The Twisted Origin of the Birth Control Pill

blog

Oct 8

Written By Comma

The Dark History of the First Birth Control Pill Trials in Puerto Rico

The birth control pill is often hailed as a cornerstone of reproductive freedom, but this medical breakthrough’s existence is rooted in exploitation, racism, and eugenic ideology. While the birth control pill’s positive impacts cannot not be understated, it is essential to prevent its successes from completely eclipsing its harmful history. In the 1950s, the pill’s creators utilized poor Puerto Rican women to test their new drug—subjecting them to strong formulations of the drug without disclosing that they were taking part in a trial or informing them of any potential risks. As we recognize Hispanic Heritage month, it is essential to acknowledge birth control’s often ignored past and the immense damage it caused, honor the unjust suffering these women endured, and commit to building a better future for all people who menstruate.

The U.S. in the 1950s and it’s Reproductive Climate

In the United States, oral contraception faced strong opposition, fueled by legal barriers, religious influence, and widespread stigma. Under the lingering Comstock laws, which criminalized birth control, contraception was labeled “obscene,” and its distribution was illegal in many states. Even doctors were limited in what they could prescribe.

At this time, American biologist Gregory Pincus and obstetrician John Rock began working (largely in secret) on developing the first oral contraception pill. They understood they would face legal backlash if they administered a clinical trial testing the pill on American women, which led to the decision to target Puerto Rican women.

Why Puerto Rico?

To Pincus and Sanger, Puerto Rico was the “perfect place” for the first large-scale birth control trails for many reasons:

As a U.S. territory, it already had a network of birth control clinics, many previously funded by the U.S. government.
The island had no restrictive birth control laws, and officials actively promoted contraception as a solution to overpopulation.
Widespread poverty made women on the island especially vulnerable, and researchers exploited this by targeting poor, uneducated women as “ideal” test subjects.

In short, Puerto Rico was treated as a convenient laboratory, with little consideration for the women’s autonomy or safety.

Inside the Pill Trials

The first large-scale pill trials began in 1956 where over 200 women in Rio Piédras were enrolled. Most participants were poor and had little to no access to formal education. Pincus argued that if poor, uneducated women of Puerto Rico could follow the Pill regimen, then women in the mainland U.S. surely could as well. But the study was full of unethical practices, such as:

Consent: There was no informed consent. The women had no idea the researchers were conducting a clinical trial or that harmful side effects were possible. They were simply told it was a pill to prevent pregnancy.
Safety: The women received no safety information about the pill. Many experienced severe side effects, including nausea, dizziness, and blood clots. Three women died during the trial, yet their deaths were never investigated and there was no further investigation into the safety of the pill.
Dosage: The pill contained a dangerously high dose of hormones, much higher than the modern pill, which caused serious side effects.
Dismissal of complaints: When women reported side effects, they were brushed off as “unreliable,” with their symptoms labeled as merely “psychosomatic.”

Despite these harms, the researchers declared the pill a success, focusing only on its effectiveness at preventing pregnancy—not its safety.

Legacy and Lessons

By 1960, the FDA approved the pill for contraceptive use in the U.S., marking the beginning of a new age in reproductive health. Today, over 100 million women use the pill for birth control. Yet the Puerto Rican women who were used as test subjects in its earliest trials were largely erased from this story. Their exploitation exposes the darker side of medical innovation: the use of marginalized groups as test subjects without proper consent or protection.

As we reflect on Hispanic Heritage Month, it is vital to remember the hundreds of women unknowingly involved in the first birth control trials. Their suffering should never be forgotten, and their contributions must be recognized. Their experiences remind us that medical progress must never come at the expense of autonomy or justice. By recognizing their story, we acknowledge the injustices they endured and affirm their unspoken contributions to reproductive freedom.

Looking ahead, we must do better. Honoring their legacy today is about more than looking back, it’s about committing to a future where everyone has full control over their reproductive health.