Tag Archives: John Rock

Why Periods? False Hopes, Popes, and the “Grandfathered” Withdrawal Bleed

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The birth control pill and other hormonal contraception are popular. Menstrual periods are not. Hormonal contraception can be used to suppress menstruation — so why isn’t this method, called “continuous contraception,” more popular?

For decades, packets of birth control pills have typically contained 21 “active” pills and seven “placebo” pills. These placebos — sugar pills — trigger bleeding (which most people think of as a menstrual period, even though it’s technically called a withdrawal bleed). Because menstruation is natural, some people think this withdrawal bleed must somehow be healthier. But there are actually no health benefits — and it might also increase risk for pregnancy.

There is no reason to have a period when on the birth control pill — unless you want one.

Last month, British medical guidelines were revised to recommend continuous use of the birth control pill — that is, with no week-long “break” designed to trigger a withdrawal bleed. We could have been skipping our periods since the Pill was introduced in 1960 — so why is it only now that we are coming to see them as optional?

A flurry of recent articles has touted a rather conspiratorial claim: that the monthly bleed was included in an attempt to make the Pill more palatable to the pope. The Telegraph quoted reproductive health expert John Guillebaud: “John Rock devised [the week of placebo pills] because he hoped that the pope would accept the Pill and make it acceptable for Catholics to use. Rock thought if it did imitate the natural cycle then the pope would accept it.”

Many journalists, pundits, and bloggers have expressed outrage that we’ve been putting up with decades of unnecessary bleeding (and all the attendant pain, headaches, and missed work) just because of an unsuccessful attempt to appease the pope before most women of reproductive age were even born. But the history of the placebo week is more complicated. Continue reading →

The History of the Birth Control Pill, Part 5: Clinical Trials

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Gregory Pincus, Min-Chueh Chang, and John Rock, three scientists employed by Margaret Sanger and Katharine McCormick to develop the birth control pill.

Gregory Pincus, Min-Chueh Chang, and John Rock were hired by Margaret Sanger and Katharine McCormick to develop the birth control pill.

Welcome to the fifth installment of our series chronicling the history of the birth control pill. In the previous installment, Margaret Sanger and Katharine McCormick envisioned and bankrolled the development of the birth control pill. Now it had to be tested in large-scale trials.

John Rock, Gregory Pincus, and Min-Chueh Chang had collaborated in the Pill’s development; now it was time to conduct clinical trials. The first study observed 60 women, some of whom were infertility patients while others were nurses. These small trials involved daily temperature readings, vaginal smears, and urine samples, as well as monthly endometrial biopsies. Although the initial results seemed promising, the sample size was small and few of the subjects complied with the protocol.

The approval of the Pill in 1960 marked a turning point in our history.

More test subjects were needed. At this point, historians’ accounts differ. Elaine Tyler May claims that, unable to locate an acceptable pool of volunteers, the researchers tested the Pill on subjects who could not give their consent, such as psychiatric patients. According to Bernard Asbell, however, Rock was scrupulous when it came to informed consent, despite it not being a legal requirement — or even much of a concept at all at this time in history.

Willing participants notwithstanding, conducting such trials in the United States posed a challenge, due to laws against contraception. So the first large-scale clinical trials were conducted in Puerto Rico in 1956. Puerto Rico was densely populated and there was a high demand for alternatives to permanent sterilization, which was widespread on the island due to funding from a wealthy eugenicist named Clarence Gamble, who advocated sterilization for the world’s poor. The clinical trials in Puerto Rico were conducted by Drs. Edris Rice-Wray and Adaline Sattherthwaite; the brand of birth control pill tested was named Enovid. Volunteers were so easy to come by that some clinics had waiting lists. Continue reading →

The History of the Birth Control Pill, Part 4: Margaret Sanger’s “Magic Pill”

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Katharine McCormick

Katharine McCormick

Welcome to the fourth installment of our series chronicling the history of the birth control pill. In the previous installment, progesterone, the birth control pill’s active ingredient, could only be administered intravenously. Scientists working in Mexico figured out how to alter its chemical structure so that progesterone would be active when taken orally.

