In the mid-1950’s Puerto Rico was one of the most densely populated countries in the world and it was important for researchers who wanted to promote the pill to be able to say, look, it worked in Puerto Rico with a population that was undereducated and poor. Therefore if it worked there, it can work anywhere.
G.D. Searle was willing to provide the pills and birth control officials in Puerto Rico were delighted to be part of a scientific experiment.
By the early ‘50s, Puerto Rico saw anything experimental as something pioneering and innovative and wonderful. Plus the island was in the midst of industrialization and there were a lot of jobs for women so all of a sudden there are all these factories ...and women all of a sudden had this opportunity to work outside the home and then children became something that they had to contend with.
The first large-scale trial of the contraceptive Pill was launched in April 1956 at Rio Piédras, a brand-new housing project. Though Puerto Rico was overwhelmingly Catholic, many women were eager to participate.
Dogma was one thing, behavior was something else. For most of the women who were concerned with their health and with bringing up the families and with struggling day to day, the fact that this was not in line with church dogma was...was pretty much irrelevant.
The women would take a pill with 10mg of progesterone, to stop ovulation, and a smaller amount of estrogen to ease discomfort. Doctors knew little about the consequences of hormones. The volunteers knew even less.
Informed consent, the way we understand it today, did not exist in the 1950’s.
Trials were much less closely regulated than they are today. Uh, a...a useful example to look at would be the polio pill vaccine. And think about the fact that two million school children were signed up to test this largely unknown vaccine to see if it worked against polio or not. People were much more receptive to medical science and to its products and were much more willing to participate in programs to...to see whether they would work or not.
As the trials progressed, some women began to complain of nausea, dizziness, headaches, stomach pain, and vomiting.
After nine months of testing, the medical director in Puerto Rico told Pincus that the Pill was 100% effective when taken properly. Nevertheless, she argued, the drug caused “too many side reactions to be generally acceptable.”
Both Rock and Pincus disagreed. The adverse side effects, they believed, were insignificant.
They probably dismissed it in their mind, “Well there’s something wrong with the patient,” and there was nothing wrong with the pill. They didn’t want to hear about uh, what might be wrong because they...they were so um, they...they just
felt so strongly uh, that this pill was necessary for women’s well-being.
Pincus had such confidence in the new drug -- he gave it out to members of his own family. All that remained was to persuade G.D. Searle to become the first pharmaceutical company to market the pill.