“Instrument of Torture”: The Dalkon Shield Disaster

This Dalkon Shield is archived at the Dittrick Medical History Center and Museum at Case Western Reserve University. Photo: Jamie Chung

This Dalkon Shield is archived at Case Western Reserve University. Photo: Jamie Chung

These days, IUDs, or intrauterine devices, have stellar reputations as highly effective contraceptives. Along with implants, IUDs can be more effective than permanent sterilization, and their safety record is fantastic. We also have powerful regulations in place to keep dangerous medical devices off the market, and the FTC can keep manufacturers from making false claims in advertising.

But a previous generation of birth-control users might associate IUDs with dangerous pelvic infections and miscarriages. That’s because a single device, called the Dalkon Shield, almost single-handedly destroyed an entire generation’s trust in IUDs. At the time of its debut, there were dozens of IUDs on the market — but the Dalkon Shield unfairly tainted the reputation of all of them. With no FDA or FTC regulations reining in untested devices or false advertising, women in the late 1960s and early 1970s didn’t enjoy the protections that we take for granted today. And it was actually the Dalkon Shield’s string, which was made with a material and by a method that hasn’t been used in IUDs before or since, that made it dangerous.


Today, IUDs are the most popular form of contraception among physicians wishing to avoid pregnancy.


We’ve known about IUDs for more than a century, and have made them out of ebony, ivory, glass, gold, pewter, wood, wool, and even diamond-studded platinum. These days, IUDs release hormones or spermicidal copper ions, but these older devices were simply objects inserted into the uterus that acted as irritants, possibly enlisting the immune system to kill sperm. They were not as effective as modern-day IUDs.

The Dalkon Shield was invented in 1968, was made primarily of plastic, and had “feet” — four or five on each side — to prevent expulsion. In 1970, after being marketed independently, it was sold to family-owned pharmaceutical giant A.H. Robins Company, of Robitussin fame. It was manufactured in the same factory where ChapStick was produced, and retailed for $4.35.

Dr. Hugh J. Davis, the Dalkon Shield’s primary inventor, claimed that users of his device had a 1.1 percent pregnancy rate — but that number was based on a small, methodologically flawed study conducted over eight months. In fact, the Dalkon Shield had a 5.5 percent failure rate over the course of a year. The fact that the Shield didn’t provide high protection against pregnancy was a huge problem, but its design also dramatically increased risk for pregnancy complications. Of the tens of thousands of users who became pregnant while wearing the Dalkon Shield, 60 percent of them had miscarriages. Continue reading

Sniping, Not Debating: The Center for Medical Progress Videos

The following guest post comes to us via a Planned Parenthood Arizona volunteer.

health care providersI watched or read the first few full-length videos and transcripts posted by the Center for Medical Progress (CMP) beginning July 25, 2015. No doubt, coming weeks will bring more videos, but I would be surprised if they stray from themes of this first batch. In a nutshell, the heavily edited videos assert that uncompassionate Planned Parenthood representatives violate laws against collecting and selling fetal tissue for profit, “haggle” over pricing, and discuss abortion procedures and tissue in a distasteful, chilling manner.

I’m pretty weary of (though never surprised by) folks who oppose a woman’s right to make her own child-bearing decisions. Why? In this case, opponents refuse to stand and fight on the merits of their arguments. Instead, they use sniping tactics that trigger emotions and ignore facts.

CMP selected snippets of their hidden-camera videos to concoct a narrative not supported by the unedited videos. Consider these snippets they left out.

Planned Parenthood affiliates help WOMEN donate THEIR fetal tissue for medical research.

Dr. Deborah Nucatola, Planned Parenthood Federation of America’s senior director of medical services, spoke of the demand for fetal tissue donation programs:

“Patients will call up, make an appointment, and say, ‘I would like to donate my tissue.’ And the affiliates are really feeling like, ‘Oh, wow, I really need to figure out a way to get this done.’ Because patients are talking about — you know, in general, in health care, a provider is not going to offer a service unless there’s demand. And there is a demand now, I mean, women know that this is something that they can do.”

Continue reading

Hobby Lobby: Birth Control and the Law

Birth control activists Margaret Sanger and Fania Mindell inside the Brownsville birth control clinic, circa October 1916

Birth control activists Fania Mindell and Margaret Sanger inside the Brownsville birth control clinic, circa October 1916

In 1964, when I was a 16-year-old college freshman, my Bronx pediatrician asked if I was sexually active, and offered to prescribe birth control whenever I started having sex.