Katharine McCormick was born into a moneyed family and was, in 1904, the second female graduated by the Massachusetts Institute of Technology. After receiving her degree in biology, she married a wealthy man, but shortly into the marriage she gained control of her husband’s estate due to his illness. She put a lot of this money to good use: In the 1920s, she aided Margaret Sanger’s efforts to smuggle diaphragms into the country.

Katharine McCormick, a philanthropist and one of the first scientifically trained women, provided early funding for the Pill.

Her involvement with Sanger didn’t end there; indeed, both Sanger and McCormick had a lot in common, despite Sanger’s working-class childhood and McCormick’s privileged upbringing. According to historian Elaine Tyler May, McCormick and Sanger both had “a tremendous faith in the possibility of science,” and Sanger “believed that science held the key to contraception and to women’s emancipation.” Back in the ’20s, Sanger wrote:

Science must make woman the owner, the mistress of herself. Science, the only possible savior of mankind, must put it in the power of woman to decide for herself whether she will or will not become a mother.

In 1950, McCormick again joined forces with Sanger. In the mid-’40s, after a countrywide tour of family-planning clinics, Sanger had come to the conclusion that the diaphragm was not an adequate form of birth control, revitalizing her hope for a “magic pill.” Neither pharmaceutical companies nor the government wanted to invest in contraceptive research, considering it a “disreputable” area of study, so Sanger hatched a scheme to bankroll the independent development of an oral contraceptive. At Sanger’s behest, McCormick provided the lion’s share of funding for the project — more than $2 million (compared to the value of a dollar in the year 2000, that would be about the equivalent of $12 million). Sanger and McCormick tapped Gregory Pincus to conduct the research. McCormick, thanks to her education in biology, oversaw the research in addition to funding it. Continue reading →

Margaret Sanger in Tucson: “Daring to Live”

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“When the marvel of the spring came to the desert, you saw the cactus and the flowering, saw the brown floor change to delicate pale yellow, stood in awe of nature daring to live without water. You were reminded of the futility of wearing out your life merely providing food and raiment. Like the challenge of death, which so many of the people there were gallantly facing, the desert itself was a challenge.” – Margaret Sanger on Tucson, in her autobiography

Sanger in 1959, with friend Grace Sternberg, returning to the United States after a trip to New Delhi, Sanger’s final overseas trip.

Margaret Sanger moved to Tucson in the 1930s and soon thereafter decided to live here full time, believing that the warm climate was conducive to good health. During Sanger’s years in Tucson, she latched onto any health fad or other technique she thought might improve her health. She exercised and experimented with various diets, including fasting on juice; eating a combination of yogurt, wheat germ, and honey; taking vitamin E supplements; and eating papayas (which she had shipped from Hawaii) for their alleged “restorative substances.”

In 1949, however, Sanger suffered a heart attack, and her son Stuart, a doctor, injected her with Demerol, a recently introduced painkiller not considered addictive at the time. The next year she had a second heart attack, resulting in another long convalescence at the hospital. Her addiction to Demerol intensified; she got Stuart to write prescriptions for her, and would sometimes falsely claim that bottles of the drug had fallen and shattered, which would require further prescriptions to be written. If a nurse refused her demand for Demerol, Sanger would inject it herself. Her son tried to wean her from the drug by collecting empty bottles and filling them with a diluted concentration of the drug, slowly increasing the proportion of water to Demerol until the solution was pure water. This was effective for a while, but eventually Sanger realized she had been duped and endeavored to get her hands back on the drug. She went through other doctors, firing them when they would decrease her dosage, and eventually took to self-administering injections of pure water every 30 minutes. Her addiction, it seemed, was both to the drug itself and the psychological comforts of the injection.  Continue reading →

Pro-Choice Book Club: Histories of Oral Contraceptives

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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. Continue reading →