America and the Pill: A History of Promise, Peril, and Liberation (15 page)

harm, or destroy the human seed. In that sense it was unlike all the other barrier or chemical methods that had come be- fore. Rock claimed that the pill was not an “artificial” form of birth control because it worked on the same principle as the rhythm method, which the Church approved, by extending the “safe” period throughout the woman’s cycle. It was, in that sense, a “natural” form of contraception and therefore should be acceptable to the Church. In 1963, Rock directly challenged the Church with the publication of his book
The Time Has Come: A Catholic Doctor’s Proposals to End the Battle over Birth Control
.
11

John Rock was hardly a radical, but he held beliefs that directly contradicted long-standing Church teachings. The Church had affirmed its opposition to contraception in 1931 when Pope Pius XI issued
Casti Canubii
, a papal decree that condemned all forms of artificial birth control but allowed for periodic abstinence if there were compelling reasons to avoid pregnancy. In 1950 and 1951 his successor, Pope Pius XII, ex- panded the exception by approving the rhythm method as an acceptable means of birth control in cases of adverse medical, economic, eugenic, or social circumstances.

Many Catholics expected further loosening of the ban, es- pecially in the wake of Vatican II. Pope John XXIII convened the Second Vatican Council in 1962, a gigantic gathering that is still considered one of the largest meetings in world history. Each fall from 1962 through 1965, 2,400 bishops from all over the world, along with thousands of aides, advisers, and reli- gious leaders, met at the Vatican to debate, discuss, and de- velop new policies that would alter Church custom around the

world. Although Church dogma remained intact, Vatican II brought a number of reforms that modernized Church prac- tices.
12
It also opened the way for clergy as well as lay Catholics to discuss and challenge the dictates coming from Rome. Vat- ican II led many to believe that the Church’s position on con- traception might be relaxed. Indeed, Pope John was putting together a committee to consider the matter shortly before his death in 1963. Although he died without making any changes in the Church’s birth control ban, his legacy included an em- powered laity that began to speak out on the issue, as well as a clergy that was divided on the matter. It fell to Pope Paul VI to resolve things.

Anticipation ran high. Even folk singer and songwriter Pete Seeger expressed the optimism of Catholics in his 1966 ballad,
The Pill
. In the song a woman with a house full of chil- dren vows she won’t have any more because the Church is going to “bless the pill.” She buys a package of pills so she will be ready when they receive the expected message from the Pope. Waiting anxiously, she hopes for the Pope’s OK “before my man comes in.”
13
But the hopes Seeger’s song expressed were dashed.

In 1964, Pope Paul appointed a commission on birth con- trol to advise him on the matter. The following year the com- mission met in closed session, and the Pope pressed for a clear recommendation. But the deliberations continued for years. In 1967, the commission’s report was leaked to the press, reveal- ing that a significant majority of its members had concluded that artificial birth control was acceptable. Those in favor of al- lowing contraception included sixty out of sixty-four theolo-

gians on the commission, and nine of the fifteen cardinals. The minority issued a separate report, calling for a continuation of the Church’s ban. After much “anguish,” the Pope issued a for- mal encyclical,
Humanae Vitae
(
Of Human Life
), in 1968, sid- ing with the minority and reaffirming the Church’s ban on any form of artificial birth control.
14

Many Catholic leaders and clergy were quick to criticize the decision. Father George Tavard blasted the Pope in the
National Catholic Reporter
. Father Bernard Häring of Rome, widely regarded as the leading moral theologian at the time, called upon Catholic women and men to follow their con- sciences, rather than the Pope’s decree.
15
When the Pope is- sued his encyclical, large numbers of American Catholics had already made up their own minds. By 1965, three out of four Catholics believed that anyone who wanted contraceptives should have access to them, and more than half had used them. The percentages were even higher in other countries. Soon, American Catholic women would be taking the pill at the same rate as non-Catholics. By the end of the decade, many American and western European priests were openly giving their married parishioners permission to use contraceptives, in defiance of the Pope’s decree.
16

