America and the Pill: A History of Promise, Peril, and Liberation Read Online Free PDF

medicine. He grew up true to his Catholic faith but with a strong belief that his conscience should be his most important guide in life. 24
    Rock became one of the pioneering physicians in the field of reproductive medicine, working on both infertility and contra- ception. A practicing Catholic and a social conservative, he be- lieved that in certain circumstances birth control was medically necessary, but only when there were particular health reasons to avoid pregnancy. Highly critical of routine use of birth control, he held “no brief for those young or even older husbands and wives who for no good reason refuse to bear as many children as they can properly rear and as society can profitably engross.” 25
    But Rock took issue with the Catholic Church’s prohibi- tion against birth control, because it prevented physicians from acting in what they believed to be their patients’ best interests. In the 1940s, he taught students at the Harvard Medical School how to fit patients with diaphragms—a bold move for a Catholic doctor in a state that outlawed the distribution of birth control information and devices. He advocated the lifting of legal restrictions that hindered physicians from providing patients with contraceptives. Later, he clashed openly with the Church, arguing that the pill was consistent with Catholic pre-

    cepts. Rock insisted that it was not an “artificial” means of birth control because the hormones in oral contraceptives mimicked those that occurred naturally in pregnancy. 26
    Rock agreed to work with Pincus to test the potential for the hormone progesterone to inhibit ovulation in humans. Now all they needed was the essential ingredient: women who would volunteer for the studies. Rock found sixty volunteers. Some of the women who joined the clinical trials were infertil- ity patients at the Free Hospital for Women; other volunteers were nurses at the Worcester State Hospital. The complicated procedure included daily basal temperature readings, vaginal smears, and urine collection as well as monthly endometrial biopsies. The results were promising: The drug apparently in- hibited ovulation. But there were problems with the study. The numbers were too small, and only half of the women complied with the rigorous protocol. The challenge was to find a large group of volunteers who would be motivated to comply.
    Katharine McCormick was frustrated by the difficulty of finding an adequate pool of volunteers. “The headache of the tests is the cooperation necessary from the women patients. I really do not know how it is obtained at all—for it is onerous— it really is—and requires intelligent, persistent attention for weeks.” 27 She was eager to begin a major clinical trial but daunted by the challenge of finding women willing to participate.
    Lacking access to volunteers, researchers turned to involun- tary subjects. In one of the most disturbing episodes in the de- velopment of the pill, Pincus forced fifteen psychiatric patients at the Worcester State Hospital to participate in trials that would afford them no benefit. Unlike the women in Rock’s

    earlier study, most of whom were infertile and eager to test the pill’s potential to temporarily suppress ovulation, thus possibly stimulating the ovaries when the drug was withdrawn, the psy- chiatric inmates were neither at risk of pregnancy nor hoping to become pregnant. Experimental programs involving coer- cion were used to test other drugs as well at the time, before professional standards prohibited such practices. Nevertheless, because the pill was tested on physically healthy women who had nothing to gain by participating in the study and possibly a great deal to lose in terms of unknown risks and side effects, serious ethical questions have been raised about these tests. 28
    Critics have long faulted doctors, scientists, and pharmaceu- tical companies for exposing women to dangerous tests of high- dose hormonal contraceptives. While there