The Drive to Develop the Pill and the IUD

Without doubt, the most difficult topic to discuss in a study of eugenics is the matter of birth control. The motives of the people who developed various birth control methods do not necessarily resemble the motives of the people who use them. There are few topics that have been addressed with so much heat and so little light. And yet, we have been able to discuss race, religion and politics, so we will plunge ahead and address this topic as well.

In 1939, a Swedish population expert described for Americans what her nation was doing, and made a distinction between two strategies of negative eugenics. Alva Myrdal addressed the Birth Control Federation of America on January 19, and her paper was published in the Birth Control Review in April 1939. Her intent was to describe a governmental population policy that was appropriate for a democracy, in contrast to "the turmoil of contemporary fascist and communist experiments."

Sweden's birthrate was below replacement level; parents were not having enough children to replace themselves. Measuring the replacement level is a little tricky. At first glance, you would think that if each set of parents has two children, that is replacement level: two parents in one generation produce two children in the next generation. But that is not enough, because some of those children will die young or be sterile. So replacement level is a little over two. That year, though, Alva Myrdal said that Sweden "faces a catastrophic decline in her population in the future." So many parts of the population plan concerned ways to make parenting easier and more attractive.

But some of the plan was about undesirables. According to Myrdal, "a small bottom layer of society could rightly be regarded as biologically inferior," and "the scope for negative eugenics thus becomes narrow." However, she explained, a complete plan for improving the quality of the Swedish people had to do something about mid-grade undesirables, not just those at the very bottom of the heap.

Part of the Swedish approach was coercive sterilization, which was "utilized with a residuum of all social classes whose perpetuation is considered least desirable. A law was enacted in 1934 enforcing sterilization of persons suffering from grave hereditary character and themselves incapable of consent. So far, these cases have not outnumbered 250 annually and have consisted mainly of mental defectives."

In addition to forced sterilization of some, there was a provision for voluntary sterilization when a person suffered from an illness, deformity, epilepsy or "would be incapable of caring for or rearing children."

Sweden's plan was not limited to sterilization, though:

Next to be considered is a border-line group, probably the most difficult to handle in any eugenic program. The hereditary capacities of this group are doubtful and thus do not indicate sterilization, but its social capacities are unfavorable to child rearing. It is officially planned, but not yet put into effect, to influence this group to severe family limitation through direct propaganda and instruction in contraceptive methods.

Myrdal was by no means the first to identify this problem group. In 1931, a four-volume series The Science of Life by H. G. Wells (still popular today for his science fiction) and Julian Huxley provided a popularized approach to eugenics. In volume four, they write that there are "ten thousand certifiable defectives in every million of the English population" but the "increase of idiots and imbeciles" is "easily controllable." On the other hand:

All those who have had experience of birth-control work in the slums seem to be convinced that there is a residuum, above the level of the definable "defective," which is too stupid or shiftless or both to profit by existing birth-control methods. These "unteachables" constitute pockets of evil germ-plasm responsible for a large amount of vice, disease, defect, and pauperism. But the problem of their elimination is a very subtle one, and there must be no suspicion of harshness or brutality in its solution. Many of these low types might be bribed or otherwise persuaded to accept voluntary sterilization.

But there were problems with using contraceptives for population control. One large problem was the persistent opposition of Roman Catholics and some other religious groups. Another problem was technical: contraceptives were unreliable. Barrier methods — condoms, cervical caps and diaphragms — were available, but did not work with 100 percent efficiency.

During World War II, the Nazis ran experiments in their camps in a search for effective birth control agents. After the war, whatever data they had amassed was lost to the public. It may have been worthless, or may have been destroyed, or may have made its way into the hands of researchers who waited a few years and then used the morally tainted information.

Pill Research

In the 1950s, Margaret Sanger and her organization, Planned Parenthood Federation of America, began funding research to develop a contraceptive that would be more effective than condoms. One of the early researchers was Dr. Carl Djerassi, who worked at Syntex, a drug firm. In 1951, the Syntex team succeeded in synthesizing a sex hormone. Dr. Gregory Pincus and Dr. Min Cheu Chang from the Worcester Foundation for Experimental Biology were also interested in birth control research. The Searle drug firm invited Pincus to do research for them, and in 1953 Searle patented a compound similar to Djerassi's. Pincus teamed up with Dr. John Rock from Harvard, and they began work on preventing ovulation using a sex hormone.

