Women’s History Month: What are the Puerto Rican pill trials?

I had no idea that the development of the birth control pill came at expense of women of color.

Last night, Planned Parenthood President Dr. Lena Wen was the guest on The Daily Show with Trevor Noah. As I watched, I realized I had a rather incomplete knowledge of the history of Planned Parenthood, so I went to the website and read the history…and I invite you to do the same here.

As I read about Planned Parenthood’s founder Margaret Sanger and her incredibly fertile mother, I was shocked to learn that birth control and education about birth control had been deemed illegal as a result of passage of the 1873 Comstock Act. Understanding that abortion was also being criminalized during this same period in American history, I found myself shouting a heartfelt, “What the f*ck?!?” at my laptop screen.

But you know…sex outside of marriage was immoral and therefore no one was doing it, right? And no God-fearing man ever raped a woman, right? And all married people definitely wanted to produce a child every single time they had sex, right? And there was no prostitution either, right? Or any other scenario that could possibly result in an unplanned or undesired pregnancy, right? So unless the woman’s life was in danger, every pregnancy was simply considered manna from heaven.

How friggin’ sweet.

It’s really a wonder as to why women didn’t regularly go full-on Lorena Bobbitt at every turn—speaking of which, there’s a documentary out about the Bobbitt ordeal on Amazon Prime aptly entitled Lorena. I digress…

Anywho, I kept reading about Sanger and the Birth Control Clinical Research Bureau followed by the development of the first oral contraceptive until I came to the Puerto Rico Pill Trials.  Y’all ever heard about that? I certainly had not.

In order to gain FDA approval of the first birth control pill, the pill’s creators John Ruck and Gregory Pincus required the completion of a large-scale human trial. This article on PBS.org explains:

In the summer of 1955, Gregory Pincus visited Puerto Rico, and discovered it would be the perfect location for the human trials. The island, a U.S. territory, was one of the most densely populated areas in the world, and officials supported birth control as a form of population control in the hopes that it would stem Puerto Rico’s endemic poverty. There were no anti-birth control laws on the books, and Pincus was impressed with the extensive network of birth control clinics already in place on the island. There were 67 clinics dispensing existing methods of birth control and a large group of women used their services.

For Pincus, the island offered a pool of motivated candidates, and a stationary population that could be easily monitored over the course of the trials. Pincus also knew that if he could demonstrate that the poor, uneducated, women of Puerto Rico could follow the Pill regimen, then women anywhere in the world could too. Pincus hoped that by showing Puerto Rican women could successfully use oral contraceptives, he could quiet critics’ concerns that oral contraceptives would be too “complicated” for women in developing nations and American inner cities to use.

Let me just go ahead and dismiss the implications of the paragraph above because I don’t need to rant about the assumption that gender, poverty and lack of education automatically deem a person incapable of taking one damn pill a day. No, I don’t need to go there.

The women who participated in this trial did so without informed consent meaning that they were unaware they were involved in an experiment and had no idea that taking the pill could cause them harm. They were simply told that the pill would prevent unwanted pregnancies if taken as directed.

Now I read several different sources saying that Puerto Rican women jumped at the opportunity to get on the pill since their primary forms of birth control were abortion and sterilization.   However, I did also come across this article which said:

Convincing them proved to be the opposite, however. Many of the women dropped out of the study because of the intolerable side effects, leading researchers to begin looking for women they could pressure into participating. Eventually they began to sign up female medical students in San Juan, forcing their hands by threatening their ability to participate in their medical programs. It came down to two options for them: Stay and take part in the study, and they could get their degrees. Oppose and they could be expelled.

Each month, students faced grueling tests. Tissue was collected from their uteruses and some participants underwent laparotomies – surgical procedures that include large incisions that would expose their abdominal cavity for research. Once the researchers felt they’d obtained sufficient data, they moved onto their field studies.

San Juan’s Rio Piers neighborhood, a community that consisted of a public housing development for farm laborers, became their target. Of these communities, one collaborating researcher wrote in his notes that “families selected were landless” and considered “to some extent [to be] social problems.”

So these women had important information about the nature of the experiment withheld from  then AND, in some cases, were forced to participate?!? Also, it was okay to treat them like lab rats because they were “social misfits”?!?! Okay.

Sweet Jesus, keep me near the cross.

As for the “intolerable side effects,” keep in mind that the pill they were given contained hormone levels that were 20 times higher than the levels contained in birth control pills today. Hence, the participants who took these pills suffered from dizziness, headaches, stomach pain, cramping and vomiting as a result. Despite 22 percent of the participants dropping out because of the side effects, Pincus and Rock deemed the side effects as being a result of stress or personal conflict and felt that the benefit of not getting pregnant outweighed any physical discomfort the women experienced.

Oh, okay. So the side effects were the participants’ fault. Got it.

Naturally this brings to mind the 2016 trials for the male oral contraceptive. That study ended early because the guys couldn’t tolerate the side effects which included acne, mood swings and an altered libido. Who/what caused the side effects in those trials and who’s the weaker sex again? Again, I digress…

Three women died during the trials but were never autopsied to see if the pill was responsible for their deaths. Similar studies continued in Haiti and Mexico.

I don’t have to mention how this is yet another example in history of Black and Brown bodies being abused and exploited in the name of science. Think Tuskegee Syphilis Study and J. Marion Sim’s fistula surgery experimentation on enslaved Black women

Let me just back away from the keyboard.

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