Sexual Chemistry: A History of the Contraceptive Pill available in Paperback
Sexual Chemistry: A History of the Contraceptive Pill
- ISBN-10:
- 0300167911
- ISBN-13:
- 9780300167917
- Pub. Date:
- 09/28/2010
- Publisher:
- Yale University Press
- ISBN-10:
- 0300167911
- ISBN-13:
- 9780300167917
- Pub. Date:
- 09/28/2010
- Publisher:
- Yale University Press
Sexual Chemistry: A History of the Contraceptive Pill
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Overview
Lara Marks traces the scientific origins of the pill to Europe and Mexico in the early years of the twentieth century, challenging previous accounts that championed it as a North American product. She explores the reasons why the pill took so long to be developed and explains why it did not prove to be the social panacea envisioned by its inventors. Unacceptable to the Catholic Church, rejected by countries such as India and Japan, too expensive for women in poor countries, it has, more recently, been linked to cardiovascular problems. Reviewing the positive effects of the pill, Marks shows how it has been transformed from a tool for the prevention of conception to a major weapon in the fight against cancer.
Product Details
| ISBN-13: | 9780300167917 |
|---|---|
| Publisher: | Yale University Press |
| Publication date: | 09/28/2010 |
| Edition description: | New Edition |
| Pages: | 416 |
| Product dimensions: | 6.10(w) x 9.10(h) x 1.30(d) |
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Read an Excerpt
Chapter One
The Population Problem and the Pill
In 1950, five years after the Second World War, Margaret Sanger, leader ofthe American birth control movement and chief promoter of the developmentof the oral contraceptive, forecast 'that the world and almost all ourcivilization for the next twenty-five years is going to depend upon a simple,cheap, safe contraceptive to be used in poverty-stricken slums and jungles,and among the most ignorant people'. Echoing this view four years later,the Catholic obstetrician-gynaecologist John Rock, who ran some of theearly clinical trials of the first oral contraceptive, declared that such a pillwould be the leading weapon against starvation and war: 'If it could bediscovered soon, the H-bomb need never fall.' Rock saw such an oral contraceptiveas providing the 'greatest aid ever discovered to the happinessand security of individual families — indeed of mankind'. According toRock, 'the greatest menace to world peace and decent standards of lifetoday is not atomic energy but sexual energy'.
Spoken at a time when the Cold War (1945-91) was intensifying, bothSanger's and Rock's statements highlight the political and economic contextin which the pill was initially developed. The years between 1948 and1953 had been a time of particularly grave tensions between the UnitedStates and the Soviet Union. During this period not only had the Sovietsattempted unsuccessfully to blockade the Western-held sectors of Berlin(1948-9), but the United States and its European allies had formed theNorth Atlantic Treaty Organization (NATO) in 1949, a military alliancedesigned to curb theSoviet presence in Europe. The Soviets had alsomanaged to explode their first atomic bomb, ahead of the time predicted bythe West and ending the American monopoly on this weapon. In addition,Chinese communists had taken power in mainland China (1949) and theSoviet-supported communist government of North Korea had invadedAmerican-supported South Korea (1950), launching a bitter war that was tocontinue until 1953. Elsewhere in Africa and Asia, pressures were alsogrowing for independence from the imperial powers of Britain, France, theNetherlands and Belgium. Two of the most populous nations in the world,India and Indonesia, had achieved independence in 1947 and 1949 respectively,after long and bitter struggles. Moreover, it was unclear whatpolitical and economic direction these newly formed states would take, andmany within the Western bloc feared they would adopt communism andbecome allies of the Soviet Union.
For those living through the 1950s the stability and future of the worldtherefore seemed far from secure. Not only were tensions increasingbetween the United States and the Soviet Union, anxieties were intensifyingabout the growth of population around the globe. At the heart of theconcern was the noticeable increase of population in less developed partsof the world. Population growth in parts of Africa, Asia and Latin America,for instance, appeared not only to be accelerating far more rapidly than inmany developed countries, but seemed far more rapid than that experiencedin any part of the world prior to 1950. Representing more people tofeed, clothe, shelter and later to provide work for, the babies being born tothe poorest and most impoverished women in the world appeared to many,such as Rock and Sanger, a potential threat to world stability. What theyfeared most were the pressures population growth would put on developingnations, providing ammunition for discontent and communism.