Although the Pope affirmed the ban, which continues to this day, the pill contributed to profound changes in the rela- tionship between Church leaders, clergy, and lay members. After Vatican II, which opened the way for greater empower- ment and expression of dissenting views among both clergy and laity, Catholic women and men increasingly consulted their consciences, in addition to Church teachings, for guidance in

their personal decisions. One Catholic husband, frustrated by the rhythm method, decided in 1969 to reject the Church’s teachings: “I’m sick of this S.O.S. (Sex On Schedule) routine. How can the church expect a couple to turn sex on and off like a light switch? Sexual relations should be guided by love, by emotion, by need and not by a schedule and not by one nega- tive vote from Rome.”
17

John Rock was the most visible of the practicing Catholics whose conscience led him to boldly reject the Church’s teach- ings, but he was not alone. Birth control had been driving a wedge between Catholics and Church leaders even before the pill arrived. The timing of the pill’s arrival, and its acceptance among Catholics, widened that chasm. The pill weakened the power of the papacy in the lives of Catholics, and after
Humanae Vitae
, turned many Catholics away from the Church altogether.

While Church authorities faced dissent, pressure
began to mount against medical experts. In the 1950s and early 1960s, it seemed that medical research could do no wrong. Miracle drugs like the polio vaccine, mild tranquilizers, and oral contraceptives seemed to offer a better and safer life for all. These new drugs promised healthy individuals peace of mind: no more fears of the dreaded polio, no more anxieties in the new atomic age, no more fears of unwanted pregnancy. Amer- icans embraced these medical breakthroughs with unbridled enthusiasm.
18
But as time went on, these miracle drugs began to seem less miraculous and more dangerous.

Tranquilizers were a case in point. When Miltown ap- peared on the market in 1955, it became an instant block-

buster. Within a year, one in every twenty Americans had tried it. Other tranquilizers quickly entered the market, including Librium and Valium in the 1960s. But soon it became obvious that these were not harmless drugs—rather, they were seriously addicting. “Mother’s little helpers” were trapping thousands of Americans, including large numbers of suburban housewives, in dependence and addiction.
19

The most horrifying tranquilizer tragedy resulted from thalidomide, a drug developed to calm the frayed nerves of anxious adults and to alleviate morning sickness in pregnant women. Thalidomide was developed in Germany and sold widely throughout Europe, but the FDA never granted ap- proval for it to be marketed in the United States, thanks to the persistence of Dr. Frances Oldham Kelsey. The mother of two children and one of the few woman doctors working for the agency, Kelsey joined the FDA as a reviewer in August 1960. With a master’s degree in pharmacology from McGill Univer- sity and M.D. and Ph.D. degrees from the University of Chicago, she was well prepared for the task of evaluating new pharmaceutical products. She also had a particular interest in drugs and fetal safety, a topic she had studied as a graduate stu- dent. One month after Kelsey took the job at the FDA, William S. Merrell, Inc., applied for approval to sell thalido- mide in the United States. The drug was so popular in Europe that its FDA approval was expected to be quick and routine. The task of evaluating its safety fell to Kelsey. Kelsey was not convinced that the drug was safe, especially for pregnant women. She asked the company to submit additional data, which it did. But she remained unconvinced.

Officials from Merrell tried in vain to persuade Kelsey to ap- prove the drug, but she stood her ground, even when they com- plained to her superiors that she was stubborn and unreasonable. She later explained that she had expected “to get bullied and pressured by industry,” and that she would need to resist such in- timidating tactics. Merrell sent its application forward six times over the next two years. As Merrell pushed for approval, thou- sands of women in Europe who had taken it during pregnancy, and a small number of American women who had gained access to the drug, gave birth to “thalidomide babies” lacking limbs and with other catastrophic birth defects. In 1961 German officials took thalidomide off the market, and the following year Merrell withdrew its FDA application. Kelsey became a national hero for preventing the drug from being marketed in the United States. Her actions earned her the medal for Distinguished Federal Civilian Service, awarded by President Kennedy.
20