In 1964, his doing so was legal in New York because of a 1918 ruling by Judge Frederick E. Crane of the New York Court of Appeals, but not in Massachusetts, where I was in school.

Birth control is only legal in this country because of a concerted campaign of civil disobedience carried out by Margaret Sanger and her followers. Here is a brief look at the legal history of birth control in the United States.


In 1917, a judge opined that women did not have “the right to copulate with a feeling of security that there will be no resulting conception.”


In 1873, the Comstock Act was passed into law, making the dissemination of “obscene” material through the mail illegal. Any attempts in the early part of the 20th century to teach about sexuality and the prevention of pregnancy — including Margaret Sanger’s work as well as Mary Ware Dennett’s The Sex Side of Life, which she wrote for her sons when she could not find any adequate literature to assist in educating them — were prosecuted under the Comstock Act.

Margaret Sanger witnessed her mother’s early death after 11 live births and seven miscarriages. Later, as a nurse on New York’s Lower East Side, she witnessed poor women dying from attempting to abort unwanted or dangerous pregnancies. She decided to challenge the Comstock Act. Continue reading

Happy New Year and Family Planning for All!

world health family planningHappy New Year! With the start of the Affordable Care Act this year and birth control available to many American women without a co-pay, we have made great strides to decrease unintended pregnancies in the United States. I was about to write about new contraceptives that may be coming down the pipeline that could add to the already vast array of choices American women have for family planning. As I lay in my warm bed, thankful for being safe and well fed, I thought about women around the world who do not have the choices I have. They aren’t reading articles about new advances in contraceptive choices. Many have no access to contraceptives at all. Globally, 222 million women have an “unmet need for contraception.”


Let’s create a healthier world where we all have access to family planning!


One of the most essential ways to increase a woman’s health and independence is to provide access to family planning. When women have access to contraception, fewer unintended pregnancies result and also fewer unsafe abortions. Women who continue to have unintended pregnancies risk not only their health and the health of their child, they also have fewer educational and economic opportunities. When a woman is able to time and space her pregnancies, the woman, her children, and her community fare better. In communities where rapid population growth is related to unintended pregnancies, social and economic progress is impaired.

Limited access to contraceptives is just a part of the problem. Fear of using modern contraceptives such as the birth control pill also contribute to decreased use of some contraceptives. In many countries, religious and cultural values may have an impact on family planning efforts. Lack of  donor support to put programs of education and access in place are also a factor, especially when many political discussions associate family planning with abortion. Continue reading

Book Club: Crow After Roe

Crow After RoeA new book by Robin Marty and Jessica Mason Pieklo takes readers on a tour of a disaster. It was a catastrophe that swept through much of the Midwest but also shook states like Arizona, Idaho, and Mississippi. Its widespread effects raised numerous health concerns as it made its way through much of the country, and its repercussions are still felt today. Undoing the damage could take years.

The disaster was not natural, but political. The 2010 midterm elections saw a wave of Republican victories, giving state legislatures a new makeup and a new agenda. Reacting to a recently elected Democratic president who had called himself “a consistent and strong supporter of reproductive justice,” conservative lawmakers introduced one bill after another to limit access to reproductive health care — especially, but not exclusively, abortion.


The defeat of Arizona’s 20-week abortion ban is a timely reminder of what activists can accomplish.


In Crow After Roe: How “Separate but Equal” Has Become the New Standard in Women’s Health and How We Can Change That (Ig Publishing, 2013), Marty and Pieklo, both reporters for the reproductive health and justice news site RH Reality Check, take a state-by-state look at the many bills that were introduced in the wake of the 2010 midterm elections. Those bills made the next year, 2011, a record year for state-level legislation to restrict abortion. States passed more anti-abortion laws in 2011 than in any year in the last three decades. What was quickly dubbed the War on Women continued into 2012. That year saw the second highest number of new state-level abortion restrictions. This year is shaping up to be much like the prior two, with new restrictions introduced in more than a dozen states, according to the Guttmacher Institute.