Pincus, Chang and Rock were all funded in part by Planned Parenthood. Also, in 1952, Margaret Sanger persuaded a wealthy donor, Katherine Dexter McCormick, to provide substantial funding for Pill research.

From the beginning, the idea was a little odd. The reproductive system is complex. The idea was to upset the system using hormones taken by mouth. There is no direct connection between the mouth and the ovaries. The question then and now is, how many systems in the body will be disrupted before a drug taken at the top end of the body alters the way an organ works in the middle of the body?

Pincus and Rock developed an oral contraceptive, Enovid, that did suppress ovulation and did not have massive and obvious side effects. They tested their drug on volunteers and psychotics for one year, then moved to Puerto Rico, where they had a huge number of women to use as potential lab rats.

Puerto Rico had been a target for population controllers for decades before Pincus's Pill project arrived. In the 1930s, population controllers had opened a sterilization campaign there, and had pushed through a law permitting the distribution of contraceptives by trained eugenicists. Testing the Pill there was the obvious course to take.

In 1956, they began testing in Puerto Rico. On April 22, 1960, the Food and Drug Administration approved Enovid for use in the United States.

IUD Research

An IUD is a piece of plastic or metal that is inserted into the woman's uterus. It inflames the uterus, and prevents implantation.

From the perspective of population control advocates, IUDs have a huge advantage over other forms of birth control. Once they are in place, no one has to do anything else to prevent births for some years. Barrier contraceptives require that the user put something in place before sexual activity, and oral contraception requires that the woman take a Pill every day. The IUD goes in and stays.

In 1961, the Population Council began funding research into the IUD. In 1963, International Planned Parenthood Federation and the Population Council funded a world tour for Alan Guttmacher and his wife, to study birth control methods. He returned recommending IUDs, and the Population Council expanded its funding dramatically, spending almost two million dollars on them over the next decade. The IUD was effective for population control, but was not good for individual women. One IUD after another was driven off the market by damage suits. The most notorious IUD was the Dalkon Shield, which was responsible for 18 deaths in the United States, many cases of permanent sterility, and various other complications.

In 1974, after little more than a decade selling the device, the manufacturer A. H. Robins pulled the Dalkon Shield off the market. But damage claims continued to pile up; before the end, 334,863 women were participating in a class action lawsuit against the company. A. H. Robins went bankrupt. The other major IUD manufacturers, including G. D. Searle, which sold IUDs as well as oral contraceptives, settled some lawsuits with large payments and then got out of the business. However, since it was the American legal system with its expensive lawsuits that drove the IUD off the market, women overseas did not have the same protection. IUDs remained in use around the world. (Twenty years later, IUDs began to make their way slowly back into the American market.)

How They Work

The Pill and the IUD are both described as "contraceptives," but that is not accurate. The Pill works to prevent birth in three ways, and one of them is by causing an early abortion of a tiny human embryo. With an IUD, the principal (and perhaps only) mode of action is to cause an early abortion. In the early days of oral contraception, the principal mode of action was the prevention of ovulation. That still happens, although the new low-dose pills are less effective at this than the 1960s pills. If there is no ovum, there can't be any conception. This is genuine "contraception."

The second mode of action is a thickening of the mucus in the woman's cervix, so that sperm cannot reach the uterus. This too is "contraception."

But the third mode of action is different. Oral contraceptives affect the lining of the uterus and prevent implantation (or nidation). Normally, at the time of ovulation, the walls are soft and spongy, ready to receive and nourish an embryo, and implantation occurs several days after fertilization. But the hormones in oral contraceptives make the uterine wall inhospitable to new life. If a sperm reaches an ovum and fertilization takes place, the newly conceived embryo will not be able to attach to the uterus (or implant) and draw nourishment; the embryo will be flushed out and will die. This is not "contraception"; it is an early abortion.

