Contraceptive trials in Puerto Rico (jan 1, 1955 – jan 1, 1960)

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The first large-scale human trial of the birth control pill was carried out in Puerto Rico in the 1950s. Between conceptualization and legalization of the first birth control drug in the United States in 1960, there were many developments and trials of test drugs. One such trial happened in Puerto Rico in the 1950s. Before the drug was approved as safe in the U.S., many Puerto Rican women were tested on.[1] The trials were conducted by Gregory Pincus and John Rock in 1955. These trials are a major component in the history of the development of female oral contraceptives, in between initial small trial testing on the east coast and the release of the drug for public consumption.

The research team decided that Puerto Rico would be the perfect place to test out the pill. More specifically, a small village called Rio Piédras, where the first trial would take place in 1956. [17]Puerto Rico offered the perfect location for the trials for three key reasons. The first reason was that contraceptives had been legal in Puerto Rico since 1937, so long as they were being used for medical reasons, rather than “social or economic ones. [18] The second reason was that Puerto Rico was facing a tremendous population boom, along with high rates of poverty and unemployment. [19] And lastly, the third major reason why Puerto Rico was the perfect spot for the trials was because Sanger and Pincus’ team had an ally with a strong foothold on the island. Puerto Rico already contained multiple birth control clinics which were originally funded by the U.S. government under the New Deal programs. However, many of these clinics were turned over to the heir of Procter & Gamble and eugenicist Clarence Gamble, who had already been involved in plans lead by the government to control the population by pushing women towards sterilization as a method of birth control.[20]

When Pincus and Rock began their experiment, over 200 women were registered to take part in the program. The women that were recruited for these trials were “ …the poorest of the poor, had no place else to go, and, short of sterilization, no birth control options”[21], and were poorly educated, nonetheless they were willing to do whatever it took to avoid sterilization. The women who were given the pills only understood that they would prevent pregnancy, they knew nothing of the potential health and safety risks of taking the pills. As one woman who participated in the trials described it, “[p]hysicians dispatched their assistants to rap on doors throughout the town's slums, telling women they didn't have to have another child if they took the pills regularly. That's how many of the test recruits were found, said Conchita Santos, 80, a lifelong resident…Santos, a homemaker, accepted her first package of pills in 1955, shortly after the birth of her first and only child. ‘You have to do what's best for you and your family,’ she said. ‘It's not easy making a choice like that."’[22]

The women were administered 10 milligrams of the experimental combination of estrogen and progesterone, more commonly known as Envoid, the first contraceptive pill.[23] Envoid contained up to ten times the now acceptable dose of hormones found in modern-day birth control. Even though the health risks were originally hidden from the women testing the contraceptive, they nonetheless began to show themselves. The women participating in the trial began to experience “ side effects of nausea, dizziness, headaches, and blood clots…”[24], however, these complaints were dismissed since the women were deemed unreliable. A small group of female medical students were also recruited to participate in the study, but dropped out due to similar symptoms despite being told that they would receive worse grades if they quit.[25] Furthermore, three women are said to have died while taking part in the trial, yet their deaths cannot be linked to the pill directly since autopsies were never done on their bodies.[26] In the minds of the researchers behind the pill, these side-effects were insignificant in comparison to what they had discovered; a hormonal oral contraceptive that did in fact stop women from becoming pregnant. Envoid was approved by the FDA in the year 1960, and became an instant success in the United States.

Alice Wolfson is among the many advocates that critiqued and condemned the contraceptive trials conducted on Puerto Rican women. Not only were advocates challenging the bigoted and hateful outlooks of both liberal and conservatives within the United States, but also the systematic inferiorization of women through colonial, racial and gendered structures.

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