Anxiety about excessive fertility was not confined to what was happeningin the developing world. Much concern was also expressed about the highbirth-rates among the indigent poor within developed countries, which itwas feared could fuel economic dislocation and disorder closer to home. Bycontrast with the poor, the fertility of the upper and middle classes was notseen as a threat; rather it was to be encouraged precisely because itprovided people who would uphold the values of the 'civilized' world. Whatwas ultimately at risk was the middle- and upper-class way of life. Asone of Sanger's supporters, Mrs Harry Guthman, pointed out in 1950,population increase prevented economic progress and any means ofraising the standard of living.
Guthman and Sanger, like many other contemporaries, attributed therecent explosion in population growth to advances in medical science. Thishad cut the number of deaths and improved the chances of infant survival,while doing nothing about curbing fertility. As Rock put it in 1954, 'Theunion of Science and Humanitarianism is increasingly successful in theexemplary prevention of premature death which in the evil past restrictedpopulations. Can this same union do nothing now to prevent [the]smothering of mankind by Man, before evils of the past inevitably againtake over?' Seeing overpopulation as a menace, he was convinced that theonly way forward was for more scientific research into simpler methods ofbirth control such as an oral contraceptive. Having caused the problem inthe first place, science now had to come up with a solution. Yet not everyonewas going to agree with the scientific solution adopted. Not only wasthe oral contraceptive to meet great opposition from the Catholic church onreligious grounds; it was also opposed by many communist governmentswho equated the technology with imperialism and capitalism.
The development of the pill was therefore powerfully intertwined withthe politics and rhetoric of the Cold War and the threat of overpopulation.Symbolically it was more than just a tool for contraception. From the startit was linked with science and the hopes that it could curb populationgrowth and bring about world stability. Questions about population growthand its implications for social stability, however, were not new in the postwarera. Indeed, many social reformers and statesmen had been concernedwith the links between population and national economic wealth, socialorder and military strength since the nineteenth century. Yet the nature ofthis discussion changed radically after the Second World War, shiftingfrom equating large populations with economic and military strength toseeing them as a danger to global security. This debate had a profoundeffect on the development and adoption of the pill.
The population question and differential fertility
Population size has been a matter of political and social interest for centuries.Some of the most influential ideas on population have been drawnfrom the writings of the British clergyman-turned-economist ThomasMalthus in the late eighteenth century. Believing that the global populationdoubled in size every twenty-five years, Malthus feared that populationgrowth would soon outstrip the world's resources. Moreover, he arguedthat the population had already reached its maximum limit and that a catastrophewas imminent. For him, famine, poverty, pestilence and war werethe natural means of keeping population growth in check. Accordingly heargued against the provision of social welfare or food to the poor becausehe saw it as interfering with a natural process. While gaining great popularity,Malthus's writings were not entirely original, but were partiallybased on the ideas of the French philosopher Condorcet. Condorcet, however,while pointing to population expansion, had a different interpretationof its implications. Unlike Malthus, he did not believe that populationgrowth had reached its upper limit, and felt that any further increase couldbe overcome by the intelligent use of science, social reform and humanreasoning, as well as contraception. The differing positions of Malthusand Condorcet helped shape population debates in subsequent years.
By the late nineteenth century the focus in Europe had shifted to theproblem of fertility decline. Some of the earliest concerns about thedecrease in the birth-rate occurred in France which experienced perhapsthe most drastic decline in Europe after 1870. The fear of Germaninvasion, reinforced by the French defeat during the Franco-Prussian war(1870-1), haunted French politicians, many of whom equated France'sweakness with the country's falling fertility rate. Such anxieties also dominatedthe politics of other countries. Heightened anxieties about the sizeand health of the population, for instance, dominated British politics in theaftermath of the South African war (1899-1902).