The IUD has the same problem, magnified. It does not prevent ovulation or thicken cervical mucus; it works by preventing implantation.

Verbal Engineering

It would seem clear that the only things that should be called "contraceptives" are things that prevent conception (contra-ception = against-conception).

In his 1961 book, Birth Control and Love, Alan Guttmacher wrote: "Contraception and sterilization accomplish the control of family size by preventing the union of sperm and egg, in this way not allowing conception to occur. Once pregnancy is initiated, family limitation is still possible by employing a wholly different procedure — induced abortion." At that time, he accepted the standard definition of conception, and contraception. Conception is the "union of sperm and egg"; "contraception is interference with conception." At that time, Guttmacher accepted that contraception was different from abortion.

In the 1960s, abortion was illegal. There were some social groups within the country who accepted abortion, and practiced it extensively. But the law, reflecting the moral code of the majority, prohibited abortion. So if the Pill and the IUD caused abortions, that would have made it very hard at that time to promote them.

The solution to this problem was a change in the language. The American College of Obstetricians and Gynecologists changed the definition of conception in the late 1960s. Under the old definition, conception was a synonym for fertilization, the union of sperm and ovum. Under the new definition, conception was a process beginning with fertilization and lasting until implantation was complete. The definition of pregnancy was also changed slightly. Previously, a woman was considered to be pregnant when she was carrying a newly conceived human within her body. Under the new definition, she was not pregnant until implantation. And the definition of contraception was changed: now it referred to preventing either fertilization or implantation.

Birth control advocates and drug companies deliberately confused these two very distinct and separate human events (implantation and fertilization) so that they could market their wares as "contraceptives." In this way, they were able to sell silent abortions even to women who were adamantly opposed to abortion, and still keep a good public image.

Who Wanted Better Birth Control?

The push for effective birth control cannot be understood without reference to two related subjects: the place of sexual activity in human life, and attitudes toward population.

In the 1920s, Margaret Sanger's books The Pivot of Civilization and Woman and the New Race described ways to bring the eugenics movement and some parts of the feminist movement together. Coming from different directions, they both wanted birth control. In the 1950s and 1960s, the funding came from eugenics.

The Population Bomb

To understand why Planned Parenthood and the Population Council funded research into more effective methods of birth control, it is important to understand the propaganda about a population explosion.

The person whose name is most often associated with the "population explosion" is Paul R. Ehrlich, who taught biology at Stanford University. He wrote The Population Bomb, published in 1968, which was circulated widely and reprinted many times. He says that the terms "population bomb" and "population explosion" were first used in 1954, in a publication with the same name issued by the Hugh Moore Fund. He says that over two million copies of that earlier tract were distributed. Hugh Moore had made his fortune with his Dixie Cup Corporation. He established a fund to bring American businessmen into the fight against population growth, and worked with Planned Parenthood both nationally and internationally.

In the 1950s, the United States and Russia were locked in an arms race, building bigger atom bombs and hydrogen bombs and missiles. The Federal government had started moving offices outside Washington, to minimize the chance that a few Russian bombs would destroy the whole government. School children were taught how to react to air raids. For Americans, the great fear of the age was not about famine or plague or invasion, but about the bomb. The Hugh Moore tract (actually written by T. O. Greissemer) played on this fear: "The population bomb threatens to create an explosion as disruptive and dangerous as an explosion of the atom, and with as much influence on prospects for progress or disaster, war or peace."

Improved contraception was supposed to keep the bomb from exploding.

Changing Attitudes Toward Sex

Who has failed to notice that sexual activity can seem very attractive, without any plans for children? Who has failed to notice that literature from the whole world throughout history is full of difficulties and challenges associated with sexual activity, pregnancy and babies?

Throughout history, sex has been a blessing and a challenge. And yet, quite suddenly in the years after World War II, social warfare broke out over sex, pitting the new and progressive attitudes of relaxed sexual mores against traditional attitudes. The struggle was most visible in the 1960s, when hippies urged the world to "make love not war." But the changes began earlier.

