Pro-Choice Book Club: Histories of Oral Contraceptives

Hormonal birth control has an incredible history that stretches back almost a century, when Margaret Sanger wrote of her dream of a “magic pill” in 1912. In the ensuing decades, scientists were busy piecing together the complex system of the body’s “chemical messengers,” hormones, and when they learned how to synthesize them in the ’40s, Sanger’s dream was but a few steps away from being fulfilled. Three engaging accounts of the Pill’s development — The Pill: A Biography of the Drug That Changed the World by Bernard Asbell (1995), America and the Pill: A History of Promise, Peril, and Liberation by Elaine Tyler May (2010), and Jungle Laboratories: Mexican Peasants, National Projects, and the Making of the Pill by Gabriela Soto Laveaga (2009) — contain some overlap, while offering different perspectives.

Each author tells the inspiring story of Russell Marker, the chemist who first finagled progesterone from a wild-growing Mexican yam. Despite a near lack of support from pharmaceutical companies and the scientific community, he traveled to rural Mexico on a hunch — and ended up co-founding a laboratory that became the world’s top hormone supplier for the next few decades. Before Marker formulated a way to synthesize hormones in abundance, they were derived from slaughterhouse byproducts and were prohibitively expensive. Marker’s experiments enabled further medical research in hormones, and progesterone was soon used not only in oral contraceptives, but as a precursor for other medications such as cortisone.

While Carl Djerassi is often credited as the “father of the Pill,” both Asbell and May tip their hats to Margaret Sanger and Katharine McCormick, the Pill’s “mothers.” These two women also have fascinating biographies. As a nurse in the early twentieth century, Sanger was acquainted with the horrors that arose when women did not have control over their fertility. Many of her patients became infected or even died as the result of illegal or self-induced abortions, which motivated Sanger to become an activist for contraception’s legalization — an avocation that saw her illegally smuggling diaphragms into the country and serving time in jail after opening a family-planning clinic in Brooklyn.

McCormick’s background is vastly different. As MIT’s second female graduate, earning a degree in biology in 1904, McCormick put her vast fortune toward philanthropic efforts. In the early ’50s, at Sanger’s behest, McCormick provided the lion’s share of funding for research into an oral contraceptive. They hired Gregory Pincus, whose previous research in the artificial insemination of rabbits provided the basis for in-vitro fertilization, to develop Sanger’s “magic pill.” While Asbell downplays her role in the Pill’s development, May claims that McCormick, as “one of the first women trained as a biologist,” oversaw the research in addition to bankrolling it.

Pincus built on previous work done by chemists Carl Djerassi and Luis Miramontes at Marker’s old lab in Mexico. Hormones had been administered intravenously, and scientists needed to formulate chemicals that were just as effective when taken orally. While most histories credit Djerassi with this accomplishment, Soto places the credit squarely on Miramontes’ shoulders. By tweaking progesterone’s chemical structure, Miramontes created norethindrone, which was eight times more potent than natural progesterone when taken orally.

The next step was for Pincus to formulate these chemicals as an oral contraceptive and test it in large-scale clinical trials. Asbell and May differ in their telling of these trials: While Asbell asserts that Pincus and his partner John Rock adhered scrupulously to the ethics of informed consent, May claims they tested the Pill on subjects who could not give consent, such as psychiatric patients. Another difference between Asbell’s and May’s narratives involves the side effects experienced by many of the test subjects; Asbell’s account seems more complete. In any case, the clinical trials’ success led to the Pill’s approval as a contraceptive in 1960.

Soto gives an in-depth history of the labor issues that are unknown to most takers of the Pill. The yam that provided the raw material for the Pill’s active ingredients had to be harvested, and that work was done by rural Mexicans. During the peak of the yam’s trade, an excess of 10 tons of it were removed from tropical Mexico every week, and the harvesters were paid a paltry half a peso per kilo of dried root. Soto claims that their labor was exploited, and she makes a solid case for this aspect of the Pill’s history in her book.

Nowadays the hormones necessary for the Pill’s formulation are cranked out by microbes in laboratories rather than gathered in the jungles of Mexico. But the history leading up to the medical miracles we take for granted today is one worth knowing.