Far more dangerous than unchecked fertility was the apparent class differentialaffecting its trend. What was most disturbing to many socialreformers was that the statistics implied that those who were reproducingleast were the better educated and more economically successful middleand upper classes. The poor, regarded as the most ignorant, unhealthy,unfit and immoral members of society, were continuing toprocreate at very high rates. In the United States, anxiety focused on whatappeared to be the greater reduction in the birth-rate of white nativemiddle-class Americans relative to that of the ethnic immigrant poor.Wherever the debate took place, worries about differential fertilitywere exacerbated by the wider social and economic upheavals of theday, such as mounting political discontent and radical unionism amongthe working class, and the escalating costs of social reform, which manysaw as inadequate to curb the ominous threat of poverty and discontent.Added to this were accelerating international economic and military competition,the collapse of empires and worsening economic depressions.
Some of the most vocal participants in the population debate wereneo-Malthusians and eugenicists. Originally started in Britain and primarilyled by upper middle-class, white, Anglo-Saxon, Protestant and educatedleaders, the neo-Malthusian and eugenics movements were ideologicallycomplex, and the ways they perceived population issues and the solutionsthey offered were diverse. Both ideological movements feared that thedifferential in fertility signified the degeneration of the physical and mentalhealth of the nation. Some neo-Malthusians attributed the problem tothe social and economic upheavals caused by rapid urbanization and industrialization.On the other hand, some eugenicists attributed the problemto recent advances in medical science, especially public hygiene, andgenerous social policies, which they believed had promoted the greatersurvival of the inherently 'weak' and 'inferior' members of society. Forthem this represented a disturbance of the natural order of evolution andthe survival of the fittest as outlined by Darwin, on whose account theirideas were based. Moreover, some eugenicists saw the higher fertility of thelowest socioeconomic classes not only as an economic burden on thenation, but also as a genetic aberration. Seeing differential fertility inbiological terms, eugenicists and neo-Malthusians promoted the idea thatfitter members of society should be encouraged to 'breed' in greater numbers,while those deemed less fit should have their fertility controlled.Within this context, human reproduction was to be scientifically managed.Known as selective breeding, this policy was considered vital to theimprovement of the 'race' and the health of the nation.
Eugenics and neo-Maltusianism provided a convenient means ofexplaining and resolving many of the social and economic difficulties of theday, ranging from immigration problems to what was thought to be a deteriorationin health and living standards, and a decline in military and economicstrength. These ideas attracted support across the political spectrumin both Europe and the United States, gaining the attention of a number ofprominent political figures, as well as well-to-do professionals, physicians,social workers, clerics, writers and professors, notably in the biological andsocial sciences. Not everyone, however, agreed with their ideas and thesolutions they proffered. Moreover, the degree to which eugenicists andneo-Malthusians were able to influence policy varied enormously, and wasgreatly dependent on the politics of individual countries and how well theirideas fitted in with more general perceptions about how to tackle populationquestions.
Different solutions adopted
By the interwar years various countries; in Europe as well as the UnitedStates were developing different strategies to address the population issue.One of the most popular was to promote more births among the 'fit' andthe healthy within the nation. Indeed, such births increasingly becamepolitically equated with a nation's economic and military survival. Knownas 'pronatalism', this policy found some of its most forceful promoters inthe fascist countries of Spain, Italy and Germany. Here a range of incentives,including government loans, were provided to encourage higher fertilityamong the 'fittest' members of society. While less extreme than thesetotalitarian regimes, many other European governments also adoptedpronatalist approaches during these years. In Sweden, for instance, theintroduction of maternity relief in 1937 aimed to increase the population.Similarly, in France special government premiums were paid to encouragecouples to have more babies. The rise in maternal and child welfareprovision during this period in countries such as Britain, France, Denmark,Sweden and the United States was essentially part of a pronatalistprogramme.