One key to the change was the sex research of Alfred Kinsey. Kinsey worked at Indiana University, collecting data about sexual practices that he published in two volumes, Sexual Behavior in the Human Male in 1948 and Sexual Behavior in the Human Female in 1953. Kinsey claimed that sexual practices that had previously been considered aberrant were in fact quite common. His work helped to break down taboos against public discussion of sexual activity, and to end much resistance to various practices. One example: the Boy Scouts had a manual that encouraged leaders to help boys avoid masturbation, but Kinsey persuaded them to end this counseling.

The Kinsey Report went beyond editing the Boy Scout manual, though. Kinsey said that 95 percent of American men were sex offenders, and that the laws should be set aside. He argued that any sexual practice that was not harmful (by his definition) should be permitted, that fornication and adultery were widespread and beneficial. He and his followers worked to end public resistance to obscenity, pornography, pedophilia and homosexuality.

Kinsey's data has been challenged. His effectiveness and his impact have not. And the central idea in all his work was that sexual activity in all its various forms should be embraced, for healthy fun. In his view, there was no connection whatsoever between sexual activity and having children.

In practice, though, sexual activity does often lead to pregnancy and birth. People who accepted Kinsey's view of sex, and who wanted to engage in sexual activity without any subsequent pregnancy, were very much interested in effective contraception.

It would seem, then, that the push for contraception came from a libertine view of sex as much as from eugenics. This is not a complete picture, because Kinsey's "research," laying the groundwork for sexual revolution, was funded by the Rockefeller Foundation. That is, even the libertine ideas that were part of the sexual revolution are rooted (historically) in eugenics. Robert Yerkes, whose intelligence tests were used in the 1920s to pass racist anti-immigration laws, was chairman of the committee that funneled Rockefeller funds to Kinsey.

Resistance from the Catholic Church

Most of the resistance to new forms of birth control came from the Roman Catholic Church. Birth control was not invented by the eugenicists; it was embraced enthusiastically and exploited by them. But Catholics had resisted birth control long before the explosion. They were not alone in their opposition, but they were the most visible opponents, and they paid a very high price for it.

The Catholic Church in the early 1960s was full of optimism. From 1962 until 1965, Catholic bishops from around the world met in Rome for the Second Vatican Council. The Council produced a series of documents that thoroughly changed the way the Church presented itself and its message to the world. For several hundred years, the Catholic Church had kept its distance from the rest of the world; the Council ended that. The election of a Catholic as President of the United States was evidence of a huge and welcome change.

The most quoted document from the Council is The Church in the Modern World. Its official Latin name is Gaudium et Spes, which means "joy and hope." Pope John XXIII, who summoned the Council, was a rotund man from a peasant family; people around the world loved him, and approved of his call to "throw open the windows" of the Church.

Most of the teaching of the Council was positive in tone, a change from previous denunciations. The Council did speak out against evils in the modern world, especially nuclear weaponry and abortion, but focused on the call to proclaim the good news that God loves the world.

Pope Paul VI took over the leadership of the Church and the Council when John XXIII died. Initially, he was seen as a progressive voice. He visited the United Nations and praised their work, called for peace, urged a global commitment to help the poor.

But in 1968, Pope Paul VI released an open letter (an "encyclical") entitled Humanae Vitae. He repeated the Church's ancient opposition to artificial methods of birth control. He argued that sexual activity is sacred, that it must be left open to the possibility of procreation. He warned that if people approved of contraception, they would turn around to find that it had become mandatory.

His encyclical caused an uproar. Overnight, his relations with many world leaders turned sour; he went suddenly from hero to villain.

What happened to the Pope affected the rest of the Church. At the close of the decade, the Catholic Church in America and in other developed nations was bitterly divided. The joys and hopes of the Second Vatican Council were eroding, replaced by anger. Millions of church-going couples who had grown up in the Catholic Church and professed a deep love for the Church now turned away — from the Church itself or at least from the teaching.