Just as Americans were learning of the thalidomide disaster unfolding in Europe, problems began to surface with the oral contraceptive. The first report of thrombosis in a woman on the pill came in 1961. A year later there were twenty-six re- ports of women who developed blood clots while taking the pill, six of whom had died.
21
It was difficult to determine whether or not the pill caused thrombosis, because there was no way to know how many women in the general population were afflicted. Eventually it became clear that women on the pill were at higher risk for blood clots. Soon, other health con- cerns surfaced. Did the pill increase or decrease the risk of cer- tain cancers? What about other side effects, such as headaches, nausea, weight gain, and depression?

Some doctors and pill advocates, including Gregory Pincus, made light of the side effects and minimized the dangers, in- sisting that the vast majority of women on the pill had no se- rious problems. But for the women who suffered from them, the statistics were cold comfort. Several early users of the pill described in a survey their experiences when the oral contra- ceptive still contained high doses of hormones. Aurora M took the pill as a teenager in the 1960s to regulate her periods, but it made her sick with vomiting, diarrhea, and headaches. These symptoms were not minor nuisances. “The pill hurt me more than helped me, I never tried to use anything else, afraid it might cause more damage to me.”
22
The harm to Jenny S was even worse. As a Catholic, she did not take the pill until after her fifth child was born. Two weeks later she had a massive stroke that left her paralyzed on the left side of her body. She remained in a coma for several weeks before being transferred to a rehabilitation hospital for several months, while her par- ents moved into her home to care for her children. She re- turned home in a wheelchair. Her daughter recalled, “The impact on the family was total devastation, both emotionally and financially. . . . None of us came out unscarred, and the ef- fects are lasting.”
23

Even women who had no problems themselves worried about the health risks of the pill. Ilene W took the pill as a teenager in the 1960s. Her father was a doctor who warned her about such drugs. “I remember him being so worried that he was seeing broken blood vessels in the eyes of young women taking these high-dose pills. . . . One of my friends did have a stroke shortly after her marriage that was attributed to the

pill.” Ilene W joined a women’s group that brought in a female doctor to discuss the risks of the pill. She eventually switched to a diaphragm. At the age of fifty-eight, Ilene got breast can- cer.
24
Although there was no evidence that the pill was a causal factor, she couldn’t help but wonder.

Within a few years of the pill’s FDA approval,
women began demanding information and answers. Initially, the pill was approved at a hormone dosage of 10 milligrams. Researchers were not sure that a lower-dose pill would be ef- fective, so the 10-milligram pill was the only one that was tested and approved. When studies showed that lower-dose pills were equally effective, researchers and pharmaceutical companies began to reduce the amount of hormones contained in each pill, which cut down on the dangers and side effects. Yet questions, doubts, and risks persisted. By the end of the decade, the pill had lost its glow as a miracle drug. In 1969, as the feminist movement gained momentum, journalist Barbara Seaman heated up the controversy with her book
The Doctors’ Case Against the Pill
.
25

Barbara Seaman had an established career as a writer for women’s magazines. In the early 1960s, she and her psychia- trist husband, Dr. Gideon Seaman, wrote a column for
Brides
magazine on marriage, and she later wrote for
Ladies Home Journal
and
Family Circle
. By the late 1960s she had become an advocate for women’s health. In
The Doctors’ Case Against the Pill
, she supported her case with the opinions of physicians who shared her views, and she insisted that ordinary women taking the pill were unaware of “the disenchantment and dis-

may that are increasingly disturbing the inner councils of the medical profession.”
26
The book included reports of research on health risks such as blood clots and provided doctors’ testi- monies regarding a host of other dangers and side effects. It also contained numerous stories of individual women who de- veloped serious complications while taking the pill. Seaman ar- gued that women needed to have access to all the information about the pill’s risks and dangers. Highly critical of the pill and the authorities who promoted it, she called upon women to take charge of their own medical decisions.