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The Dark Side of Birth Control: The Pill Still Has Many Adverse Affects Glossed Over By Big Pharma

On the 50th anniversary of the pill, we need to appreciate this remarkable innovation while also being honest about its limitations.
 
 
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As we get ready, in 2010, to celebrate the 50th anniversary of hormonal contraception in the United States, women have every right to stand up and cheer for a birth control option that has revolutionized how effective a contraceptive can be. “The Pill” and its descendants have indeed provided women with a unique tool that has changed the terms in which women control their social and professional choices. 

Amidst all the applause, though, let us not oversimplify the history of a drug that has often coupled danger with opportunity, and indeed reinforced some serious inequities even as it promised to enhance women’s rights.  Today, 50 years later, ovulation suppression through hormonal drugs still harbors many adverse effects, which range from mood swings and diminished libido, to fatalities from blood clots. The innovation itself emerged at the cost of experimentation on poor women, and came, in part, out of a desire to control the fertility of poor populations.

The pill was able to be born because of deep social and economic injustices, not solely as a response to them.  The pill trials were conducted on poor women in Puerto Rico, in part because they had fewer legal protections against some of the dangers of new drug trials.  Male doctors scoffed when female doctor Edris Rice-Wray suggested that the side effects of the new pill might be too numerous to be generally tolerable and carried on with hardly a pause when more than one woman in the trial died mysteriously.  It turned out that Rice-Wray was right about the risks of the pill but wrong about women’s willingness to endure them.

It might be easy to see the approval acceptance of hormonal contraception as a pure female victory, and indeed it happened in part because women deeply hungered for reliable birth control.  It is also true that it was moved forward not only to satisfy this need, but because of deep anxieties among the powerful that a booming population in the developing world would lead to the spread of communism, and that a similar growth in poor (and non-white) populations within the United States would cause domestic instability.  Even as the pill offered the promise of liberation to affluent women it provided a powerful and easily abused tool for controlling the fertility of poor and disempowered women.  Margaret Sanger realized this, and readily voiced deeply racist and classist sentiments in service of her otherwise valiant agenda. 

Within just a few years of the approval of Enovid, the first pill, it became clear that women were experiencing serious adverse health effects.  Barbara Seaman, a young journalist for Brides and Ladies Home Journal magazines realized how common truly frightening health problems were when she began receiving letters from readers.  Experiences ranged from the aggravating —weight gain, mood swings, sexual problems—to the life threatening—blood clots and other potentially fatal problems including cancers.  Seaman’s ground-breaking 1969 book, The Doctors’ Case Against the Pill, chronicled the suffering of real women on the pill and documented the multiple health risks tying the silence and lack of information about them to drug company greed, unequal power between doctors and patients, and sexism in American life.  

It was a tough message for many women to hear, and certainly one that defied (and continues to defy) a narrative that argues simply that access to reliable birth control gives women power.  But for those who were willing to take up the difficult implications of Seaman’s work, an important feminist model emerged.  When members of DC Women’s Liberation disrupted hearings on the pill spearheaded by Senator Gaylord Nelson it was to protest the manipulative way the pill was being marketed to women, not to praise the product.  Women were demanding something truly radical: the right to insist not just on access to contraception, but to demand that the products be safe.  Today, while many valid questions about the pill’s safety and side effects remain, the hormone dose has been reduced ten times, and patient package inserts have been added to warn patients of the risks. This is due to the tireless efforts of the women’s health movement.