Laws against Contraception Swept Away

By 1961, birth control was readily available throughout the country. Connecticut still tried to enforce their anti-contraceptive laws, and Planned Parenthood decided to challenge the law directly. They opened a clinic in New Haven to distribute contraceptives illegally. The director was arrested, tried and fined. Planned Parenthood appealed the decision all the way to the U.S. Supreme Court, which ruled in their favor in 1965 in Griswold v. Connecticut.

The Connecticut law said that "Any person who uses any drug, medicinal article or instrument for the purpose of preventing conception shall be fined not less than fifty dollars or imprisoned not less than sixty days nor more than one year or be both fined and imprisoned." Also, "Any person who assists, abets, counsels, causes, hires or commands another to commit any offense may be prosecuted and punished as if he were the principal offender."

The Supreme Court ruled in Griswold v. Connecticut that the law was a violation of the right to privacy. Although there is no "right to privacy" in the Constitution, they argued, "specific guarantees in the Bill of Rights have penumbras [partial shadows], formed by emanations from those guarantees that help give them life and substance."

The Court concluded that the Connecticut law was a repulsive invasion of privacy: "Would we allow the police to search the sacred precincts of marital bedrooms for telltale signs of the use of contraceptives? The very idea is repulsive to the notions of privacy surrounding the marriage relationship."

This decision, which put an end to all laws against contraception, was issued on June 7, 1965. All laws against abortion fell eight years later, on January 22, 1973, in Roe v. Wade and the companion case, Doe v. Bolton.

Alan Guttmacher Switches on Conception

Alan Guttmacher was an officer in the American Eugenics Society during the period after World War II when the eugenics movement was being re-structured. He was a Director of the AES in 1955, Vice President from 1956 to 1963, and then a Director again from 1964 to 1966.

When the International Planned Parenthood Federation was founded in 1952, Guttmacher became a consultant for their medical publications and their newsletter. He also served on their Medical Committee in the 1960s. He was President of the Planned Parenthood Federation of America from 1962 to 1974, during the period when the Supreme Court decided Griswold v. Connecticut and also Roe v. Wade.

In 1961, when he was promoting contraception, he wrote that after fertilization had taken place, there was a baby. But in 1968, when the contraception fight was apparently over and he was promoting abortion, he said, "My feeling is that the fetus, particularly during its early intrauterine life, is merely a group of specialized cells that do not differ materially from other cells." (See Law, Morality and Abortion, 22 Rutgers Law Review, 436.)

Change at Lambeth: Dean Inge Triumphs

Until 1930, nearly all Christian churches taught that contraception was immoral. The first major crack in this unanimity appeared at the 1930 Lambeth conference of the Anglican Church. The Church of England gave approval for the use of contraception by married couples.

The change was a triumph for Rev. William Ralph Inge, the Dean of St. Paul's Cathedral in London, a member of the Eugenics Society. Margaret Sanger, in her Pivot of Civilization, said that Inge "pointed out that the doctrine of Birth Control was to be interpreted as of the very essence of Christianity." According to Sanger, Dean Inge said:

We should be ready to give up all our theories if science proved that we were on the wrong lines. And we can understand, though we profoundly disagree with, those who oppose us on the grounds of authority. ... We know where we are with a man who says, 'Birth Control is forbidden by God; we prefer poverty, unemployment, war, the physical, intellectual and moral degeneration of the people, and a high deathrate to any interference with the universal command to be fruitful and multiply'; but we have no patience with those who say that we can have unrestricted and unregulated propagation without those consequences. It is a great part of our work to press home to the public mind the alternative that lies before us. Either rational selection must take the place of the natural selection which the modern State will not allow to act, or we must go on deteriorating. When we can convince the public of this, the opposition of organized religion will soon collapse or become ineffective.

We do wish to remind our orthodox and conservative friends that the Sermon on the Mount contains some admirably clear and unmistakable eugenic precepts. "Do men gather grapes of thorns, or figs of thistles? A corrupt tree cannot bring forth good fruit, neither can a good tree bring forth evil fruit. Every tree which bringeth not forth good fruit is hewn down, and cast into the fire."