By Donna J. Drucker ~
G.D. Searle’s Enovid pill came on the market for married women in June 1960 when the U.S. Food and Drug Administration (FDA) approved it for contraceptive use. It was available only with a doctor’s prescription, and the FDA initially limited use to two years. As more and more women began to take it, it came under scrutiny by physicians, pharmaceutical companies, the FDA, and non-profit health organizations. By 1969, it was clear that the pill’s combination of estrogen and progestin harmed some users, and each of these entities considered what steps to take next.
Some of those considerations were made public through film. The National Library of Medicine (NLM) produced a series of nine educational films in 1969–1970 called “Concepts and Controversies in Modern Medicine.” One of the topics that producers chose was the pill. Exploring the content and context of this film illustrates how information about the pill was publicly presented—and the reasons why the U.S. feminist health movement organized and pushed for greater transparency in sexual and reproductive information not long afterward.
The half-hour-long film depicts three male physicians, all employed at elite East Coast universities, discussing the pros and cons of the pill from their specialist perspectives. Dr. Celso-Ramón García approached the pill from an obstetrician-gynecologist’s viewpoint, Dr. Louis Lasagna addressed it from a pharmacological angle, and Dr. Sheldon Segal, who directed the Rockefeller Foundation-funded Population Council, served as moderator but interjected his own views from time to time. The speakers seemed to address fellow physicians or scientists and not potential or actual pill users.
García opened with a statement that the pill contributed to the health of individuals despite any disadvantages, and that any metabolic alterations were reversible when the patient discontinued use. He disdained contraceptives such as diaphragms or condoms that did not provide the same level of effectiveness as the pill, as “when a woman comes to me, she does not want to be half-safe.” Lasagna pointed out that since oral contraceptives affected every cell in the body, the pill was more like “buckshot” than “a magic bullet” when it came to preventing pregnancy. He highlighted known side effects of the pill, including decreased liver function, higher risk of blood clots and deep vein thrombosis, and increased incidences of depression, migraines, and breast cancer. He countered García, arguing that “I don’t think all women want 100 percent protection” against pregnancy. Many women accepted the lower effectiveness rate of the diaphragm or condom, he thought, because they wanted to have children in the future but were not committed to a specific plan of child spacing. Their opinions on women’s certainty regarding the possibility of future pregnancy clearly influenced their positions on contraceptive methods.
Even though these physicians disagreed about how to balance contraceptive side effects and effectiveness with women’s desire for pregnancy, they were certain of their medical authority. Segal cautioned that the pill should never be designated as an over-the-counter medication, should remain part of the “physician’s armamentarium” of medications, and should always be taken under medical guidance. However, none of them advocated that patients should inform themselves of the risks and benefits of a medication, and at the time, medications had no patient insert detailing usage instructions or side effects.
Not long after this film was produced, U.S. women’s frustration at that situation rose to a boiling point. To take one example, a women’s group in Boston gathered sexual and contraceptive information and mimeographed a booklet called Women and Their Bodies in 1970. The high demand for this publication led to commercial reprintings and translations of the information under the title Our Bodies, Ourselves. To take another, the Senate held hearings in January 1970 about the pill’s potential harm. The all-male panel of witnesses so outraged members of D.C. Women’s Liberation that they disrupted the hearings. The pill hearings eventually led to the FDA requirement that information inserts be included in all medications, not just contraceptives. The hearings also energized the organization of a national feminist health movement.
In summary, this film marks a specific moment in the history of medical information. These physicians put forward opinions in a formal, public setting just before second-wave feminism and the U.S. feminist health movement changed the way that medical information was available to the lay public. After 1970, medical information would no longer only be filtered through a physician’s expertise. Laypeople also demanded and increasingly accessed information about drugs and their side effects so that they could make more informed decisions about their own health care.
Dr. Donna J. Drucker is the author of The Classification of Sex: Alfred Kinsey and the Organization of Knowledge (Pittsburgh, 2014) and The Machines of Sex Research: Technology and the Politics of Identity, 1945–1985 (Springer, 2014). Her book Contraception: A Concise History is forthcoming from MIT Press in April 2020. She tweets from @histofsex.