Marty and Pieklo argue that this onslaught of bad legislation has put women — especially poor, minority, and rural women — in a separate and secondary class of health care consumers who have little choice or control over their reproductive health. The authors posit that the goal of the many restrictions is to render abortion “legal in name only” — still legal, but largely unavailable. Continue reading

A Conversation With Faye Wattleton: Part 4, Looking Back

Faye Wattleton was president of Planned Parenthood Federation of America from 1978 to 1992. She was generous enough to speak to me on January 7, 2013, and throughout the month of February we’ve shared her experiences and perspectives in observance of Black History Month. In this final installment, we look at her thoughts about her time at PPFA and her life after leaving Planned Parenthood.

In 1970, just a few years after receiving her master’s degree, Faye Wattleton left the Dayton Health Department and the Visiting Nurses Association to serve as executive director for Planned Parenthood of Miami Valley in Ohio. While she was there, the Roe v. Wade decision was handed down, and when a local reporter asked for a comment, Ms. Wattleton realized that her affiliate had no prepared statement. As she wrote in her autobiography, “The national offices had communicated no strategy for addressing the implications of such a landmark decision.”


“The exercise of safe reproductive health services and choices for women around the world is vital to the planet.”


At the time, no one had known what to expect from the Supreme Court, and the ruling came as a shock to Wattleton and her colleagues. But the Roe v. Wade decision would eventually thrust Planned Parenthood into the highly politicized abortion debate, despite the fact that their mission was — and is — broader than that, focusing most of their energies on contraception, preventive care, and education.

When Ms. Wattleton became Planned Parenthood Federation of America’s president in 1978, the organization had become, according to a 1979 Time Magazine article, “as all-American as the Girl Scouts and debutante parties.” But Ms. Wattleton restructured the national office staff in preparation for increasing political challenges, while continuing to expand medical and education services. During her first year, more than 60 percent of the national managerial staff left the organization.

Reflecting on the restructuring, Ms. Wattleton says that had she known then what she knows now, she would have begun her tenure at PPFA differently. “I had been the executive director of a Planned Parenthood [affiliate] for seven years before I became president [of the national organization]. I felt like I really knew the organization, but what I learned [is that] anyone who has the privilege to ascend to national or international responsibilities can’t quite appreciate what it’s like, until you’re actually in the seat. Perhaps I really overestimated my perspective on some of the nuances of the importance of touching base with a number of the elements within the organization; like any other organization, Planned Parenthood has its factions.” Continue reading

A Conversation With Faye Wattleton: Part 3, Family Planning and Race

Faye Wattleton (left) with Maxine Waters and Jesse Jackson, 1992

Faye Wattleton was president of Planned Parenthood Federation of America from 1978 to 1992. She was generous enough to speak to me on January 7, 2013, and throughout the month of February we’ll be sharing her experiences and perspectives in observance of Black History Month. This third installment covers questions of racism, especially as aimed at Planned Parenthood and its founder, Margaret Sanger.

Faye Wattleton is clear that women’s autonomy is at the core of the reproductive rights debate. Her philosophy regarding the struggle for reproductive rights, as she said during our interview, “gradually evolved to the conclusion that this is still really about the fundamental right and values that women are held to. That our reproduction is still a proxy for the larger question of our full status as human beings and as citizens.” The question is whether the government will seize the power to make decisions about women’s bodies.


“Racism has a very deep vein in this country and our culture.”


Ms. Wattleton, as the first African American president of Planned Parenthood Federation of America, was often asked how she could work for an organization founded by Margaret Sanger, a woman who allegedly saw birth control as a tool to eradicate the Negro race, to use the language of Sanger’s time. For example, when Ms. Wattleton debated Randall Terry, founder of Operation Rescue, on the Phil Donahue Show in 1991, he accused her of being a traitor to her race by working for Planned Parenthood: “Margaret Sanger … wanted to eliminate the black community,” Terry said to Ms. Wattleton. “You have been bought.”

Ms. Wattleton responded, “I do not need you to tell me what my choices are about my life and my body because I am a black person. I can make that choice for myself, just as every black woman can make that choice for herself.” Reflecting further on Margaret Sanger during our conversation, Ms. Wattleton added, “I could never understand why Margaret Sanger was hauled out. Maybe she was racist. George Washington had slaves. What am I supposed to do? Give up my American citizenship for that?” Continue reading