In Europe as well as the United States the emphasis on pronatalismthwarted attempts to legalize abortion and increase access to contraceptionduring the interwar years. Many politicians and social reformers saw abortionand contraception as the equivalent of national suicide. In 1920France passed a law which prohibited the sale of contraceptives. During theSecond World War, with the German occupation of France, the collaborationistFrench Vichy government also passed laws declaring abortion to bea 'crime against society, the state and the race — an act of treason punishableby death'. Similarly, in 1941 Franco's regime in Spain elevatedabortion to a crime against the state and severely restricted access tocontraception.
The advocacy of pronatalism, however, should not be equated with anargument for the reproduction of children at any cost. In the case of NaziGermany, pronatalist policies were intrinsically tied to questions of antinatalism,the prevention of births deemed 'unsuitable'. An instruction putout by Goebbels's Ministry for Propaganda highlights the belief of manypronatalists during these years: the goal is not 'children at any cost', but'racially worthy, physically and mentally unaffected children of Germanfamilies'. Germany was not the only country to twin antinatalism with itspronatalist policies. During the early twentieth century, while manygovernments across Europe and in the United States were making increasingprovision for mothers and their infants and encouraging motherhood,compulsory sterilization was also gaining increasing ground.
Some of the earliest antinatalist measures were undertaken in theUnited States, where 3,233 people were compulsorily sterilized between1907 and 1920. Among these were epileptics, the insane, and habitual orconfirmed criminals who had been incarcerated for drug addiction or sexualoffences, such as rape. By the 1920s the average rate of sterilizationhad reached between 200 and 600 per year. This shot up to 2,000 to 4,000per year after 1930. Such policies had mass appeal around the country. In1937 the American magazine Fortune reported that 37 per cent of citizensin the United States endorsed compulsory sterilization of habitual criminalsand 66 per cent were in favour of sterilizing those regarded as'mentally defective'. In 1941, 36,000 people were sterilized, and, manyfamilies facing the prospect of going on welfare feared they would besterilized.
Sterilization was not a project confined to the United States. Sweden, forexample, pursued a rigorous sterilization policy from the interwar yearsright up to the 1970s, leading to the sterilization of 60,000 people in total.Most were those classified as mentally defective, but this category wasloosely defined so that a very wide range of people were sterilized, includingthose who were considered to be 'displaying undesirable racialcharacteristics', to have poor eyesight, or to be living a vagabond life.Single mothers and habitual criminals were given no right of appealagainst sterilization. Other countries also attempted to institutethe practice. Britain, for instance, tried but failed to pass sterilization lawsin 1913 in association with its policies related to mental deficiency. Duringthe 1930s Norwegian socialists also favoured the use of sterilization, seeingit as part of a planned socialist society.
Taken to even greater and more horrific extremes were the sterilizationmeasures implemented in Germany under National Socialism. In 1933 theNazi regime passed a Eugenic Sterilization Law which was based on theModel Sterilization Law developed by the Eugenics Record Office in theUnited States. The German law, however, went far beyond the policiesimplemented in the United States. By 1937, 225,000 people had beensterilized in Germany, almost ten times the number sterilized over theprevious 30 years in the United States. The brutal sterilization procedurealso resulted in the death of approximately 5,000 people, over 90 per centof whom were women. Over half of those sterilized were categorized as'feeble-minded' or 'mentally deficient'. Many of the victims included thosesuffering from 'schizophrenia, epilepsy, blindness, severe drug or alcoholaddiction, and physical deformities that seriously interfered with locomotionor were grossly offensive', or with hereditary defects. By 1939 apolicy of euthanasia had replaced sterilization, leading to the shooting ofvictims and then to the erection of gas chambers. Those killed not onlyincluded thousands of inmates from psychiatric clinics and other institutionswho were considered too old, ill or handicapped to work, but alsothose considered racially inferior, particularly Jews, gypsies and blacks.
