel. Then, as the articles appeared, he waited for a backlash that never came.

Life
magazine ran pictures of the smiling Pincus and Rock along with a lengthy article that described the pluses and minuses of their newly invented pill. On the plus side, reported the magazine: “Treatment consists of nothing but swallowing a pill once a day, beginning on the fifth day after menstruation and continuing for 20 days. . . . If ovulation is wanted, the patient has only to stop the pills for a while to revert to normal.” On the minus side: “Although this seems to be simplicity itself, numbers of women in the clinical trials found it beyond their mental and emotional capacity, and it must be presumed that
numbers of Indians, Chinese,
et al.
would likewise.”

The
Time
article and others like it made little mention of side effects and even less mention of potential long-term hazards. The magazine editors treated the story of the birth-control pill as they might have treated the story of residential air conditioning or any other great life-changing invention finding its way into American homes in the 1950s. It was a subject of fascination, a glimpse of the future, and another glittering example of the wonders of American ingenuity. Pincus, Rock, and officials at Searle were hit with another wave of letters from women who wanted the pill and wanted it now. The so-called Baby Boom was underway, and many women had already seen enough of it. The more savvy among them knew that help was already available. All they needed to do was find a doctor willing to prescribe Enovid for menstrual regulation.

Though it was not yet officially recognized as birth control, more than five hundred thousand women were taking the pill.