While the zeal for sterilization faded in the light of the Nazi atrocities, itis important to remember how popular ideas of selective breeding wereduring the interwar years. For instance, although brutal in its impact onwomen, sterilization was favoured by many feminists during this period.Margaret Sanger, for instance, who championed her cause in the hope ofenhancing women's position in society, did not see sterilization as a contradictionin her campaign. She advocated the 'national sterilization' of'certain dysgenic types', whom she saw as destroying the civilized 'way oflife'. Like many other social reformers in these years Sanger saw the chiefobject of birth control as being to produce 'more children from the fit andless from the unfit'. It could be argued that Sanger and her fellow supporterswere merely utilizing the eugenic rhetoric of selective breeding asa convenient platform on which to build their demands for increasedaccess to contraception. However, for Sanger the eugenic language and thecall for sterilization were a powerful means of adding scientific credibilityto her calls for greater access to contraception. For Sanger the scientific criteriapromoted by eugenicists was vital not only in justifying the use of contraceptionon social and economic grounds but also in challenging themedical profession's derision.
The eugenicists' call for sterilization was not universally accepted, however.In Britain, for instance, the eugenics movement met great resistancein its attempt to have legislation passed to allow for a comprehensivevoluntary sterilisation programme to deal with the mentally 'unfit'. Thedifficulty they experienced in winning support is particularly interestinggiven the fact that during the interwar years many prominent British politicalfigures, such as Lloyd George, Eleanor Rathbone, Joseph Chamberlain,William Beveridge, Winston Churchill and Harold Macmillan, usedeugenic arguments for tactical gains. Nonetheless, voluntary sterilizationnever had much appeal to the medical and scientific community, manyof whose members argued against the eugenic premise that mentaldeficiency was inherited. As a result, individuals who wanted sterilization,particularly vasectomies, as a means of contraception within marriageoften found difficulty in finding surgeons willing to undertake the operationin Britain. Many within the working class were also hostile to the ideaof voluntary sterilization, seeing it as a measure which was primarilydirected at them. In addition the Catholic church was also strongly opposedto sterilization. Clearly, the degree to which antinatalist measures, suchas sterilization, could be undertaken depended greatly on the politicalclimate and culture of each country.
The planning of population and national security
By the 1940s the population debate had taken a new turn in the light of theDepression and the Second World War, both of which had encouragedrationalization and economic planning in countries such as Britain and theUnited States. Within this context fertility became something which manythought should be and was susceptible to planning. Much of the debatearound fertility also reflected wider beliefs about science and the rationalizationof modern life. One American family planning poster in the early1940s effectively captured the spirit:
MODERN LIFE IS BASED ON CONTROL AND SCIENCE. We control the speed of our automobile. We control machines. We endeavour to control disease and death. Let us control the size of our family to ensure health and happiness.
Significantly it was in this period that birth control became known as'family planning', primarily directed at the prevention of 'unplanned' pregnancies.Within this new thinking there was a new concern about whatconstituted a healthy family.
It was alongside ideas like these that planned families became intrinsicallytied to questions of economic and national security. As onestatement drafted by the Planned Parenthood Federation of America(PPFA) in 1940 argued:
A nation's strength does not depend upon armaments and manpower alone; it depends also upon the contentment ... of its people. To the extent that birth control contributes to the health and morale of our people, it makes them less receptive to subversive propaganda, more ready to defend our national system.
(Continues...)
Excerpted from Sexual Chemistry by Lara V. Marks. Copyright © 2001 by Lara V. Marks. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Table of Contents
List of Illustrations, Figures, Tables vi
Acknowledgements ix
Preface to the Paperback Edition xiii
Introduction: 'A Whole New Bag of Beans' 1
1 The Population Problem and the Pill 13
2 The Contraceptive Challenge: The Search for a Pill 41
3 Sexual Chemistry 60
4 Human Guinea Pigs? 89
5 Doctors and the Pill 116
6 Handling Health Concerns of the Pill: Thrombosis 138
7 The Pill and the Riddle of Cancer 158
8 'A Dream Come True': The Reception of the Pill 183
9 Divisive Device: The Pill and the Catholic Church 216
10 Panacea or Poisoned Chalice? 237
Bibliographical Abbreviations 266
Notes 268
Bibliography 334
Index 360